父母逼迫进食、学龄前儿童食欲特征和儿童体重间的作用路径

Path analysis of the relationships among parental pressure to eat,preschoolers′appetitive traits and weight status

目的分析父母逼迫进食、学龄前儿童食欲特征和儿童体重之间的作用关系。方法2022年11月—2023年1月对上海市8所幼儿园1086名学龄前儿童及其父母进行调查。采用学龄前儿童照护人喂养行为量表、学龄前儿童进食行为量表分别调查父母逼迫进食和学龄前儿童食欲特征(食物响应、过饱响应)。采用结构方程模型中的路径分析对变量间的作用关系进行检验。结果路径分析结果表明,父母逼迫进食正向预测儿童过饱响应(B=0.329,95%CI:0.278~0.380,P<0.001),过饱响应负向预测儿童年龄别体重指数Z评分(BAZ)(B=-0.176,95%CI:-0.258~-0.094,P<0.001),儿童BAZ负向预测父母逼迫进食(B=-0.064,95%CI:-0.115~-0.013,P=0.015);但父母逼迫进食与儿童食物响应缺乏统计学意义的关联(P>0.05)。结论父母逼迫进食、学龄前儿童食欲特征和儿童体重三者间存在“三角”复杂关系。社区儿童保健工作应指导学龄前儿童父母采用合理喂养行为,以减少对儿童食欲特征的干扰,维持儿童健康体重。

Objective To analyze the relationships among parental pressure to eat,preschoolers′appetitive traits,and child weight status.Methods From December 2022to January 2023,a total of 1086preschoolers and their parents from 8kindergartens in Shanghai were included in the investigation.The Chinese Preschooler′s Caregivers′Feeding Behavior Scale and the Chinese Preschoolers′Eating Behavior Questionnaire were utilized to assess parental pressure to eat and child appetitive traits,specifically food responsiveness and satiety responsiveness.The relationship between these variables was examined using path analysis within a structural equation model.Results The results of path analysis revealed that pressure to eat positively predicted child satiety responsiveness(B=0.329,95%CI:0.278-0.380,P<0.001),satiety responsiveness negatively predicted child BMI-for-age Z score(BAZ)(B=-0.176,95%CI:-0.258--0.094,P<0.001),child BAZ negatively predicted parental pressure to eat(B=-0.064,95%CI:-0.115--0.013,P=0.015).However,parental pressure to eat was not statistically associated with child food responsiveness(P>0.05).Conclusions There may be a complex"triangle"relationship among parental pressure to eat,preschoolers′appetitive traits and child weight.Community child health professionals should guide parents of preschoolers to adopt reasonable feeding practices to minimize the interference with child appetitive traits and maintain a healthy weight.