Dourado Bruna Larine Lemos Fontes Silva, De Melo Jayanne Mayara Magalhães, Longo-Silva Giovana, de Menezes Risia Cristina Egito, da Silveira Jonas Augusto Cardoso
Graduate Program in Nutrition, School of Nutrition (FANUT), Federal University of Alagoas (UFAL), Maceió, Brazil.
Food Environment Studies and Research Center (NEPAAL), School of Nutrition (FANUT), Federal University of Alagoas (UFAL), Maceió, Brazil.
Pediatr Obes. 2022 Aug;17(8):e12912. doi: 10.1111/ijpo.12912. Epub 2022 Mar 16.
Although childhood obesity is increasing in low-income regions, theoretical models cannot be adequately applied due to the lack of prospective studies with under 2-year-old children from impoverished populations.
To analyse direct and indirect effects of environmental, maternal, and individual factors on excess weight gain among low-income children during the first year of life.
We analysed data from a prospective birth cohort conducted in Brazil, which followed infants at birth, 3rd, 6th, and 12th month of life (n = 205). The weight-for-age z-score was used to calculate the conditional weight gain (CWG). Direct and indirect effects on CWG were estimated using structural equation modelling.
Children's consumption of ultra-processed food (UPF) ≥1 time/day, breastfeeding duration >90 days, and maternal obesity showed a statistically significant direct effect on children's CWG. We observed a positive indirect pathway linking the maternal intake of UPF ≥4 times/day to the CWG, given its direct effect on the infant's UPF consumption.
In this low-income population, women who were frequent users of UPF tended to introduce these products more frequently into their children's diets. The early trade-off trend in children's diet between breastfeeding and UPF was the leading cause of excessive weight gain.
尽管低收入地区儿童肥胖现象在增加，但由于缺乏针对贫困家庭2岁以下儿童的前瞻性研究，理论模型无法得到充分应用。
分析环境、母亲和个体因素对低收入儿童出生后第一年体重过度增加的直接和间接影响。
我们分析了巴西一项前瞻性出生队列研究的数据，该研究对婴儿出生时、3个月、6个月和12个月时进行跟踪（n = 205）。采用年龄别体重Z评分来计算条件体重增加（CWG）。使用结构方程模型估计对CWG的直接和间接影响。
儿童每天食用超加工食品（UPF）≥1次、母乳喂养持续时间>90天以及母亲肥胖对儿童的CWG有统计学显著的直接影响。鉴于母亲每天食用UPF≥4次对婴儿UPF消费有直接影响，我们观察到一条将母亲每天食用UPF≥4次与CWG联系起来的正向间接途径。
在这个低收入人群中，频繁食用UPF的女性往往更频繁地将这些产品引入孩子的饮食中。儿童饮食中母乳喂养和UPF之间早期的权衡趋势是体重过度增加的主要原因。
