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一项针对拉丁裔母婴二元组的、为期24个月的以减少含糖饮料摄入为重点的行为干预措施的效果:一项随机对照试验的证据

Efficacy of a 24-month behavioral intervention focused on sugary beverage reduction for Latino mother-infant dyads: evidence from a randomized controlled trial.

作者信息

Machle Christopher J, Berger Paige K, Salvy Sarah-Jeanne, Rios Claudia, Durazo-Arvizu Ramon, Goran Michael I

机构信息

Department of Pediatrics, Children's Hospital Los Angeles, Los Angeles, CA, United States; Department of Psychology, University of Oregon, Eugene, OR, United States.

Department of Pediatrics, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States.

出版信息

Am J Clin Nutr. 2025 Feb;121(2):355-366. doi: 10.1016/j.ajcnut.2024.11.009. Epub 2025 Jan 9.

Abstract

BACKGROUND

Childhood obesity disproportionately impacts marginalized and under-resourced communities, particularly Latinos. Although consumption of sugar-sweetened beverages and juices (SSBJs) in infancy is linked to increased obesity, few early-life interventions have targeted SSBJ reduction.

OBJECTIVES

To determine the efficacy of a culturally tailored home intervention for reducing SSBJ intake and obesity risk in Latino mothers and infants.

METHODS

Mother-infant dyads (N = 210) were randomly assigned to 1 of 3 interventions for 2 years: 1) general health education (Control); 2) SSBJ intake reduction education (Intervention); 3) intervention plus home water delivery (Intervention + Water Delivery). Trained interventionists delivered education sessions 2 days/month during year 1 and 1 day/month during year 2. Mixed-effects models were used to examine changes in sugar consumption and weight-related outcomes over time by group for mothers and infants separately.

RESULTS

The mean prepregnancy BMI for mothers was 28.1 ± 5.6 kg/m. Mothers receiving Intervention + Water Delivery demonstrated significantly greater reductions in consumption of free sugars from beverages from baseline to 12 months compared to the other 2 groups, where free sugars are total sugars except lactose (B: -7.98 g; 95% CI: (-13.96 g, -2.00 g), P = 0.009, P= 0.036). However, this effect was not apparent in year 2. Group differences for infant sugar consumption followed a similar pattern but were smaller and nonsignificant. Weight-related outcomes were not significantly associated with treatment group for mothers or infants.

CONCLUSIONS

This intervention, combined with home delivery of bottled water, was effective in reducing sugar consumption from beverages for Latina mothers by roughly 8 g/day in the first year after childbirth. However, this effect was not maintained and was not significant for infants. More comprehensive and sustained strategies are likely needed to maintain efficacy and improve outcomes related to weight or body composition, particularly for infants. This trial was registered at clinicaltrials.gov as NCT03141346.

摘要

背景

儿童肥胖对边缘化和资源不足的社区,尤其是拉丁裔社区产生了不成比例的影响。尽管婴儿期饮用含糖饮料和果汁(SSBJs)与肥胖风险增加有关,但很少有针对降低SSBJs摄入量的早期生活干预措施。

目的

确定一种针对文化定制的家庭干预措施对降低拉丁裔母亲和婴儿SSBJs摄入量及肥胖风险的效果。

方法

母婴二元组(N = 210)被随机分配到3种干预措施中的一种,为期2年:1)一般健康教育(对照组);2)减少SSBJs摄入量教育(干预组);3)干预措施加家庭送水(干预+送水组)。经过培训的干预人员在第1年每月进行2天的教育课程,在第2年每月进行1天的教育课程。使用混合效应模型分别按组检查母亲和婴儿随时间推移糖消费和体重相关结果的变化。

结果

母亲孕前平均体重指数为28.1±5.6kg/m²。与其他两组相比,接受干预+送水组的母亲从基线到12个月时饮料中游离糖的消费量显著降低,游离糖是指除乳糖外的总糖(B:-7.98g;95%CI:(-13.96g,-2.00g),P = 0.009,P = 0.036)。然而,这种效果在第2年并不明显。婴儿糖消费的组间差异遵循类似模式,但差异较小且无统计学意义。体重相关结果与母亲或婴儿的治疗组无显著关联。

结论

这种干预措施,结合家庭送瓶装水,在产后第一年能够有效降低拉丁裔母亲饮料中的糖消费量,约为每天8克。然而,这种效果未能持续,且对婴儿不显著。可能需要更全面和持续的策略来维持效果,并改善与体重或身体成分相关的结果,特别是对于婴儿。该试验在clinicaltrials.gov上注册,注册号为NCT03141346。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/76ab/11863324/699fdb80e0f1/gr1.jpg

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