Wang Jian, Winkley Kirsty, Wei Xiaoxue, Cao Yang, Chang Yan-Shing
Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, SE1 8WA, London, UK.
School of Nursing, Shanghai Jiao Tong University, 200025, Shanghai, China.
Appetite. 2023 Jan 1;180:106343. doi: 10.1016/j.appet.2022.106343. Epub 2022 Oct 10.
The impacts of caregivers' perception of child weight on their non-responsive feeding practices are inconclusive. This systematic review aimed to examine their relationships.
A systematic search of five databases was conducted from inception to March 2022, following PRISMA guidelines. Data synthesis was performed using semi-quantitative approach and meta-analysis.
Twenty-two studies with 12005 respondents were included for semi-quantitative analyses. Eighteen studies examined 26 associations between caregivers' perception of child weight and food restriction with 12 statistically significant associations being observed. A total of 22 relationships between caregivers' perception of child weight and pressure to eat were investigated, with 13 being statistically significant. The statistically significant associations consistently reported that caregivers' visual and self-reported perception of child weight was positively associated with their restrictive feeding and negatively associated with pressure to eat. The pooled odds ratios (ORs) indicated that caregivers who perceived their child as overweight were found to apply pressure to eat less frequently (OR = 0.61; 95%CI: 0.44, 0.84) compared with those who did not. However, caregivers' perception of child weight was not statistically significantly associated with restrictive feeding (OR = 1.37; 95%CI: 0.74, 2.55).
Caregivers' self-reported and visual perception of child weight may be important risk factors for non-responsive feeding practices, particularly food restriction and pressure to eat. Thus, interventions need to consider the role of caregivers' perception of child weight, which may optimize feeding practices. Furthermore, longitudinal and intervention-based studies using validated measurements while controlling for potential covariates are needed to provide more evidence on their causal relationships.
照顾者对儿童体重的认知对其非顺应性喂养行为的影响尚无定论。本系统评价旨在研究二者之间的关系。
按照PRISMA指南，对五个数据库进行了从建库至2022年3月的系统检索。采用半定量方法和荟萃分析进行数据综合。
纳入22项研究，共12005名受访者进行半定量分析。18项研究考察了照顾者对儿童体重的认知与食物限制之间的26种关联，其中12种关联具有统计学意义。共调查了照顾者对儿童体重的认知与进食压力之间的22种关系，其中13种具有统计学意义。具有统计学意义的关联一致表明，照顾者对儿童体重的视觉及自我报告认知与限制性喂养呈正相关，与进食压力呈负相关。合并比值比（OR）表明，与未将孩子视为超重的照顾者相比，将孩子视为超重的照顾者施加少吃压力的频率更低（OR = 0.61；95%CI：0.44，0.84）。然而，照顾者对儿童体重的认知与限制性喂养之间无统计学显著关联（OR = 1.37；95%CI：0.74，2.55）。
照顾者对儿童体重的自我报告及视觉认知可能是非顺应性喂养行为，尤其是食物限制和进食压力的重要危险因素。因此，干预措施需要考虑照顾者对儿童体重认知的作用，这可能会优化喂养行为。此外，需要开展纵向研究和基于干预的研究，采用经过验证的测量方法并控制潜在协变量，以提供更多关于二者因果关系的证据。
