儿童短期能量补偿的个体间差异：系统评价和荟萃分析。
Inter-individual differences in children's short-term energy compensation: a systematic review and meta-analysis.
机构信息
The Pennsylvania State University, Department of Nutritional Sciences, University Park, Pennsylvania, United States.
University of Pennsylvania, Department of Biobehavioral Health Sciences, Philadelphia, Pennsylvania, United States.
出版信息
Am J Clin Nutr. 2023 Dec;118(6):1202-1213. doi: 10.1016/j.ajcnut.2023.09.013. Epub 2023 Sep 25.
BACKGROUND
The ability to regulate energy intake is often assessed using a preloading paradigm to measure short-term energy compensation. In children, large variability exists with this paradigm both within- and across- studies and is poorly understood.
OBJECTIVES
This systematic review and meta-analysis aimed to better understand factors contributing to variability in children's energy compensation. We tested 1) whether children demonstrated "good" energy compensation, defined as adjusting meal intake commensurate with preload intake and 2) differences in children's energy compensation by child age, sex, and weight status (assessed both continuously and categorically).
METHODS
Standard guidelines for systematic review were followed to search PubMed, PsychInfo, and Web of Science. Data on study design (preload form, preload-to-meal interval, preload energy difference, study setting) and participant characteristics (sex, age, weight status) were extracted from 29 experiments meeting inclusion criteria, and 13 were included in meta-analyses. COMPx (energy compensation index), a linear transformation comparing food intake following a high- vs. low-energy preload, was the outcome. Hedge's g was calculated, and random intercept-only models tested associations between COMPx and sex, age, and weight status.
RESULTS
The systematic review revealed mixed results regarding children's energy compensation and the role of inter-individual differences. Meta-analytic models revealed that children undercompensated (overate) for preload energy (β = -0.38; P = 0.008). Sex (β = 0.11; P = 0.76), age (β = 0.03; P = 0.75), and weight (assessed continuously; β = -0.07, P = 0.37) were not related to compensation. Children with overweight/obesity (assessed categorically) undercompensated more than children with healthy weight (β = 0.18; P = 0.04).
CONCLUSIONS
The systematic review highlighted wide variability across studies, while the meta-analysis demonstrated differences in COMPx by child weight status but not by age or sex. Standardizing protocols across studies is recommended, along with designing adequately powered studies aiming to test inter-individual differences a priori. Alternative approaches to the use of COMPx are recommended to allow better characterization of children's energy compensation ability. This study was registered at PROSPERO as CRD42020197748.
背景
通常使用预加载范式来评估调节能量摄入的能力，以测量短期能量补偿。在儿童中，这种范式在研究内和研究间都存在很大的变异性，而且这种变异性的机制尚未得到很好的理解。
目的
本系统评价和荟萃分析旨在更好地理解导致儿童能量补偿变异性的因素。我们检验了 1）儿童是否表现出“良好”的能量补偿，定义为根据预加载摄入量调整膳食摄入量，以及 2）儿童的能量补偿是否因儿童年龄、性别和体重状况（连续和分类评估）而不同。
方法
遵循系统评价的标准指南，在 PubMed、PsychInfo 和 Web of Science 中进行搜索。从符合纳入标准的 29 项实验中提取研究设计（预加载形式、预加载-膳食间隔、预加载能量差异、研究场所）和参与者特征（性别、年龄、体重状况）的数据，并进行荟萃分析。COMPx（能量补偿指数）是一种比较高能量和低能量预加载后食物摄入的线性转换，是结果。计算了 Hedge's g，并使用随机截距仅模型检验了 COMPx 与性别、年龄和体重状况之间的关联。
结果
系统评价显示，关于儿童的能量补偿以及个体差异的作用，结果喜忧参半。荟萃分析模型显示，儿童对预加载能量的补偿不足（过度进食）（β=-0.38；P=0.008）。性别（β=0.11；P=0.76）、年龄（β=0.03；P=0.75）和体重（连续评估；β=-0.07，P=0.37）与补偿无关。超重/肥胖（分类评估）的儿童比健康体重的儿童补偿不足（β=0.18；P=0.04）。
结论
系统评价强调了研究之间的广泛变异性，而荟萃分析则表明，儿童的 COMPx 因体重状况而异，但与年龄或性别无关。建议在研究中标准化方案，同时设计足够有力的研究，以预先测试个体差异。建议使用替代方法来评估 COMPx，以更好地描述儿童的能量补偿能力。本研究在 PROSPERO 中注册为 CRD42020197748。
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