11 Larger Less Frequent Meals Decrease Hunger in the Pediatric Obese Population

Abstract

Childhood obesity is increasing at an alarming rate. Studies of the mechanisms of abnormal weight gain are rare in the pediatric population. Abnormal weight gain has been associated with impaired control of appetite. Studies in lean adults have demonstrated that frequent small meals may increase satiety and decrease hunger. Purpose: To examine the effect of frequent feedings of low caloric density versus less frequent feedings of high caloric density on hunger and satiety in lean and obese prepubertal children. We hypothesized that frequent low caloric density feedings should increase satiety and lead to decreased hunger. Methods: Fifteen lean and eight obese children (age 6-10) were admitted fasting to the General Clinical Research Center (GCRC) on two separate days. On each of the two study visits children were randomly assigned to receive one of two meal patterns: either 3 meals or 3 meals and 2 snacks. The total caloric intake as well as carbohydrate, protein, and fat composition on each day were identical. Each day, two hours following the last meal, subjects were offered a dessert (ice cream) and asked to consume as much as they would like (up to a predetermined upper limit). Hunger related questionnaires and amount of ice cream consumed were recorded as outcome measures of satiety. Paired t tests were used to evaluate the difference between ice cream consumption as affected by feeding patterns. Each lean and obese subject served as their own control. Data from parental questionnaires were also collected. These questionnaires assessed if restrictive feeding practices in parents were correlated to ice cream consumption in the children. Results: Preliminary results indicate that obese children consumed significantly less ice cream on the day when larger, less frequent feedings were administered (p <0.05). No difference was found between ice cream consumption and meal patterns in lean subjects. In lean subjects, a correlation (r=0.523) at a p value of 0.05 was observed between greater scores of parental restriction of food and ice cream consumption. Data from hunger questionnaires in all subjects did not reveal a significant relationship between the hunger-rating instrument used and amount of ice cream consumed. Conclusions: Our preliminary data, as opposed to our hypothesis, indicate that obese children may experience greater satiety when offered larger meals without snacks. No relationship with meal patterns and ice cream consumption was found in the lean pediatric population. In the lean group, greater parental restriction of “forbidden” food correlated with greater consumption of that food when the restriction was absent