EXERCISE IN THE LONG-TERM CONTROL OF CHILDHOOD OBESITY

肥胖儿童选择久坐而不是运动，久坐不动 行为影响体重控制，因为它们与积极的行为竞争， 并设置摄入过量卡路里的场合。我们最近展示了 增强儿童减少久坐行为的能力会导致 与接受强化治疗的儿童相比，他们的体重控制更好 活跃的，或为增加活跃和增强的组合而加强的 减少久坐的行为。所有的孩子都有类似的进步。 在健身方面。对运动的偏好增加最多的是 因减少久坐行为而得到强化的儿童。 这些结果表明，以久坐为目标的行为与 改善儿童体重控制。 拟议的临床和实验室研究旨在了解 影响久坐与运动选择的因素 另类选择。临床结果研究评估了 与超重相关的久坐或活动行为的改变 当久坐行为的减少而不是 积极行为的增加得到了加强。肥胖的孩子将会是 随机分成四组，每组都有我们的标准家庭- 基于行为治疗计划，改变休闲时间的数量 允许的久坐行为或规定的运动量。 活动模式、活动偏好、摄入量、实验室评估 剧烈运动或久坐运动的相对强化价值和 将测量决策平衡和对选择的感知 了解这些变量是如何影响体重变化的。三位一体 实验室研究为临床提供了直接的机制测试 我们已经确认的现象。第一项研究测试了 强化久坐行为的减少而不是增加 积极的行为；第二项研究测试了高针对性的重要性 或低偏好的久坐行为；而第三项研究测试了三个 减少久坐行为的其他方法。在每项免费研究中 活动或久坐替代品的选择将在之前和 在实验程序已经进行了多天之后 效果。

Obese children choose to be sedentary rather than active, and sedentary behaviors influence weight control since they compete with being active, and set the occasion for excess caloric intake. We recently demonstrated that reinforcing children for reducing sedentary behaviors resulted in superior weight control compared to children who were reinforced for being active, or reinforced for the combination of increasing active and reducing sedentary behaviors. All children showed similar improvements in fitness. Preference for being active was increased the most for children who were reinforced for reducing their sedentary behavior. These results suggest the relevance of targeting sedentary behaviors to improve childhood weight control. The proposed clinical and laboratory studies are designed to understand factors that influence the choice of sedentary versus active alternatives. The clinical outcome study assesses the parameters of the changes in sedentary or active behaviors associated with superior weight control observed when a decrease in sedentary behaviors rather than an increase in active behaviors is reinforced. Obese children will be randomized to one of four groups who are provided our standard family- based behavioral treatment program, varying the amount of leisure time sedentary behaviors allowed or the amount of exercise prescribed. Activity patterns, activity preference, intake, laboratory assessment of the relative reinforcing value of vigorous or sedentary activity and measures of decisional balance and perception of choice will be measured to understand how these variables influence weight change. The three laboratory studies provide direct tests of mechanisms for the clinical phenomena we have identified. The first study tests the importance of reinforcing a decrease in sedentary behaviors versus an increase in active behaviors; the second study tests the importance of targeting high or low preference sedentary behaviors; and the third study tests three alternative ways to decrease sedentary behavior. In each study free choice for active or sedentary alternatives will be assessed before and after multiple days in which the experimental procedures have been in effect.