Asta Katharine, Miller Alison L, Retzloff Lauren, Rosenblum Katherine, Kaciroti Niko A, Lumeng Julie C
Center for Human Growth and Development, University of Michigan, Ann Arbor, Michigan;
Center for Human Growth and Development, University of Michigan, Ann Arbor, Michigan; Departments of Health Behavior and Health Education.
Pediatrics. 2016 May;137(5). doi: 10.1542/peds.2015-3786. Epub 2016 Apr 18.
To identify predictors of eating in the absence of hunger (EAH) in low-income toddlers, describe affect during EAH, test EAH as a predictor of body mass index (BMI), and examine the type of food eaten as a predictor of BMI.
EAH, indexed as kilocalories (sweet, salty, and total) of palatable foods consumed after a satiating meal, was measured (n = 209) at ages 21, 27, and 33 months. Child gender, age, race/ethnicity, and previous exposure to the foods; maternal education and depressive symptoms; and family chaos, food insecurity, and structure were obtained via questionnaire. Child and mother BMI were measured. Child affect was coded from videotape. Linear regression was used to examine predictors of EAH and the association of kilocalories consumed and affect with 33 month BMI z-score (BMIz).
Predictors of greater total kilocalories included the child being a boy (P < .01), being older (P < .001), and greater maternal education (P < .01). Being in the the top quartile of sweet kilocalories consumed at 27 months and showing negative affect at food removal had higher BMIz (β = 0.29 [95% confidence interval 0.10 to 0.48] and β = 0.34 [95% confidence interval, 0.12 to 0.56], respectively).There was no association of salty kilocalories consumed or positive affect with BMIz.
There was little evidence that maternal or family characteristics contribute to EAH. EAH for sweet food predicts higher BMIz in toddlerhood. Studies investigating the etiology of EAH and interventions to reduce EAH in early childhood are needed.
确定低收入幼儿在不饥饿时进食(EAH)的预测因素,描述EAH期间的情绪,测试EAH作为体重指数(BMI)的预测因素,并检查所吃食物类型作为BMI的预测因素。
以一顿饱腹感餐后食用的可口食物的千卡数(甜味、咸味和总热量)为指标测量EAH(n = 209),测量时间为21、27和33个月。通过问卷获取儿童性别、年龄、种族/民族以及之前对食物的接触情况;母亲的教育程度和抑郁症状;以及家庭混乱、粮食不安全和家庭结构情况。测量儿童和母亲的BMI。从录像带中对儿童情绪进行编码。使用线性回归来检查EAH的预测因素以及所消耗千卡数和情绪与33个月时BMI z评分(BMIz)的关联。
总千卡数较高的预测因素包括儿童为男孩(P < 0.01)、年龄较大(P < 0.001)以及母亲教育程度较高(P < 0.01)。27个月时甜味千卡摄入量处于前四分位数且在食物被拿走时表现出负面情绪的儿童BMIz较高(β分别为0.29 [95%置信区间0.10至0.48]和β为0.34 [95%置信区间0.12至0.56])。所消耗的咸味千卡数或积极情绪与BMIz无关联。
几乎没有证据表明母亲或家庭特征会导致EAH。幼儿期对甜食的EAH可预测较高的BMIz。需要开展研究来调查EAH的病因以及减少幼儿期EAH的干预措施。