Tuan Nguyen T, Withers Mellissa, Frongillo Edward A, Hajeebhoy Nemat
Alive & Thrive Project, Hanoi, Vietnam.
Keck School of Medicine, University of Southern California, Los Angeles, California, USA.
Matern Child Nutr. 2017 Apr;13(2). doi: 10.1111/mcn.12295. Epub 2016 Feb 3.
The World Health Organization's (WHO) standardized questionnaire for assessing infant and young child feeding practices does not include commercial baby cereals (CBC), which are derived from several food groups and are fortified with micronutrients. We examined how different scenarios for classifying CBC affect estimates of the quality of complementary feeding in children ages 6-23 months in Vietnam in 2014 (n = 4811). In addition to the WHO standardized 24-h recall questionnaire for infant and young child feeding, we asked mothers about the consumption of CBC. The five resulting scenarios were S1 - omitted CBC; S2 - CBC classified as grains; S3 - as grains and dairy; S4 - as grains, dairy and fruit/vegetables; and S5 - as grains, dairy, fruit/vegetables and any others. Including CBC resulted in 4-11 percentage points higher in the prevalence of children who were fed each of the six food groups compared with what was reported in the WHO standardized questionnaire. Minimum dietary diversity (% fed ≥ 4 out of the 7 food groups) was higher in S5 (90%) than in S1 (84%), S2 (84%), S3 (85%) and S4 (86%). Minimum acceptable diet was also higher in scenarios S5 (80%) than in S1 (74%), S2 (75%), S3 (75%) and S4 (77%). Consumption of iron-rich foods was 94% when CBC was accounted, which was higher than the alternative scenario (89%). In summary, when CBC were included, population-level estimates of dietary quality were higher than when CBC were omitted. Guidance is required from the WHO about how to account for the consumption of CBC when estimating the quality of complementary feeding.
世界卫生组织（WHO）用于评估婴幼儿喂养方式的标准化问卷未涵盖商业婴儿谷物食品（CBC），这类食品源自多个食物类别并添加了微量营养素。我们研究了2014年越南6至23个月儿童中，对CBC进行不同分类的情况如何影响辅食喂养质量的评估（n = 4811）。除了WHO的婴幼儿喂养标准化24小时回顾问卷外，我们还询问了母亲们CBC的食用情况。由此产生的五种情况分别为：S1 - 忽略CBC；S2 - 将CBC归类为谷物；S3 - 归类为谷物和奶制品；S4 - 归类为谷物、奶制品和水果/蔬菜；S5 - 归类为谷物、奶制品、水果/蔬菜及其他任何食物。与WHO标准化问卷所报告的情况相比，纳入CBC后，食用六种食物类别中每一种的儿童患病率高出4至11个百分点。在S5（90%）中，最低饮食多样性（7种食物类别中至少食用4种的比例）高于S1（84%）、S2（84%）、S3（85%）和S4（86%）。在S5（80%）中，最低可接受饮食也高于S1（74%）、S2（75%）、S3（75%）和S4（77%）。计入CBC时，富含铁食物的食用率为94%，高于其他情况（89%）。总之，纳入CBC时，人群层面的饮食质量估计值高于忽略CBC时。WHO需要就估计辅食喂养质量时如何考虑CBC的食用情况提供指导。
