Normalizing Eating Behavior Reduces Body Weight and Improves Gastrointestinal Hormonal Secretion in Obese Adolescents
Normalizing Eating Behavior Reduces Body Weight and Improves Gastrointestinal Hormonal Secretion in Obese Adolescents
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DOI：
10.1210/jc.2011-1999
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发表时间：
2012-02-01
影响因子：
5.8
通讯作者：
Shield, J. P. H.
中科院分区：
文献类型：
--
作者：
Galhardo, J.;Hunt, L. P.;Shield, J. P. H.
假设：重新训练肥胖青少年放慢进食速度将导致胃肠道饱腹感激素循环浓度发生有益变化。方法：在一项随机试验中，在口服葡萄糖耐量试验期间、基线和 12 个月时测量了胃饥饿素和肽酪氨酸-酪氨酸，该随机试验评估了旨在重新训练饮食行为的设备（Mandometer）的临床有效性。这种计算机化量表在干预组（n = 14）的进餐期间提供实时反馈，以减慢进食速度。对照组（n = 13）仅接受旨在改善生活方式行为的标准护理。与标准护理相比，Mandometer 在体重减轻方面有更大的改善。结果：与基线相比，只有使用 Mandometer 的患者表现出较低的空腹 ghrelin 平均水平（48.14 +/- 18.47 与 68.45 +/- 17.78 pg/ml；P = 0.002）和平均 ghrelin 曲线下面积（72.08 +/- 24.11 与 10.11 pg/ml）。 12 个月时为 125.50 +/- 29.72 pg/ml +/- 分钟；P < 0.001)。 60 分钟时生长素释放肽的绝对平均抑制增强（-40.50 +/- 21.06 对比 -12.14 +/- 19.74 pg/ml x 分钟；P = 0.001）。标准护理组中 90 分钟的肽酪氨酸-酪氨酸反应保持不变，而压力计组中的肽酪氨酸-酪氨酸反应有所增加 (P < 0.001)：基线和 12 个月之间，平均 90 分钟反应增加了 72 pg/ml [95% 置信区间 (CI) 52-92 pg/ml]。在调整体重指数 SD 评分变化 (Delta) 的偏相关分析中，Delta 进餐时间与 60 分钟时 ghrelin 的 Delta 绝对抑制呈负相关 (r = -0.58; P = 0.037; 95% CI -0.79 至 -0.27) 以及 Delta ghrelin 曲线下面积 (r = -0.62; P = 0.025; 95% CI = -0.81 至 -0.27)。 -0.31).结论：重新训练肥胖青少年放慢进食速度对胃肠道激素对碳水化合物负荷的反应有显着影响，这表明外部可改变的饮食行为实际上调节了对食物的激素反应。 （临床内分泌代谢杂志 97：E193-E201，2012 年）
Hypothesis: Retraining obese adolescents to eat more slowly will lead to beneficial changes in circulating concentrations of gastrointestinal satiety hormones.Methods: Ghrelin and peptide tyrosine-tyrosine were measured during an oral glucose tolerance test, at baseline and at 12 months during a randomized trial assessing the clinical effectiveness of a device (Mandometer) designed to retrain eating behavior. This computerized scale provided real-time feedback during meals in the intervention arm (n = 14) to slow down the speed of eating. The control group (n = 13) received only standard care aimed at improving lifestyle behavior. The Mandometer elicited greater improvements in weight loss than standard care.Results: Compared with baseline, only those using the Mandometer exhibited lower mean levels of fasting ghrelin (48.14 +/- 18.47 vs. 68.45 +/- 17.78 pg/ml; P = 0.002) and mean ghrelin area under the curve (72.08 +/- 24.11 vs. 125.50 +/- 29.72 pg/ml +/- min; P < 0.001) at 12 months. Absolute mean suppression in ghrelin at 60 min was enhanced (-40.50 +/- 21.06 vs. -12.14 +/- 19.74 pg/ml x min; P = 0.001). Peptide tyrosine-tyrosine response at 90 min remained unaltered in the standard care arm, whereas those in the Mandometer arm increased (P < 0.001): the mean 90-min response increased by 72 pg/ml [95% confidence interval (CI) 52-92 pg/ml] between baseline and 12 months. In a partial correlation analysis adjusting for change (Delta) in body mass index SD scores, Delta meal duration correlated negatively with Delta absolute suppression in ghrelin at 60 min (r = -0.58; P = 0.037; 95% CI -0.79 to -0.27) and Delta ghrelin area under the curve (r = -0.62; P = 0.025; 95% CI = -0.81 to -0.31).Conclusions: Retraining obese adolescents to eat more slowly has a significant impact on the gastrointestinal hormone response to a carbohydrate load, suggesting that externally modifiable eating behaviors actually regulate the hormonal response to food. (J Clin Endocrinol Metab 97: E193-E201, 2012)