Role of appetitive phenotype trajectory groups on child body weight during a family-based treatment for children with overweight or obesity
Role of appetitive phenotype trajectory groups on child body weight during a family-based treatment for children with overweight or obesity
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DOI：
10.1038/s41366-019-0463-4
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发表时间：
2019-11-01
影响因子：
4.9
通讯作者：
Strong, David R.
中科院分区：
文献类型：
--
作者：
Boutelle, Kerri N.;Sim, D. Eastern Kang;Strong, David R.
目的新出现的证据表明，个体的食欲特征可以有效地解释儿童行为减肥治疗中的减肥模式。本研究的目的是确定轨迹的儿童食欲性状和对儿童体重变化的影响随着时间的推移，2011年和2015年之间进行的随机非劣效性试验的二次数据分析评估儿童的食欲性状和体重减轻。超重和肥胖儿童（平均年龄= 10.4;平均BMI z = 2.0; 67%的女孩; 32%的西班牙裔）及其父母（平均年龄= 42.9;平均BMI = 31.9; 87%的女性; 31%的西班牙裔）参加了减肥计划，并在基线、3、6、12和24个月完成了评估。重复评估儿童的食欲特征，包括饱腹感反应，食物反应和情绪化饮食，被用来确定简约的变化轨迹分组。线性混合效应模型被用来确定组轨迹对儿童BMIz随时间推移而变化的影响。三组轨迹模型是最简约的，包括高饱腹感反应组（HighSR; 47.4%），高食物反应组（HighFR; 34.6%）和高情绪饮食组（HighEE; 18.0%）。所有轨迹中的儿童在治疗期间以大致相同的速度减轻体重，然而，只有HighSR组在随访期间保持体重减轻，而HighFR和HighEE组体重恢复（调整后的p值< 0.05）。确定的高风险亚组可能建议有针对性的干预和维护计划的机会。
Objective Emerging evidence suggests that individual appetitive traits may usefully explain patterns of weight loss in behavioral weight loss treatments for children. The objective of this study was to identify trajectories of child appetitive traits and the impact on child weight changes over time.Methods Secondary data analyses of a randomized noninferiority trial conducted between 2011 and 2015 evaluated children's appetitive traits and weight loss. Children with overweight and obesity (mean age = 10.4; mean BMI z = 2.0; 67% girls; 32% Hispanic) and their parent (mean age = 42.9; mean BMI = 31.9; 87% women; 31% Hispanic) participated in weight loss programs and completed assessments at baseline, 3, 6,12, and 24 months. Repeated assessments of child appetitive traits, including satiety responsiveness, food responsiveness and emotional eating, were used to identify parsimonious grouping of change trajectories. Linear mixed-effects models were used to identify the impact of group trajectory on child BMIz change over time.Results One hundred fifty children and their parent enrolled in the study. The three-group trajectory model was the most parsimonious and included a high satiety responsive group (HighSR; 47.4%), a high food responsive group (HighFR; 34.6%), and a high emotional eating group (HighEE; 18.0%). Children in all trajectories lost weight at approximately the same rate during treatment, however, only the HighSR group maintained their weight loss during follow-ups, while the HighFR and HighEE groups regained weight (adjusted p-value < 0.05).Conclusions Distinct trajectories of child appetitive traits were associated with differential weight loss maintenance. Identified high-risk subgroups may suggest opportunities for targeted intervention and maintenance programs.