Beverage Choice and Lifestyle Modification for Childhood Overweight Treatment

描述（申请人提供）：儿童期超重是一种令人担忧的公共卫生疾病，与许多医疗并发症有关，可追溯到成年期，并且难以治疗。儿童期超重和体重过度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不断增加。增加含糖饮料的摄入量可能是超重（倾向）儿童实现正能量平衡的重要饮食行为。然而，还没有开发出专门针对减少含糖饮料和果汁摄入量的以家庭为基础的儿童早期超重行为干预措施。这些干预措施如果有效，可以为幼儿超重预防和/或治疗提供一种新的方法。另一方面，一些儿童可能会“补偿”无热量饮料所丢失的热量（通过增加食物或非目标热量饮料的摄入量），或者他们对“限制”热量饮料的需求可能会增加。这些问题值得认真研究。作为朝着这个方向迈出的第一步，拟议的研究将使用R21机制来开发和测试一种“饮料选择和生活方式改变”（BCLM）干预措施，该干预措施针对4至7岁的儿童，这些儿童有超重或超重的风险，并消耗大量的含糖饮料。为期6个月、16次的BCLM干预将针对儿童和家长减少含糖饮料和果汁的摄入量，采用促进无热量饮料选择（“替代品”）的策略，以帮助实现能量平衡。60个家庭将被随机分配到BCLM（N=30）或营养教育（NE）（N=30）对照组。主要结局指标将是定量的（即儿童BMI/超重百分比、饮料和食物选择以及总能量摄入的变化）和定性的（即治疗满意度和可接受性评级）。二次分析将测试BCLM儿童通过增加食物或非目标饮料的摄入量或增加他们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。研究结果将有助于设计和驱动更大规模的R 01应用程序。 公共卫生相关性：摄入过量含糖饮料（如果汁或普通苏打水）的儿童比摄入较少含糖饮料的儿童更容易超重。这项研究将为4至7岁的超重儿童及其父母开发和评估一种新的“饮料选择和生活方式改变”治疗方法。干预措施将教授生活方式技能，以促进更健康（热量更低）的饮料，以改善儿童的体重状况。

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.