Carolina Population Center, University of North Carolina at Chapel Hill, USA; Department of Anthropology, University of North Carolina at Chapel Hill, USA.
Soc Sci Med. 2013 Nov;97:288-96. doi: 10.1016/j.socscimed.2012.12.007. Epub 2012 Dec 17.
Childhood obesity is an increasing public health problem, particularly among minority infants and young children. Disparities in overweight prevalence persist and widen with age, highlighting the need to identify factors contributing to early excess weight gain. We review the behavioral, social and macro-environmental factors contributing to the development of obesogenic early feeding practices among African-American infants and young children. We then examine the sociodemographic, household factors, feeding beliefs and infant characteristics associated with age-inappropriate feeding of liquids and solids (inappropriate feeding) among mothers and infants participating the U.S. Infant Care and Risk of Obesity Study, a cohort study of 217 low-income, first-time mothers and infants followed from 3 to 18 months of age. Maternal and infant anthropometry, infant diet, and maternal and household characteristics were collected at home visits at 3, 6, 9, 12 and 18 months of age. Mixed logistic regression was used to estimate the association between maternal and infant characteristics and inappropriate feeding. Rates of age-inappropriate feeding are high; over 75% of infants received solids or juice by 3 months of age. The odds of age-inappropriate feeding were higher among mothers who were single, depressed or believed that their infant is a "greedy" baby. Inappropriate feeding was associated with higher daily energy intake in infants (β = 109.28 calories, p = 0.01) and with increased odds of high infant weight-for-length (WFL; OR = 1.74, 95%CI: 1.01-3.01). Our findings suggest that age-inappropriate complementary feeding influences current energy intakes and infant WFL, factors that may increase long-term obesity risk by shaping infant appetite, food preferences, and metabolism. Given the intractability of pediatric obesity, understanding the role of early feeding in shaping long-term health disparities is critical for developing prevention strategies to stem obesity in early childhood.
儿童肥胖是一个日益严重的公共卫生问题，尤其是在少数族裔婴儿和幼儿中。超重患病率的差异持续存在且随年龄增长而扩大，这凸显了确定导致早期超重的因素的必要性。我们回顾了导致非裔美国婴儿和幼儿形成肥胖相关早期喂养习惯的行为、社会和宏观环境因素。然后，我们研究了与美国婴儿护理和肥胖风险研究（一项对 217 名低收入初产妇及其婴儿进行的队列研究，从婴儿 3 个月到 18 个月进行随访）中，母亲和婴儿的社会人口学、家庭因素、喂养观念和婴儿特征相关的液体和固体（不当喂养）的年龄不适当喂养的问题。在婴儿 3、6、9、12 和 18 个月时，通过家访收集母亲和婴儿的人体测量学、婴儿饮食以及母亲和家庭特征数据。采用混合逻辑回归估计母亲和婴儿特征与不当喂养之间的关联。年龄不适当喂养的比例很高；超过 75%的婴儿在 3 个月大时就开始食用固体食物或果汁。单身、抑郁或认为婴儿“贪吃”的母亲更有可能进行年龄不适当的喂养。不当喂养与婴儿每日能量摄入较高（β=109.28 卡路里，p=0.01）以及婴儿体重与身长比（WFL）较高的几率增加相关（OR=1.74，95%CI：1.01-3.01）。我们的研究结果表明，年龄不适当的补充喂养会影响当前的能量摄入和婴儿 WFL，这些因素可能会通过塑造婴儿的食欲、食物偏好和新陈代谢，增加长期肥胖风险。鉴于儿科肥胖的顽固性，了解早期喂养在塑造长期健康差异方面的作用对于制定预防策略以遏制儿童早期肥胖至关重要。
