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Observations

Opinion, arguments & analyses from the editors of Scientific American

A device that curbs speed eating could help obese children and adolescents cut the fat

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Wolfing down a meal in record time can lead to more than digestive discomfort and possible acclaim in food-eating contests. Studies have warned that speed eaters can easily become overeaters, possibly because they lose track of how sated they are amidst hurried bites. Moreover, the pattern of consuming large portions of food quickly is associated with obesity in children, adolescents and adults. 


Researchers in Bristol, England, sought to break this pattern in children and adolescents using a machine dubbed the Mandometer, which is designed to manage the pace of meals. The device features a computerized scale that calculates the rate of food intake and, like a hovering mother, constantly reminds the user if he or she should eat slower or faster. The device, first developed to help treat anorexia and bulimia nervosa, actually issues verbal feedback.


In a study published January 5 in the British Medical Journal, participants who received Mandometer assistance for one year lost significantly more body mass index (BMI), which is a measure of weight based on height, than those who did not. In fact, the Mandometer group, but not the control group, achieved the reduction in BMI that the authors had previously determined was necessary to lead to a difference in body composition and metabolism.


The finding suggests that "modifying eating behavior might provide additional benefits to standard lifestyle modification in treating obese adolescents," the authors wrote, noting that adolescents have been more difficult to treat for obesity through counseling than younger children. The study was led by Julian P.H. Shield, a professor of diabetes and metabolic endocrinology at the University of Bristol. 


To test the merits of the Mandometer, Shield's group worked with a group of 106 obese pre-adolescents and adolescents, from 9 to 17 {sorry, this was dyslexia on my part mixing up "9 to 17" with "7 to 19"}  years of age. The researchers factored into their analysis the pubertal stage of the participants, which ranged from pre-puberty to post-puberty. All participants saw a dietician at the beginning of the study, as well as a dietitian and exercise specialist every four months during the 12-month trial. Fifty-four of the participants were randomly selected to incorporate the Mandometer into their dietary regime. The researchers measured subjects' BMI, eating pattern and cholesterol levels at the beginning and end of the one-year trial and six months after the trial ended.


The researchers asked the Mandometer group to use the devise for one meal a day, which usually ended up being dinner. "Eating meals at school had proved difficult for some participants for practical or personal…reasons," the authors wrote.  For this meal, subjects ate from a plate that was on a scale that was, in turn, attached to a computer. During the session, the Mandometer would measure the amount of food eaten, based on the weight of the plate. The computer plotted these numbers on the y-axis of a graph, and the time of food consumption, in minutes, on the x-axis. The computer voice prompted the eater to slow down when the resulting line on the graph started to veer from what had been entered into the computer as the normal eating rate. (Although in this experiment the computer voice reminded the user to slow down, previous studies used the "speed up" prompt to encourage anorexic patients to eat.) In addition, the computer asked the participant to rate his or her satiety at regular intervals during the meal.


At the outset of the trial, all of the participants had a BMI that was at least three standard deviations above the healthy range. Shield's group determined this difference—also expressed as BMI standard deviation score, or BMI SDS—by comparing the participants' BMIs to those of healthy children of similar age and height. At the end of the trial and at the six-month follow-up, the group found that the BMS SDS of the Mandometer group had shifted closer, by 0.4 standard deviations, to the healthy BMI range than the control group, which shifted 0.14 standard deviations. Doctors usually start to see an improvement in blood pressure and cholesterol in obese patients after they have shifted by at least 0.25 standard deviations. Although blood pressure, "bad" cholesterol levels and insulin metabolism actually improved for both groups, the level of "good" cholesterol rose only in the Mandometer group.


Given that participants who had a Mandometer "eating companion" lost more weight than those that did not, it would make sense that the success was due to a slower eating pace, the authors wrote. Although eating pace dropped 11 percent among Mandometer users compared with a 4 percent increase in the control group over the course of the study period, the difference was not great enough to be considered statistically significant. In addition, participants using the device felt sated after consuming smaller portions, although this effect was lost after six months of not using the Mandometer. This result "suggests that intermittent short periods of retraining [with the Mandometer] might be necessary to maintain maximum benefits," the authors wrote.


The drop in BMI SDS of 0.4 among pre-adolescents and adolescents using the Mandometer is greater than the BMI SDS reduction of 0.3 that is achieved in younger obese children through counseling, the authors wrote. They also point out that the device should also be tested on adults and younger children. And, because regulating food consumption is important following laparoscopic gastric banding (surgery aimed at countering obesity), the Mandometer could prove useful to help people moderate how fast they eat following this surgery.

   

Image courtesy of iStockphoto/keeweeboy

The views expressed are those of the author and are not necessarily those of Scientific American.

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