Influência do uso de distratores durante as refeições na ingestão calórica de crianças e adolescentes: revisão sistemática e meta-análise de ensaios controlados com intervenção

Abstract

Unhealthy eating habits developed during childhood can be perpetuated along life and contribute to the emergence of eating disorders. We aimed to systematically review the influence of distractors during meals on the caloric intake of children and adolescents. We followed the PRISMA guidelines (Preferred Reporting Items for Systematic Review and Meta-Analysis) and the study was registered in the International Prospective Register of Systematic Reviews (PROSPERO CRD42021259946). The PICOS strategy consisted of children and adolescents (P), exposed to distractors during meals (I), compared with no distraction (C) and the outcome was caloric ingestion (O) evaluated by means of crossover or randomized clinical trials (RCTs) (S). Searches were conducted in PubMed, Scopus, Web of Science, Cochrane, Proquest, Embase, and LILACs databases. We employed the Risk of Bias 2 (RoB 2) tool. The level of evidence was determined by the Grading of Recommendations Assessment, Development and Evaluation (GRADE). Databases searches returned 9,576 references (without duplicates). Thirteen articles were selected based on eligibility criteria, being five crossover and eight RCT. Volunteers aged from 3 to 17 years-old. All studies evaluated TV as distractor, but two articles also evaluated music and eating in groups. Most studies presented high to moderate risk of bias. In the qualitative analysis, eight studies (61%) indicated no influence of distractors on caloric ingestion, while three found an increase (23%). Meta-analysis of RCT also indicated no significant difference in caloric ingestion while eating with TV (MD=0.05; 95% CI -0.13 – 0.23, P=0.57), but the level of certainty was low. In conclusion, under laboratory conditions, eating with distractors seems to barely alter the caloric ingestion for children and adolescents.