Epidemiology Research Unit, Caribbean Institute for Health Research, The University of the West Indies, Mona, Jamaica.
Front Public Health. 2023 Jun 30;11:1161808. doi: 10.3389/fpubh.2023.1161808. eCollection 2023.
To explore whether maternal feeding styles at 12 months predict child Body Mass Index (BMI) z-scores at 72 months and evaluate whether BMI z-scores at 18 months mediates the association.
Data from 239 mother-child pairs participating in a parenting intervention were analyzed. Feeding information was ascertained at 12 months by questionnaire with feeding styles identified using factor analysis. Children's weight and length/height were measured at 18 and 72 months and BMI z-scores computed. Maternal sociodemographic data, depressive symptoms and language skills were obtained by questionnaire. Multilevel linear regression analysis was used to examine whether feeding styles predicted 72 month BMI z-scores. Complete case analysis was conducted and multiple imputation used to treat missing values of explanatory and outcome variables at 18 and 72 months. Mediational analysis was performed to assess the indirect effects of feeding styles on 72 month BMI z-scores via 18 month BMI z-scores.
Restrictive feeding at age 12 months predicted higher 72 month BMI z-scores in both complete case analysis [ (95%CI): 0.19 (0.02, 0.37)] and multiple imputation [ (95%CI): 0.20 (0.02, 0.39)]. Uninvolved, forceful, indulgent and responsive feeding styles were not significant predictors of 72 month BMI z-scores. A significant indirect effect was observed between restrictive feeding and child BMI z-scores at 72 months via 18 month BMI z-scores [ (95% CI) 0.12 (0.03, 0.22)].
Restrictive feeding at 12 months was associated with higher BMI z-scores at 72 months and appeared to be mediated by BMI z-scores at 18 months.
探讨 12 个月时的母婴喂养方式是否能预测 72 个月时儿童的体重指数（BMI）Z 分数，并评估 18 个月时的 BMI Z 分数是否在两者之间起中介作用。
对 239 对母婴参与的育儿干预研究的数据进行了分析。12 个月时通过问卷调查确定喂养信息，使用因子分析确定喂养方式。18 个月和 72 个月时测量儿童的体重和身高/长度，并计算 BMI Z 分数。通过问卷调查获取母亲的社会人口统计学数据、抑郁症状和语言技能。采用多水平线性回归分析来检验喂养方式是否能预测 72 个月时的 BMI Z 分数。采用完整案例分析，并使用多重插补法处理 18 个月和 72 个月时解释变量和结果变量的缺失值。通过 18 个月时的 BMI Z 分数来评估喂养方式对 72 个月时 BMI Z 分数的间接影响，进行中介分析。
12 个月时的限制喂养方式预测 72 个月时的 BMI Z 分数更高，在完整案例分析中为[（95%置信区间）：0.19（0.02，0.37）]，在多重插补分析中为[（95%置信区间）：0.20（0.02，0.39）]。不参与、强制、放纵和响应喂养方式均不是 72 个月时 BMI Z 分数的显著预测因素。在 18 个月时的 BMI Z 分数和 72 个月时的儿童 BMI Z 分数之间观察到了限制喂养与儿童 BMI Z 分数之间的显著间接影响[（95%置信区间）0.12（0.03，0.22）]。
12 个月时的限制喂养与 72 个月时的 BMI Z 分数较高有关，且似乎通过 18 个月时的 BMI Z 分数起中介作用。
