BACKGROUND The high level of obesity in Latino children, especially in farmworker families, may be partly attributed to feeding styles of parents. Feeding styles used in Latino farmworker families have not been well characterized. OBJECTIVE This study sought to identify and describe feeding styles used by mothers in farmworker families with 2.5- to 3.5-year-old children, describe how styles change over time, and characterize the relationship of feeding styles to dietary outcomes and measures of overweight and obesity. DESIGN This was a longitudinal cohort study, with families participating for a 2-year period; surveys were administered to mothers with varying frequency depending on the instrument, and dietary measurements were collected at baseline and 12 and 24 months. PARTICIPANTS/SETTING Eligible participants were self-identified Latino women with a co-resident child aged 2.5 to 3.5 years old and at least one household member engaged in farm work during the previous year. The sample included 248 farmworker families enrolled between 2011 and 2012 in the Niños Sanos study, a longitudinal investigation of Latino mothers and their young children in rural North Carolina. Eleven families provided incomplete dietary data, so the analysis included 237 families. Fifteen families were lost to follow-up and 12 withdrew during the course of the study. MAIN OUTCOME MEASURES Feeding style was assessed using items from the Caregiver's Feeding Style Questionnaire, selected dietary components were assessed using the Revised Children's Diet Quality Index, and weight outcomes were determined using body mass index-for-age percentile. Performance on the Caregiver's Feeding Style Questionnaire items was used to assign mothers to one of four feeding style states. STATISTICAL ANALYSES PERFORMED Exploratory factor analysis was conducted on baseline data to verify the replicability of the factor structure of the instrument Caregiver's Feeding Style Questionnaire. Hidden Markov Model analysis was used to delineate different subtypes of feeding style. Multivariable mixed-effects regression models were used to assess the impact of feeding style on selected dietary components, energy intake, and body mass index-for-age percentile. RESULTS Four distinct states emerged from the Hidden Markov Model: low parent-centered (PC)/moderate child-centered (CC) feeding style (28% at baseline), high PC/CC without physical control (24%), high PC/CC (26%), and moderate PC/CC (22%). The low PC/moderate CC state increased in prevalence over time. Compared to high PC/CC, the low PC/moderate CC state was associated with greater intake of added sugars (P<0.01), lower intake of whole grains and vegetables (P<0.01), and lower overall diet quality (P<0.05). Children in low PC/moderate CC also had higher mean body mass index percentiles (76.2 percentile vs 66.7 percentile in high PC/CC; P<0.001). CONCLUSIONS High PC feeding along with high CC feeding is associated with improved diet quality and weight outcomes for children in the study.

中文翻译：

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一组拉丁裔农场工人家庭的儿童喂养方式和饮食结果

背景拉丁裔儿童，尤其是农场工人家庭中的高肥胖率可能部分归因于父母的喂养方式。拉丁裔农场工人家庭使用的喂养方式尚未得到很好的描述。目的 本研究旨在识别和描述有 2.5 至 3.5 岁儿童的农场工人家庭的母亲使用的喂养方式，描述方式如何随时间变化，并描述喂养方式与饮食结果和超重和肥胖测量的关系. 设计 这是一项纵向队列研究，家庭参与为期 2 年；根据仪器，对母亲进行不同频率的调查，并在基线和 12 个月和 24 个月时收集饮食测量值。参与者/环境 符合条件的参与者是自我认同的拉丁裔妇女，他们有一个 2.5 至 3.5 岁的共同居住的孩子，并且至少有一个家庭成员在上一年从事农业工作。样本包括在 2011 年至 2012 年间参加 Niños Sanos 研究的 248 个农场工人家庭，该研究是对北卡罗来纳州农村的拉丁裔母亲及其幼儿的纵向调查。11 个家庭提供了不完整的饮食数据，因此分析包括 237 个家庭。在研究过程中，15 个家庭失去了随访，12 个家庭退出了。主要观察指标 使用照料者喂养方式问卷中的项目评估喂养方式，使用修订后的儿童膳食质量指数评估选定的膳食成分，体重结果是使用年龄百分比的体重指数确定的。看护人喂养方式问卷项目的表现用于将母亲分配到四种喂养方式状态之一。执行的统计分析 对基线数据进行探索性因素分析，以验证工具看护人喂养方式问卷的因素结构的可重复性。隐马尔可夫模型分析用于描绘不同的喂养方式亚型。多变量混合效应回归模型用于评估喂养方式对所选膳食成分、能量摄入和年龄百分比体重指数的影响。结果 隐马尔可夫模型出现了四种不同的状态：低以父母为中心 (PC)/中度以儿童为中心 (CC) 的喂养方式（基线为 28%），无物理控制的高 PC/CC (24%)、高 PC/CC (26%) 和中等 PC/CC (22%)。随着时间的推移，低 PC/中度 CC 状态的患病率增加。与高 PC/CC 相比，低 PC/中等 CC 状态与更多的添加糖摄入量（P<0.01）、较低的全谷物和蔬菜摄入量（P<0.01）以及较低的整体饮食质量（P<0.05）相关）。低 PC/中度 CC 的儿童的平均体重指数百分位数也更高（高 PC/CC 的 76.2 个百分点 vs 66.7 个百分点；P<0.001）。结论 高 PC 喂养和高 CC 喂养与研究中儿童饮食质量和体重结果的改善有关。低 PC/中等 CC 状态与更多的添加糖摄入量（P<0.01）、较低的全谷物和蔬菜摄入量（P<0.01）以及较低的整体饮食质量（P<0.05）相关。低 PC/中度 CC 的儿童的平均体重指数百分位数也更高（高 PC/CC 的 76.2 个百分点 vs 66.7 个百分点；P<0.001）。结论 高 PC 喂养和高 CC 喂养与研究中儿童饮食质量和体重结果的改善有关。低 PC/中等 CC 状态与更多的添加糖摄入量（P<0.01）、较低的全谷物和蔬菜摄入量（P<0.01）以及较低的整体饮食质量（P<0.05）相关。低 PC/中度 CC 的儿童的平均体重指数百分位数也更高（高 PC/CC 的 76.2 个百分点 vs 66.7 个百分点；P<0.001）。结论 高 PC 喂养和高 CC 喂养与研究中儿童饮食质量和体重结果的改善有关。