FAMILY SYSTEMS APPROACH TO CHILDHOOD OBESITY

目前的估计显示，25%的美国人 儿童肥胖，儿童早期肥胖的发病率是 增加。 许多超重的儿童成为肥胖的成年人， 与体重问题和随之而来的代谢紊乱作斗争 肥胖 如果一个孩子在进入青春期时处于肥胖状态， 4比1反对在以后的生活中达到正常体重。照经上所 显然，预防或早期管理这种疾病是至关重要的， 与终生肥胖及其并发症作斗争。 然而当 许多治疗方案的长期成功率进行了检查 很明显，长期保持体重减轻的成年人 是个异常现象 对儿童的影响更为严峻， 关于治疗的研究很少， 儿童肥胖症 此前报道的研究集中在 选择性地改变肥胖发作前的行为（食物摄入 和锻炼方案）或替代地记录和改善 肥胖的代谢后果 这项提案的目的是统一行为和代谢程序 在一个共同的实验设计下， 早期儿童肥胖的前因和后果。 先前 将采用开发的方案来表征个体 5-10岁儿童，在以下方面：1）他们的能力， 调节食物摄入量; 2）饮食结构对儿童的影响 食物摄入调节; 3）他们的身体组成特征; 4） 24小时能量消耗由整个房间间接测定 量热法; 5）选定的心理变量，如儿童的 自尊，身体形象和他们的感知程度， 父母试图控制他们的饮食行为。 此外，数据 将收集的重点是家庭环境， 儿童结果测量的差异可以解释为 这是他们成长的家庭环境。 父母的节食史和体重状况，他们对 他们孩子的体重状况以及他们的喂养方式 实践将被衡量。 这些数据将被用来测试一个模型， 肥胖的发展，根据初步数据，这表明， 儿童的能量摄入调节和体重结果是 父母和孩子之间的双向关系， 遗传和环境的影响。 长期目标是 一条研究路线是确定有效干预的点， 可以制定预防策略。

DESCRIPTION: Current estimates reveal that 25 percent of American children are obese and that the incidence of early childhood obesity is increasing. Many overweight children become obese adults who constantly struggle with weight issues and the metabolic disorders that accompany obesity. If a child enters adolescence in the obese state, the odds are 4 to 1 against achieving normal weight later in life. Thus, it is evident that prevention or early management of this disease is critical in combating a lifetime of obesity and its complications. However, when long-term success rates of the numerous treatment programs are examined it becomes apparent that the adult who maintains a long-term weight loss is an anomaly. The results for children are even more grim since there is little research, and less consensus, regarding the treatment of childhood obesity. Previously reported studies have focussed on selectively modifying behaviors which precede obesity onset (food intake and exercise protocols) or alternatively on documenting and ameliorating the metabolic consequences of obesity. The aim of this proposal is to unify behavioral and metabolic procedures under a common experimental design to produce a comprehensive view of the antecedents and consequences of early childhood obesity. Previously developed protocols will be employed to characterize individual children, 5-10 years of age, with respect to: 1) their ability to regulate food intake; 2) the influence of diet composition on children's food intake regulation; 3) their body composition characteristics; 4) 24 hour energy expenditure as determined by whole room indirect calorimetry; and 5) selected psychological variables such as children's self-esteem, body image and their perception of the degree to which parents attempt to control their eating behavior. In addition, data will be collected which focusses on the family environment so that differences in children's outcome measures can be interpreted in the context of the family environment in which they have developed. Parents' dieting histories and weight statuses, their concerns about their children's weight statuses as well as their child-feeding practices will be measured. These data will be used to test a model of obesity development which, based upon preliminary data, suggests that children's energy intake regulation and weight outcome are the result of a bidirectional relationship between parents and children that is both genetic and environmental in nature. The long-term goal of this line of research is to identify points at which effective intervention and prevention strategies can be developed.