Center for Human Growth and Development, University of Michigan, Ann Arbor, Mich; Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, Mich.
Department of Psychology, University of Michigan, Ann Arbor, Mich.
Acad Pediatr. 2018 Aug;18(6):685-691. doi: 10.1016/j.acap.2018.01.007. Epub 2018 Jan 31.
To identify whether psychosocial stress exposure during early childhood predicts subsequent increased eating in the absence of hunger (EAH), emotional overeating, food responsiveness, and enjoyment of food.
This was an observational longitudinal study. Among 207 low-income children (54.6% non-Hispanic white, 46.9% girls), early childhood stress exposure was measured by parent report and a stress exposure index calculated, with higher scores indicating more stress exposure. Eating behaviors were measured in early (mean, 4.3; standard deviation, 0.5 years) and middle (mean, 7.9; standard deviation, 0.7 years) childhood. Observed EAH was assessed by measuring kilocalories of palatable food the child consumed after a meal. Parents reported on child eating behaviors on the Child Eating Behavior Questionnaire. Child weight and height were measured and body mass index z score (BMIz) calculated. Multivariable linear regression, adjusting for child sex, race/ethnicity, and BMIz, was used to examine the association of stress exposure with rate of change per year in each child eating behavior.
Early childhood stress exposure predicted yearly increases in EAH (β = 0.14; 95% confidence interval, 0.002, 0.27) and Emotional Overeating (β = 0.14; 95% confidence interval, 0.008, 0.27). Stress exposure was not associated with Food Responsiveness (trend for decreased Enjoyment of Food; β = -0.13; 95% confidence interval, 0.002, -0.26). All child obesogenic eating behaviors increased with age (P < .05).
Early stress exposure predicted increases in child eating behaviors known to associate with overweight/obesity. Psychosocial stress may confer overweight/obesity risk through eating behavior pathways. Targeting eating behaviors may be an important prevention strategy for children exposed to stress.
确定儿童早期的心理社会压力暴露是否会预测随后在不饥饿的情况下增加进食（EAH）、情绪性暴食、食物反应性和对食物的享受。
这是一项观察性纵向研究。在 207 名低收入儿童（54.6%为非西班牙裔白人，46.9%为女孩）中，通过父母报告和计算应激暴露指数来测量儿童早期的应激暴露，得分越高表示应激暴露越多。在儿童早期（平均年龄为 4.3 岁；标准差为 0.5 年）和中期（平均年龄为 7.9 岁；标准差为 0.7 年）测量饮食行为。通过测量儿童在餐后摄入的可口食物的卡路里数来观察 EAH。父母使用儿童饮食行为问卷报告儿童的饮食行为。测量儿童的体重和身高，并计算体重指数 z 分数（BMIz）。采用多元线性回归，调整儿童性别、种族/民族和 BMIz，来检验应激暴露与每个儿童饮食行为的年变化率之间的关联。
儿童早期的应激暴露预测 EAH（β=0.14；95%置信区间，0.002，0.27）和情绪性暴食（β=0.14；95%置信区间，0.008，0.27）的逐年增加。应激暴露与食物反应性（食欲下降的趋势；β=-0.13；95%置信区间，0.002，-0.26）无关。所有儿童肥胖相关的饮食行为都随着年龄的增长而增加（P<0.05）。
早期的应激暴露预测了与超重/肥胖相关的儿童饮食行为的增加。心理社会应激可能通过饮食行为途径导致超重/肥胖的风险。针对饮食行为可能是应激暴露儿童的重要预防策略。
