Broaddus-Shea Elena T, Thorne-Lyman Andrew L, Manohar Swetha, Nonyane Bareng A S, Winch Peter J, West Keith P
Center for Human Nutrition and Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA.
Curr Dev Nutr. 2018 Jun 29;2(9):nzy058. doi: 10.1093/cdn/nzy058. eCollection 2018 Sep.
Children's dietary patterns vary seasonally, particularly in subsistence agriculture settings like Nepal, but the seasonality of nutritious nonstaple food consumption is not well explored in the literature.
This study aimed to examine seasonal differences in children's consumption of provitamin A-rich fruit and vegetables, dairy, eggs, meat, and fish in Nepal's 3 agroecological zones, and to assess whether seasonal patterns vary by wealth and caste/ethnicity.
Multivariable negative binomial regression models were used to analyze dietary data from 7-d food-frequency questionnaires, producing coefficient estimates in the form of incidence rate ratios (IRRs). Data were collected 3 times per year for 2 y from children aged 6-72 mo in Nepal's mountains ( = 226), hills ( = 168), and plains ( = 225).
There were significant seasonal differences in children's consumption of provitamin A-rich fruit and vegetables, dairy, meat, and fish that varied by agroecological zone. Adopting monsoon season as the referent for all comparisons, children in the mountains ate provitamin A-rich fruit and vegetables less frequently during the postmonsoon and winter seasons (IRRs: 0.5 and 0.7, respectively; both < 0.004), whereas in the plains, children's consumption of these foods was lower only during the postmonsoon season (IRR: 0.2; < 0.001). Children's dairy intake frequency increased during the winter in the mountains (IRR: 0.7; < 0.004) and decreased during the winter in the hills (IRR: 1.5; < 0.001). Only in the plains did children's meat and fish intakes vary seasonally, increasing during the postmonsoon season (IRR: 1.6; < 0.004). Wealth and caste/ethnicity variability influenced children's consumption of each of these nutritious groups of foods, and moderated seasonal effects in some instances.
Children's diets varied differently by season within each agroecological zone of Nepal and in some cases across socioeconomic groups, revealing the importance of taking a season- and location-specific approach to assessing diets and tailoring dietary strategies.
儿童的饮食模式随季节变化,在尼泊尔这样的自给农业环境中尤其如此,但营养非主食消费的季节性在文献中并未得到充分探讨。
本研究旨在调查尼泊尔三个农业生态区儿童富含维生素A原的水果和蔬菜、乳制品、鸡蛋、肉类和鱼类消费的季节性差异,并评估季节性模式是否因财富和种姓/族裔而异。
使用多变量负二项回归模型分析来自7天食物频率问卷的饮食数据,以发病率比(IRR)的形式得出系数估计值。在2年的时间里,每年对尼泊尔山区(n = 226)、丘陵地区(n = 168)和平原地区(n = 225)6至72个月大的儿童收集3次数据。
儿童对富含维生素A原的水果和蔬菜、乳制品、肉类和鱼类的消费存在显著的季节性差异,且因农业生态区而异。以季风季节作为所有比较的参照,山区儿童在季风后和冬季食用富含维生素A原的水果和蔬菜的频率较低(IRR分别为0.5和0.7;均P < 0.004),而在平原地区,儿童仅在季风后季节食用这些食物的频率较低(IRR为0.2;P < 0.001)。山区儿童的乳制品摄入频率在冬季增加(IRR为0.7;P < 0.004),而丘陵地区儿童的乳制品摄入频率在冬季下降(IRR为1.5;P < 0.001)。只有在平原地区,儿童的肉类和鱼类摄入量存在季节性变化,在季风后季节增加(IRR为1.6;P < 0.004)。财富和种姓/族裔差异影响了儿童对这些营养食物组中每一组的消费,并在某些情况下调节了季节性影响。
在尼泊尔的每个农业生态区内,儿童的饮食因季节而异,在某些情况下,不同社会经济群体之间也存在差异,这表明采用针对季节和地点的方法来评估饮食和制定饮食策略非常重要。