Faith Myles S, Dennison Barbara A, Edmunds Lynn S, Stratton Howard H
Weight and Eating Disorders Program, University of Pennsylvania School of Medicine, 3535 Market St, 3rd Floor, Philadelphia, PA 19104, USA.
Pediatrics. 2006 Nov;118(5):2066-75. doi: 10.1542/peds.2006-1117.
Our goal was to test the hypothesis that increased fruit juice intake and parental restriction of children's eating are associated with increased adiposity gain and whether exposure to nutritional counseling predicted reduced adiposity gain among children.
A sample of parents or guardians of children aged 1 to 4 years who attended 1 of 49 Special Supplemental Nutrition Program for Women, Infants, and Children agencies in New York State were surveyed in 1999 or 2000 (N = 2801). The survey addressed children's dietary intake, parental feeding practices, and parental exposure to nutritional counseling messages to increase fruit, vegetable, and low-fat milk intakes. Each child's height and weight were measured approximately every 6 months for up to 48 months. A prospective cohort design was used in which survey variables were the predictors and the outcome was change in children's adiposity, defined as change in age- and gender-standardized BMI per month (ie, BMI z-score slope).
Controlling for gender and ethnicity, the relationship between juice intake and adiposity gain depended on children's initial overweight status. Among children who were initially either at risk for overweight or overweight, increased fruit juice intake was associated with excess adiposity gain, whereas parental offerings of whole fruits were associated with reduced adiposity gain. Each additional daily serving of fruit juice was associated with an excess adiposity gain of 0.009 SD per month. Feeding restriction was greater among parents whose children were initially at risk for overweight or overweight compared with those at a healthy weight. Parental exposure to nutritional messages was not associated with reduced child adiposity gain.
This study supports the Institute of Medicine recommendations to reduce fruit juice intake as a strategy for overweight prevention in high-risk children.
我们的目标是检验以下假设，即儿童果汁摄入量增加和父母对孩子饮食的限制与肥胖增加有关，以及接受营养咨询是否能预测儿童肥胖增加的减少。
1999年或2000年对纽约州49个妇女、婴儿和儿童特别补充营养项目机构中1至4岁儿童的父母或监护人样本进行了调查（N = 2801）。该调查涉及儿童的饮食摄入、父母的喂养方式以及父母接触增加水果、蔬菜和低脂牛奶摄入量的营养咨询信息的情况。在长达48个月的时间里，大约每6个月测量一次每个孩子的身高和体重。采用前瞻性队列设计，其中调查变量为预测因素，结果为儿童肥胖的变化，定义为每月年龄和性别标准化BMI的变化（即BMI z评分斜率）。
在控制性别和种族后，果汁摄入量与肥胖增加之间的关系取决于儿童最初的超重状况。在最初有超重风险或超重的儿童中，果汁摄入量增加与肥胖过度增加有关，而父母提供的完整水果则与肥胖增加减少有关。每天额外多喝一份果汁与每月肥胖过度增加0.009标准差有关。与体重正常的儿童相比，最初有超重风险或超重的儿童的父母对其饮食限制更大。父母接触营养信息与儿童肥胖增加减少无关。
本研究支持医学研究所的建议，即减少果汁摄入量作为高危儿童预防超重的一项策略。
