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Cluster randomized control trial promoting child self-regulation around energy-dense food.

ABSTRACT: Children with lower inhibitory control have greater weight gain over time and consume more snack food. Our goal was to test whether a pilot program based on enhancing self-regulation in preschool children could decrease consumption of energy-dense foods. Ninety-two preschool children were randomized to the intervention or control group. The intervention was a three-week, play-based program that focused on enhancing executive function skills and decreasing consumption of energy dense snack foods. Controls met for a similar length of time, but focused on dental hygiene, good sleep habits/routines, and physical activity. Primary outcome included calories consumed during the post-intervention "Eating in the Absence of Hunger" paradigm, controlling for baseline calories consumed. Inhibitory control was assessed using the "Day/Night" and "Less is More" tasks. There were no differences in post-intervention calories consumed between groups (p?=?0.42). However, post-hoc analysis revealed a significant interaction between group and weight status (p?=?0.04). In the intervention group, overweight/obese and healthy weight children consumed a similar number of calories (118.0?kcals vs. 124.1?kcals respectively, p?=?0.64). However, in the control group, overweight/obese children consumed more than normal weight children (155.9?kcals vs. 103.6?kcals respectively; p?=?0.01). With regards to inhibitory control, post-hoc analysis revealed a significant interaction between group and age (p?=?0.03), with younger children in the intervention group scoring higher than younger children in the control group (0.93 vs 0.78 respectively, p?=?0.007). No differences were observed between groups among older children (0.93 vs 0.96, p?=?0.42). These types of programs for preschool children may help to temper consumption of excess calories among overweight/obese children. Further development and investigation of pediatric programs that prevent consumption of excess calories are warranted. TRIAL REGISTRATION: Clinicaltrials.gov: NCT02077387.

SUBMITTER: Rhee KE

PROVIDER: S-EPMC6325077 | biostudies-literature | 2019 Feb

REPOSITORIES: biostudies-literature

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Cluster randomized control trial promoting child self-regulation around energy-dense food.

Rhee Kyung E KE Kessl Stephanie S Manzano Michael A MA Strong David R DR Boutelle Kerri N KN

Appetite 20181101

Children with lower inhibitory control have greater weight gain over time and consume more snack food. Our goal was to test whether a pilot program based on enhancing self-regulation in preschool children could decrease consumption of energy-dense foods. Ninety-two preschool children were randomized to the intervention or control group. The intervention was a three-week, play-based program that focused on enhancing executive function skills and decreasing consumption of energy dense snack foods. ...[more]

PMID: 30391226

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Project description:BackgroundFood-assisted maternal and child health and nutrition programs are a widely used approach to address undernutrition. Little is known about the effects of these programs' combined household and individual food rations on household and individual food consumption. Tubaramure in Burundi targeted women and children during the first 1000 d of life, and included: 1) food rations (corn-soy blend and micronutrient-fortified vegetable oil); 2) health services strengthening and promotion of their use; and 3) behavior change communication on nutrition, hygiene, and health practices.ObjectivesThe objectives were: 1) to assess Tubaramure's impact on household food consumption and food security, maternal dietary diversity, and infant and young child feeding practices; 2) to explore the role of the food rations; and 3) assess 6-8 mo impacts around 8 mo after the end of the program.MethodsWe used a 4-arm cluster-randomized controlled repeated cross-sectional design (11,906 observations). The treatment arms received the same food ration but differed in the ration timing and duration: 1) the first 1000 d; 2) from pregnancy through 17.9 mo of age; or 3) from birth through 23.9 mo of age.ResultsTubaramure significantly (P < 0.05) improved the percentage of food secure households [from 4.5 to 7.3 percentage points (pp)], and increased household energy consumption (from 17% to 20%) and micronutrient consumption. The program had a positive effect on maternal dietary diversity (+0.4 food groups, P < 0.05) and increased the proportion of children aged 6-23.9 mo consuming ≥4 food groups (from 8.0 to 9.6 pp, P < 0.05). The effects on many outcomes were attributable to the food rations. Postprogram effects (P < 0.05) were found on household food security, maternal dietary diversity, and younger sibling's complementary feeding practices.ConclusionsPrograms such as Tubaramure have the potential to improve food security and household and individual energy and micronutrient consumption in severely resource-constrained populations, as seen in rural Burundi. This trial was registered at clinicaltrials.gov as NCT01072279.

Project description:BACKGROUND/OBJECTIVE:Although reducing energy density (ED) enhances weight loss, it is unclear whether all dietary strategies that reduce ED are comparable, hindering effective ED guidelines for obesity treatment. This study examined how changes in number of low-energy-dense (LED) (<4.186?kJ/1.0?kcal?g-1) and high-energy-dense (HED) (>12.56?kJ/3.0?kcal?g-1) foods consumed affected dietary ED and weight loss within an 18-month weight loss trial. METHODS:This secondary analysis examined data from participants randomized to an energy-restricted lifestyle intervention or lifestyle intervention plus limited non-nutrient dense, energy-dense food variety (n=183). Number of daily LED and HED foods consumed was calculated from three, 24-h dietary recalls and anthropometrics were measured at 0, 6 and 18 months. Multivariable-adjusted generalized linear models and repeated-measures mixed linear models examined associations between 6-month changes in number of LED and HED foods and changes in ED, body mass index (BMI), and percent weight loss at 6 and 18 months. RESULTS:Among mostly female (58%), White (92%) participants aged 51.9 years following an energy-restricted diet, increasing number of LED foods or decreasing number of HED foods consumed was associated with 6- and 18-month reductions in ED (?=-0.25 to -0.38?kJ?g-1 (-0.06 to -0.09?kcal?g-1), P<0.001). Only increasing number of LED foods consumed was associated with 6- and 18-month reductions in BMI (?=-0.16 to -0.2?kg?m-2, P<0.05) and 6-month reductions in percent weight loss (?=-0.5%, P<0.05). Participants consuming ?2 HED foods per day and ?6.6 LED foods per day experienced better weight loss outcomes at 6- and 18-month than participants only consuming ?2 HED foods per day. CONCLUSION:Despite similar reductions in ED from reducing number of HED foods or increasing number of LED foods consumed, only increasing number of LED foods related to weight loss. This provides preliminary evidence that methods used to reduce dietary ED may differentially influence weight loss trajectories. Randomized controlled trials are needed to inform ED recommendations for weight loss.

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Cluster randomized control trial promoting child self-regulation around energy-dense food.

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Cluster randomized control trial promoting child self-regulation around energy-dense food.

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