A Better Start - National Science Challenge, New Zealand.
Liggins Institute, University of Auckland, Auckland, New Zealand.
Obes Rev. 2021 Feb;22(2):e13110. doi: 10.1111/obr.13110. Epub 2020 Aug 10.
Improving dietary intake early in life is a common behavioural target in obesity prevention trials. We undertook a systematic review of randomised controlled trials aiming to improve dietary intake of complementary foods during infancy (0-24 months). PubMed, Cochrane Library, EMBASE, Medline, and PsycInfo were searched for trials focussed on obesity prevention conducted between January 2000 and August 2019 where dietary intake was an outcome. Two reviewers screened studies and extracted data from selected articles. Risk of bias was assessed using the Cochrane Collaboration Risk of Bias 2 tools. The protocol was registered on Open Science Framework (https://osf.io/6srg7/). Seventeen articles from 12 trials were selected for data extraction. Statistically significant group differences in outcomes were observed in 36 of 165 (21.8%) of dietary variables examined. Measurement and analysis of outcomes varied between studies. Overall risk of bias was rated as high, primarily due to missing outcome data. Improving dietary intake at this age appears challenging based on a relatively limited number of studies. Future research could consider dietary pattern analyses, which may provide more meaningful outcomes for this age group. Opportunities exist for further exploration of maternal-focussed interventions, responsive feeding interventions, and interventions delivered outside of homes.
在生命早期改善饮食摄入是肥胖预防试验中的一个常见行为目标。我们系统地回顾了随机对照试验，旨在改善婴儿期（0-24 个月）补充食品的饮食摄入。我们在 PubMed、Cochrane Library、EMBASE、Medline 和 PsycInfo 中搜索了 2000 年 1 月至 2019 年 8 月期间进行的以肥胖预防为重点的试验，其中饮食摄入是一个结果。两名评审员筛选了研究并从选定的文章中提取了数据。使用 Cochrane 协作风险偏倚 2 工具评估了风险偏倚。该方案已在开放科学框架（https://osf.io/6srg7/）上注册。从 12 项试验中选择了 17 篇文章进行数据提取。在 165 个饮食变量中，有 36 个观察到组间结果存在统计学显著差异（21.8%）。研究之间的结果测量和分析有所不同。总体风险偏倚被评为高，主要是由于缺失的结局数据。根据相对有限的研究数量，在这个年龄段改善饮食摄入似乎具有挑战性。未来的研究可以考虑饮食模式分析，这可能为这个年龄组提供更有意义的结果。存在进一步探索以母亲为重点的干预措施、反应性喂养干预措施以及在家庭之外实施的干预措施的机会。
