The Development of Eating Behavior in Infancy

 描述(申请人提供)：肥胖是一个严重的公共卫生问题。预防肥胖症比治疗肥胖症有效得多，一旦肥胖症得到证实，它很可能会持续一生。预防方案取得的成功有限，因此，努力越来越多地集中在越来越年轻的年龄段。到两岁时，27%的儿童已经超重或肥胖，出生第一年的体重增加速度是儿童后期和以后肥胖的独立和强有力的风险因素 成年期，不受产前因素或出生体重的影响。因此，人们开始把重点放在婴儿期体重增加的速度上。出生第一年体重快速增加的机制 目前还不得而知。儿童和成年后期肥胖的经典预测因素，如体力活动、久坐行为和饮食结构，并不能直接转化为婴儿期。此外，越来越多的证据并没有有力地支持母乳喂养或延迟引入固体食物的保护作用。因此，干预论者最近的努力集中在这样一个概念上，即母亲误解了婴儿的饥饿和饱腹感，结果是过度喂养他们。这些干预措施背后的隐含假设是，如果母亲能够准确地读懂婴儿的暗示，婴儿自然会准确地自我调节卡路里摄入量。然而，在本应用程序中，我们提出了另一个概念模型。具体地说，我们认为一些人比其他人有更大的饥饿感，这些个体间的差异是可以检测到的，并且从婴儿早期就有很高的稳定性。我们建议，为了开发有效的干预措施来防止婴儿体重迅速增加，有必要首先了解婴儿饥饿。该应用程序的目标是更好地定义婴儿饮食行为的不同领域，它们的测量，它们随时间的发展，它们的相关性，以及它们与婴儿快速体重增加的关联。最终，这项工作将有助于在生命早期对食欲驱动的个体发生的基本科学理解，并导致开发更精确和有针对性的干预措施来塑造婴儿的食欲驱动。我们将招募325名新生儿期的婴儿，并使用独特的观察方法和母体报告测量饮食行为结构，包括吮吸活力、饱腹感、对甜味的享乐反应、蔗糖的舒缓效果、为食物而持续工作，以及在没有饥饿的情况下进食。因此，我们的具体目标是：目标1：确定婴儿进食行为的领域及其在生命第一年的发展轨迹。目的2：检验特定婴儿进食行为的特定轨迹与婴儿体重快速增加相关的假设。目的3：验证以下假设：婴儿的气质、心理社会压力、母亲肥胖、饮食行为和饮食可以预测婴儿的饮食行为领域与快速增重率有关。

 DESCRIPTION (provided by applicant): Obesity is a significant public health problem. Preventing obesity is much more effective than treating it and once obesity is established it is very likely to persist throughout the lifespan. Prevention programs have had limited success and efforts have therefore increasingly focused on younger and younger age groups. By age 2 years, 27 percent of children are already overweight or obese and the rate of weight gain in the first year of life is an independent and robust risk factor for obesity later in childhood and into adulthood, independent of prenatal factors or birth weight. Efforts have therefore begun to focus on the rate of weight gain in infancy. The mechanism of rapid weight gain in the first year of life is currently unknown. The classic predictors of obesity in later childhood and adulthood, such as physical activity, sedentary behavior, and dietary composition, do not translate directly to infancy. In addition, the accumulating body of evidence does not provide robust support for protective effects of breastfeeding or delayed introduction of solid foods. Interventionists have therefore most recently focused efforts on the notion that mothers misread infant hunger and satiety cues and as a result, over-feed them. Underlying these interventions is the implied hypothesis that infants would naturally accurately self-regulate caloric intake if mothers could accurately read the infant's cues. In this application we propose an alternate conceptual model, however. Specifically, we propose that some individuals have greater hunger than others, and that these inter-individual differences are detectable and have high stability from early infancy. We propose that in order to develop effective interventions to prevent rapid weight gain in infancy, there is a need to first understand infant hunger. The goal of this application is to bettr define distinct domains of infant eating behavior, their measurement, their development over time, their correlates, and their association with rapid infant weight gain. Ultimately, the work wll contribute to the basic scientific understanding of the ontogeny of appetitive drive very early in the life span and lead to the development of more precise and targeted interventions to shape infant appetitive drive. We will recruit a cohort of 325 infants in the newborn period and measure, using unique observational methods and maternal report measures, eating behavior constructs including sucking vigor, satiety responsiveness, hedonic response to sweet taste, soothing effect of sucrose, persistent working for food, and eating in the absence of hunger. Our specific aims therefore are: Aim 1: To identify domains of infant eating behavior and their trajectories of development over the first year of life. Aim 2: To test the hypothesis that specifi trajectories of specific infant eating behaviors are associated with more rapid rates of infant weight gain. Aim 3: To test the hypothesis that the infant eating behavior domains linked with rapid rates of weight gain are predicted by infant temperament; psychosocial stress; and maternal obesity, eating behavior, and diet.