Department of Pediatrics, New York University Grossman School of Medicine, New York.
Department of Pediatrics, New York University Grossman School of Medicine, New York.
J Acad Nutr Diet. 2021 Nov;121(11):2210-2220. doi: 10.1016/j.jand.2021.04.001. Epub 2021 May 11.
Child appetite traits (ATs) are associated with later child weight and obesity risk. Less research has focused on ATs in low-income Hispanic children or included longitudinal associations with infant weight.
To determine stability of ATs during infancy and childhood and their relationship with subsequent weight and obesity risk at age 3 years among low-income Hispanic children.
A secondary longitudinal analysis of data from the Starting Early Program randomized controlled obesity prevention trial.
PARTICIPANTS/SETTING: Three hundred twenty-two low-income, Hispanic mother-child pairs enrolled between 2012 and 2014 in a public hospital in New York City.
ATs, including Slowness in Eating, Satiety Responsiveness, Food Responsiveness, and Enjoyment of Food were assessed using the Baby and Child Eating Behavior Questionnaires at ages 3 months, 2 years, and 3 years. Main outcome measures were child standardized weight-for-age z score (WFAz) and obesity risk (WFA≥95th percentile) at age 3 years.
AT stability was assessed using correlations and multilevel modeling. Linear and logistic regression analyses examined associations between ATs and child WFAz and obesity risk at age 3 years.
There was limited stability for all ATs measured over time. During infancy, Slowness in Eating was associated with lower 3-year WFAz (B = -0.18, 95% CI -0.33 to -0.04; P = 0.01). At age 2 years, Slowness in Eating and Satiety Responsiveness were associated with lower WFAz (B = -0.29, 95% CI -0.47 to -0.12; P < 0.01; B = -0.36, 95% CI -0.55 to -0.17; P < 0.01) and obesity risk (adjusted odds ratio 0.49, 95% CI 0.28 to 0.85; adjusted odds ratio 0.61, 95% CI 0.38 to 0.99) at 3 years. Increased Slowness in Eating and Satiety Responsiveness over time were associated with lower 3-year WFAz (B = -0.74, 95% CI -1.18 to -0.2 [Slowness in Eating]; B = -1.19, 95% CI -1.87 to -0.52 [Satiety Responsiveness], both P values = 0.001). Higher Enjoyment of Food over time was associated with higher 3-year WFAz (B = 0.62, 95% CI 0.24 to 1.01; P = 0.002).
Infants with lower Slowness in Eating and Satiety Responsiveness may have higher levels of obesity risk and need more tailored approaches to nutrition counseling and obesity prevention.
儿童食欲特质（ATs）与日后儿童体重和肥胖风险相关。针对低收入西班牙裔儿童的 AT 研究较少，且很少有研究将其与婴儿期体重进行纵向关联。
确定低收入西班牙裔儿童在婴儿期和儿童期 AT 的稳定性及其与 3 岁时体重和肥胖风险的后续关系。
对来自“早期启动计划”随机对照肥胖预防试验的数据进行二次纵向分析。
参与者/设置：2012 年至 2014 年，在纽约市一家公立医院招募了 322 名低收入的西班牙裔母婴对。
使用婴儿和儿童饮食行为问卷在 3 个月、2 岁和 3 岁时评估 AT，包括进食慢、饱腹感反应、食物反应和对食物的享受。主要观察指标为儿童标准化体重-年龄 z 评分（WFAz）和 3 岁时肥胖风险（WFA≥95 百分位）。
使用相关性和多层次模型评估 AT 稳定性。线性和逻辑回归分析考察了 AT 与儿童 3 岁时 WFAz 和肥胖风险的关系。
所有 AT 的稳定性都有限。在婴儿期，进食慢与较低的 3 岁 WFAz 相关（B=-0.18，95%CI -0.33 至 -0.04；P=0.01）。在 2 岁时，进食慢和饱腹感反应与较低的 WFAz（B=-0.29，95%CI -0.47 至 -0.12；P<0.01；B=-0.36，95%CI -0.55 至 -0.17；P<0.01）和肥胖风险（调整后的优势比 0.49，95%CI 0.28 至 0.85；调整后的优势比 0.61，95%CI 0.38 至 0.99）相关。随着时间的推移，进食慢和饱腹感反应的增加与较低的 3 岁 WFAz 相关（B=-0.74，95%CI -1.18 至 -0.2[进食慢]；B=-1.19，95%CI -1.87 至 -0.52[饱腹感反应]，均 P 值=0.001）。随着时间的推移，对食物的享受程度增加与较高的 3 岁 WFAz 相关（B=0.62，95%CI 0.24 至 1.01；P=0.002）。
进食慢和饱腹感反应较低的婴儿可能存在更高的肥胖风险，需要更有针对性的营养咨询和肥胖预防方法。
