Parental feeding attitudes and styles and child body mass index: Prospective analysis of a gene-environment interaction
Parental feeding attitudes and styles and child body mass index: Prospective analysis of a gene-environment interaction
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DOI：
10.1542/peds.2003-1075-l
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发表时间：
2004-10-01
期刊：
影响因子：
8
通讯作者：
Stunkard, AJ
中科院分区：
文献类型：
--
作者：
Faith, MS;Berkowitz, RI;Stunkard, AJ
背景在横断面研究中，父母的喂养方式与孩子的体重有关，但无法测试影响的方向。前瞻性研究可以最好地建立这些变量之间的因果关系。我们测试了父母喂养态度和方式的2年稳定性，并调查了这些变量是否预测2年后的儿童体重指数（BMI）z评分。我们评估这些协会是否依赖于儿童的肥胖倾向。参与者是57个家庭，他们参加了一项婴儿生长研究，根据母亲怀孕前超重或消瘦，出生时肥胖风险高或低的儿童。在3岁、5岁和7岁时对儿童的体重和身高进行评估。父母喂养的态度和风格的措施，确定在5岁和7岁的儿童喂养问卷。相关性和多元回归分析检验了5岁时父母的喂养方式是否能预测2年后儿童BMI z评分的增加。父母喂养的态度和风格是稳定的儿童年龄为5至7岁。在喂养态度方面，在低风险家庭中，5岁时的责任感预测了7岁时儿童BMI z分数的降低，而在高风险家庭中，对儿童体重的关注和对儿童体重的感知预测了儿童BMI z分数的增加。在喂养方式方面，监测预测低风险儿童7岁时BMI z评分降低。相比之下，在高危儿童中，限制饮食可预测较高的BMI z评分，而进食压力可预测降低的BMI z评分。在控制了3岁时的儿童体重状况后，这些关联仍然显着。父母喂养方式与儿童BMI z评分之间的关系取决于儿童肥胖倾向，这表明基因-环境相互作用。在易患肥胖症的儿童中，儿童体重增加似乎会引起限制性喂养，这反过来又可能导致额外的体重增加。预防超重的育儿指南可能会受益于对儿童特征的考虑，例如肥胖的易感性和当前的体重状况。
Background. Parental feeding styles were linked to child weight in cross-sectional studies, which were unable to test the direction of effect. Prospective studies can best establish causal relationships among such variables.Objective. We tested the 2-year stability of parental feeding attitudes and styles and investigated whether these variables predict child body mass index (BMI) z scores 2 years later. We evaluated whether these associations were dependent on children's predisposition to obesity.Methods. Participants were 57 families enrolled in an Infant Growth Study of children born at high risk or low risk for obesity, on the basis of maternal prepregnancy overweight or leanness. Children were evaluated for weight and height at 3, 5, and 7 years of age. Measures of parental feeding attitudes and styles were ascertained with the Child Feeding Questionnaire at 5 and 7 years of age. Correlation and multiple regression analyses tested whether parental feeding styles at age 5 predicted increased child BMI z scores 2 years later.Results. Parental feeding attitudes and styles were stable for child ages of 5 to 7 years. With respect to feeding attitudes, perceived responsibility at age 5 predicted reduced child BMI z scores at age 7 among low-risk families, whereas child weight concern and perceived child weight predicted increased child BMI z scores among high-risk families. With respect to feeding styles, monitoring predicted reduced child BMI z scores at age 7 among low-risk children. In contrast, restriction predicted higher BMI z scores and pressure to eat predicted reduced BMI z scores among high-risk children. These associations remained significant after controlling for child weight status at age 3.Conclusions. The relationship between parental feeding styles and child BMI z scores depends on child obesity predisposition, suggesting a gene-environment interaction. Among children predisposed to obesity, elevated child weight appears to elicit restrictive feeding practices, which in turn may produce additional weight gain. Parenting guidelines for overweight prevention may benefit from consideration of child characteristics such as vulnerability to obesity and current weight status.