1 Department of Nutrition, Gillings School of Global Public Health, University of North Carolina-Chapel Hill , Chapel Hill, NC.
Child Obes. 2013 Oct;9(5):427-36. doi: 10.1089/chi.2012.0098.
Poorer "division of responsibility" (DoR) feeding, characterized by high parental control and reduced child food choice, may promote pediatric obesity, although population-based prospective data are lacking. We tested whether poorer DoR feeding predicts childhood overweight/obesity onset and BMI z-score gain, over 10 years in the National Longitudinal Study of Youth.
We studied 302 girls and 316 boys, with mean ages 52.24 and 52.35 months, respectively, in 1986, who were followed for 10 years. We excluded children who were initially overweight/obese. Mothers completed three DoR feeding questions in 1986: (1) child eating compliance of prompted foods; (2) child eating compliance of initially refused foods; and (3) mother-allotted child food choice. Child BMI (kg/m(2)) was calculated from measured weights and heights in 1986, 1988, 1992, 1994, and 1996.
Daughters who complied with maternal food prompts [odds ratio (OR), 2.01] and those who obeyed maternal prompts to consume initially rejected foods (OR, 2.29) "most of the time" were significantly more likely than daughters who complied less frequently to become overweight/obese after 8 years. Also, more frequent eating compliance (p<0.001) and more frequent compliance of initially rejected foods (p=0.003) predicted greater BMI z-score gain in girls. These associations were not found for boys. Maternal obesity consistently predicted overweight/obesity risk in girls (ORs, 2.48-8.63) and boys (ORs, 2.27- 4.03).
Teaching parents to avoid coercive feeding practices, while encouraging child self-selection of healthier foods, may help their daughters to achieve better energy balance.
较差的“责任分工”（DoR）喂养方式，其特点是父母高度控制和减少儿童食物选择，可能会促进小儿肥胖，但缺乏基于人群的前瞻性数据。我们在全国青少年纵向研究中测试了较差的 DoR 喂养是否预示着儿童超重/肥胖的发生以及 BMI z 评分的增加，随访时间为 10 年。
我们研究了 1986 年分别具有平均年龄 52.24 岁和 52.35 岁的 302 名女孩和 316 名男孩，随访 10 年。我们排除了最初超重/肥胖的儿童。母亲在 1986 年完成了三个 DoR 喂养问题：（1）儿童对提示食物的进食依从性；（2）儿童对最初拒绝食物的进食依从性；（3）母亲分配给儿童的食物选择。儿童 BMI（kg/m2）由 1986 年、1988 年、1992 年、1994 年和 1996 年测量的体重和身高计算得出。
“大多数时候”遵从母亲食物提示的女儿（比值比[OR]，2.01）和那些遵从母亲提示食用最初拒绝食物的女儿（OR，2.29）比那些不经常遵从的女儿更有可能在 8 年后超重/肥胖。此外，更频繁的进食依从性（p<0.001）和更频繁的最初拒绝食物的依从性（p=0.003）预示着女孩 BMI z 评分增加更多。这些关联在男孩中并未发现。母亲肥胖一直预示着女孩（ORs，2.48-8.63）和男孩（ORs，2.27-4.03）的超重/肥胖风险。
教导父母避免强制性喂养方式，同时鼓励儿童选择更健康的食物，可能有助于女孩达到更好的能量平衡。
