Reduced Eating Pace (RePace) Behavioral Intervention for Children Prone to or with Obesity: Does the Turtle Win the Race?

Abstract

Rapid eating is a risk factor for childhood obesity but has not been a focus of intervention with young children. The short-term effects of a novel family-based treatment, "Reduced Eating Pace" (RePace), were tested on child eating speed and secondary outcomes. Twenty-eight rapid eating children were randomized to RePace (n =14) or Delayed Usual Care Control (DUC) (n =14). RePace taught families a slower eating pace using psychoeducational and behavioral techniques, including silent vibrating devices that prompted 30-second "turtle bites." Outcomes included child "slowness in eating" assessed by parent-report questionnaire and observed eating in the laboratory (i.e., mouthfuls/minute and kilocalories/minute). Child BMI and other eating variables were secondary outcomes. Children in RePace compared with DUC showed increased "slowness in eating" (P < 0.001), increased food enjoyment (P =0.04), and less BMI gain (P =0.02) after 8 weeks. There was no treatment effect for observed eating speed, although typicality of the laboratory test meal was an effect modifier in exploratory analyses. Specifically, RePace versus DUC showed attenuated increases in mouthfuls per minute over time among youth for whom the laboratory food amount was more typical of amounts served at home. Slower eating may be a novel target for family-based obesity prevention targeting high-risk children.