Beverage Choice and Lifestyle Modification for Childhood Overweight Treatment

描述（由申请人提供）：儿童超重是一种令人担忧的公共卫生疾病，与许多医学并发症相关，可追溯至成年期，且难以治疗。儿童超重和体重增加与含糖饮料和果汁的摄入量增加有关，这是一个重要的发现，因为美国儿童对这些饮料的消费量不断增加，商业销售的饮料的份量也在增加。增加含糖饮料的摄入可能是一种重要的饮食行为，通过它，超重（容易）的儿童可以达到正能量平衡。然而，针对儿童早期超重的以家庭为基础的行为干预还没有发展出专门针对减少含糖饮料和果汁摄入量的干预措施。这些干预措施如果有效，可能为预防和/或治疗幼儿超重提供一种新的方法。另一方面，有些儿童可能会“补偿”无热量饮料中缺失的卡路里（通过增加食物摄入量或非目标热量饮料），或者他们对“限制”卡路里饮料的渴望可能会因治疗而增加。这些问题值得认真调查。作为这个方向的第一步，拟议的研究将使用R21机制来开发和测试“饮料选择和生活方式改变”（BCLM）干预措施，目标是4到7岁的儿童，他们有超重或超重的风险，并饮用大量的含糖饮料。这项为期6个月、16期的BCLM干预将以减少儿童和家长对含糖饮料和果汁的摄入为目标，通过推广无热量饮料的选择（“替代品”）来帮助实现能量平衡。60个家庭将随机分为BCLM （N=30）和营养教育（NE）对照组（N=30）。主要结果测量将是定量的（如儿童BMI/超重百分比的变化，饮料和食物的选择，以及总能量摄入）和定性的（如治疗满意度和可接受性评级）。二级分析将测试BCLM儿童通过增加食物或非目标饮料的摄入量或增加对目标含糖饮料的偏好来补偿的程度。还将测试父母和儿童饮料摄入量变化之间的相关性。结果将有助于设计和驱动更大规模的R01应用程序。

DESCRIPTION (provided by applicant): Childhood overweight is a concerning public health disorder that is associated with numerous medical complications, tracks into adulthood, and is difficult to treat. Childhood overweight and excess weight gain have been linked to increased intake of sugar sweetened beverages and juice, an important finding given the rising consumption of these beverages by US children and the increasing portion sizes of commercially sold beverages. Increased intake of sugar sweetened beverages may be an important dietary behavior through which overweight (prone) children achieve positive energy balance. However, family-based behavioral interventions for early childhood overweight have not been developed that specifically target reduced sugar sweetened beverage and juice intake. Such interventions, if effective, could provide a novel approach for overweight prevention and/or treatment in young children. On the other hand, it is possible that some children may "compensate" for the missing calories of non-caloric beverages (either by increasing intake of foods or untargeted caloric beverages) or that their desire for "restricted" caloric beverages may increase in response to treatment. These questions merit rigorous investigation. As a first step in this direction, the proposed study would use the R21 mechanism to develop and test a "Beverage Choice and Lifestyle Modification" (BCLM) intervention that targets 4 to 7 year old children who are at-risk for overweight or overweight and consume large amounts of sugar sweetened beverages. The 6-month, 16-session BCLM intervention will target reducing sugar sweetened beverage and juice intake by children and parents using strategies to promote non-caloric beverage choices ("substitutes ) to help achieve energy balance. Sixty families will be randomized to either BCLM (N=30) or a Nutrition Education (NE) (N=30) control group. Primary outcome measures will be quantitative (ie, changes in child BMI/percent overweight, beverage and food choices, and total energy intake) and qualitative (ie, treatment satisfaction and acceptability ratings). Secondary analyses will test the extent to which children in BCLM compensate by increasing intake of foods or untargeted beverages or increase their preference for targeted sugar sweetened beverages. Correlations between changes in parent and child beverage intakes also will be tested. Results will help design and power a larger-scale R01 application. PUBLIC HEALTH RELEVANCE: Children who consume excess amounts of sugar sweetened beverages (such as fruit juices or regular sodas) are more likely to be overweight than children who consume less sugar sweetened beverages. This research study would develop and evaluate a new "Beverage Choice and Lifestyle Modification" treatment for 4 to 7 year old overweight children and their parents. The intervention will teach lifestyle skills to promote healthier (less caloric) beverages to improve children's weight status.