Meal time interactions and risk of obesity in toddlers

进餐时间的相互作用和幼儿肥胖的风险

• 批准号: 9127464
• 负责人: Chantelle Nobile Hart
• 金额: $ 66.28万
• 依托单位: TEMPLE UNIV OF THE COMMONWEALTH
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-08-01 至 2020-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9127464
• 关键词: Accelerometer; Affect; Age-Months; Area; Behavior Therapy; Birth; Birth Weight; Child; Conscious; Control Groups; Cues; Data; Desire for food; Development; Diet; Dietary intake; Early identification; Eating; Eating Behavior; Educational workshop; Enrollment; Funding; Height; Home environment; Hour; Hunger; Infant; Institute of Medicine (U.S.); Intake; Intervention; Investigation; Latina; Lead; Length; Life; Link; Long-Term Effects; Longitudinal Studies; Measures; Mothers; National Heart, Lung, and Blood Institute; Obesity; Overweight; Parents; Participant; Patient Self-Report; Perception; Perinatal; Physical activity; Pregnancy; Preventive Intervention; Prospective Studies; Public Health; Randomized; Randomized Controlled Trials; Recruitment Activity; Reporting; Research; Risk; Risk Factors; Role; Satiation; Shapes; Site; Sleep; Temperament; Time; Toddler; United States National Institutes of Health; Weight; Weight Gain; Woman; base; cost; cost effective; critical developmental period; critical period; demographics; early childhood; efficacy testing; feeding; follow-up; gestational weight gain; infancy; interest; lifestyle intervention; novel; obesity in children; obesity prevention; obesity risk; offspring; prenatal intervention; prospective; public health relevance; restraint; therapy design

 DESCRIPTION (provided by applicant): The first two years of life are increasingly recognized as a critical period for the development of obesity. Prior studies demonstrate the importance of parents in shaping this risk with particular emphasis on associations between maternal responsive feeding (i.e., higher responsiveness to child hunger and satiety cues and fewer assertive prompts to eat) and lower child BMI. However, research to date has been primarily cross-sectional, based on parent-report, and done almost exclusively in preschoolers or older children; longitudinal studies of mothers and toddlers that assess objective measures of responsive feeding within the context of antecedent and concurrent factors, are needed to better understand factors that promote responsive feeding and reduce long-term child obesity risk. We propose to enroll 156 mother-toddler dyads into a prospective study of feeding interactions and obesity risk, with assessments at 18, 24, and 36 months, in order to achieve the following aims: 1) understand factors related prospectively to responsive feeding between mothers and toddlers at 18 months; 2) determine whether responsive feeding at 18 and 24 months predicts change in zBMI and adiposity from 18-36 months; and 3) explore which factors are most strongly predictive of child zBMI change from birth to 36 months. Responsive feeding will be assessed with two home-based meal observations at both 18 and 24 months (total of 4). At these time points, mothers and toddlers will wear accelerometers to assess physical activity and sleep, and mothers will also complete three 24-hour dietary recalls of their own and their toddler's intake, and measures assessing additional maternal (e.g., perceptions of feeding practices and styles, dietary restraint) and toddler (e.g., temperament, appetite) factors that could influence maternal responsiveness and toddler obesity risk. Mothers' and toddlers' heights, weights and circumference/skinfolds will be measured at 18, 24, and 36 months. We propose to recruit participants from Healthy Beginnings (HB), an NHLBI-funded, two site randomized controlled trial testing the efficacy of a multi-component behavioral intervention in reducing risk of excessive weight gain during pregnancy. Half of HB participants were randomized to an intervention designed to reduce pregnancy weight gain, providing a unique opportunity to examine long-term effects on all of the above-noted study aims. HB also provides a unique opportunity to cost-effectively conduct this longitudinal study: participants are already being enrolled in HB; all are overweight or obese and 42 percent are Latina (important risk factors for child obesity); relevant assessments of women in HB occur at study entry (<16 weeks gestation), 22-24 weeks and 35 weeks gestation, and mothers and infants at delivery, 6 and 12 months. HB ends when infants are 12 months old. Extending follow-up through 36 months will enable understanding of longitudinal associations between early life influences on responsive feeding during toddlerhood, and prospective associations between responsive feeding and obesity risk. Findings will have important implications for preventive interventions during this important and understudied developmental period.

 描述（由适用提供）：生命的前两年越来越被认为是对物体开发的关键时期。先前的研究表明，父母在塑造这种风险方面的重要性特别强调了主要反应式喂养之间的关联（即，对儿童饥饿和饱腹感的反应性更高，较少的果断提示提示）和降低BMI儿童。但是，迄今为止的研究是基于父母报告的主要横断面，几乎完全在学龄前儿童或年龄较大的孩子中进行。需要对母亲和幼儿进行纵向研究，以评估在先前和并发因素的背景下对响应式喂养的客观度量，以更好地理解促进反应式喂养并降低长期儿童肥胖风险的因素。我们建议将156个母亲二元组纳入对喂养相互作用和肥胖风险的前瞻性研究，并在18、24和36个月的评估中进行评估，以实现以下目的：1）了解与可能在18个月时母亲和幼儿之间反应迅速喂养相关的因素； 2）确定在18和24个月时的反应式喂养是否可以预测ZBMI的变化以及从18-36个月开始的肥胖。 3）探索哪些因素最有力地预测了从出生到36个月的儿童ZBMI变化。响应式喂养将在18个月和24个月（总计为4个）时通过两个基于家庭的进餐观测来评估。在这些时间点，母亲和幼儿将穿上加速度计评估体育锻炼和睡眠，母亲还将完成三个24小时的饮食召回和幼儿的摄入量，并评估额外的孕妇的措施（例如，对喂养实用和样式的感知，饮食约束），饮食约束）和幼儿（例如，临时性，温度和温度）的态度，可能会影响临界。母亲和幼儿的高度，体重和圆周/皮肤折叠仪将在18、24和36个月时测量。我们建议从健康起点（HB）招募参与者，这是NHLBI资助的两个地点随机对照试验，以测试多组分行为干预措施的效率，以降低怀孕期间体重增加的风险。一半的HB参与者被随机分配为旨在减少怀孕体重增加的干预措施，提供了一个独特的机会来检查对所有上述研究目的的长期影响。 HB还提供了一个独特的机会来进行成本效益进行这项纵向研究：参与者已经被招募到HB；所有人都超重或肥胖，42％是拉丁裔（儿童肥胖的重要危险因素）； HB中妇女的相关评估在研究条目（<16周）时进行，妊娠22-24周和35周妊娠，以及分娩时的母亲和婴儿，为6和12个月。当婴儿12个月大时，HB结束。将随访延长至36个月，将使早期生活对幼儿期间反应式喂养的影响与反应迅速喂养与肥胖风险之间的前瞻性关联之间的纵向关联。在这个重要且理解的发展时期，发现对预防干预措施将具有重要意义。