Department of Pediatrics, Penn State College of Medicine, Hershey, Pennsylvania, USA.
Obesity (Silver Spring). 2011 Feb;19(2):353-61. doi: 10.1038/oby.2010.182. Epub 2010 Aug 19.
More than 20% of US children between ages 2 and 5 years are overweight suggesting efforts to prevent obesity must begin earlier. This study tested the independent and combined effects of two behavioral interventions delivered to parents, designed to promote healthy infant growth in the first year. Mother-newborn dyads intending to breastfeed were recruited from a maternity ward. With a 2 × 2 design, 160 dyads were randomized into one of four treatment cells to receive both, one, or no interventions delivered at two nurse home visits. The first intervention ("Soothe/Sleep") instructed parents on discriminating between hunger and other sources of infant distress. Soothing strategies were taught to minimize feeding for non-hunger-related fussiness and to prolong sleep duration, particularly at night. The second intervention ("Introduction of Solids") taught parents about hunger and satiety cues, the timing for the introduction of solid foods, and how to overcome infants' initial rejection of healthy foods through repeated exposure. A total of 110 mother-infant dyads completed the year-long study. At 1 year, infants who received both interventions had lower weight-for-length percentiles (P = 0.009). Participants receiving both interventions had a mean weight-for-length in the 33rd percentile; in contrast, those in other study groups were higher first intervention only--50th percentile; second intervention only--56th percentile; control group--50th percentile).This suggests that multicomponent behavioral interventions may have potential for long-term obesity prevention (ClinicalTrials.gov number, NCT00359242).
超过 20%的 2 至 5 岁美国儿童超重,这表明预防肥胖的努力必须更早开始。本研究测试了两项针对父母的行为干预措施的独立和联合效果,旨在促进婴儿在第一年的健康成长。从产科病房招募了打算母乳喂养的母婴二人组。采用 2×2 设计,将 160 对母婴二人组随机分配到四个治疗组中的一个,接受两次家访时提供的两种、一种或没有干预措施。第一项干预措施(“安抚/睡眠”)指导父母区分饥饿和婴儿其他不适的原因。教授安抚策略,以最大限度地减少非饥饿相关烦躁不安的喂养,并延长睡眠时间,尤其是在夜间。第二项干预措施(“引入固体食物”)向父母传授关于饥饿和饱腹感的线索、引入固体食物的时间以及如何通过反复暴露克服婴儿对健康食物的最初拒绝。共有 110 对母婴二人组完成了为期一年的研究。在 1 岁时,接受两种干预措施的婴儿体重长度百分比较低(P=0.009)。接受两种干预措施的参与者的体重长度百分比平均值为第 33 个百分位;相比之下,其他研究组的婴儿体重长度百分比分别为:仅接受第一项干预措施——第 50 个百分位;仅接受第二项干预措施——第 56 个百分位;对照组——第 50 个百分位)。这表明,多组分行为干预措施可能具有预防长期肥胖的潜力(临床试验注册号:NCT00359242)。