Budree Shrish, Goddard Elizabeth, Brittain Kirsty, Cader Shihaam, Myer Landon, Zar Heather J
Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital and MRC Unit on Child and Adolescent Health, University of Cape Town, Cape Town, South Africa.
Department of Dietetics, Red Cross War Memorial Children's Hospital, Cape Town, South Africa.
Matern Child Nutr. 2017 Jul;13(3). doi: 10.1111/mcn.12371. Epub 2016 Oct 2.
Childhood malnutrition is highly prevalent in low- and middle-income countries. The choices of complementary foods, which are important in infant nutrition, are poorly described in this setting. We investigated infant feeding practices in a South African birth cohort, the Drakenstein Child Health Study. Longitudinal feeding data were collected from March 2012 to March 2015. Feeding practices at birth, 6-10 and 14 weeks and 6, 9, and 12 months, were investigated using food frequency questionnaires. Anthropometry was measured at birth and 12 months. The quality of the diet was analyzed using the World Health Organization infant and young child feeding indicators. Regression models were used to explore associations between feeding and growth outcomes at 1 year. Exclusive breastfeeding for 6 months was low (13%), and 19% of infants were introduced to solid foods before 4 months. There was high daily consumption of processed meat (56%) and inappropriate foods such as fruit juice (82%), soft drinks (54%), and refined sugary foods (51%) at 1 year. Dietary diversity and consumption of iron rich foods were low at 6 months (5% and 3%, respectively) but higher by 12 months (75% and 78%). Longer duration of exclusive breastfeeding was associated with a lower height-for-age z-score at 1 year. Several dietary deficits and a rising trend in the consumption of inappropriate nutritionally poor foods were identified. These findings raise concern about poor dietary practices and the impact on child and long-term health.
儿童营养不良在低收入和中等收入国家极为普遍。在这种情况下，对婴儿营养至关重要的辅食选择却鲜有描述。我们在南非一个出生队列——德拉肯斯堡儿童健康研究中调查了婴儿喂养方式。从2012年3月至2015年3月收集纵向喂养数据。使用食物频率问卷调查出生时、6 - 10周、14周以及6、9和12个月时的喂养方式。在出生时和12个月时测量人体测量学指标。使用世界卫生组织婴幼儿喂养指标分析饮食质量。采用回归模型探讨1岁时喂养与生长结果之间的关联。6个月纯母乳喂养率较低（13%），19%的婴儿在4个月前就开始添加固体食物。1岁时加工肉类的每日摄入量较高（56%），果汁（82%）、软饮料（54%）和精制含糖食品（51%）等不适当食物的摄入量也较高。6个月时饮食多样性和富含铁食物的摄入量较低（分别为5%和3%），但到12个月时有所增加（分别为75%和78%）。纯母乳喂养时间较长与1岁时年龄别身高Z评分较低有关。研究发现了一些饮食缺陷以及食用营养较差的不适当食物的上升趋势。这些发现引发了对不良饮食习惯及其对儿童和长期健康影响的担忧。
