Zhao Chunxia, Guan Hongyan, Shi Huifeng, Zhang Jingxu, Huang Xiaona, Wang Xiaoli
Ministry of Health Key Laboratory of Reproductive Health, Department of Child, Adolescent and Women's Health, School of Public Health, Peking University Health Science Center, Beijing, China.
Department of Integrated Early Childhood Development, Capital Institute of Pediatrics, Beijing, China.
Matern Child Nutr. 2021 Jan;17(1):e13073. doi: 10.1111/mcn.13073. Epub 2020 Sep 9.
The period from birth to 2years of age is highly sensitive with respect to the relationship between nutrition and neurodevelopment, but data regarding the association between dietary diversity and early childhood neurodevelopment are limited. We sought to examine the association of two feeding indicators-minimum dietary diversity (MDD) and minimum meal frequency (MMF)-with the neurodevelopment of children aged 6-23 months, using data from a cross-sectional survey conducted in six rural counties in China. Data on 1,534 children were analysed using logistic regression to explore the associations between dietary diversity and early neurodevelopment, with adjustments for the age, sex and prematurity of the child; the age, sex and educational level of the caregiver; and family size, income and simulative care practices and resources. We found that 32.4% of children had suspected developmental delays based on the Chinese version of the Ages and Stages Questionnaires Version 3, whereas 77.0% and 39.2% failed to meet the MDD and MMF, respectively. Meeting the MDD was associated with a 39% lower risk of developmental delays (AOR = 0.61, 95% CI [0.43, 0.86]). There was a significant association between MDD and reduced likelihood of developmental delays in gross motor, fine motor, problem-solving and personal social subscales, whereas MMF was only associated with a lower risk of developmental delays in the gross motor subscale (AOR = 0.63, 95% CI [0.42, 0.94]). We observed an inverse dose-response relationship between the number of food groups consumed and the risk of developmental delays (P < .001).
从出生到2岁这段时期,营养与神经发育之间的关系极为敏感,但关于饮食多样性与幼儿神经发育之间关联的数据却很有限。我们利用在中国六个农村县进行的横断面调查数据,试图研究两个喂养指标——最低饮食多样性(MDD)和最低进餐频率(MMF)——与6至23个月儿童神经发育之间的关联。对1534名儿童的数据进行逻辑回归分析,以探究饮食多样性与早期神经发育之间的关联,并对儿童的年龄、性别和早产情况;照料者的年龄、性别和教育水平;以及家庭规模、收入、模拟照料做法和资源进行了调整。我们发现,根据中文版《年龄与阶段问卷第3版》,32.4%的儿童存在疑似发育迟缓情况,而分别有77.0%和39.2%的儿童未达到MDD和MMF标准。达到MDD与发育迟缓风险降低39%相关(比值比=0.61,95%置信区间[0.43, 0.86])。MDD与大运动、精细运动、解决问题和个人社交子量表发育迟缓可能性降低之间存在显著关联,而MMF仅与大运动子量表发育迟缓风险较低相关(比值比=0.63,95%置信区间[0.42, 0.94])。我们观察到所食用食物种类数量与发育迟缓风险之间存在反向剂量反应关系(P<0.001)。