Translating basic habituation research to childhood obesity treatment

将基本习惯研究转化为儿童肥胖治疗

• 批准号: 10579899
• 负责人: Hollie A Raynor
• 金额: $ 50.4万
• 依托单位: UNIVERSITY OF TENNESSEE KNOXVILLE
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-03-01 至 2025-02-28
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10579899
• 关键词: Acceleration; Adult; Behavioral; Behavioral Mechanisms; Behavioral Research; Body Weight decreased; Body mass index; Caregivers; Child; Diet; Dietary intake; Eating; Energy Intake; Family; Fatty acid glycerol esters; Food; Goals; Individual; Intake; Intervention; Light; Measures; Mediating; Methods; Motivation; Outcome; Overweight; Physical activity; Physiological; Pilot Projects; Randomized; Research; Risk; Salivary; Standardization; Testing; Time; Translating; Translational Research; Weight; aged; behavioral phenotyping; comparison intervention; dietary; dietary approach; efficacy trial; family influence; food consumption; habituation; healthy weight; improved; individual variation; individualized medicine; novel; obesity in children; obesity treatment; precision medicine; psychologic; reduced food intake; saliva secretion; theories; therapy development; vigorous intensity

PROJECT SUMMARY/ABSTRACT Identifying successful methods for reducing long-term energy intake continues to be a challenge in obesity treatment. Basic behavioral research has found that the rate of habituation (i.e., rate of reduction in physiological and behavioral responding) to food is related to amount of food consumed, and faster habituation rates reduce food intake. The rate of habituation to food can be accelerated when variety in foods is limited, producing decreased intake. Thus, a dietary prescription that limits variety of high-energy-dense (RED) foods may boost ability to reduce long-term energy intake, enhancing long-term weight loss. Furthermore, habituation rates to food show large individual variability. Individuals with overweight habituate slower to food than individuals with a healthy weight, and slower habituation rates predict greater increases in child standardized body mass index. Thus, slower habituation rates to food may be a behavioral phenotype for increased risk of suboptimal weight outcomes. Obesity interventions that accelerate habituation to food may then be more beneficial for those with this behavioral phenotype. We have been conducting a line of translational research that applies habituation theory to obesity treatment, involving: 1) studies systematically testing basic concepts to better inform intervention development; 2) “proof-of-concept” testing; and 3) efficacy trials. The long-term goal is to develop a dietary prescription that harnesses habituation as a mechanism for reducing long-term energy intake. We have piloted a limited variety prescription (limited variety of RED foods) within a 6-month family-based behavioral obesity treatment (FBT) for children. Twenty-four families, with a child > 85th percentile body mass index (BMI) and aged 8 to 12 years, were randomized to FBT or to FBT that included a limited dietary variety prescription (FBT+Variety). At 6-months children in FBT+Variety had a significantly greater reduction in percent overweight than those in FBT (−15.4% vs.− 8.9%). Research is needed to examine if limiting variety improves long-term weight loss, if this improvement is due to enhanced habituation, and explore if there is a behavioral phenotype that more greatly benefits from this dietary approach. We plan to implement a novel limited food variety prescription within a 24-month FBT to examine its effect on 24-month BMI. One hundred fifty-six children aged 8 to 12 years at > 85th percentile BMI will be randomized to one of two, 24- month interventions compared in our 6-month pilot study: FBT or FBT+Variety. Child and adult caregiver assessments will occur at 0, 6, 12, 18, and 24 months on anthropometrics, dietary intake, and habituation. We will determine: 1) the influence of FBT+Variety on long-term weight loss; and 2) the influence of FBT+Variety on long-term habituation and if habituation rate mediates differences in dietary intake and BMI between conditions. We will explore if the behavioral phenotype can be used to identify who benefits most from the limited variety prescription to better individualize treatment (“precision medicine”).

项目总结/摘要 确定减少长期能量摄入的成功方法仍然是肥胖症的一个挑战 治疗基本的行为研究发现，习惯化的速度（即，下调多少 对食物的生理和行为反应）与食物消耗量和更快的习惯化有关 费率减少食物摄入量。当食物种类有限时， 导致摄入量减少。因此，限制各种高能量密度（RED）食物的饮食处方 可以提高减少长期能量摄入的能力，促进长期减肥。此外，习惯化 对食物的比率显示出很大的个体差异。超重的人对食物的习惯比 健康体重和较慢习惯率的个体预测儿童标准化 体重指数因此，较慢的食物习惯率可能是增加风险的行为表型。 次优体重结果。那么，加速对食物习惯化的肥胖干预可能会更多。 对具有这种行为表型的人有益。我们一直在进行一系列的转化研究 将习惯化理论应用于肥胖治疗，包括：1）系统测试基本概念的研究 更好地为干预措施的制定提供信息; 2）“概念验证”测试; 3）功效试验。长期 我们的目标是开发一种饮食处方，利用习惯作为减少长期 能量摄入我们在6个月内试行了有限品种的处方（红色食品的有限品种） 以家庭为基础的儿童肥胖行为治疗（FBT）。24个家庭，有一个孩子>第85百分位 体重指数（BMI）和年龄8至12岁，被随机分配到FBT或FBT，包括有限的 日粮品种配方（FBT+Variety）。在6个月时，FBT+Variety组的儿童具有显著更大的 超重百分比低于FBT（-15.4% vs.-8.9%）。需要进行研究， 限制品种可以改善长期减肥，如果这种改善是由于增强习惯，并探讨 是否有一种行为表型能从这种饮食方法中获益更大。我们计划实施 在24个月的FBT内使用一种新的有限食物种类处方，以检查其对24个月BMI的影响。一 将体重指数> 85百分位数的五十六名8 - 12岁儿童随机分为两组， 在我们为期6个月的试点研究中比较了为期6个月的干预措施：FBT或FBT+Variety。儿童和成人照顾者 将在0、6、12、18和24个月时对人体测量学、饮食摄入和习惯进行评估。我们 将确定：1）FBT+品种对长期减肥的影响; 2）FBT+品种的影响 长期习惯化，如果习惯化率介导饮食摄入量和BMI之间的差异， 条件我们将探讨行为表型是否可以用来确定谁从治疗中获益最多。 有限的处方品种，以更好地个性化治疗（“精准医疗”）。

项目成果

The role of structure in dietary approaches for the treatment of pediatric overweight and obesity: A critical review.

• DOI: 10.1111/obr.13266
• 发表时间: 2021-09
• 期刊: Obesity reviews : an official journal of the International Association for the Study of Obesity
• 作者: Griffiths LA;Douglas SM;Raynor HA
• 通讯作者: Raynor HA