A longitudinal study of eating behaviours in childhood and later eating disorder behaviours and diagnoses
A longitudinal study of eating behaviours in childhood and later eating disorder behaviours and diagnoses
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DOI：
10.1192/bjp.2019.174
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发表时间：
2020-02-01
影响因子：
10.5
通讯作者：
Micali, Nadia
中科院分区：
文献类型：
--
作者：
Herle, Moritz;De Stavola, Bianca;Micali, Nadia
背景 儿童时期的饮食行为被认为是青春期饮食失调行为和诊断的危险因素。然而，很少有纵向研究检验了这种关联。目标 我们调查了生命前 10 年的儿童饮食行为与 16 岁时饮食失调行为（暴食、清除、禁食和过度运动）和诊断（神经性厌食症、暴食症、清除障碍和神经性贪食症）之间的关联。方法 纳入了来自雅芳家长和儿童纵向研究的 4760 名参与者的数据。父母评价的儿童饮食行为的纵向轨迹（8个时间点，1.3-9岁）是通过潜在阶级增长分析得出的。饮食失调的诊断来自于 16 岁时自我报告、父母报告和客观测量的人体测量数据。我们使用多变量逻辑回归模型估计了儿童饮食行为与饮食失调行为和诊断之间的关联。结果 儿童期暴饮暴食与青少年暴食（风险差异，7%；95% CI 2 至 12）和暴食障碍（风险差异，1%；95% CI 0.2 至 3）的风险增加相关。仅在青春期女孩中，持续饮食不足与较高的神经性厌食症风险相关（风险差异，6%；95% CI，0 至 12）。持续挑食与较高的神经性厌食症风险相关（风险差异为 2%；95% CI 0 至 4）。结论 我们的结果表明，从生命早期到青春期，饮食行为对饮食失调具有连续性。儿童饮食行为是否是特定表型的早期表现，或者这种连续性背后的机制是否更为复杂，仍有待确定。研究结果有可能为饮食失调的预防策略提供信息。
Background Eating behaviours in childhood are considered as risk factors for eating disorder behaviours and diagnoses in adolescence. However, few longitudinal studies have examined this association. Aims We investigated associations between childhood eating behaviours during the first ten years of life and eating disorder behaviours (binge eating, purging, fasting and excessive exercise) and diagnoses (anorexia nervosa, binge eating disorder, purging disorder and bulimia nervosa) at 16 years. Method Data on 4760 participants from the Avon Longitudinal Study of Parents and Children were included. Longitudinal trajectories of parent-rated childhood eating behaviours (8 time points, 1.3-9 years) were derived by latent class growth analyses. Eating disorder diagnoses were derived from self-reported, parent-reported and objectively measured anthropometric data at age 16 years. We estimated associations between childhood eating behaviours and eating disorder behaviours and diagnoses, using multivariable logistic regression models. Results Childhood overeating was associated with increased risk of adolescent binge eating (risk difference, 7%; 95% CI 2 to 12) and binge eating disorder (risk difference, 1%; 95% CI 0.2 to 3). Persistent undereating was associated with higher anorexia nervosa risk in adolescent girls only (risk difference, 6%; 95% CI, 0 to 12). Persistent fussy eating was associated with greater anorexia nervosa risk (risk difference, 2%; 95% CI 0 to 4). Conclusions Our results suggest continuities of eating behaviours into eating disorders from early life to adolescence. It remains to be determined whether childhood eating behaviours are an early manifestation of a specific phenotype or whether the mechanisms underlying this continuity are more complex. Findings have the potential to inform preventative strategies for eating disorders.