Enhancing alternatives to eating in infancy

摘要 肥胖是一种能量摄入超过能量消耗的正能量平衡失调。这个 进食动机是人类的一种基本需求，这种需求在出生时就存在。一个可能导致增加的因素 能量摄入是进食的动机和从事其他行为的动机之间的不平衡。 与其他行为相比，进食动机可以被操作为相对强化 饮食的价值与另类行为的对比。强烈的进食动机，而不是参与替代 成年人的行为与能量摄入量增加有关。进食的动机是横截面的， 预期与儿童、青少年和成人的肥胖有关，并与体重横截面相关 婴儿的状况。将平衡从吃的高动力转变为参与的动力增加 另类行为可以减少能量摄入，并可能对体重增加起到保护作用。我们最近做了 研究表明，这是一项有组织的计划，旨在提高有强烈进食动机的婴儿的音乐参与度 可以把他们的选择从食物转向音乐。这项研究的目标是扩大这一初步研究和 检查这种干预对有强烈进食动机的婴儿的长期影响。我们正在提议 将92名食物强化程度较高的健康婴儿随机分为音乐强化组和对照组 注意安慰剂游戏日期，并评估食物/非食物强化、婴儿能量摄入量、体重的变化 为长度z分，丰富的家庭环境，并跟踪这些婴儿24岁以上的发育情况 一个月的期间。我们预测，与控制播放日期相比，音乐节目将导致 从进食动机到参与进食替代品的动机的选择(具体目标1)，因此 减少能量摄入(特定目标1a)，降低体重/长度z分数(ZWFL)(特定目标2)，并创造 在每个测量间隔有更丰富的家庭环境(具体目标3)。我们建议 增强人们参与饮食替代品的动机是一种治疗肥胖的新方法 预防，而且这些干预措施易于实施和可扩展。

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.