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Picky eating in an obesity intervention for preschool-aged children - what role does it play, and does the measurement instrument matter?
International Journal of Behavioral Nutrition and Physical Activity ( IF 8.7 ) Pub Date : 2019-09-03 , DOI: 10.1186/s12966-019-0845-y
Pernilla Sandvik 1 , Anna Ek 2 , Karin Eli 3, 4 , Maria Somaraki 1 , Matteo Bottai 5 , Paulina Nowicka 1, 2
Affiliation  

INTRODUCTION Research on picky eating in childhood obesity treatment is limited and inconsistent, with various instruments and questions used. This study examines the role of picky eating in a randomized controlled obesity intervention for preschoolers using subscales from two instruments: The Child Eating Behavior Questionnaire (CEBQ) and the Lifestyle Behavior Checklist (LBC). METHOD The study includes 130 children (mean age 5.2 years (SD 0.7), 54% girls, mean Body Mass Index (BMI) z-score 2.9 (SD 0.6)) and their parents (nearly 60% of non-Swedish background, 40% with university degree). Families were randomized to a parent-group treatment focusing on evidence-based parenting practices or to standard treatment focusing on lifestyle changes. The children's heights and weights (BMI z-score) were measured at baseline, and at 3, 6 and 12 months post baseline. At these time-points, picky eating was reported by parents using the CEBQ (Food Fussiness scale, 6 items) and 5 items from the LBC. Child food intake was reported with a Food Frequency Questionnaire (FFQ). Pearson correlation was used to study associations between baseline picky eating and baseline BMI z-scores and food intake. Mixed effects models were used to study associations between the two measurements of picky eating and changes in picky eating, to assess the effects of changes in picky eating on BMI z-scores, and to evaluate baseline picky eating as a predictor of changes in BMI z-scores. RESULTS Neither the standard treatment nor the parent-group treatment reduced the degree of picky eating (measured with CEBQ or LBC). Baseline picky eating measured with the CEBQ was associated with a lower BMI z-score and lower intake of vegetables. Children with a higher degree of picky eating at baseline (measured with the CEBQ) displayed a lower degree of weight loss. When degree of picky eating was examined, for 25% of the children, the CEBQ and the LBC yielded diverging results. CONCLUSIONS Baseline picky eating may weaken the effectiveness of obesity treatment, and assessments should be conducted before treatment to adjust the treatment approach. Different measurements of picky eating may lead to different results. The CEBQ seems more robust than the LBC in measuring picky eating. TRIAL REGISTRATION Clinicaltrials.gov , NCT01792531. Registered 15 February 2013 - Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT01792531.

中文翻译:

在肥胖干预中对学龄前儿童进行挑剔的饮食-它起着什么作用,并且测量仪器重要吗?

引言在儿童肥胖治疗中对挑食的研究是有限且不一致的,使用了各种手段和问题。这项研究使用两种工具的分量表,对学龄前儿童在随机控制的肥胖干预中挑食的作用进行了研究:儿童饮食行为问卷(CEBQ)和生活方式行为清单(LBC)。方法该研究包括130名儿童(平均年龄5.2岁(SD 0.7),54%的女孩,平均身体质量指数(BMI)z得分2.9(SD 0.6))及其父母(近60%的非瑞典背景,40岁) %(拥有大学学位)。家庭被随机分配到以循证育儿实践为重点的父母组治疗或以生活方式改变为中心的标准治疗。在基线和3岁时测量孩子的身高和体重(BMI z评分),基线后6个月和12个月。在这些时间点,家长报告了使用CEBQ(食品简易量表,6项)和LBC的5项进行挑食。通过食物频率问卷(FFQ)报告了儿童食物摄入量。皮尔逊相关性用于研究基线挑食和基线BMI z得分与食物摄入量之间的关联。混合效应模型用于研究两次进食量与进食量变化之间的关联,评估进食量变化对BMI z评分的影响,并评估基线进食量作为BMI z变化的预测指标得分。结果标准治疗和父母组治疗均未减少挑食的程度(以CEBQ或LBC衡量)。用CEBQ进行基线挑食与较低的BMI z评分和较低的蔬菜摄入量相关。基线时挑剔饮食较高的儿童(用CEBQ测量)体重减轻程度较低。当检查挑食的程度时,对于25%的孩子,CEBQ和LBC产生了分歧的结果。结论基线挑食可能会削弱肥胖治疗的有效性,应在治疗前进行评估以调整治疗方法。挑食的不同测量可能会导致不同的结果。在衡量挑剔饮食方面,CEBQ似乎比LBC更强大。试验注册Clinicaltrials.gov,NCT01792531。2013年2月15日注册-追溯注册,https://clinicaltrials.gov/ct2/show/NCT01792531。基线时挑剔饮食较高的儿童(用CEBQ测量)体重减轻程度较低。当检查挑食的程度时,对于25%的孩子,CEBQ和LBC产生了分歧的结果。结论基线挑食可能会削弱肥胖治疗的有效性,应在治疗前进行评估以调整治疗方法。挑食的不同测量可能会导致不同的结果。在衡量挑剔饮食方面,CEBQ似乎比LBC更强大。试验注册Clinicaltrials.gov,NCT01792531。2013年2月15日注册-追溯注册,https://clinicaltrials.gov/ct2/show/NCT01792531。基线时挑剔饮食较高的儿童(用CEBQ测量)体重减轻程度较低。当检查挑食的程度时,对于25%的孩子,CEBQ和LBC产生了分歧的结果。结论基线挑食可能会削弱肥胖治疗的有效性,应在治疗前进行评估以调整治疗方法。挑食的不同测量可能会导致不同的结果。在衡量挑剔饮食方面,CEBQ似乎比LBC更强大。试验注册Clinicaltrials.gov,NCT01792531。2013年2月15日注册-追溯注册,https://clinicaltrials.gov/ct2/show/NCT01792531。当检查挑食的程度时,对于25%的孩子,CEBQ和LBC产生了分歧的结果。结论基线挑食可能会削弱肥胖治疗的有效性,应在治疗前进行评估以调整治疗方法。挑食的不同测量可能会导致不同的结果。在衡量挑剔饮食方面,CEBQ似乎比LBC更强大。试验注册Clinicaltrials.gov,NCT01792531。2013年2月15日注册-追溯注册,https://clinicaltrials.gov/ct2/show/NCT01792531。当检查挑食的程度时,对于25%的孩子,CEBQ和LBC产生了分歧的结果。结论基线挑食可能会削弱肥胖治疗的有效性,应在治疗前进行评估以调整治疗方法。挑食的不同测量可能会导致不同的结果。在衡量挑剔饮食方面,CEBQ似乎比LBC更强大。试验注册Clinicaltrials.gov,NCT01792531。2013年2月15日注册-追溯注册,https://clinicaltrials.gov/ct2/show/NCT01792531。挑食的不同测量可能会导致不同的结果。在衡量挑剔饮食方面,CEBQ似乎比LBC更强大。试验注册Clinicaltrials.gov,NCT01792531。2013年2月15日注册-追溯注册,https://clinicaltrials.gov/ct2/show/NCT01792531。挑食的不同测量可能会导致不同的结果。在衡量挑剔饮食方面,CEBQ似乎比LBC更强大。试验注册Clinicaltrials.gov,NCT01792531。2013年2月15日注册-追溯注册,https://clinicaltrials.gov/ct2/show/NCT01792531。
更新日期:2019-09-03
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