Bork Kirsten A, Diallo Aldiouma
IRD, UMI 233, Inserm U 1175, University of Montpellier, TransVIHMI Research Unit, Montpellier, France; and
IRD, UMR 198, International Research Campus IRD/University Cheikh Anta Diop at Hann, Dakar, Senegal.
J Nutr. 2017 May;147(5):940-947. doi: 10.3945/jn.116.243246. Epub 2017 Mar 15.
Girls tend to have a lower risk of stunting than boys do in low-income countries. We evaluated differences in height status and complementary food (CF) intake between sexes from ages 2 to 39 mo in Senegal. Length and weight measurements were taken at ages 2-3, 4-5, 6-8, and 9-10 mo ( = 7319). Qualitative 24-h and 7-d food recalls were conducted in a subgroup ( = 2512). A smaller subsample was followed up to age 39 mo ( = 512). Height was measured, and intake of CF was noted. Boys and girls were compared in terms of height-for-age score (HAZ) of WHO standards and National Center for Health Statistics growth reference, height-for-age difference, stunting, and consumption of CF by using chi-square tests, general linear models, and mixed-effects linear models (MLMs). By using WHO standards, the mean HAZ was lower for boys than for girls in infancy, i.e., at 2-3 mo of age (-0.65 compared with -0.57; = 0.002) and beyond, i.e., at 24-29 mo of age (-2.01 compared with -1.65; < 0.001). Overall risk of stunting was 24.5% and 19.4% for boys and girls, respectively, during infancy ( < 0.001) compared with 59.2% and 47.9%, respectively, at 12-39 mo ( = 0.010). In MLMs from ages 2 to 39 mo, boys had a lower mean HAZ than girls had at age 2 mo (β = -0.19; = 0.035), and sex differences increased with increasing age (β = -0.007 scores/mo; < 0.001). At 2-3 mo of age, boys were more likely to have been fed CF every day during the past week (15.8% compared with 11.2% for girls; = 0.005) and to have eaten ≥2 meals in the past 24 h (13.4% compared with 8.2% for girls; < 0.001). In Senegalese infants, CF intake differed by sex, with boys more likely to consume CF. Boys had lower HAZs than girls had during infancy, and sex differences increased up to age 39 mo. The importance of sex in complementary feeding and growth warrants further attention in low-income countries.
在低收入国家,女孩发育迟缓的风险往往低于男孩。我们评估了塞内加尔2至39个月大儿童中不同性别的身高状况和辅食(CF)摄入量差异。在2至3、4至5、6至8和9至10个月龄时测量身长和体重(n = 7319)。对一个亚组进行了定性的24小时和7天食物召回调查(n = 2512)。对一个更小的子样本随访至39个月龄(n = 512)。测量身高并记录CF摄入量。使用卡方检验、一般线性模型和混合效应线性模型(MLM)比较男孩和女孩在世界卫生组织(WHO)标准的年龄别身高Z评分(HAZ)、美国国家卫生统计中心生长参考值、年龄别身高差异、发育迟缓以及CF摄入量方面的情况。按照WHO标准,在婴儿期,即2至3个月龄时,男孩的平均HAZ低于女孩(分别为-0.65和-0.57;P = 0.002),在24至29个月龄及以后也是如此(分别为-2.01和-1.65;P < 0.001)。婴儿期男孩和女孩发育迟缓的总体风险分别为24.5%和19.4%(P < 0.001),而在12至39个月龄时分别为59.2%和47.9%(P = 0.010)。在2至39个月龄的MLM中,2个月龄时男孩的平均HAZ低于女孩(β = -0.19;P = 0.035),且性别差异随年龄增长而增加(β = -0.007 Z评分/月;P < 0.001)。在2至3个月龄时,男孩在过去一周内每天更有可能接受CF喂养(分别为15.8%和11.2%;P = 0.005),且在过去24小时内进食≥2餐的可能性更大(分别为13.4%和8.2%;P < 0.001)。在塞内加尔婴儿中,CF摄入量存在性别差异,男孩摄入CF的可能性更大。在婴儿期男孩的HAZ低于女孩,且性别差异一直持续到39个月龄。在低收入国家,性别在辅食喂养和生长方面的重要性值得进一步关注。