دورية أكاديمية
Intermittent Energy Restriction for Adolescents With Obesity: The Fast Track to Health Randomized Clinical Trial.
| العنوان: | Intermittent Energy Restriction for Adolescents With Obesity: The Fast Track to Health Randomized Clinical Trial. |
|---|---|
| المؤلفون: | Lister NB; Faculty of Medicine and Health, Sydney Medical School, The University of Sydney, Westmead, New South Wales, Australia.; Institute of Endocrinology and Diabetes, The Children's Hospital at Westmead, Westmead, New South Wales, Australia., Baur LA; Faculty of Medicine and Health, Sydney Medical School, The University of Sydney, Westmead, New South Wales, Australia.; Weight Management Services, The Children's Hospital at Westmead, Westmead, New South Wales, Australia., House ET; Faculty of Medicine and Health, Sydney Medical School, The University of Sydney, Westmead, New South Wales, Australia.; Institute of Endocrinology and Diabetes, The Children's Hospital at Westmead, Westmead, New South Wales, Australia., Alexander S; Weight Management Services, The Children's Hospital at Westmead, Westmead, New South Wales, Australia., Brown J; Department of Paediatric Endocrinology and Diabetes, Monash Children's Hospital, Clayton, Victoria, Australia.; Department of Paediatrics, Monash University, Clayton, Victoria, Australia., Collins CE; School of Health Sciences, College of Health, Medicine and Wellbeing, The University of Newcastle, Callaghan, New South Wales, Australia.; Food and Nutrition Research Program, Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia., Cowell CT; Faculty of Medicine and Health, Sydney Medical School, The University of Sydney, Westmead, New South Wales, Australia.; Kids Research, The Children's Hospital at Westmead, Westmead, New South Wales, Australia., Day K; School of Agriculture, Food and Ecosystem Sciences, The University of Melbourne, Melbourne, Victoria, Australia.; Department of Nutrition, Dietetics & Food, Monash University, Melbourne, Victoria, Australia., Garnett SP; Faculty of Medicine and Health, Sydney Medical School, The University of Sydney, Westmead, New South Wales, Australia.; Kids Research, The Children's Hospital at Westmead, Westmead, New South Wales, Australia., Gow ML; Faculty of Medicine and Health, Sydney Medical School, The University of Sydney, Westmead, New South Wales, Australia., Grunseit AM; Department of Nutrition and Dietetics, The Children's Hospital at Westmead, Westmead, New South Wales, Australia., Henderson M; Institute of Endocrinology and Diabetes, The Children's Hospital at Westmead, Westmead, New South Wales, Australia., Inkster MK; Department of Paediatric Endocrinology and Diabetes, Monash Children's Hospital, Clayton, Victoria, Australia.; Department of Nutrition, Dietetics & Food, Monash University, Melbourne, Victoria, Australia., Kwok C; Faculty of Medicine and Health, Sydney Medical School, The University of Sydney, Westmead, New South Wales, Australia.; Weight Management Services, The Children's Hospital at Westmead, Westmead, New South Wales, Australia., Lang S; Department of Nutrition, Dietetics & Food, Monash University, Melbourne, Victoria, Australia., Paxton SJ; School of Psychology and Public Health, La Trobe University, Melbourne, Victoria, Australia., Truby H; School of Primary and Allied Health Care, Monash University, Victoria, Australia.; School of Human Movement and Nutrition Sciences, University of Queensland, Queensland, Australia., Varady KA; Department of Kinesiology and Nutrition, University of Illinois, Chicago., Jebeile H; Faculty of Medicine and Health, Sydney Medical School, The University of Sydney, Westmead, New South Wales, Australia.; Institute of Endocrinology and Diabetes, The Children's Hospital at Westmead, Westmead, New South Wales, Australia. |
| المصدر: | JAMA pediatrics [JAMA Pediatr] 2024 Aug 26. Date of Electronic Publication: 2024 Aug 26. |
| Publication Model: | Ahead of Print |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: American Medical Association Country of Publication: United States NLM ID: 101589544 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 2168-6211 (Electronic) Linking ISSN: 21686203 NLM ISO Abbreviation: JAMA Pediatr Subsets: MEDLINE |
| أسماء مطبوعة: | Original Publication: Chicago, IL : American Medical Association, [2013]- |
| مستخلص: | Importance: Adolescent obesity requires effective and accessible treatment. Intensive dietary interventions have the potential to be used as adjunctive therapy for behavioral weight management. Objective: To examine the effectiveness of 2 diet therapies, delivered as part of an intensive behavioral weight management intervention, in adolescents with metabolic complications associated with obesity. Design, Setting, and Participants: This multisite, 52-week randomized clinical trial was conducted from January 31, 2018, to March 31, 2023, at 2 tertiary pediatric centers in Australia. Adolescents (aged 13-17 years) with obesity and 1 or more associated complications were included. Interventions: Intensive behavioral interventions, delivered by a multidisciplinary team, comparing intermittent energy restriction (IER) or continuous energy restriction (CER), with 3 phases: very low-energy diet (weeks 0-4), intensive intervention (weeks 5-16), and continued intervention and/or maintenance (weeks 17-52). Main Outcomes and Measures: The primary outcome was body mass index (BMI) z score at 52 weeks in the IER vs CER group. Anthropometry, body composition, and cardiometabolic health were assessed at baseline and 52 weeks. The BMI z score and percentiles were determined using Centers for Disease Control and Prevention growth charts. Insulin resistance, dyslipidemia, and elevated hepatic function were assessed. Results: A total of 141 adolescents (median [IQR] age, 14.8 [12.9-17.9] years; 71 male [50.4%]) were enrolled, 71 in the IER group and 70 in the CER group, and 97 (68.8%) completed the intervention, 43 in the IER group and 54 in the CER group. At week 52, both groups had reduced BMI z scores (estimated marginal mean change, -0.28 [95% CI, -0.37 to -0.20] for IER and -0.28 [95% CI, -0.36 to -0.20] for CER) and reduced BMI expressed as a percentage of the 95th percentile (estimated marginal mean change, -9.56 [95% CI, -12.36 to -6.83] for IER and -9.23 [95% CI, -11.82 to -6.64] for CER). No differences were found in body composition or cardiometabolic outcomes between the groups. Both groups had a reduction in the occurrence of insulin resistance (from 52 of 68 [76.5%] to 32 of 56 [57.1%] in the IER group and from 59 of 68 [86.8%] to 31 of 60 [57.1%] in the CER group) at week 16; however, at week 52, this effect was observed in the CER group only (from 59 of 68 [86.7%] to 30 of 49 [61.2%]). The occurrence of dyslipidemia was unchanged between baseline and week 52 (60 of 137 [42.6%] and 37 of 87 [42.5%], respectively), with a small improvement in occurrence of impaired hepatic function tests (37 of 139 [27.0%] and 15 of 87 [17.2%], respectively). No differences were found in dyslipidemia or hepatic function between groups. Conclusions and Relevance: These findings suggest that for adolescents with obesity-associated complications, IER can be incorporated into a behavioral weight management program, providing an option in addition to CER and offering participants more choice. Trial Registration: http://anzctr.org.au Identifier: ACTRN12617001630303. |
| References: | Gastroenterology. 2007 Dec;133(6):1814-20. (PMID: 18054554) Obes Rev. 2019 Jun;20(6):871-882. (PMID: 30734459) J Intern Med. 2022 Dec;292(6):870-891. (PMID: 35883220) Pediatrics. 2016 Feb;137(2):e20151766. (PMID: 26817935) Diabetes Care. 2014 Jan;37 Suppl 1:S81-90. (PMID: 24357215) Can Fam Physician. 2020 Feb;66(2):117-125. (PMID: 32060194) Behav Sci (Basel). 2019 Dec 07;9(12):. (PMID: 31817943) Nat Rev Endocrinol. 2018 Jun;14(6):331-344. (PMID: 29654249) J Pharmacol Pharmacother. 2010 Jul;1(2):100-7. (PMID: 21350618) JAMA. 2023 Jun 13;329(22):1947-1956. (PMID: 37314275) Pediatr Obes. 2012 Aug;7(4):284-94. (PMID: 22715120) BMJ. 2020 Dec 23;371:m4910. (PMID: 33361106) Obes Rev. 2023 May;24(5):e13550. (PMID: 36721999) Int J Behav Nutr Phys Act. 2016 Apr 01;13:43. (PMID: 27036113) Int J Eat Disord. 1994 Dec;16(4):363-70. (PMID: 7866415) J Pediatr. 2019 May;208:57-65.e4. (PMID: 30853195) N Engl J Med. 2022 Dec 15;387(24):2245-2257. (PMID: 36322838) J Clin Endocrinol Metab. 2023 Aug 18;108(9):2184-2192. (PMID: 36947630) JBI Database System Rev Implement Rep. 2018 Feb;16(2):507-547. (PMID: 29419624) Nutrients. 2022 Jul 14;14(14):. (PMID: 35889853) Am J Clin Nutr. 2009 Nov;90(5):1314-20. (PMID: 19776142) Nat Rev Dis Primers. 2023 May 18;9(1):24. (PMID: 37202378) Pediatrics. 2023 Feb 1;151(2):. (PMID: 36622115) Child Obes. 2017 Feb;13(1):9-17. (PMID: 27732057) Diabetes Care. 2004 Feb;27(2):314-9. (PMID: 14747206) Am J Clin Nutr. 2007 Jul;86(1):7-13. (PMID: 17616757) Lancet Child Adolesc Health. 2020 Mar;4(3):210-219. (PMID: 31978372) J Affect Disord. 2014 Apr;158:154-60. (PMID: 24655780) Obes Rev. 2021 Jan;22(1):e13132. (PMID: 32896058) J Nutr. 2019 Jul 1;149(7):1189-1197. (PMID: 31006807) J Clin Endocrinol Metab. 2013 May;98(5):2116-25. (PMID: 23533232) Cochrane Database Syst Rev. 2017 Jun 22;6:CD012691. (PMID: 28639320) Ann Pediatr Endocrinol Metab. 2015 Sep;20(3):125-9. (PMID: 26512347) Child Obes. 2021 Sep;17(6):420-426. (PMID: 33978453) Pediatr Obes. 2021 Sep;16(9):e12798. (PMID: 33955208) JAMA Pediatr. 2024 Aug 26;:. (PMID: 39186289) Hypertension. 2023 Jun;80(6):e101-e111. (PMID: 36994715) Obes Res Clin Pract. 2020 Jan - Feb;14(1):80-90. (PMID: 31818675) Clin Obes. 2023 Apr;13(2):e12567. (PMID: 36370062) |
| تواريخ الأحداث: | Date Created: 20240826 Latest Revision: 20240829 |
| رمز التحديث: | 20240830 |
| مُعرف محوري في PubMed: | PMC11348084 |
| DOI: | 10.1001/jamapediatrics.2024.2869 |
| PMID: | 39186288 |
| قاعدة البيانات: | MEDLINE |
| تدمد: | 2168-6211 |
|---|---|
| DOI: | 10.1001/jamapediatrics.2024.2869 |