IHMP decreases energy intake by 20% - 25% of ad libitum value (baseline) in 7-day home diary of food intake. The decrease is explained by 16% decrease in energy expenditure and 4% decrease in fecal energy emission.

RESTING METABOLIC RATE (RMR) AFTER INTERNAL HUNGER VS. AFTER ‘AD LIBITUM’ MEAL. M. Ciampolini, G. Fognani, M. Cavuta, B. de Pont, And W. de Haan. Dept. Pediatrics, Meyer Hospital 50132 Firenze, Italy, & AMC, 1100 DD Amsterdam, The Nederlands. Appetite 1999; 33: 237 (abstract). .(Link to the Summary)

Administration of enough energy-dense food with fruit and vegetables for maintenance of satiety between meals, avoidance of snacks, of over-heating and over-clothing and increase of outdoors activity planned emergence of manifestation of ‘internal hunger-onset’ by infants at mealtimes. The meal was planned again at subsequent mealtimes and given in abundant, scarce or null amount on the basis of this manifestation. This feeding is associated with 25% decrease in energy intake. The decrease is partly explained by decrease in fecal energy emission. RMR under this intervention might be lower than under ‘ad libitum’ eating. 16 healthy infants in the second year of life were recruited from free-living subjects willing for acquiring subjective improvements in health. Assessments were made at baseline and after 50 days. 7-day home diaries were reported. RMR was measured in the sleeping infant by indirect calorimetry (deltatrac II monitor, Datex Italiana, Milano) four hours after lunch. Body weight increased from 11.0 ± 2.6 to 11.2 kg (P = 0.07). Energy intake decreased from 882 ± 283kcal/d to 763 ± 127kcal/d (- 13.5%, P = 0.02). RMR after the ‘ad libitum’ offered lunch was 658 ± 124kcal/d, and 551 ± 115kcal/d (- 16.3%, P = 0.0001) after the lunch requested by the child with internal-hunger manifestation. Free choice of food type was maintained under intervention, except for planned limits in energy, and abundant vegetables. None of the subjects showed any deterioration in inter-meal behavior, or physical performances. This planning increased the correlation between energy intake and insulin sensitivity in our findings, and might serve to prevent overfeeding.