Healthy Weight Center, Helen DeVos Children's Hospital, Grand Rapids, MI, United States.
Department of Pediatrics and Human Development, Michigan State University College of Human Medicine, Grand Rapids, MI, United States.
Front Endocrinol (Lausanne). 2022 Apr 21;13:811489. doi: 10.3389/fendo.2022.811489. eCollection 2022.
Adherence to dietary interventions is a significant barrier in the treatment of childhood obesity. Time-limited eating (TLE) is a simple dietary approach that limits food intake to a given number of consecutive hours per day, but parental and youth acceptability of TLE in youth with obesity is unknown. This study explored the feasibility of utilizing TLE among parents and youth attending pediatric weight management (PWM).
Members of COMPASS (Childhood Obesity Multi-Program Analysis and Study System) developed a survey to assess the acceptability of TLE in families attending PWM, which included patient characteristics, current diet and sleep schedules, and interests in trying TLE. The survey was administered electronically REDCap or manually to parents of patients between the ages of 8-17 years old and to patients 11-17 years old attending one of five PWM practices in the COMPASS network.
Patients (n=213) were 13.0 ± 2.5 years old, 58% female, 52% White, 22% Black, 17% Hispanic/Latino, and 47% reported a diagnosed psychological disorder. On average, parents reported their child's daily eating spanned 12.5 ± 1.9 hours (7:35am - 8:05pm) and included 5.6 ± 1.6 eating bouts (meals + snacks). Most parents reported being likely to try TLE ≤12 hours/d (TLE12: 66%), which was similar to the likelihood of following a nutrient-balanced diet (59%). Likelihood was lower for TLE ≤10 hours/d (TLE10: 39%) or ≤8 hours/d (TLE8: 26%) (p<0.001 for both). Interest in TLE was not consistently related to patient age, sex, or ethnicity, but was lower in patients with a psychiatric diagnosis vs. no diagnosis (TLE8: 19% vs. 32%; p=0.034). Patients of parents who reported being likely to try TLE, compared to those unlikely to try TLE, had shorter eating windows (p<0.001) and ate fewer snacks (p=0.006).
Two-thirds of parents with children attending PWM programs report interest in TLE ≤12 hours/d regardless of demographic characteristics, but interest wanes when limiting eating to ≤10 or ≤8 hours per day. Time-limited eating appears to be a feasible option in PWM settings provided treatment options are individualized based on the interests and barriers of patients and their families.
儿童肥胖症的治疗中，饮食干预的坚持是一个重大障碍。限时进食（TLE）是一种简单的饮食方法，每天将进食时间限制在特定的连续小时数内，但在肥胖青少年中，父母和青少年对 TLE 的接受程度尚不清楚。本研究探讨了在参加儿科体重管理（PWM）的父母和青少年中采用 TLE 的可行性。
COMPASS（儿童肥胖多计划分析和研究系统）的成员制定了一项调查，以评估在参加 PWM 的家庭中 TLE 的可接受性，该调查包括患者特征、当前饮食和睡眠时间表，以及对尝试 TLE 的兴趣。该调查通过电子方式（REDCap）或手动方式向年龄在 8-17 岁之间的患者的父母以及参加 COMPASS 网络中五个 PWM 实践之一的 11-17 岁患者进行。
患者（n=213）年龄为 13.0 ± 2.5 岁，58%为女性，52%为白人，22%为黑人，17%为西班牙裔/拉丁裔，47%报告有诊断出的心理障碍。平均而言，父母报告孩子每天的进食时间跨度为 12.5 ± 1.9 小时（7:35am - 8:05pm），包括 5.6 ± 1.6 次进食（餐点+零食）。大多数父母表示可能会尝试 TLE ≤12 小时/天（TLE12：66%），这与遵循营养均衡饮食的可能性相似（59%）。尝试 TLE ≤10 小时/天（TLE10：39%）或 ≤8 小时/天（TLE8：26%）的可能性较低（两者均 p<0.001）。对 TLE 的兴趣与患者的年龄、性别或种族没有一致的关系，但与没有诊断的患者相比，有精神诊断的患者的兴趣较低（TLE8：19%比 32%；p=0.034）。与不太可能尝试 TLE 的父母相比，报告可能尝试 TLE 的父母的孩子的进食窗口较短（p<0.001），且零食较少（p=0.006）。
无论人口统计学特征如何，有 2/3 的参加 PWM 计划的儿童的父母对 TLE ≤12 小时/天感兴趣，但当限制进食时间每天≤10 或≤8 小时时，兴趣会减弱。在 PWM 环境中，TLE 似乎是一种可行的选择，但前提是根据患者及其家属的兴趣和障碍来个体化治疗方案。
