Department of Pediatrics, University of Washington, Seattle, WA, USA.
Seattle Children's Research Institute, Seattle, WA, USA.
Child Obes. 2022 Mar;18(2):84-91. doi: 10.1089/chi.2021.0080. Epub 2021 Aug 5.
Understanding child characteristics that relate to weight management treatment outcome could help identify opportunities for intervention innovation or tailoring. The limited evidence available is inconsistent regarding whether and which aspects of children's general or food-specific impulsivity and inhibition relate to treatment outcomes. Children with ( = 54) and without obesity ( = 22) were compared on various measures of impulsivity and inhibition. Children with obesity ( = 40) then completed family-based treatment for weight management. Analyses examined associations between baseline children's impulsivity and inhibition and child weight status change (BMI z-score) and between treatment-based changes in impulsivity and inhibition and weight status change, with and without adjustment by baseline functional magnetic resonance imaging-measured appetitive drive. Children with obesity scored more poorly on some, but not all, measures of impulsivity and inhibition than children without obesity. Lower baseline general inhibition and greater parent-report of child impulsivity were associated (independently) with greater improvements in child weight status, with modest attenuation after appetite drive adjustment. Children improved task-based general inhibition during treatment. Improvements in general inhibition and snack food discounting were associated with better child weight outcomes, although adjusting for baseline values attenuated these associations. Children with obesity having greater initial impulsivity had better weight outcomes in treatment even after adjusting for initial appetitive drive. In contrast, improvements in task-based inhibition and food-related discounting during treatment were also related to better outcomes. Research is needed on innovative approaches to better address impulsivity and inhibition in children's weight management. Clinical Trial Registration number: NCT02484976.
了解与体重管理治疗结果相关的儿童特征可能有助于确定干预创新或调整的机会。关于儿童一般冲动性和抑制性的哪些方面以及是否与治疗结果相关,现有证据有限且不一致。
比较了肥胖儿童(n=54)和非肥胖儿童(n=22)在各种冲动性和抑制性测量方面的差异。然后,肥胖儿童(n=40)完成了基于家庭的体重管理治疗。分析检查了基线儿童冲动性和抑制性与儿童体重状况变化(BMI z 评分)之间的关联,以及治疗中冲动性和抑制性的变化与体重状况变化之间的关联,同时也调整了基线功能磁共振成像测量的食欲驱动因素。
与非肥胖儿童相比,肥胖儿童在某些但不是所有冲动性和抑制性测量方面的得分较低。较低的基线一般抑制和父母报告的儿童冲动性增加与儿童体重状况的更大改善相关(独立相关),在食欲驱动调整后略有减弱。儿童在治疗过程中提高了基于任务的一般抑制。一般抑制和零食折扣的改善与更好的儿童体重结果相关,但调整基线值后减弱了这些关联。
即使在调整初始食欲驱动后,肥胖儿童的初始冲动性越高,治疗效果越好。相反,治疗过程中基于任务的抑制和与食物相关的折扣的改善也与更好的结果相关。需要研究创新性方法来更好地解决儿童体重管理中的冲动性和抑制性问题。临床试验注册号:NCT02484976。