Combined effects of weight change trajectories and eating behaviors on childhood adiposity status: A birth cohort study
Combined effects of weight change trajectories and eating behaviors on childhood adiposity status: A birth cohort study
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体重变化轨迹和饮食行为对儿童肥胖状况的综合影响：出生队列研究
DOI：
10.1016/j.appet.2021.105174
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发表时间：
2021-02-27
期刊：
影响因子：
5.4
通讯作者：
Jiang, Fan
中科院分区：
文献类型：
--
作者：
Lin, Qingmin;Jiang, Yanrui;Jiang, Fan
以前的研究表明，婴儿体重的快速变化可能与以后生活中体重的增加有关。然而，随着时间的推移，早期生活中的体重变化轨迹以及儿童生活方式行为可能会改变体重快速变化的风险尚未得到表征。通过我们正在进行的出生队列研究，我们已经解决了这些问题。使用9个随访时间点（出生、3、6、9、12、18、24、36和48个月）计算两个相邻年龄别体重z评分之间的变化（WAZ变化），然后通过基于组的轨迹建模定义WAZ变化轨迹。WAZ变化轨迹和每个生活方式因素（饮食行为，身体活动，媒体暴露时间和总睡眠时间）对4岁时儿童肥胖测量的单独，独立和综合影响使用多变量回归分析确定。总体而言，84名（38%）儿童从出生到4岁有稳定的生长轨迹，而其他137名（62%）儿童有婴儿早期快速生长轨迹，特别是在前三个月。与生长稳定的儿童相比，婴儿早期快速生长的儿童的体重指数、腰围和皮下脂肪显著较高。此外，体重变化轨迹和三种饮食行为（即食物反应性，饱腹感反应性和食物烦躁），不仅有独立的影响，但也联合（协同）对大多数肥胖的措施。我们的研究结果扩展了现有文献，并提供了一个潜在的有价值的模型，以帮助临床医生和卫生专业人员设计针对特定人群，特定年龄和特定生活方式行为的早期干预措施，以预防儿童超重/肥胖。
Previous studies have suggested that infant rapid weight change can be associated with an increased weight later in life. However, the weight change trajectory in early life over time and which childhood lifestyle behaviors may modify the risk of rapid weight change have not been characterized. Using our ongoing birth cohort study, we have addressed these issues. Nine follow-up time points (birth, 3, 6, 9, 12, 18, 24, 36, and 48 months) were used to calculate the change between two adjacent weight-for-age z-scores (WAZ-change), and then WAZ-change trajectories were defined via group-based trajectory modeling. The solitary, independent and combined effects of WAZ-change trajectories and each lifestyle factor (eating behaviors, physical activity, media exposure time and total sleep duration) on childhood adiposity measures at age 4 years were determined using multivariate regression analysis. Overall, 84 (38%) children had a steady growth trajectory from birth to 4 years, while the other 137 (62%) children had an early infancy rapid growth trajectory, particularly in the first three months. Compared to children with steady growth, children with early infancy rapid growth had a significantly higher body mass index, waist circumference, and subcutaneous fat. Moreover, weight change trajectory and three eating behaviors (i.e. food responsiveness, satiety responsiveness and food fussiness), not only had independent effects, but also combined (synergistic) effects on the majority of adiposity measures. Our results extend the current literature and provide a potentially valuable model to aid clinicians and health professionals in designing early-life interventions targeting specific populations, specific ages and specific lifestyle behaviors to prevent childhood overweight/obesity.