使用行为干预以有效改善便秘儿童的膳食纤维摄入量

                                                                                             人类营养与饮食学杂志
背景：功能性便秘在儿童时期很常见;由于纤维含量不足，富裕的工业化国家的饮食可能是一个重要的促成因素。据报道，只有少数干预研究通过增加膳食纤维来治疗儿童便秘。本研究旨在证明使用专门设计的行为改变技术和自我监测和奖励系统可以增加便秘儿童的膳食纤维摄入量。方法：43名2-14岁儿童，功能性便秘（定义为每周少于3次排便，大便硬化，排便困难或延迟）被随机分配到两个治疗组之一：对照组（n = 20） ），使用干预工具接受增加膳食纤维摄入或干预（n = 23）的一般建议。使用父母填写的日记在基线和3,6和12个月评估纤维摄入量，通便使用和大便频率。结果：与标准饮食治疗相比，行为干预方法显着增加3个月便秘儿童的纤维摄入量（P = 0.005），在调整基线纤维摄入量后仍然如此（P = 0.007）。 6个月和12个月的随访显示没有进一步增加。没有显示出在减少使用泻药或增加与额外纤维摄入相关的大便频率方面的显着益处。结论：这些发现证实了儿童开始和维持高纤维饮食时遇到的困难。

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.