A Feeding Dynamic Intervention for Regulation of Energy Intake

描述(申请人提供)：在过去的三十年里，儿童肥胖症的患病率有了显著的增长。目前，美国23%的学龄前儿童(2-5岁)超重或肥胖，这是希望扭转这一趋势的关键时期。新的共识表明，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风险因素。针对这些行为在肥胖症治疗方面具有巨大的潜力。在这项为期3年的R03应用中，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对能量摄入的自我调节的有效性。在一项对84名有3至5岁肥胖儿童的母亲进行的试点随机对照试验中，我们将检验我们的外国直接投资与等待名单对照组(WLG)相比在以下方面的影响：(I)母亲自我报告的喂养做法；(Ii)改善能量补偿(CompX)，减少饥饿时的进食(EAH)，以及增加母亲报告的孩子的饱腹感反应。最后，我们将调查一个探索性假设，即与等待名单控制组的儿童相比，FDI组的儿童在6个月后的身体质量指数(BMI)z得分增幅较低。在这项研究完成后，我们期望知道：(1)外国直接投资对肥胖儿童母亲自我报告的喂养行为的影响；(2)通过父母指导的干预可以在多大程度上教育儿童自我调节他们的食物摄入量；以及(3)估计的影响大小，使我们能够在R01应用中计算随后的大规模多中心试验所需的样本量。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。 公共卫生相关性：拟议的研究将测试一种创新的方法，以加强对肥胖学龄前儿童有限的现有干预，并增进我们对幼儿能量摄入量自我调节的理解。

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. PUBLIC HEALTH RELEVANCE: The proposed research will test an innovative approach to augment limited existing interventions for obese preschoolers and advance our understanding of self-regulation of energy intake among young children.