Enhancing alternatives to eating in infancy

摘要 肥胖症是一种正能量平衡紊乱，其中能量摄入超过能量消耗。的 吃东西的动机是人类的基本需求，在出生时就存在。一个因素可能导致增加 能量摄入是进食动机和从事其他行为动机之间的不平衡。 吃东西的动机与从事其他行为的动机可以被操作为相对强化 吃的价值与替代行为的关系一个强烈的动机吃，而不是从事替代 行为与成年人能量摄入增加有关。吃东西的动机是跨部门的， 与儿童、青少年和成人肥胖症的前瞻性相关，与体重的横断面相关 婴儿的地位。将平衡从高动力吃到增加动力参与 替代行为可以减少能量摄入，并可能防止体重增加。我们最近 研究表明，一个结构化的计划，以提高音乐参与的婴儿谁是强烈的动机吃， 可以将他们的选择从食物转移到音乐。本研究的目的是扩大这一初步研究， 研究这种干预对高度进食动机的婴儿的长期影响。我们建议 将92名健康婴儿随机分为两组，一组是食物强化高的婴儿，另一组是音乐强化计划的婴儿， 注意安慰剂游戏日期，并评估食物/非食物强化、婴儿能量摄入、体重的变化 为长度z分数，和丰富的家庭环境，并遵循这些婴儿的发展超过24 月期间。我们预测，与控制播放日期相比，音乐程序将导致 从吃的动机到从事替代饮食的动机的选择（具体目标1）， 减少能量摄入（具体目标1a），降低长度重量z评分（zWFL）（具体目标2）， 在每个测量时间间隔内提供更丰富的家庭环境（具体目标3）。我们建议 增强参与饮食替代品的动机是一种新的肥胖方法， 这些干预措施易于实施和推广。

ABSTRACT Obesity is a disorder of positive energy balance in which energy intake exceeds energy expenditure. The motivation to eat is a basic human need, which is present at birth. One factor that may lead to increased energy intake is the imbalance between the motivation to eat and the motivation to engage in other behaviors. The motivation to eat versus engaging in other behaviors can be operationalized as the relative reinforcing value of eating versus alternative behaviors. A strong motivation to eat instead of engaging in alternative behaviors has been related to increased energy intake in adults. The motivation to eat is cross-sectionally and prospectively related to obesity in children, adolescents, and adults, and cross-sectionally related to weight status in infants. Shifting the balance from high motivation to eat to increased motivation to engage in alternative behaviors can reduce energy intake, and may be protective against weight gain. We have recently shown that a structured program to enhance music engagement in infants who are strongly motivated to eat can shift their choice from food to music. The goal of this study is to expand on this preliminary research and examine long-term effects of this intervention in infants who are highly motivated to eat. We are proposing to randomize 92 healthy infants who are high in food reinforcement to a music enhancement program versus an attention placebo play date and assess changes in food/non-food reinforcement, infant energy intake, weight for length z-score, and enriched home environment, and follow the development of these infants over a 24 month period. We predict that the music program, in comparison to the control play date, will result in a shift in choice from a motivation to eat to a motivation to engage in alternatives to eating (Specific Aim 1) and thus reduce energy intake (Specific Aim 1a), lower weight for length z-score (zWFL) (Specific Aim 2), and create a more enriched home environment (Specific Aim 3) at each measurement interval. We propose that enhancing the motivation to engage in alternatives to eating represents a novel approach to obesity prevention, and these interventions are easily implemented and scalable.