Bidirectional association between parental child-feeding practices and body mass index at 4 and 7 y of age
Bidirectional association between parental child-feeding practices and body mass index at 4 and 7 y of age
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DOI：
10.3945/ajcn.115.120824
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发表时间：
2016-03-01
影响因子：
7.1
通讯作者：
Oliveira, Andreia
中科院分区：
文献类型：
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作者：
Afonso, Lisa;Lopes, Carla;Oliveira, Andreia
工作背景：父母的喂养习惯和儿童的身体质量指数（BMI）之间的关联的证据是有争议的，双向效应已经很少研究。目的：我们的目的是检查父母的喂养习惯和BMI之间的双向关联在4岁和7岁。设计：这项研究包括3708名来自第二十一代出生队列的单胎儿童，这些儿童的父母喂养方式和4岁和7岁时的BMI数据。喂养的做法进行了评估，通过自我管理的问卷调查相结合的儿童喂养问卷和显性/隐性控制规模，然后将其调整到葡萄牙学龄前儿童。根据标准化程序测量体重和身高，并根据WHO生长参考值计算年龄和性别特异性BMI z评分。使用线性回归模型来估计每种做法和BMI z评分之间的双向关联。进行交叉标记分析以比较这些关联的方向结果：调整后，4岁时的进食压力和明显的控制与3年后较低的BMI z评分相关（β：-0.05; 95%CI：-0.08，-0.03和β：-0.05; 95%CI：-0.09，-0.01）。关于相反的关联方向，4岁时较高的BMI z评分与7岁时较高的限制和隐蔽控制水平显著相关（分别为β：0.06; 95% CI：0.03，0.08和β：0.06; 95% CI：0.04，0.08）和进食压力水平较低（β：-0.17; 95% CI：-0.20，-0.15）。唯一的双向做法，压力吃，更强烈的影响BMI z得分比反向（β（标准化）：-0.17相比，β（标准化）：-0.04;似然比检验：P < 0.001）。结论：我们发现，父母都响应和影响孩子的体重，因此，这种孩子父母的互动应在未来的研究中加以考虑。
Background: Evidence of the association between parental child feeding practices and the child's body mass index (BMI) is controversial, and bidirectional effects have been poorly studied.Objective: We aimed to examine bidirectional associations between parental child-feeding practices and BMI at 4 and 7 y of age.Design: This study included 3708 singleton children from the Generation XXI birth cohort with data on parental child-feeding practices and BMI at 4 and 7 y old. Feeding practices were assessed through a self-administered questionnaire by combining the Child Feeding Questionnaire and the Overt/Covert Control scale and then adapting it to Portuguese preschool children. Weight and height were measured according to standardized procedures, and age- and sex-specific BMI z scores were computed based on the WHO Growth References. Linear regression models were used to estimate the bidirectional associations between each practice and BMI z score. Crosslagged analyses were performed to compare the directions of those associations (the mean score of each practice and BMI z score at both ages were standardized to enable effect size comparisons).Results: After adjustments, pressure to eat and overt control at 4 y of age were associated with a lower BMI z score 3 y later (beta: -0.05; 95% CI: -0.08, -0.03 and beta: -0.05; 95% CI: -0.09, -0.01, respectively). Regarding the opposite direction of association, a higher BMI z score at 4 y of age was significantly associated with higher levels of restriction and covert control at 7 y of age (beta: 0.06; 95% CI: 0.03, 0.08 and beta: 0.06; 95% CI: 0.04, 0.08, respectively) and with lower levels of pressure to eat (beta: -0.17; 95% CI: -0.20, -0.15). The only bidirectional practice, pressure to eat, was more strongly influenced by the BMI z score than the reverse (beta(standardized): -0.17 compared with beta(standardized): -0.04; likelihood ratio test: P < 0.001).Conclusions: We found that parents both respond to and influence the child's weight; thus, this child parent interaction should be considered in future research.