Shizawa Miho, Yoshimura Sayaka, Zhao Shuo, Toichi Motomi, Hoshino Akiko, Katsura Toshiki
School of Nursing, Kyoto Prefectural University of Medicine.
Human Health Sciences, Graduate School of Medicine, Kyoto University.
Nihon Koshu Eisei Zasshi. 2018;65(8):411-420. doi: 10.11236/jph.65.8_411.
Objective The objective of this study was to examine the influence of environmental factors on eating behaviors of children.Method The participants were the caregivers of 1,678 children attending nursery schools or kindergartens in two different cities of a prefecture. We distributed several self-administered questionnaires to the caregivers in conjunction with collaborating organizations. The participants returned the questionnaires either to collection boxes placed at the collaborating organizations facilities or by mailing them. The questionnaires included assessment of the child's basic attributes, caregiver assessments of eating behaviors, the Social Responsiveness Scale (SRS) measure of autistic traits, the Japanese Sensory Inventory-Revised (JSI-R), and the Index of Child Care Environment (ICCE). We conducted a chi-square (χ) test, Fisher's exact test, and a multiple regression analysis.Results We received responses from 843 participants (response rate=50.4%), and of those, 583 were considered valid (34.7%). The mean number of problematic eating behaviors for each child as perceived by the caregivers was 2.43±2.26. In general, caregivers thought that about 40% of the children had an unbalanced diet and about 30% had a problem of "not being able to sit still." The multiple regression analysis showed that the number of problematic eating behaviors was significantly and positively affected by the SRS T-score total (β=0.188, P<0.001), sense of taste (β=0.319, P<0.001) and auditory sense (β=0.168, P<0.001) in JSI-R. A positive relationship was found between the environmental factors of human stimulation (β=0.096, P=0.010) and social support (β=0.085, P=0.022). A negative relationship was found between sense of smell (β=-0.108, P=0.013), number of siblings (β=-0.100, P=0.005), age (β=-0.077, P=0.029), and sex (β=-0.091, P=0.010).Conclusion Our study results showed that having an unbalanced diet and "not being able to sit still" were typical features of eating behaviors. The number of problematic eating behaviors was associated with personal factors such as autistic tendency and sensory characteristics, and also with environmental factors, such as human stimulation and social support. Our findings show the importance of evaluating all relevant factors when dietary guidance is provided in the treatment of problematic eating behaviors.
目的 本研究旨在探讨环境因素对儿童饮食行为的影响。
方法 研究对象为某县两个不同城市的1678名就读于托儿所或幼儿园儿童的照料者。我们与合作组织共同向照料者发放了几份自填式问卷。参与者将问卷返还至合作组织场所设置的收集箱或通过邮寄方式返还。问卷内容包括对儿童基本属性的评估、照料者对饮食行为的评估、自闭症特征的社会反应量表（SRS）测量、日本感官量表修订版（JSI-R）以及儿童保育环境指数（ICCE）。我们进行了卡方（χ）检验、费舍尔精确检验和多元回归分析。
结果 我们收到了843名参与者的回复（回复率=50.4%），其中583份被视为有效（34.7%）。照料者认为每个儿童存在问题的饮食行为平均数量为2.43±2.26。总体而言，照料者认为约40%的儿童饮食不均衡，约30%的儿童存在“坐不住”的问题。多元回归分析表明，问题饮食行为的数量受到SRS总分T值（β=0.188，P<0.001）、JSI-R中的味觉（β=0.319，P<0.001）和听觉（β=0.168，P<0.001）的显著正向影响。在人际刺激（β=0.096，P=0.010）和社会支持（β=0.085，P=0.022）的环境因素之间发现了正相关关系。在嗅觉（β=-0.108，P=0.013）、兄弟姐妹数量（β=-0.100，P=0.005）、年龄（β=-0.077，P=0.029）和性别（β=-0.091，P=0.010）之间发现了负相关关系。
结论 我们的研究结果表明，饮食不均衡和“坐不住”是饮食行为的典型特征。问题饮食行为的数量与自闭症倾向和感官特征等个人因素以及人际刺激和社会支持等环境因素有关。我们的研究结果表明，在针对问题饮食行为进行治疗时提供饮食指导时，评估所有相关因素非常重要。
