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干预护士促进婴儿健康成长轨迹(INSIGHT)对首胎婴儿的响应式育儿干预影响二胎婴儿的饮食摄入。

The Intervention Nurses Start Infants Growing on Healthy Trajectories (INSIGHT) Responsive Parenting Intervention for Firstborns Affects Dietary Intake of Secondborn Infants.

机构信息

Center for Childhood Obesity Research, Pennsylvania State University, University Park, PA, USA.

Department of Nutritional Sciences, Pennsylvania State University, University Park, PA, USA.

出版信息

J Nutr. 2020 Aug 1;150(8):2139-2146. doi: 10.1093/jn/nxaa135.

Abstract

BACKGROUND

Although previous work has shown that children with older siblings tend to have poorer diet quality, no study has directly compared diets of infant siblings.

OBJECTIVE

The goals of this analysis were to examine birth-order differences in dietary intake between firstborn (FB) and secondborn (SB) siblings, and to determine whether a responsive parenting (RP) intervention modified birth-order effects on diet.

METHODS

The Intervention Nurses Start Infants Growing on Healthy Trajectories (INSIGHT) study randomly assigned first-time mothers to an RP intervention, which included guidance on feeding, sleep, soothing, and interactive play, or control. INSIGHT mothers who delivered a second child enrolled in an observation-only study of their SB infant (SIBSIGHT). Mothers completed FFQs for both children at ages 6 (n = 97 sibling pairs) and 12 (n = 100) mo. FB compared with SB intake of food groups of interest were compared, and the moderating effect of the RP intervention on birth-order differences was tested using generalized linear mixed models.

RESULTS

Though FBs and SBs had similar diets, more FBs than SBs consumed 100% fruit juice at both 6 (13.8 compared with 3.2%, P = 0.006) and 12 mo (46.0 compared with 32.0%, P = 0.01). SBs consumed fruit more frequently (FB 2.8 compared with SB 3.2 times/d, P = 0.01), and were more likely to consume fried potatoes (FB 38.4 compared with SB 57.6%, P = 0.0009) and processed meats (FB 43.0 compared with SB 58.0%, P = 0.02) than FBs at 12 mo. There were no differences by birth order in intake of sweets, snacks, or sugar-sweetened beverages at 12 mo. At 12 mo, RP-group SBs ate vegetables more times per day (3.2) than control SBs (2.2, P = 0.01). RP-SBs also consumed a greater variety of vegetables (10.2) than control-SBs (7.9, P = 0.01).

CONCLUSIONS

Birth order is not consistently associated with healthy or unhealthy infant dietary intake. However, an RP intervention delivered to first-time mothers may benefit subsequent infants' vegetable intake. This trial was registered at clinicaltrials.gov as NCT01167270.

摘要

背景

尽管先前的研究表明,有兄弟姐妹的儿童往往饮食质量较差,但尚无研究直接比较过婴儿兄弟姐妹的饮食。

目的

本分析的目的是研究头胎(FB)和二胎(SB)兄弟姐妹之间饮食摄入的出生顺序差异,并确定反应性养育(RP)干预是否改变了出生顺序对饮食的影响。

方法

干预护士启动婴儿健康轨迹(INSIGHT)研究随机将初产妇分配到 RP 干预组,该干预组包括喂养、睡眠、安抚和互动游戏方面的指导,或对照组。INSIGHT 母亲在生二胎时参加了他们的 SB 婴儿(SIBSIGHT)的观察研究。母亲们在 6 个月(n=97 对兄弟姐妹)和 12 个月(n=100)时完成了 FFQ 对两个孩子的饮食摄入情况进行了调查。比较了 FB 与 SB 对感兴趣食物组的摄入情况,并使用广义线性混合模型检验了 RP 干预对出生顺序差异的调节作用。

结果

尽管 FB 和 SB 的饮食相似,但在 6 个月(13.8%比 3.2%,P=0.006)和 12 个月(46.0%比 32.0%,P=0.01)时,更多的 FB 比 SB 消费 100%的果汁。SB 更频繁地食用水果(FB 2.8 次/天比 SB 3.2 次/天,P=0.01),并且在 12 个月时更有可能食用炸土豆(FB 38.4%比 SB 57.6%,P=0.0009)和加工肉类(FB 43.0%比 SB 58.0%,P=0.02)比 FB 多。在 12 个月时,SB 的甜食、零食或含糖饮料摄入量在出生顺序上没有差异。在 12 个月时,RP 组 SB 每天吃蔬菜的次数(3.2)多于对照组 SB(2.2,P=0.01)。RP-SB 还食用了更多种类的蔬菜(10.2 种比对照组 SB 食用的 7.9 种,P=0.01)。

结论

出生顺序并不总是与婴儿健康或不健康的饮食摄入有关。然而,提供给初产妇的 RP 干预可能会有益于后续婴儿的蔬菜摄入量。这项试验在 clinicaltrials.gov 上注册为 NCT01167270。

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