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

Abstract

Objective: 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. Methods: 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. Results: 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. Conclusions: Slower eating may be a novel target for family-based obesity prevention targeting high-risk children.

Combined Impact of a Faster Self-Reported Eating Rate and Higher Dietary Energy Intake Rate on Energy Intake and Adiposity

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A Biopsychosocial Model of Sex Differences in Children’s Eating Behaviors

“…Although not specifically related to the ability to regulate food intake, some investigators have referred to eating behaviors that make up meal microstructure (e.g., bite rate, eating rate, and bite size) as indicators of satiety responsiveness [91]. Of these characteristics, eating rate has been most consistently associated with weight status in adults [92] and children [93], and is therefore a target for interventions to treat obesity [94]. Observational coding of meal-time behaviors in the GUSTO cohort from Singapore showed that male children have faster eating rate (g/min), larger bite size (g/bite), and shorter oral exposure (min) than female children [95].…”

Mobile Health Apps in Pediatric Obesity Treatment: Process Outcomes From a Feasibility Study of a Multicomponent Intervention

“…A recent review appraised a number of commercial apps targeting appetite regulation [ 17 ]. Research-driven interventions include real-time technology-assisted tools for meal times, including utensils with vibrotactile feedback [ 12 , 14 ] and Mandolean, a plate scale measuring eating rate with real-time computer or smartphone feedback [ 13 , 15 , 16 ]. Mandolean has shown promise for the treatment of childhood obesity [ 16 ].…”