Strategies to Moderate Energy Intake for the Prevention of Obesity in Children

描述（由申请人提供）：鉴于儿童超重和肥胖患病率的上升，有必要制定营养合理的饮食策略，以防止儿童体重过度增加并鼓励他们保持健康的体重。一种在成人中显示出希望的饮食方法包括改变影响饱腹感和能量摄入的食物的特性。例如，食用膳食能量密度（千卡/克）降低的食物会减少成年人的能量摄入，改善饮食质量。食物份量的变化和食物种类的变化也会影响能量的摄入。拟议中的研究将扩展这些发现，并确定如何策略性地使用食物和膳食的变化来调节学龄前儿童的能量摄入和改善饮食质量。具体的重点将是通过增加儿童膳食中蔬菜的摄入量来降低能量密度和能量摄入量。在[三个]托儿中心进行的一系列交叉研究中，将通过提供不同份量、种类和膳食结构的膳食来测试影响能量密度和食物摄入量的不同策略。一种策略是在没有可与之竞争的食物的情况下，在用餐开始时提供蔬菜。据推测，蔬菜摄入量会增加，而这种影响将取决于所提供的份量。另一个策略是增加餐中蔬菜的比例。公共卫生组织推荐这种方法，虽然它可能改善饮食质量，但它对能量摄入的影响尚未确定。最后，将评估增加餐中蔬菜种类的效果。具体目的是确定以下因素对蔬菜摄入量和能量摄入量的影响：1)在用餐开始时改变蔬菜的份量；2)通过添加额外的蔬菜或用蔬菜代替其他食物来增加每餐中蔬菜的比例；3)在餐前或主菜时增加蔬菜的种类。近年来，在理解能量密度、份量大小和食物种类对成年人能量摄入和饮食质量的影响方面取得了重大进展，但这些知识中的大部分尚未推广到儿童身上。本研究将前人关于成人饱腹感的研究成果应用于进一步了解食物的特性和膳食结构如何影响学龄前儿童的能量摄入。这些数据将转化为制定可适应儿童能量需求的具体战略，并为设计有效的公共卫生信息提供信息，以帮助预防儿童肥胖。公共卫生相关性：由于儿童超重和肥胖率不断上升，迫切需要找到有助于减少儿童过量能量摄入的有效策略。拟议的研究将表明，如何调整餐中食物的份量和种类，以增加蔬菜摄入量，改善饮食质量，并帮助儿童调节能量摄入。这些战略将在预防儿童肥胖及其对健康的严重后果方面发挥实际作用。

DESCRIPTION (provided by applicant): Given the rise in the prevalence of childhood overweight and obesity, it is essential to develop nutritionally sound dietary strategies that prevent excessive weight gain and encourage the maintenance of healthy body weight in children. One dietary approach that has shown promise in adults involves varying the properties of foods that affect satiety and energy intake. For example, consuming foods that are reduced in dietary energy density (kcal/g) leads to decreased energy intake and improved diet quality in adults. Changes in the portion size and the variety of available foods can also affect energy intake. The proposed studies will extend these findings and determine how changes in foods and meals can be used strategically to moderate energy intake and improve diet quality in preschool children. The specific focus will be on reducing energy density and energy intake by increasing children's intake of vegetables at meals. In a series of crossover studies in [three] childcare centers, different strategies for influencing energy density and food intake will be tested by serving meals that are varied in portion size, variety, and meal structure. One strategy is to serve vegetables at the start of a meal when there are no competing foods available. It is hypothesized that vegetable intake will increase and that this effect will depend upon the portion served. Another strategy is to increase the proportion of vegetables served at meals. Public health organizations recommend this approach, and while it is likely to improve diet quality, its effect on energy intake has not been determined. Finally, the effect of increasing the variety of vegetables served at the meal will be assessed. The specific aims are to determine the effects on vegetable intake and energy intake of the following: 1) varying the portion size of vegetables served at the start of a meal; 2) increasing the proportion of vegetables served during a meal either by adding extra vegetables or by substituting vegetables for other foods; and 3) increasing the variety of vegetables at the start of a meal or at the main course. In recent years there have been significant advances in understanding the influence of energy density, portion size, and variety of foods on energy intake and diet quality among adults, but much of this knowledge has not yet been extended to children. The proposed studies apply the findings from previous research on satiety in adults to advancing understanding of how the properties of foods and the structure of meals influence energy intake in preschool children. These data will translate to the development of specific strategies that can be adapted to children's energy needs and inform the design of effective public health messages to help prevent childhood obesity. PUBLIC HEALTH RELEVANCE: Because of the increasing rates of childhood overweight and obesity, there is an urgent need to find effective strategies that will help to reduce excess energy intake in children. The proposed studies will indicate how modifications in the portion size and variety of foods served at meals can be employed to increase vegetable intake, improve diet quality, and help to moderate energy intake in children. Such strategies will be of practical use in preventing childhood obesity and its serious consequences to health.