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学龄儿童的总体和腹部脂肪状况与婴儿喂养模式有关。

General and abdominal fat outcomes in school-age children associated with infant breastfeeding patterns.

作者信息

Durmuş Büşra, Heppe Denise H M, Gishti Olta, Manniesing Rashindra, Abrahamse-Berkeveld Marieke, van der Beek Eline M, Hofman Albert, Duijts Liesbeth, Gaillard Romy, Jaddoe Vincent W V

机构信息

From the Generation R Study Group (BD, DHMH, OG, RG, and VWVJ) and the Departments of Pediatrics (DHMH, OG, LD, RG, and VWVJ) and Epidemiology (BD, DHMH, OG, AH, LD, RG, and VWVJ), Erasmus University Medical Center, Rotterdam, Netherlands; the Department of Radiology, Radboud University, Nijmegen, Netherlands (RM); and Nutricia Research, Utrecht, Netherlands (MA-B and EMvdB).

出版信息

Am J Clin Nutr. 2014 Jun;99(6):1351-8. doi: 10.3945/ajcn.113.075937. Epub 2014 Mar 12.

Abstract

BACKGROUND

Breastfeeding may have a protective effect on the development of obesity in later life. Not much is known about the effects of infant feeding on more-specific fat measures.

OBJECTIVE

We examined associations of breastfeeding duration and exclusiveness and age at the introduction of solid foods with general and abdominal fat outcomes in children.

DESIGN

We performed a population-based, prospective cohort study in 5063 children. Information about infant feeding was obtained by using questionnaires. At the median age of 6.0 y (95% range: 5.7 y, 6.8 y), we measured childhood anthropometric measures, total fat mass and the android:gynoid fat ratio by using dual-energy X-ray absorptiometry, and preperitoneal abdominal fat by using ultrasound.

RESULTS

We observed that, in the models adjusted for child age, sex, and height only, a shorter breastfeeding duration, nonexclusive breastfeeding, and younger age at the introduction of solid foods were associated with higher childhood general and abdominal fat measures (P-trend < 0.05) but not with higher childhood body mass index. The introduction of solid foods at a younger age but not breastfeeding duration or exclusivity was associated with higher risk of overweight or obesity (OR: 2.05; 95% CI: 1.41, 2.90). After adjustment for family-based sociodemographic, maternal lifestyle, and childhood factors, the introduction of solid food between 4 and 4.9 mo of age was associated with higher risks of overweight or obesity, but the overall trend was not significant.

CONCLUSIONS

Associations of infant breastfeeding and age at the introduction of solid foods with general and abdominal fat outcomes are explained by sociodemographic and lifestyle-related factors. Whether infant dietary composition affects specific fat outcomes at older ages should be further studied.

摘要

背景

母乳喂养可能对晚年肥胖的发展具有保护作用。关于婴儿喂养对更具体的脂肪指标的影响,人们了解得并不多。

目的

我们研究了母乳喂养持续时间、排他性以及开始添加固体食物的年龄与儿童总体脂肪和腹部脂肪指标之间的关联。

设计

我们对5063名儿童进行了一项基于人群的前瞻性队列研究。通过问卷调查获取婴儿喂养的信息。在中位年龄6.0岁(95%范围:5.7岁,6.8岁)时,我们使用双能X线吸收法测量了儿童的人体测量指标、总脂肪量以及男性型脂肪与女性型脂肪比例,并使用超声测量了腹膜前腹部脂肪。

结果

我们观察到,在仅对儿童年龄、性别和身高进行调整的模型中,母乳喂养持续时间较短、非纯母乳喂养以及开始添加固体食物的年龄较小与儿童较高的总体和腹部脂肪指标相关(P趋势<0.05),但与儿童较高的体重指数无关。开始添加固体食物的年龄较小而非母乳喂养持续时间或排他性与超重或肥胖的较高风险相关(比值比:2.05;95%置信区间:1.41,2.90)。在对基于家庭的社会人口统计学、母亲生活方式和儿童因素进行调整后,在4至4.9个月龄之间开始添加固体食物与超重或肥胖的较高风险相关,但总体趋势不显著。

结论

社会人口统计学和生活方式相关因素解释了婴儿母乳喂养和开始添加固体食物的年龄与总体和腹部脂肪指标之间的关联。婴儿饮食成分是否会影响较大年龄时的特定脂肪指标,应进一步研究。

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