孕期食物不安全、父母心理健康症状、喂养控制方式与婴儿食物反应性的纵向关联。
Longitudinal Associations Among Food Insecurity During Pregnancy, Parental Mental Health Symptoms, Controlling Feeding Styles, and Infant Food Responsiveness.
机构信息
Human Development and Family Studies, University of North Carolina Greensboro, Greensboro, NC, USA.
Department of Nutrition, University of North Carolina Greensboro, Greensboro, NC, USA.
出版信息
J Nutr. 2023 Jan 14;152(12):2659-2668. doi: 10.1093/jn/nxac225.
BACKGROUND
Research is needed to identify pathways by which household food insecurity (FI) contributes to parental controlling feeding styles and infant food responsiveness, 2 factors that play a role in shaping obesity risk across infancy and early childhood.
OBJECTIVES
This longitudinal study tested the hypothesis that prenatal FI would be positively associated with higher infant food responsiveness via greater parental mental health symptomatology and controlling feeding styles (pressuring, restrictive).
METHODS
Participants included a community sample of 170 birth parents and their infants participating in an ongoing longitudinal study. Parents self-reported household FI and mental health symptoms (depression and anxiety) during pregnancy. Postnatally, parents reported their mental health symptoms, their use of controlling feeding styles, and infant food responsiveness. Path analyses with bias-corrected 95% bootstrapped CIs tested direct and indirect associations between prenatal FI and infant food responsiveness.
RESULTS
Prenatal FI was indirectly associated with higher infant food responsiveness via greater parental mental health symptomatology and pressuring to finish (b = 0.01; 95% CI: 0.001, 0.025). Prenatal FI was associated with greater parental mental health symptomatology across the peripartum period (β = 0.54; P < 0.001), which in turn was associated with more pressuring to finish at 2 months pospartum (β = 0.29; P = 0.01) and higher infant food responsiveness at 6 months (β = 0.17; P = 0.04). There were no direct effects of prenatal FI on controlling feedings styles or infant food responsiveness.
CONCLUSIONS
Our findings point to parental mental health as a potential pathway by which FI may be associated with obesity-promoting parental feeding styles and infant appetitive behaviors. In addition to ensuring reliable access to enough quality food during pregnancy, multipronged assistance that promotes emotional well-being during the peripartum period and clinical guidance on noncontrolling feeding styles could benefit parent and infant health and well-being.
背景
需要研究家庭食物不安全（FI）如何影响父母控制喂养方式和婴儿食物反应性，这两个因素在塑造婴儿期和幼儿期肥胖风险中起着重要作用。
目的
本纵向研究检验了以下假设，即产前 FI 与较高的婴儿食物反应性呈正相关，这是通过父母心理健康症状和控制喂养方式（施压、限制）来实现的。
方法
参与者包括 170 名参与正在进行的纵向研究的母婴社区样本。父母在怀孕期间自我报告家庭 FI 和心理健康症状（抑郁和焦虑）。产后，父母报告了他们的心理健康症状、控制喂养方式和婴儿食物反应性。路径分析采用偏置校正的 95% bootstrap CI 检验了产前 FI 与婴儿食物反应性之间的直接和间接关联。
结果
产前 FI 通过增加父母的心理健康症状和施压让孩子吃完间接与婴儿食物反应性呈正相关（b = 0.01；95% CI：0.001，0.025）。产前 FI 与围产期父母的心理健康症状呈正相关（β = 0.54；P < 0.001），进而与产后 2 个月施压让孩子吃完的程度呈正相关（β = 0.29；P = 0.01）和 6 个月婴儿食物反应性呈正相关（β = 0.17；P = 0.04）。产前 FI 对控制喂养方式或婴儿食物反应性没有直接影响。
结论
我们的研究结果表明，父母的心理健康是 FI 可能与促进肥胖的父母喂养方式和婴儿食欲行为相关的潜在途径。除了确保孕妇在怀孕期间获得可靠的高质量食物外，多管齐下的援助可以促进围产期的情绪健康，并提供关于非控制喂养方式的临床指导，这将有益于父母和婴儿的健康和福祉。
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