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儿童营养咨询对青少年智力的影响:一项 15 年随访的集群随机试验。

Effect of childhood nutrition counselling on intelligence in adolescence: a 15-year follow-up of a cluster-randomised trial.

机构信息

1Postgraduate Program in Epidemiology,Federal University of Pelotas,Pelotas,Brazil.

3Faculty of Medicine,Federal University of Rio Grande,Rio Grande,Brazil.

出版信息

Public Health Nutr. 2017 Aug;20(11):2034-2041. doi: 10.1017/S1368980017000751. Epub 2017 May 23.

Abstract

OBJECTIVE

The present study aimed to assess the effects of an early childhood nutrition counselling intervention on intelligence (as measured by the intelligence quotient (IQ)) at age 15-16 years.

DESIGN

A single-blind, cluster-randomised trial.

SETTING

In 1998, in Southern Brazil, mothers of children aged 18 months or younger were enrolled in a nutrition counselling intervention (n 424). Counselling included encouragement and promotion of exclusive breast-feeding until 6 months of age and continued breast-feeding supplemented by protein-, lipid- and carbohydrate-rich foods after age 6 months up to age 2 years. The control group received routine feeding advice. In 2013, the fourth round of follow-up of these individuals, at the age of 15-16 years, was undertaken. IQ was assessed using the short form of the Wechsler Adult Intelligence Scale (WAIS-III). Mental disorders (evaluated using the Development and Well-Being Assessment (DAWBA)) and self-reported school failure, smoking and alcohol use were also investigated. Adjusted analyses were conducted using a multilevel model in accordance with the sampling process.

SUBJECTS

Adolescents, mean (sd) age of 15·4 (0·5) years (n 339).

RESULTS

Mean (sd) total IQ score was lower in the intervention group than the control group (93·4 (11·4) and 95·8 (11·2), respectively) but the association did not persist after adjustment. The prevalence of any mental disorders was similar between intervention and control groups (23·1 and 23·5 %, respectively). There were no differences between groups regarding school failure, smoking and alcohol use.

CONCLUSIONS

Nutrition counselling intervention in early childhood had no effect on intelligence measured during adolescence.

摘要

目的

本研究旨在评估婴幼儿营养咨询干预对 15-16 岁时智力(以智商(IQ)衡量)的影响。

设计

单盲、整群随机试验。

地点

1998 年,在巴西南部,18 个月或以下儿童的母亲参加了营养咨询干预(n=424)。咨询包括鼓励和促进 6 个月龄前纯母乳喂养,并在 6 个月龄后继续母乳喂养,同时补充富含蛋白质、脂肪和碳水化合物的食物,直至 2 岁。对照组接受常规喂养建议。2013 年,对这些个体进行了第四轮随访,年龄在 15-16 岁之间。智商使用韦氏成人智力量表(WAIS-III)的简短形式进行评估。还使用发展和福利评估(DAWBA)评估了精神障碍,并调查了自我报告的学业失败、吸烟和饮酒情况。使用多层次模型根据抽样过程进行了调整分析。

受试者

青少年,平均(标准差)年龄为 15.4(0.5)岁(n=339)。

结果

干预组的平均(标准差)总智商得分低于对照组(分别为 93.4(11.4)和 95.8(11.2)),但调整后这种关联不再存在。干预组和对照组的任何精神障碍患病率相似(分别为 23.1%和 23.5%)。两组在学业失败、吸烟和饮酒方面没有差异。

结论

婴幼儿营养咨询干预对青春期智力没有影响。

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