Evaluation of an intervention to promote protective infant feeding practices to prevent childhood obesity: outcomes of the NOURISH RCT at 14 months of age and 6 months post the first of two intervention modules
Evaluation of an intervention to promote protective infant feeding practices to prevent childhood obesity: outcomes of the NOURISH RCT at 14 months of age and 6 months post the first of two intervention modules
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DOI：
10.1038/ijo.2012.96
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发表时间：
2012-10-01
影响因子：
4.9
通讯作者：
Magarey, A.
中科院分区：
文献类型：
--
作者：
Daniels, L. A.;Mallan, K. M.;Magarey, A.
目的：评估一个普遍的肥胖预防干预，从婴儿4-6个月开始，使用两个干预模块中的第一个完成后6个月和基线9个月的结果数据进行评估。设计：基于社区的早期喂养干预的随机对照试验。698名初次生育的母亲（平均年龄30+/-5岁），其健康足月婴儿（51%为男性）在基线时年龄为4.3+/-1.0个月。母亲和婴儿被随机分配到自我指导的日常护理或参加两个小组教育模块，每个模块提供超过3个月，提供早期喂养实践的预期指导。本文报告的结局数据在婴儿年龄13.7+/-1.3个月时进行评估。人体测量学表示为z评分（WHO参考）。快速体重增加定义为年龄别体重z评分（WAZ）变化>+0.67。母亲喂养的做法进行了评估，通过自填式questionnaire.RESULTS：有没有根据组分配的关键产妇和婴儿的特征的差异。随访时（n = 598（86%）），对照组婴儿具有较高的BMI年龄z评分（BMIZ）（0.42+/-0.85 vs 0.23+/-0.93，P = 0.009），并且更可能显示从基线到随访的快速体重增加（比值比（OR）1.5，置信区间（CI）95%1.1 -2.1，P = 0.014）。对照组的母亲更有可能报告使用对婴儿饱腹感暗示没有反应的无反应喂养方法，例如通过使用食物作为奖励（15% vs 4%，P = 0.001）或使用游戏（67% vs 29%，P = 0.001）来鼓励进食。
OBJECTIVE: To evaluate a universal obesity prevention intervention, which commenced at infant age 4-6 months, using outcome data assessed 6 months after completion of the first of two intervention modules and 9 months from baseline.DESIGN: Randomised controlled trial of a community-based early feeding intervention.SUBJECTS AND METHODS: Six hundred and ninety-eight first-time mothers (mean age 30+/-5 years) with healthy term infants (51% male) aged 4.3+/-1.0 months at baseline. Mothers and infants were randomly allocated to self-directed access to usual care or to attend two group education modules, each delivered over 3 months, that provided anticipatory guidance on early feeding practices. Outcome data reported here were assessed at infant age 13.7+/-1.3 months. Anthropometrics were expressed as z-scores (WHO reference). Rapid weight gain was defined as change in weight-for-age z-score (WAZ) of >+0.67. Maternal feeding practices were assessed via self-administered questionnaire.RESULTS: There were no differences according to group allocation on key maternal and infant characteristics. At follow-up (n = 598 (86%)), the control group infants had higher BMI-for-age z-score (BMIZ) (0.42+/-0.85 vs 0.23+/-0.93, P = 0.009) and were more likely to show rapid weight gain from baseline to follow-up (odds ratio (OR) 1.5, confidence interval (CI) 95% 1.1-2.1, P = 0.014). Mothers in the control group were more likely to report using non-responsive feeding practices that fail to respond to infant satiety cues such as encouraging eating by using food as a reward (15% vs 4%, P = 0.001) or using games (67% vs 29%, P