Johnson C M, Henderson M S, Tripicchio G, Rozin P, Heo M, Pietrobelli A, Berkowitz R I, Keller K L, Faith M S
Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, USA.
Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill, Chapel Hill, USA.
Pediatr Obes. 2018 Apr;13(4):222-231. doi: 10.1111/ijpo.12209. Epub 2017 Mar 10.
Restrictive feeding is associated with child overweight; however, the majority of studies used parent-report questionnaires.
The relationship between child adiposity measures and directly observed parent and child behaviours were tested using a novel behavioural coding system (BCS).
Data from 109 children, participants in a twin study and their mothers, were analyzed. Parent-child dyads were video-recorded twice in the laboratory, while children ate ad libitum from a buffet lunch. Mother and child behaviours were assessed using the BCS. Height, body weight and body fat were directly measured for each child. Associations between child adiposity measures and average BCS behaviour (i.e. pooled across visits) were tested using partial correlations adjusting for child age.
Regarding discouragement prompts, child body mass index (BMI) z-score was significantly associated with a greater rate of total discouragements (per minute, min ), nonverbal discouragements (min ) and temporary (delay) discouragements (min ) (p < 0.05). Child percent body fat was associated with greater nonverbal discouragements (min ). Regarding encouragement prompts, child BMI z-score was significantly associated with a greater rate of total encouragements (min ), nonverbal encouragements (min ) and reward encouragements (min ). Child BMI z-score and percent body fat were both positively associated with greater maternal health encouragements (min ). Associations with encouragement to eat prompts were no longer significant when accounting for the dependence among twins (being part of the same family).
Heavier children received greater maternal discouragements to eat and, with qualifications, encouragements to eat. The role of nonverbal parenting cues warrants further research regarding child eating regulation and obesity.
限制喂养与儿童超重有关；然而，大多数研究使用的是家长报告问卷。
使用一种新颖的行为编码系统（BCS）来测试儿童肥胖指标与直接观察到的家长和儿童行为之间的关系。
对109名参与双胞胎研究的儿童及其母亲的数据进行了分析。亲子二元组在实验室中被录像两次，期间孩子们可以随意享用自助午餐。使用BCS评估母亲和孩子的行为。直接测量每个孩子的身高、体重和体脂。使用调整了儿童年龄的偏相关分析来测试儿童肥胖指标与平均BCS行为（即各次访视的汇总）之间的关联。
关于劝阻提示，儿童体重指数（BMI）z评分与总劝阻率（每分钟，min）、非言语劝阻率（min）和临时（延迟）劝阻率（min）显著相关（p < 0.05）。儿童体脂百分比与更高的非言语劝阻率（min）相关。关于鼓励提示，儿童BMI z评分与总鼓励率（min）、非言语鼓励率（min）和奖励鼓励率（min）显著相关。儿童BMI z评分和体脂百分比均与更高的母亲健康鼓励率（min）呈正相关。在考虑双胞胎之间的依赖性（属于同一个家庭）时，与鼓励进食提示的关联不再显著。
较重的儿童受到母亲更多的进食劝阻以及在一定条件下的进食鼓励。非言语育儿线索在儿童饮食调节和肥胖方面的作用值得进一步研究。
