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使用行為干預(yù)以有效改善便秘兒童的膳食纖維攝入量

                                                                                             人類營養(yǎng)與飲食學(xué)雜志
背景：功能性便秘在兒童時期很常見;由于纖維含量不足，富裕的工業(yè)化國家的飲食可能是一個重要的促成因素。據(jù)報道，只有少數(shù)干預(yù)研究通過增加膳食纖維來治療兒童便秘。本研究旨在證明使用專門設(shè)計的行為改變技術(shù)和自我監(jiān)測和獎勵系統(tǒng)可以增加便秘兒童的膳食纖維攝入量。方法：43名2-14歲兒童，功能性便秘（定義為每周少于3次排便，大便硬化，排便困難或延遲）被隨機(jī)分配到兩個治療組之一：對照組（n = 20） ），使用干預(yù)工具接受增加膳食纖維攝入或干預(yù)（n = 23）的一般建議。使用父母填寫的日記在基線和3,6和12個月評估纖維攝入量，通便使用和大便頻率。結(jié)果：與標(biāo)準(zhǔn)飲食治療相比，行為干預(yù)方法顯著增加3個月便秘兒童的纖維攝入量（P = 0.005），在調(diào)整基線纖維攝入量后仍然如此（P = 0.007）。 6個月和12個月的隨訪顯示沒有進(jìn)一步增加。沒有顯示出在減少使用瀉藥或增加與額外纖維攝入相關(guān)的大便頻率方面的顯著益處。結(jié)論：這些發(fā)現(xiàn)證實了兒童開始和維持高纖維飲食時遇到的困難。

Effectiveness of using a behavioural intervention to improve dietary fibre intakes in children with constipation

                                                                    P. B. Sullivan,N. Alder,B. Shrestha, et al. 2012,25(1):33-42.
                                                                                 DOI: 10.1111/j.1365-277X.2011.01179.x

                                                                              Journal of Human Nutrition and Dietetics

　 　Background: Functional constipation is common in childhood; diets in affluent industrialised countries may be a significant contributory factor as a result of inadequate fibre content. Only a few intervention studies have been reported where childhood constipation has been treated by increasing dietary fibre. The present study aimed to demonstrate that dietary fibre intakes of children with constipation can be increased using a specifically-designed behaviour modification technique with a self-monitoring and reward system. Methods:  Forty-three children, aged 2–14 years, with functional constipation (defined as less than three bowel movements per week with hard stools and difficulty or delay in defecation) were randomised to one of two treatment groups: Control (n = 20), receiving general advice on increasing dietary fibre intake, or Intervention (n = 23), using the intervention tool. Fibre intake, laxative use and stool frequency were assessed at baseline, and at 3, 6 and 12 months, using parent-filled diaries. Results:  A behavioural intervention method significantly increases the fibre intakes of children with constipation at 3 months compared to standard dietary treatment (P = 0.005), remaining so after adjusting for baseline fibre intake (P = 0.007). Follow-up at 6 and 12 months showed no further increase. No significant benefit in terms of a reduction in laxative use or increased stool frequency associated with additional fibre intake was demonstrated. Conclusions:  The findings confirm the difficulties encountered in beginning and maintaining high-fibre diets in children.