Esfarjani Fatemeh, Roustaee Roshanak, Mohammadi-Nasrabadi Fatemeh, Esmaillzadeh Ahmad
Department of Food Policy and Nutrition Planning, National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
J Health Popul Nutr. 2013 Jun;31(2):202-10. doi: 10.3329/jhpn.v31i2.16384.
To the best of our knowledge, no information is available to link major dietary patterns to stunting during childhood, although dietary patterns are associated with chronic diseases. This study was conducted to determine the relationship between major dietary patterns and stunting in the first grade pupils of Tehran in 2009. In this case-control study, 86 stunted children (defined as height-for-age of less than the 5th percentile of CDC2000 cutoff points) were enrolled from among 3,147 first grade pupils of Tehran, selected using a multistage cluster random-sampling method. Participants for the control group (n=308) were selected randomly from non-stunted children (height-for-age more than the 5th percentile of CDC2000 cutoff points), after matching for age, sex, and area of residence. Dietary data were collected using two 24-hour dietary recalls through face-to-face interview with mothers. Factor analysis was used for identifying major dietary patterns. Mean consumption of dairy products (308 +/- 167 vs 382 +/- 232 g/day, p < 0.05), dried fruits and nuts (2.5819 vs 7.15 +/- 26 g/day, p < 0.05) were significantly lower among stunted children than those in the control group. Three major dietary patterns were identified: 'traditional dietary pattern' that was dominated by bread, potato, fats, eggs, flavours, vegetables other than leafy ones, sugar, drinks, and fast food; 'mixed dietary pattern' that was dominated by leafy vegetables, fast foods, nuts, fats, cereals other than bread, fruits, legumes, visceral meats, sugars, eggs, and vegetables other than leafy vegetables; and 'carbohydrate-protein pattern' that was dominated by sweets and desserts, poultry, dairy, fruits, legumes, and visceral meats. No significant relationships were found between traditional and mixed dietary patterns and stunting. Individuals in the third quartile of carbohydrate-protein dietary pattern were less likely to be stunted compared to those in the bottom quartile (OR: 0.31, 95% CI 0.13-0.78, p < 0.05). Adherence to dietary patterns high in protein (e.g. dairy, legumes, and meat products) and carbohydrates (e.g. fruits, sweets, and desserts) might be associated with reduced odds of being stunted among children.
据我们所知，尽管饮食模式与慢性疾病有关，但尚无信息表明主要饮食模式与儿童期发育迟缓之间存在关联。本研究旨在确定2009年德黑兰一年级学生中主要饮食模式与发育迟缓之间的关系。在这项病例对照研究中，从德黑兰3147名一年级学生中选取了86名发育迟缓儿童（定义为年龄别身高低于CDC2000标准的第5百分位数），采用多阶段整群随机抽样方法进行选择。对照组参与者（n = 308）从非发育迟缓儿童（年龄别身高高于CDC2000标准的第5百分位数）中随机选取，匹配年龄、性别和居住地区。通过与母亲面对面访谈，使用两份24小时饮食回忆法收集饮食数据。采用因子分析确定主要饮食模式。发育迟缓儿童的乳制品平均摄入量（308±167 vs 382±232克/天，p < 0.05）、干水果和坚果平均摄入量（2.58±1.9 vs 7.15±2.6克/天，p < 0.05）显著低于对照组儿童。确定了三种主要饮食模式：“传统饮食模式”，以面包、土豆、脂肪、鸡蛋、调味料、非叶菜类蔬菜、糖、饮料和快餐为主；“混合饮食模式”，以叶菜类蔬菜、快餐、坚果、脂肪、非面包类谷物、水果、豆类、内脏肉、糖、鸡蛋和非叶菜类蔬菜为主；以及“碳水化合物 - 蛋白质模式”，以糖果和甜点、家禽、乳制品、水果、豆类和内脏肉为主。未发现传统饮食模式和混合饮食模式与发育迟缓之间存在显著关系。与处于碳水化合物 - 蛋白质饮食模式最低四分位数的个体相比，处于该模式第三四分位数的个体发育迟缓的可能性较小（比值比：0.31，95%置信区间0.13 - 0.78，p < 0.05）。坚持高蛋白（如乳制品、豆类和肉类产品）和高碳水化合物（如水果、糖果和甜点）的饮食模式可能与儿童发育迟缓几率降低有关。
