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Does maternal feeding restriction lead to childhood obesity in a prospective cohort study?
  1. S L Rifas-Shiman1,
  2. B Sherry2,
  3. K Scanlon2,
  4. L L Birch3,
  5. M W Gillman1,
  6. E M Taveras1
  1. 1Obesity Prevention Program, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts, USA
  2. 2Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
  3. 3The Center for Childhood Obesity Research, Pennsylvania State University, 129 Noll Laboratory, University Park, Pennsylvania, USA
  1. Correspondence to Sheryl L Rifas-Shiman, MPH, Obesity Prevention Program, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, 133 Brookline Avenue, 3rd Floor, Boston, MA 02215, USA; sheryl_rifas{at}hphc.org

Abstract

Background Some studies show that greater parental control over children's eating habits predicts later obesity, but it is unclear whether parents are reacting to infants who are already overweight.

Objective To examine the longitudinal association between maternal feeding restriction at age 1 and body mass index (BMI) at age 3 and the extent to which the association is explained by weight for length (WFL) at age 1.

Methods We studied 837 mother–infant pairs from a prospective cohort study. The main exposure was maternal feeding restriction at age 1, defined as agreeing or strongly agreeing with the following question: “I have to be careful not to feed my child too much.” We ran multivariable linear regression models before and after adjusting for WFL at age 1. All models were adjusted for parental and child sociodemographic characteristics.

Results 100 (12.0%) mothers reported feeding restriction at age 1. Mean (SD) WFL z-score at age 1 was 0.32 (1.01), and BMI z-score at age 3 was 0.43 (1.01). Maternal feeding restriction at age 1 was associated with higher BMI z-score at age 3 before (β 0.26 (95% CI 0.05 to 0.48)) but not after (β 0.00 (95% CI −0.17 to 0.18)) adjusting for WFL z-score at age 1. Each unit of WFL z-score at age 1 was associated with an increment of 0.57 BMI z-score units at age 3 (95% CI 0.51 to 0.62).

Conclusions We found that maternal feeding restriction was associated with children having a higher BMI at age 3 before, but not after, adjusting for WFL at age 1. One potential reason may be that parents restrict the food intake of infants who are already overweight.

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Footnotes

  • Funding This study was supported by grants from the US National Institutes of Health (NIH) (HD 34568, HL 64925, HL 68041) and contract funding from the Centers for Disease Control and Prevention.

  • Competing interests None.

  • Ethics approval This study was conducted with the approval of the Human Subjects Committees of Harvard Pilgrim Health Care, Brigham and Women's Hospital, and Beth Israel Deaconess Medical Center.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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