Treatment of childhood obesity by retraining eating behaviour: randomised controlled trial
Treatment of childhood obesity by retraining eating behaviour: randomised controlled trial
复制标题
DOI：
10.1136/bmj.b5388
复制
发表时间：
2010-01-05
影响因子：
105.7
通讯作者：
Shield, Julian P. H.
中科院分区：
文献类型：
--
作者：
Ford, Anna L.;Bergh, Cecilia;Shield, Julian P. H.
目的确定使用反馈装置改变饮食行为是否有助于肥胖青少年的减肥。设计随机对照试验，干预12个月。建立以医院为基础的肥胖诊所。参与者106名9-17岁的新肥胖者。干预一种计算机化的设备，曼度计，在用餐期间向参与者提供实时反馈，以减缓进食速度，减少总摄入量；标准的生活方式改变治疗。主要结果衡量身体质量指数(BMI)标准偏差分数(SDS)在12个月内的变化，并在干预开始18个月后进行评估。结果使用所有参与者的最新数据(n=106)，Mandeter组患者在12个月时的平均BMI-SDS显著低于标准护理(基线调整后的平均差值0.24，95%可信区间0.11-0.36)。当分析只包括91名按方案参加的患者时，也得到了类似的结果(基线调整后的平均差异为0.27，0.14至0.41；P<；0.001)，差异维持在18个月(0.27，0.11至0.43；P=0.001)(n=87)。Mandeter组的平均餐量减少了45g(7到84 g)。根据基线水平调整的平均体脂标准差在12个月时显著降低(分别为0.24、0.10和0.39；P=0.001)。治疗组高密度脂蛋白胆固醇水平也有较大改善(P=0.043)。结论饮食行为反馈训练是标准生活方式治疗青少年肥胖的有效辅助手段。
Objective To determine whether modifying eating behaviour with use of a feedback device facilitates weight loss in obese adolescents.Design Randomised controlled trial with 12 month intervention.Setting Hospital based obesity clinic.Participants 106 newly referred obese young people aged 9-17.Interventions A computerised device, Mandometer, providing real time feedback to participants during meals to slow down speed of eating and reduce total intake; standard lifestyle modification therapy.Main outcome measures Change in body mass index (BMI) standard deviation score (SDS) over 12 months with assessment 18 months after the start of the intervention. Secondary outcomes were body fat SDS, metabolic status, quality of life evaluation, change in portion size, and eating speed.Results Using the last available data on all participants (n=106), those in the Mandometer group had significantly lower mean BMI SDS at 12 months compared with standard care (baseline adjusted mean difference 0.24, 95 % confidence interval 0.11 to 0.36). Similar results were obtained when analyses included only the 91 who attended per protocol (baseline adjusted mean difference 0.27, 0.14 to 0.41; P < 0.001), with the difference maintained at 18 months (0.27, 0.11 to 0.43; P=0.001) (n=87). The mean meal size in the Mandometer group fell by 45 g (7 to 84 g). Mean body fat SDS adjusted for baseline levels was significantly lower at 12 months (0.24, 0.10 to 0.39; P=0.001). Those in the Mandometer group also had greater improvement in concentration of high density lipoprotein cholesterol (P=0.043).Conclusions Retraining eating behaviour with a feedback device is a useful adjunct to standard lifestyle modification in treating obesity among adolescents.