Taylor Caroline M, Northstone Kate, Wernimont Susan M, Emmett Pauline M
Centre for Child and Adolescent Health, School of Social and Community Medicine, University of Bristol, Bristol, UK.
School of Social and Community Medicine, University of Bristol, Bristol, UK.
Appetite. 2016 May 1;100:263-71. doi: 10.1016/j.appet.2016.02.021. Epub 2016 Feb 12.
It has been suggested that constipation may be associated with picky eating. Constipation is a common condition in childhood and a low intake of dietary fibre may be a risk factor. Differences in fibre intake between picky and non-picky children and its relation to stool consistency is currently not well-understood. Children enrolled in the Avon Longitudinal Study of Parents and Children identified as picky eaters (PE) were compared with non-picky eaters (NPE): (1) to determine dietary fibre intake at 38 months; (2) to investigate whether any difference in dietary fibre intake was predictive of usual stool hardness at 42 months. PE was identified from questionnaires at 24 and 38 months. Usual stool hardness was identified from a questionnaire at 42 months. Dietary intake was assessed at 38 months with a food frequency questionnaire. Dietary fibre intake was lower in PE than NPE (mean difference -1.4 (95% CI -1.6, -1.2) g/day, p < 0.001). PE was strongly associated with dietary fibre intake (adjusted regression model; unstandardised B -1.44 (95% CI -1.62, -1.24) g/day, p < 0.001). PE had a lower percentage of fibre from vegetables compared with NPE (8.9% vs 15.7%, respectively, p < 0.001). There was an association between PE and usually having hard stools (adjusted multinomial model; OR 1.31, 95% CI 1.07, 1.61; p = 0.010). This was attenuated when dietary fibre was included in the model, suggesting that fibre intake mediated the association (OR 1.16, 95% CI 0.94, 1.43, p = 0.180). Picky eating in 3-year-old children was associated with an increased prevalence of usually having hard stools. This association was mediated by low dietary fibre intake, particularly from vegetables, in PE. For children with PE, dietary advice aimed at increasing fibre intake may help avoid hard stools.
有人认为便秘可能与挑食有关。便秘是儿童期的常见病症，膳食纤维摄入量低可能是一个风险因素。目前，挑食儿童与不挑食儿童在膳食纤维摄入量上的差异及其与大便稠度的关系尚不清楚。将参与雅芳亲子纵向研究中被确定为挑食者（PE）的儿童与不挑食者（NPE）进行比较：（1）确定38个月时的膳食纤维摄入量；（2）调查膳食纤维摄入量的任何差异是否可预测42个月时的日常大便硬度。通过24个月和38个月时的问卷确定挑食情况。通过42个月时的问卷确定日常大便硬度。在38个月时用食物频率问卷评估饮食摄入量。挑食儿童的膳食纤维摄入量低于不挑食儿童（平均差异-1.4（95%可信区间-1.6，-1.2）克/天，p<0.001）。挑食与膳食纤维摄入量密切相关（调整后的回归模型；未标准化B-1.44（95%可信区间-1.62，-1.24）克/天，p<0.001）。与不挑食儿童相比，挑食儿童来自蔬菜的纤维百分比更低（分别为8.9%和15.7%，p<0.001）。挑食与经常有硬便之间存在关联（调整后的多项模型；比值比1.31，95%可信区间1.07，1.61；p=0.010）。当模型中纳入膳食纤维时，这种关联减弱，表明纤维摄入量介导了这种关联（比值比1.16，95%可信区间0.94，1.43，p=0.180）。3岁儿童挑食与经常有硬便的患病率增加有关。这种关联由挑食儿童低膳食纤维摄入量介导，尤其是来自蔬菜的膳食纤维摄入量低。对于挑食儿童，旨在增加纤维摄入量的饮食建议可能有助于避免硬便。
