Hohman Emily E, Paul Ian M, Birch Leann L, Savage Jennifer S
Center for Childhood Obesity Research, The Pennsylvania State University, University Park, Pennsylvania, USA.
Pediatrics and Public Health Sciences, Penn State College of Medicine, Hershey, Pennsylvania, USA.
Obesity (Silver Spring). 2017 Jan;25(1):185-191. doi: 10.1002/oby.21705.
To determine whether a responsive parenting (RP) intervention affects infant dietary patterns.
Primiparous mother-newborn dyads (n = 291) were randomized to the Intervention Nurses Start Infants Growing on Healthy Trajectories (INSIGHT) RP intervention or control. Curricula were delivered at nurse home visits at ages 3, 16, 28, and 40 weeks. RP group feeding guidance advised responsive feeding, delayed introduction of solids, repeated exposure to novel foods, and age-appropriate portion sizes. Latent class analysis identified patterns of dietary exposure at 9 months. Class membership at 9 months was used to predict BMI percentile at 2 years.
Five dietary patterns were identified: "Breastfed, Fruits and Vegetables," "Breastfed, Low Variety," "Formula, Fruits and Vegetables," "Formula, Low Variety," and "Formula, High Energy Density." Over 60% of infants had patterns low in fruits and vegetables or high in energy-dense foods. RP group infants were less likely than control to be in the "Formula, Low Variety" class (OR = 0.40, 95% CI 0.23-0.71) or "Formula, High Energy Density" class (OR = 0.28, 95% CI 0.12-0.61) relative to the "Formula, Fruits and Vegetables" class. Dietary pattern at 9 months was significantly associated with BMI percentile at 2 years.
While a majority of infants consumed diets low in fruits and vegetables, the INSIGHT RP intervention was associated with healthier dietary patterns.
确定响应式育儿(RP)干预是否会影响婴儿的饮食模式。
初产母婴二元组(n = 291)被随机分为干预组(护士启动婴儿健康成长轨迹干预项目[INSIGHT]的RP干预)或对照组。在婴儿3、16、28和40周龄时,由护士进行家访并提供课程。RP组的喂养指导建议采用响应式喂养、延迟引入固体食物、反复接触新食物以及适合年龄的食物分量。潜在类别分析确定了9个月大时的饮食暴露模式。使用9个月大时的类别归属来预测2岁时的BMI百分位数。
确定了五种饮食模式:“母乳喂养,水果和蔬菜”、“母乳喂养,种类少”、“配方奶喂养,水果和蔬菜”、“配方奶喂养,种类少”以及“配方奶喂养,高能量密度”。超过60%的婴儿存在水果和蔬菜摄入量低或能量密集型食物摄入量高的模式。相对于“配方奶喂养,水果和蔬菜”类别,RP组婴儿属于“配方奶喂养,种类少”类别的可能性低于对照组(OR = 0.40,95%CI 0.23 - 0.71),属于“配方奶喂养,高能量密度”类别的可能性也低于对照组(OR = 0.28,95%CI 0.12 - 0.61)。9个月大时的饮食模式与2岁时的BMI百分位数显著相关。
虽然大多数婴儿的饮食中水果和蔬菜含量较低,但INSIGHT RP干预与更健康的饮食模式相关。