Parent-child mealtime interactions: longitudinal observations to inform obesity prevention

项目总结/摘要 预防肥胖的努力越来越多地集中在幼儿期。新出现的证据表明， 父母和孩子之间互动的情绪质量影响肥胖的风险，自我调节可能 是一种解释机制。然而，传统上，父母与孩子的互动是在玩耍时观察到的， 进餐时间的相互作用与儿童肥胖风险之间的关系尚未进行长期研究。此外， 涉及的自律方面尚不清楚。早产儿患肥胖症的风险 对于足月出生的孩子来说，早产儿的自我调节能力有缺陷的风险更高。的目标 本申请是对幼儿（所有胎龄）进行纵向研究，以确定 在家庭和实验室的用餐时间和游戏环境中观察到的亲子互动质量 通过学龄前体重和肥胖的变化，并确定自我调节的方面， 涉案我们的中心假设是，父母和孩子在进餐时间的互动轨迹会有所不同， 42个月时肥胖的风险比玩耍时亲子互动的观察结果更强， 胎龄和气质反应作为影响因素，情绪调节作为自我调节的方面， 与肥胖症密切相关的调节。目前项目的理由是， 迫切需要预防幼儿肥胖，父母的参与对成功至关重要; 研究亲子互动随着时间的推移和跨环境，与所有胎龄的儿童，将 有助于确定预防肥胖的可修改目标。该提案有三个具体目标：1） 描述幼儿到学龄前时期亲子进餐互动的轨迹， 亲子游戏中的互动，2）确定增加肥胖风险的亲子进餐时间互动， 和3）确定自我调节的方面，预测学龄前儿童的健康体重， 识别前兆。我们的方法来实现这些目标将是一个前瞻性研究的250名儿童登记 在18个月时，并在24，36和42个月大时在我们的实验室和家中进行评估。亲子 在家中玩耍和用餐期间以及在实验室标准化自助午餐中的互动将 被观察和客观编码。学龄前儿童的自我调节能力将通过一系列 目标任务和家长报告。本研究的预期成果将详细了解 与肥胖风险相关的自我调节和亲子进餐互动方面， 童年早期该项目是创新的，将发展科学的概念和方法带到了 儿童肥胖的挑战和利用观察到的用餐时间亲子互动的客观编码 和非进餐时间的情况下，随着时间的推移，并与所有胎龄的儿童。这个项目意义重大 因为它将为育儿和儿童肥胖的研究带来一个二元的视角， 可用于对儿童和家庭的健康和福祉产生积极影响。

PROJECT SUMMARY/ABSTRACT Obesity prevention efforts are increasingly focused on early childhood. Emerging evidence suggests that the emotional quality of interactions between parents and children impacts risk for obesity and self-regulation may be an explanatory mechanism. However, parent-child interactions are traditionally observed during play, and mealtime interactions have not been studied over time in relationship to children's obesity risk. Further, which aspects of self-regulation are involved is unclear. Children born preterm have risks for obesity that are similar to children born at term, and preterm children are at higher risk for deficits in self-regulation. The objective of this application is to conduct a longitudinal study of toddlers (of all gestational ages) to determine how the quality of parent-child interactions observed in mealtime and play settings in the home and laboratory impacts changes in weight and adiposity through preschool-age, and to identify the aspects of self-regulation that are involved. Our central hypothesis is that trajectories of parent-child mealtime interaction will differ and predict risk for obesity at 42 months more robustly than observations of parent-child interaction during play, with gestational age and temperamental reactivity as effect modifiers, and emotion regulation as the aspect of self- regulation most strongly associated with obesity. The rationale for the current project is that strategies to prevent obesity in young children are urgently needed and parent engagement will be crucial to their success; studying parent-child interaction over time and across contexts, with children of all gestational ages, will facilitate identification of modifiable targets for obesity prevention. The proposal has three specific aims: 1) to characterize trajectories of parent-child mealtime interactions across the toddler to preschool period relative to parent-child interactions in play, 2) to identify parent-child mealtime interactions that increase risk for obesity, and 3) to determine the aspects of self-regulation that predict healthy weight in preschool-aged children and identify precursors. Our approach to accomplish these aims will be a prospective study of 250 children enrolled at 18 months and assessed at 24, 36, and 42 months of age in our laboratory and in their homes. Parent-child interaction during play and during mealtimes at home and in a standardized buffet lunch in the laboratory will be observed and objectively coded. Self-regulation at preschool-age will be assessed using a battery of objective tasks and parent-report. The expected outcomes of this research will be detailed understanding of the aspects of self-regulation and parent-child mealtime interactions that are associated with risk for obesity in early childhood. The project is innovative in bringing concepts and methods from developmental science to the challenge of childhood obesity and utilizing objective coding of observed parent-child interactions in mealtime and non-mealtime contexts over time and with children of all gestational ages. The project is significant because it will bring a dyadic perspective to research on parenting and childhood obesity and what is learned can be applied to have a positive impact on the health and well-being of children and families.