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Fewer Meals, Minimal Constraints on Food Choices May Benefit Obese Kids


 

INDIANAPOLIS — Obese children may eat less when offered larger, less frequent meals, Dr. Rinku Mehra reported at the annual meeting of the Midwest Society for Pediatric Research.

“The preliminary results of our study suggest that altering meal frequency affects satiety in obese children, but not in the way we had hypothesized,” Dr. Mehra said.

The researchers' hypothesis was based largely on previous studies of adults in which smaller, more frequent meals increased satiety and cut total caloric consumption. “Obese children may experience greater satiety when offered larger meals without snacks,” said Dr. Mehra of the University of Iowa Hospitals and Clinics in Iowa City.

The results of the 2-day study also suggest that the more restrictions parents place on certain foods, the more of those foods children will eat when unsupervised. In this case, the food in question was ice cream.

During the study, 18 normal weight and 8 obese children were admitted fasting to the General Clinical Research Center.

The normal children's body mass index (BMI) ranged from the 25th to the 85th percentile and produced an average BMI score of 0.31. In the obese cohort, BMIs were all greater than the 95th percentile and the average score was 2.37. The children were aged 6–10 years.

On the first day, subjects were randomly assigned to diet A (three meals and two snacks) or diet B (three meals). The energy distribution was the same in all meals: 14% from protein, 32% from fat, and 54% from carbohydrate per the current National Health and Nutrition Examination Survey guidelines for childhood reference intakes.

On the second day, they got the opposite meal pattern. At the end of each day, all the children were offered eight scoops of ice cream and were told they could eat as much as they wanted. Parents were given child feeding questionnaires (CFQs) to complete, said Dr. Mehra.

“Obese children consumed more ice cream when given frequent small meals than when given less frequent, larger meals. Despite receiving equivalent meals adjusted for energy requirements, obese children ate more ice cream than nonobese children. Also, the parents of heavier children had higher restriction scores on the CFQ than parents of normal weight children—and higher parental restriction scores, regardless of the child's weight, correlated with higher ice cream consumption,” said Dr. Mehra.

“High levels of parental control and increased restriction may influence the development of the child's self-control based on hunger and satiety cues, and less frequent meals and less parental restriction may improve satiety in obese children,” he said.

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