Redsell Sarah A, Edmonds Barrie, Swift Judy Anne, Siriwardena Aloysius Niroshan, Weng Stephen, Nathan Dilip, Glazebrook Cris
Faculty of Health, Social Care and Education, Anglia Ruskin University, Cambridge, UK.
School of Health Sciences, Queen's Medical Centre, University of Nottingham, Nottingham, UK.
Matern Child Nutr. 2016 Jan;12(1):24-38. doi: 10.1111/mcn.12184. Epub 2015 Apr 20.
The risk factors for childhood overweight and obesity are known and can be identified antenatally or during infancy, however, the majority of effective interventions are designed for older children. This review identified interventions designed to reduce the risk of overweight/obesity that were delivered antenatally or during the first 2 years of life, with outcomes reported from birth to 7 years of age. Six electronic databases were searched for papers reporting randomised controlled trials of interventions published from January 1990 to September 2013. A total of 35 eligible studies were identified, describing 27 unique trials of which 24 were behavioural and three were non-behavioural. The 24 behavioural trials were categorised by type of intervention: (1) nutritional and/or responsive feeding interventions targeted at parents of infants, which improved feeding practices and had some impact on child weight (n = 12); (2) breastfeeding promotion and lactation support for mothers, which had a positive effect on breastfeeding but not child weight (n = 5); (3) parenting and family lifestyle (n = 4); and (4) maternal health (n = 3) interventions that had some impact on feeding practices but not child weight. The non-behavioural trials comprised interventions manipulating formula milk composition (n = 3). Of these, lower/hydrolysed protein formula milk had a positive effect on weight outcomes. Interventions that aim to improve diet and parental responsiveness to infant cues showed most promise in terms of self-reported behavioural change. Despite the known risk factors, there were very few intervention studies for pregnant women that continue during infancy which should be a priority for future research.
儿童超重和肥胖的风险因素是已知的,在产前或婴儿期即可识别,然而,大多数有效的干预措施是针对年龄较大的儿童设计的。本综述确定了在产前或生命的头两年实施的旨在降低超重/肥胖风险的干预措施,并报告了从出生到7岁的结果。检索了六个电子数据库,以查找报告1990年1月至2013年9月期间发表的干预措施随机对照试验的论文。共确定了35项符合条件的研究,描述了27项独特的试验,其中24项是行为干预,3项是非行为干预。24项行为干预试验按干预类型分类:(1)针对婴儿父母的营养和/或反应性喂养干预,改善了喂养方式并对儿童体重有一定影响(n = 12);(2)对母亲进行母乳喂养促进和泌乳支持,对母乳喂养有积极影响,但对儿童体重无影响(n = 5);(3)育儿和家庭生活方式(n = 4);(4)对喂养方式有一定影响但对儿童体重无影响的孕产妇健康干预(n = 3)。非行为干预试验包括对配方奶成分进行操控的干预(n = 3)。其中,低蛋白/水解蛋白配方奶对体重结果有积极影响。旨在改善饮食和父母对婴儿暗示的反应性的干预措施在自我报告的行为改变方面显示出最大的前景。尽管存在已知的风险因素,但针对孕妇并持续到婴儿期的干预研究非常少,这应该是未来研究的重点。
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