婴儿的第一口食物：一项随机对照试验，旨在评估蔬菜暴露和敏感喂养对婴幼儿蔬菜接受度、饮食行为和体重增加的影响。
Baby's first bites: a randomized controlled trial to assess the effects of vegetable-exposure and sensitive feeding on vegetable acceptance, eating behavior and weight gain in infants and toddlers.
机构信息
Institute of Education and Child Studies (trial sponsor), Leiden University, P.O. Box 9555, 2300, RB, Leiden, The Netherlands.
Division of Human Nutrition and Health, Wageningen University, P.O. Box 17, 6700, AA, Wageningen, The Netherlands.
出版信息
BMC Pediatr. 2019 Aug 1;19(1):266. doi: 10.1186/s12887-019-1627-z.
BACKGROUND
The start of complementary feeding in infancy plays an essential role in promoting healthy eating habits. Evidence shows that it is important what infants are offered during this first introduction of solid foods: e.g. starting exclusively with vegetables is more successful for vegetable acceptance than starting with fruits. How infants are introduced to solid foods also matters: if parents are sensitive and responsive to infant cues during feeding, this may promote self-regulation of energy intake and a healthy weight. However, the effectiveness of the what and the how of complementary feeding has never been experimentally tested in the same study. In the current project the what and how (and their combination) are tested in one study to determine their relative importance for fostering vegetable acceptance and self-regulation of energy intake in infants.
METHODS
A four-arm randomized controlled trial (Baby's First Bites (BFB)) was designed for 240 first-time Dutch mothers and their infants, 60 per arm. In this trial, we compare the effectiveness of (a) a vegetable-exposure intervention focusing on the what in complementary feeding; (b) a sensitive feeding intervention focusing on the how in complementary feeding, (c) a combined intervention focusing on the what and how in complementary feeding; (d) an attention-control group. All mothers participate in five sessions spread over the first year of eating solid foods (child age 4-16 months). Primary outcomes are vegetable consumption, vegetable liking and self-regulation of energy intake. Secondary outcomes are child eating behaviors, child anthropometrics and maternal feeding behavior. Outcomes are assessed before, during and directly after the interventions (child age 18 months), and when children are 24 and 36 months old.
DISCUSSION
The outcomes are expected to assess the impact of the interventions and provide new insights into the mechanisms underlying the development of vegetable acceptance, self-regulation and healthy eating patterns in infants and toddlers, as well as the prevention of overweight. The results may be used to improve current dietary advice given to parents of their young children on complementary feeding.
TRIAL REGISTRATION
The trial was retrospectively registered during inclusion of participants at the Netherlands National Trial Register (identifier NTR6572 ) and at ClinicalTrials.gov ( NCT03348176 ). Protocol issue date: 1 April 2018; version number 1.
背景
婴儿期开始补充喂养在促进健康饮食习惯方面起着至关重要的作用。有证据表明，在此期间提供给婴儿的食物非常重要：例如，与从水果开始相比，仅从蔬菜开始更有助于婴儿接受蔬菜。婴儿开始接受固体食物的方式也很重要：如果父母在喂养过程中对婴儿的暗示敏感并做出回应，这可能有助于婴儿自我调节能量摄入并保持健康的体重。然而，补充喂养的“内容”和“方法”的有效性从未在同一研究中进行过实验测试。在当前的项目中，“内容”和“方法”（及其组合）在一项研究中进行了测试，以确定它们对促进婴儿接受蔬菜和自我调节能量摄入的相对重要性。
方法
为 240 名首次荷兰母亲及其婴儿设计了一项四臂随机对照试验（Baby's First Bites (BFB)），每组 60 名婴儿。在这项试验中，我们比较了以下几种方法的有效性：（a）专注于补充喂养中“内容”的蔬菜暴露干预；（b）专注于补充喂养中“方法”的敏感喂养干预；（c）专注于补充喂养中“内容”和“方法”的综合干预；（d）注意力对照组。所有母亲都参加了五个与固体食物进食第一年相关的课程（婴儿年龄 4-16 个月）。主要结果是蔬菜摄入量、蔬菜喜好和能量摄入的自我调节。次要结果是儿童的饮食行为、儿童的人体测量学和母亲的喂养行为。在干预之前、期间和之后（婴儿年龄 18 个月）以及婴儿 24 个月和 36 个月时进行评估。
讨论
预期结果将评估干预措施的影响，并为婴儿和幼儿接受蔬菜、自我调节和健康饮食习惯的发展以及超重预防的潜在机制提供新的见解。结果可用于改善目前向幼儿父母提供的关于补充喂养的饮食建议。
试验注册
该试验在参与者入组期间于荷兰国家试验注册中心（标识符 NTR6572）和 ClinicalTrials.gov（NCT03348176）进行了回顾性注册。方案制定日期：2018 年 4 月 1 日；版本号 1。
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