Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
J Nutr. 2013 Feb;143(2):166-74. doi: 10.3945/jn.112.163857. Epub 2012 Dec 12.
Infant feeding practices generally influence infant growth, but it is unclear how introduction of specific foods affects growth across global populations. We studied 3 urban populations in the Global Exploration of Human Milk study to determine the association between infant feeding and anthropometry at 1 y of age. Three hundred sixty-five breastfeeding mother-infant pairs (120 US, 120 China, and 125 Mexico) were recruited soon after the infant's birth. Enrollment required agreement to breastfeed ≥75% for at least 3 mo. Weekly, 24-h, food frequency data were conducted on infants for 1 y and exclusive breastfeeding (EBF) duration and timing of specific complementary food introduction were calculated. Weight and length were measured at age 1 y and anthropometry Z-scores calculated using WHO standards. Cohorts in the 3 urban populations (Shanghai, China; Cincinnati, USA; and Mexico City, Mexico) differed by median EBF duration (5, 14, and 7 wk, respectively; P < 0.001), timing of introduction of meat/eggs/legumes (4.8, 9.3, and 7.0 mo, respectively; P < 0.0001), and other feeding practices. By age 1 y, infants in Shanghai were heavier and longer than Cincinnati and Mexico City infants (P < 0.001). Adjusting for nonfeeding covariates, the only feeding variable associated with anthropometry was EBF duration, which was modestly inversely associated with weight-for-age but not length-for-age or BMI Z-scores at 1 y. Although feeding variables differed by cohort, their impact on anthropometry differences was not consistent among cohorts. Overall, across these urban, international, breast-fed cohorts, differences in specific feeding practices did not explain the significant variation in anthropometry.
婴儿喂养方式通常会影响婴儿的生长,但目前尚不清楚特定食物的引入如何影响全球各地人群的生长。我们在全球母乳探索研究中对 3 个人口稠密的城市人群进行了研究,以确定婴儿喂养方式与 1 岁时人体测量学的关系。在婴儿出生后不久,我们招募了 365 对母乳喂养的母婴(120 对来自美国,120 对来自中国,125 对来自墨西哥)。入组需要至少 3 个月内母乳喂养≥75%。在 1 年内每周对婴儿进行 24 小时食物频率数据收集,计算纯母乳喂养(EBF)持续时间和特定补充食物引入的时间。在 1 岁时测量体重和身长,并使用世卫组织标准计算人体测量学 Z 分数。来自 3 个人口稠密城市(中国上海;美国辛辛那提;墨西哥城)的队列在 EBF 持续时间(分别为 5、14 和 7 周;P<0.001)、引入肉类/鸡蛋/豆类的时间(分别为 4.8、9.3 和 7.0 个月;P<0.0001)和其他喂养方式上存在差异。在 1 岁时,上海婴儿的体重和身长均大于辛辛那提和墨西哥城婴儿(P<0.001)。调整非喂养因素后,唯一与人体测量学相关的喂养变量是 EBF 持续时间,其与体重与年龄比呈适度负相关,但与身长与年龄比或 BMI Z 分数无关。尽管各队列的喂养变量存在差异,但这些差异对人体测量学差异的影响在各队列中并不一致。总体而言,在这些城市、国际化、母乳喂养队列中,特定喂养方式的差异并不能解释人体测量学差异的显著变化。