Weker Halina, Barańska Marta, Riahi Agnieszka, Strucińska Małgorzata, Więch Małgorzata, Rowicka Grażyna, Dyląg Hanna, Klemarczyk Witold, Bzikowska Agnieszka, Socha Piotr
Nutrition Department, Institute of Mother and Child, Warsaw, Poland, Human Nutrition Department, Faculty of Health Sciences, Medical University of Warsaw, Poland.
Early Psychological Intervention Department, Institute of Mother and Child, Warsaw, Poland.
Dev Period Med. 2017;21(3):272-285. doi: 10.34763/devperiodmed.20172103.272285.
Children's appropriate dietary pattern determines their optimal development, reduces the risk of childhood diseases and the risk of diet-dependent diseases, including obesity in adulthood.
To analyze the dietary patterns of children with excess weight aged 1-3 years in comparison with the main components of the safe nutrition model including: the organization of meals (frequency of meals), selection of products (food intake), energy and nutritional value of children's diets.
The study was carried out in 2016 on a representative nationwide sample of children aged 5-36 months (n=1059). The analysis of dietary patterns covered 173 with excess weight children aged 13-36 months (BMI-z-score >1 SD). Their nutritional status was evaluated based on BMI and its standardisation according to the WHO reference child growth standards for children aged 0-5 years (BMI z-score). The diets of children were assessed using 3-day dietary records. The dietary patterns of the children who were analysed were determined using the cluster analysis (k-means method), including 11 variables concerning average daily intake of main food group products (cow's milk, junior formula, milk products, bread, groats and rice, cereals, cured meats, fats, sugar and sweets, fruits, nectars and juices).
Three clusters of overweight and obese children with different dietary patterns were identified. The diet of children from the first cluster (n=58) was based primarily on junior formula and foods for infants and toddlers. This dietary pattern was defined as the "baby food diet". The second cluster comprised 33 children whose diets were characterised by high consumption of cow's milk and dairy products, as well as cereal products, including bread, groats, rice and breakfast cereals. This dietary pattern was defined the "milk and cereals diet". The third cluster consisted of 82 children whose dietary pattern was characterised by high consumption of bread, cold meats and fats, sweets, juices and fruits (the "sandwich and sugar diet"). In all the clusters the average intake of vegetables and fruit by children with excess weight was significantly lower than the recommended amounts. The study showed too high intake of energy, protein, sodium, B vitamins and saccharose and an insufficient supply of calcium, fibre, vitamin D, vitamin E, LCPUFA, iodine and potassium in the children's diet in reference to nutritional recommendations. Younger children with the "baby food diet" pattern, due to the contribution of enriched food, had a more balanced diet in relation to the model of safe nutrition (nutritional norms). Older children's diets - in the third year of life, were characterized by a diversified choice of products that are a source of protein and carbohydrates (milk, breakfast cereals, meat, bread, cold meats, sugar from beverages, dairy desserts and juices).
The identified dietary patterns of toddlers with excess weight differ from the safe nutrition model in terms of product selection and nutrient profile.
儿童适宜的饮食模式决定其最佳发育状态,降低儿童疾病风险以及与饮食相关疾病的风险,包括成年期肥胖症。
分析1至3岁超重儿童的饮食模式,并与安全营养模式的主要组成部分进行比较,包括:进餐安排(进餐频率)、食物选择(食物摄入量)、儿童饮食的能量和营养价值。
2016年,对全国范围内具有代表性的5至36个月儿童样本(n = 1059)进行了研究。饮食模式分析涵盖了173名13至36个月超重儿童(BMI-z评分>1个标准差)。根据BMI及其按照世界卫生组织0至5岁儿童生长标准进行的标准化评估他们的营养状况(BMI z评分)。使用3天饮食记录评估儿童的饮食。通过聚类分析(k均值法)确定所分析儿童的饮食模式,包括11个关于主要食物组产品平均每日摄入量的变量(牛奶、幼儿配方奶粉、奶制品、面包、谷物和大米、谷类食品、腌制肉类、脂肪、糖和甜食、水果、花蜜和果汁)。
识别出了三组具有不同饮食模式的超重和肥胖儿童。第一组(n = 58)儿童的饮食主要以幼儿配方奶粉以及婴幼儿食品为主。这种饮食模式被定义为“婴儿食品饮食”。第二组包括33名儿童,其饮食特点是大量摄入牛奶和奶制品以及谷物产品,包括面包、谷物、大米和早餐谷类食品。这种饮食模式被定义为“牛奶和谷物饮食”。第三组由82名儿童组成,其饮食模式的特点是大量摄入面包、冷肉和脂肪、甜食、果汁和水果(“三明治和糖饮食”)。在所有组中,超重儿童蔬菜和水果的平均摄入量均显著低于推荐量。研究表明,参照营养建议,儿童饮食中能量、蛋白质、钠、B族维生素和蔗糖的摄入量过高,而钙、纤维、维生素D、维生素E、长链多不饱和脂肪酸、碘和钾的供应不足。采用“婴儿食品饮食”模式的幼儿,由于食用了强化食品,其饮食与安全营养模式(营养规范)相比更为均衡。大龄儿童(三岁儿童)的饮食特点是蛋白质和碳水化合物来源产品的选择多样(牛奶、早餐谷类食品、肉类、面包、冷肉、饮料中的糖、奶类甜点和果汁)。
所识别出的超重幼儿饮食模式在食物选择和营养成分方面与安全营养模式不同。