Department of Pediatrics, Duke University Medical Center, PO Box 3099, Durham, NC, 27710, USA,
Matern Child Health J. 2014 May;18(4):1023-30. doi: 10.1007/s10995-013-1331-9.
Numerous studies indicate an association between breastfeeding and decreased toddler adiposity. The mechanism behind this association is still unknown. One possibility is that children who are breastfed may have increased responsiveness to internal satiety cues. This study assessed the effect of satiety responsiveness on the association between breastfeeding and weight status among toddlers. We conducted a secondary analysis of data from 428 toddlers aged 2 years. Mothers' body mass index (BMI) and children's BMI z score were calculated from measured height and weight. Mothers completed a detailed breastfeeding survey and the satiety responsiveness subscale of the Child Eating Behaviour Questionnaire. Multiple linear regression and logistic regression were used to determine if satiety responsiveness mediated the effect of breastfeeding on BMI z score or overweight/obesity (BMI ≥ 85th percentile). Establishment of breastfeeding was associated with decreased BMI z score (0.40 vs. 0.60; p = 0.04), and increased breastfeeding intensity was associated with lower odds of overweight/obesity (OR 0.97, p = 0.04). Satiety responsiveness was not associated with either breastfeeding measures, suggesting it does not play a meditational role in the relationship between breastfeeding and toddler weight status. Furthermore, a relationship between satiety responsiveness and obesity does not exist after controlling for well-known confounders. This study did not find a mediation effect of satiety responsiveness on the association between breastfeeding and weight status in toddlers. More research is needed to characterize satiety responsiveness and its influence on the relationship between breastfeeding and childhood obesity.
许多研究表明母乳喂养与幼儿肥胖率降低之间存在关联。这种关联的背后机制尚不清楚。一种可能性是,母乳喂养的儿童可能对内部饱腹感信号更敏感。本研究评估了饱腹感反应对母乳喂养与幼儿体重状况之间关联的影响。我们对 428 名 2 岁幼儿的数据进行了二次分析。母亲的体重指数(BMI)和儿童的 BMI z 分数是根据测量的身高和体重计算得出的。母亲完成了详细的母乳喂养调查和儿童饮食行为问卷的饱腹感反应分量表。使用多元线性回归和逻辑回归来确定饱腹感反应是否调节母乳喂养对 BMI z 分数或超重/肥胖(BMI≥第 85 百分位)的影响。建立母乳喂养与 BMI z 分数降低相关(0.40 与 0.60;p=0.04),母乳喂养强度增加与超重/肥胖的几率降低相关(OR 0.97,p=0.04)。饱腹感反应与任何母乳喂养措施均无相关性,这表明它在母乳喂养与幼儿体重状况之间的关系中不起中介作用。此外,在控制了已知混杂因素后,饱腹感反应与肥胖之间也不存在关系。本研究未发现饱腹感反应在母乳喂养与体重状况之间的关联中具有中介作用。需要进一步研究来描述饱腹感反应及其对母乳喂养与儿童肥胖之间关系的影响。