A Feeding Dynamic Intervention for Regulation of Energy Intake

描述（由申请人提供）：在过去的三十年中，儿童肥胖症的患病率显著增加。目前，美国23%的学龄前儿童（2-5岁）超重或肥胖，这是一个关键时期，希望扭转这一趋势。逐渐形成的共识表明，过度的，侵入性的，公开的喂养控制或混乱的非结构化喂养环境是儿童肥胖的危险因素。针对这些行为对肥胖治疗具有重大潜力。在这项为期3年的R 03申请中，我们建议调查喂养动态干预（FDI）在短期内改善照顾者喂养实践、儿童饮食行为和儿童自我调节能量摄入的有效性。在一项对84名患有3至5岁肥胖儿童的母亲进行的试点随机对照试验中，我们将检查我们的FDI与等待名单对照组（WLG）相比对（i）母亲自我报告的喂养实践的影响;（ii）改善能量补偿（COMPX），减少饥饿情况下的进食（EAH），并增加母亲报告的孩子的饱腹感反应。最后，我们将研究一个探索性假设，即与等待名单对照组的儿童相比，FDI组的儿童在6个月内的体重指数（BMI）z评分增幅较低。在本研究完成时，我们希望了解：（1）FDI对肥胖儿童母亲自我报告的喂养实践的影响;（2）通过父母指导的干预，儿童可以自我调节其食物摄入量的程度;以及（3）估计的效应量，使我们能够计算R 01应用中后续大规模多中心试验的样本量要求。我们的长期研究目标是开发有效和务实的干预措施，使儿童能够改善他们对能量摄入的自我调节，并保持健康的体重。

DESCRIPTION (provided by applicant): In the last three decade, there has been a marked increase in the prevalence of childhood obesity. Currently, 23% of preschoolers (2-5 years) in the United States are overweight or obese, a critical period to target in hopes of reversing this trend. Emerging consensus indicates that excessive, intrusive, overt control in feeding or a chaotic non-structured feeding environment are risk factors for childhood obesity. Targeting these behaviors has significant potential for obesity treatment. In this 3-year R03 application, we propose to investigate the efficacy of a Feeding Dynamic Intervention (FDI) for improving caregiver feeding practices, child eating behaviors, and child self-regulation of energy intake in the short term. In a pilot randomized controlled trial of 84 mothers with 3- to 5-year-old obese children, we will examine the effect of our FDI in comparison to a wait-list control group (WLG) on (i) maternal self-reported feeding practices; (ii) improving energy compensation (COMPX), decreasing Eating in the Absence of Hunger (EAH) and increasing mother-reported satiety responsiveness in their child. Finally, we will investigate an exploratory hypothesis that children in the FDI group, compared to children in the wait-list control group, will demonstrate a lower increase in body mass index (BMI) z-score over 6 months. At the completion of this study, we expect to know: (1) the effect of the FDI on maternal self- reported feeding practices for obese children; (2) the degree to which children can be taught to self-regulate their food intake via parent-directed intervention; and (3) the estimated effect size to enable us to calculate sample size requirements for a subsequent large-scale multicenter trial in an R01 application. Our long-term research goal is to develop effective and pragmatic interventions that enable children to improve their self-regulation of energy intake and maintain a healthy weight.