RESUMEN
BACKGROUND: Intervention Nurses Start Infants Growing on Healthy Trajectories tested an early life responsive parenting (RP) intervention designed for obesity prevention. Body mass index z-score at age 3 years was lower for the RP group versus controls with a larger effect for girls than boys. We sought to determine if child sex was associated with differing maternal feeding practices and whether sex moderated intervention effects on feeding. DESIGN/METHODS: Mothers (N = 279) completed the Infant Feeding Styles Questionnaire (IFSQ) at 28 weeks, the Structure and Control in Parent Feeding (SCPF) at 1, 2, and 3 years, and the Child Feeding Questionnaire (CFQ) at 3 years. Study aims were tested using 2-way analysis of variance and repeated measures. RESULTS: Mothers reported greater restriction (limiting food quantity) for boys at 28 weeks (IFSQ: 3.0 ± 1.1 vs 2.8 ± 1.0, P = .07) and across annual measurements from age 1 to 3 years (SCPF: P = .04). At age 3, the intervention group effect on restriction differed by sex (CFQ: P = .047) such that higher restriction was reported by RP group mothers of boys versus girls (3.4 ± 0.7 vs 3.0 ± 0.9, P = .002) with no control group sex difference (3.4 ± 0.8 vs 3.3 ± 0.9, P = .79). There were no sex differences or sex by intervention group interactions in other reported feeding practices at any assessment (ie, structure-based feeding, pressure). CONCLUSIONS: Mothers of boys used more restrictive feeding through age 3. These findings may be partially explained by previously reported better self-soothing and self-regulation abilities of participating girls.
Asunto(s)
Enfermeras y Enfermeros , Obesidad Infantil , Índice de Masa Corporal , Niño , Preescolar , Conducta Alimentaria , Femenino , Humanos , Lactante , Masculino , Madres , Responsabilidad Parental , Obesidad Infantil/prevención & control , Caracteres Sexuales , Encuestas y CuestionariosRESUMEN
BACKGROUND: Although widely used by infants, little is known about the long-term effects of pacifiers. We investigated relationships between pacifier use in infancy and appetite, temperament, feeding, and weight outcomes through age 2 years using data from the Intervention Nurses Start Infants Growing on Healthy Trajectories study. METHODS: Mother-newborn dyads were randomized to a responsive parenting intervention for obesity prevention or a control group. Infants with data on pacifier use (n = 250) were categorized as using a pacifier beyond early infancy (≥4 months of age) or not. Anthropometrics were measured at 6 months, 1, and 2 years with overweight defined as weight-for-length ≥95th percentile at 1 year and BMI ≥85th percentile at 2 years. Mothers completed questionnaires on temperament, appetite, and feeding. RESULTS: Infants who used a pacifier at 4 months or later (68%) had greater conditional weight gain from birth to 6 months (p = 0.01), weight-for-length z-score at 1 year (p < 0.001), and BMI z-score at 2 years (p < 0.001) than infants who did not. Infants using a pacifier at ≥4 months were more likely to be overweight at ages 1 year (11.7% vs. 1.3%, p = 0.03) and 2 years (20.1% vs. 7.9%, p = 0.03). Pacifier use was associated with shorter breastfeeding duration and less responsive parent feeding styles, but these variables did not mediate the relationship between pacifiers and weight. Parent-reported temperament and appetite were unrelated to pacifier use. CONCLUSIONS: Pacifier use beyond early infancy is associated with accelerated infant growth and toddler overweight, although the reasons for this relationship are unclear.
Asunto(s)
Peso Corporal , Chupetes/efectos adversos , Apetito , Estatura , Índice de Masa Corporal , Lactancia Materna , Preescolar , Conducta Alimentaria , Femenino , Humanos , Lactante , Recién Nacido , Masculino , Madres , Chupetes/estadística & datos numéricos , Obesidad Infantil/epidemiología , Obesidad Infantil/prevención & control , Temperamento , Aumento de PesoRESUMEN
The prevalence of obesity among children is high and is increasing. We know that obesity runs in families, with children of obese parents at greater risk of developing obesity than children of thin parents...
Asunto(s)
Masculino , Femenino , Humanos , Niño , Nutrición del Niño , Obesidad Infantil , Salud Infantil , Responsabilidad ParentalRESUMEN
Previous studies have found that breastfeeding may protect infants against future overweight...
Asunto(s)
Masculino , Femenino , Humanos , Recién Nacido , Lactante , Lactancia Materna , Bienestar del Lactante , Obesidad Infantil , Conducta AlimentariaRESUMEN
During the first 2 y of life, development is rapid and includes dramatic changes in eating behavior. Individual patterns of food preferences and eating behaviors emerge and differ depending on the foods offered and on the contexts of feeding during this early period of dietary transition. In this review, we discuss evidence on ways in which early learning influences food preferences and eating behavior, which, in turn, shape differences in dietary patterns, growth, and health. Although the evidence reviewed indicates that this early period of transition provides opportunities to influence children's developing intake patterns, there is no consistent, evidence-based guidance for caregivers who are feeding infants and toddlers; the current Dietary Guidelines are intended to apply to Americans over the age of 2 y. At present, the evidence base with regard to how and what children learn about food and eating behavior during these first years is limited. Before developing guidance for parents and caregivers, more scholarship and research is necessary to understand how infants and toddlers develop the food preferences and self-regulatory processes necessary to promote healthy growth, particularly in today's environment. By the time they reach 2 y of age, children have essentially completed the transition to "table foods" and are consuming diets similar to those of other family members. This article discusses parenting and feeding approaches that may facilitate or impede the development of self-regulation of intake and the acceptance of a variety of foods and flavors necessary for a healthy diet. We review the limited evidence on how traditional feeding practices, familiarization, associative learning, and observational learning affect the development of eating behavior in the context of the current food environment. Areas for future research that could inform the development of anticipatory guidance for parents and caregivers responsible for the care and feeding of young children are identified.
Asunto(s)
Desarrollo Infantil , Medicina Basada en la Evidencia , Conducta Alimentaria , Promoción de la Salud , Conducta del Lactante , Fenómenos Fisiológicos Nutricionales del Lactante , Regulación del Apetito , Ingestión de Energía , Métodos de Alimentación , Preferencias Alimentarias , Humanos , Lactante , Recién Nacido , Sobrepeso/etiología , Sobrepeso/prevención & control , Responsabilidad ParentalRESUMEN
BACKGROUND: Mothers use a range of feeding practices to limit children's intake of palatable snacks (eg, keeping snacks out of reach, not bringing snacks into the home), but less is known about the effects of these practices on children's eating and weight outcomes. OBJECTIVE: The objective was to identify distinct feeding practice profiles and evaluate the interactive effects of these profiles and girls' temperament (inhibitory control and approach) on girls' eating behaviors and weight outcomes at 5 and 7 y. DESIGN: Participants included 180 mother-daughter dyads; measures were mothers' reports of controlling feeding practices and girls' height and weight, eating in the absence of hunger (EAH) at 5 y, and inhibitory control (a measure of behavioral inhibition) and approach (a measure of appetitive motivation) at 7 y. RESULTS: Latent profile analysis of maternal feeding practices showed 4 feeding profiles based on maternal use of limit-setting practices and keeping snacks out of girls' physical reach, a restrictive practice: Unlimited Access to Snacks, Sets Limits+Does Not Restrict Snacks, Sets Limits+Restricts High Fat/Sugar Snacks, and Sets Limits+Restricts All Snacks. Girls whose mothers used Sets Limits+Restricts All Snacks had a higher approach and EAH at 5 y. Low inhibitory control girls whose mothers used Sets Limits+Restricts All Snacks or Unlimited Access to Snacks had greater increases in EAH and body mass index (BMI) from 5 to 7 y. CONCLUSIONS: Effects of maternal control on girls' EAH and BMI may differ by the type of practice used (eg, limit-setting or restrictive practices). Girls with low inhibitory control were more susceptible to the negative effects of low and high control.
Asunto(s)
Índice de Masa Corporal , Conducta Alimentaria , Hambre/fisiología , Responsabilidad Parental , Estatura , Peso Corporal , Niño , Preescolar , Estudios Transversales , Ingestión de Alimentos/psicología , Femenino , Humanos , Relaciones Madre-Hijo , Madres , Bocadillos , Encuestas y CuestionariosRESUMEN
OBJECTIVE: A priority for research is to identify individuals early in development who are particularly susceptible to weight gain in the current, obesogenic environment. This longitudinal study investigated whether early individual differences in inhibitory control, an aspect of temperament, predicted weight outcomes and whether parents' restrictive feeding practices moderated this relation. STUDY DESIGN: Participants included 197 non-Hispanic white girls and their parents; families were assessed when girls were 5, 7, 9, 11, 13, and 15 years old. Measures included mothers' reports of girls' inhibitory control levels, girls' reports of parental restriction in feeding, girls' body mass indexes (BMIs), and parents' BMIs, education, and income. RESULTS: Girls with lower inhibitory control at age 7 had higher concurrent BMIs, greater weight gain, higher BMIs at all subsequent time points, and were 1.95 times more likely to be overweight at age 15. Girls who perceived higher parental restriction exhibited the strongest inverse relation between inhibitory control and weight status. CONCLUSION: Variability in inhibitory control could help identify individuals who are predisposed to obesity risk; the current findings also highlight the importance of parenting practices as potentially modifiable factors that exacerbate or attenuate this risk.
Asunto(s)
Índice de Masa Corporal , Conducta Alimentaria/psicología , Preferencias Alimentarias/psicología , Obesidad/prevención & control , Relaciones Padres-Hijo , Adolescente , Factores de Edad , Análisis de Varianza , Niño , Desarrollo Infantil/fisiología , Preescolar , Escolaridad , Metabolismo Energético , Femenino , Estudios de Seguimiento , Humanos , Estudios Longitudinales , Responsabilidad Parental/psicología , Probabilidad , Factores de Riesgo , Factores Socioeconómicos , Aumento de PesoRESUMEN
OBJECTIVE: To examine the relationship between pubertal timing and physical activity. STUDY DESIGN: A longitudinal sample of 143 adolescent girls was assessed at ages 11 and 13 years. Girls' pubertal development was assessed at age 11 with blood estradiol levels, Tanner breast staging criteria, and parental report of pubertal development. Girls were classified as early maturers (n = 41) or later maturers (n = 102) on the basis of their scores on the 3 pubertal development measures. Dependent variables measured at age 13 were average minutes/day of moderate to vigorous and vigorous physical activity as measured by the ActiGraph accelerometer. RESULTS: Early-maturing girls had significantly lower self-reported physical activity and accumulated fewer minutes of moderate to vigorous and vigorous physical activity and accelerometer counts per day at age 13 than later maturing girls. These effects were independent of differences in percentage body fat and self-reported physical activity at age 11. CONCLUSION: Girls experiencing early pubertal maturation at age 11 reported lower subsequent physical activity at age 13 than their later maturing peers. Pubertal maturation, in particular early maturation relative to peers, may lead to declines in physical activity among adolescent girls.
Asunto(s)
Conductas Relacionadas con la Salud , Actividad Motora , Pubertad , Adolescente , Distribución de la Grasa Corporal , Estatura , Índice de Masa Corporal , Peso Corporal , Niño , Estradiol/sangre , Femenino , Humanos , Estudios Longitudinales , Monitoreo Ambulatorio/instrumentación , SobrepesoRESUMEN
OBJECTIVE: To assess cross-sectional and longitudinal relations between television (TV) viewing and girls' body mass index (BMI), weight status, and percentage of body fat. STUDY DESIGN: Participants included 169 girls who were measured at ages 7, 9, and 11 years. Height and weight were measured and used to calculate girls' BMI and to classify their weight status. Girls' percentage of body fat was assessed with the use of dual-energy x-ray absorptiometry. Mothers reported the hours per day that girls watched TV on a typical day. RESULTS: No significant cross-sectional associations were identified. Results from longitudinal analyses showed that in comparison to girls who never exceeded the American Academy of Pediatrics TV viewing recommendations (ie, watched
Asunto(s)
Distribución de la Grasa Corporal , Índice de Masa Corporal , Obesidad/epidemiología , Televisión , Absorciometría de Fotón , Niño , Estudios Transversales , Femenino , Conductas Relacionadas con la Salud , Humanos , Estudios Longitudinales , Pennsylvania/epidemiologíaRESUMEN
OBJECTIVE: Parental child-feeding practices are potentially significant determinants of body weight in youth. To date, research has focused on white middle class mother-child dyads. This study examines the longitudinal influences of child-feeding practices with time on total fat mass in white and African American boys and girls. STUDY DESIGN: Seventy-four white children (49 girls, 25 boys) and 47 African American children (25 girls, 22 boys; mean age at baseline, 11.0 years) and their mothers participated in this study. Child-feeding practices were measured with the Child Feeding Questionnaire. Total fat mass was measured by means of Dual energy X-ray absorptiometry on a yearly basis. The average follow-up period was 2.7 years. RESULTS: Pressure to eat and concern for the child's weight in white participants and restriction and concern for the child's weight in African American participants were significantly related to total fat mass at baseline. Concern for the child's weight was negatively related to the change of total fat mass with time in white participants. No longitudinal effects of child feeding practices on the change of total fat mass were found in African American participants. CONCLUSION: Parental concern for weight is a predictor of change in total fat mass with time in white children, but not African American children.
Asunto(s)
Fenómenos Fisiológicos Nutricionales Infantiles , Conducta Alimentaria , Conocimientos, Actitudes y Práctica en Salud , Relaciones Madre-Hijo , Obesidad/prevención & control , Población Negra , Índice de Masa Corporal , Niño , Femenino , Conductas Relacionadas con la Salud , Humanos , Estudios Longitudinales , Masculino , Obesidad/etnología , Encuestas y Cuestionarios , Estados Unidos , Población BlancaRESUMEN
OBJECTIVE: This longitudinal study examines links between parents' television (TV)-related parenting practices and their daughter's daily TV viewing hours. STUDY DESIGN: Participants included 173 non-Hispanic white girls and their parents who were examined when girls were age 9 and 11 years. Girls' daily TV viewing hours, mothers' and fathers' daily TV viewing hours, parents' use of TV as a recreational activity, family TV co-viewing, and parents' restriction of girls' access to TV were assessed. RESULTS: Approximately 40% of girls exceeded the TV-viewing recommendations (ie, < or =2 hours/day). Girls watched significantly more TV when their parents were high-volume TV viewers, relied heavily on TV as a recreational activity, watched TV with them, and failed to limit their access to TV. A parenting risk score was calculated by collapsing information across all parenting variables. In comparison with girls exposed to 1 or fewer parenting risk factors at age 9, girls exposed to 2 or more parenting risk factors were 5 to 10 times more likely to exceed TV viewing recommendations at age 9 and 11. CONCLUSIONS: Efforts to reduce TV viewing among children should encourage parents to limit their own TV viewing, reduce family TV viewing time, and limit their children's access to TV.
Asunto(s)
Conducta Infantil , Responsabilidad Parental/psicología , Televisión , Índice de Masa Corporal , Niño , Femenino , Humanos , Estudios Longitudinales , Masculino , Relaciones Padres-Hijo , Recreación , Factores de TiempoRESUMEN
OBJECTIVE: To identify portion sizes (quantity ingested at a meal/snack) of foods commonly consumed in early childhood, temporal stability, and relations to energy intake, weight status, and sociodemographic characteristics. STUDY DESIGN: Three samples were evaluated: the Continuing Survey of Food Intakes by Individuals, 1994 to 1996, 1998 (CSFII 94-96, 98) (n = 1039), the Nationwide Food Consumption Survey, 1977 to 1978 (NFCS 77-78) (n = 1045), and a longitudinal sample (n = 55) studied from 12 to 18 months. The CSFII 94-96, 98, and NFCS 77-78 samples were compared to evaluate secular trends. Change from 12 to 18 months was assessed in the longitudinal sample. Relations of portion size to other relevant variables were evaluated in the CSFII 94-96, 98 sample. RESULTS: In recent decades, portions remained remarkably similar for most foods. An exception was for meat portions, which were smaller in recent samples. Portions were longitudinally stable for most foods but increased for milk, bread, cereal, juice, and peanut butter. Body weight was positively related to energy intake and portion size but not number of eating occasions and/or foods. Sociodemographically, portion size was inversely related to number of eating occasions and/or foods. CONCLUSIONS: Children regulate energy intake largely through portion size. Sociodemographic patterns may have implications for later weight status.