Vanderhout Shelley M, Corsi Daniel J
Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada.
School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada.
Matern Child Nutr. 2021 Apr;17(2):e13090. doi: 10.1111/mcn.13090. Epub 2020 Sep 30.
Dairy milk has been shown to contribute to child growth in many countries, but the relationship between milk intake and anthropometric outcomes among Indian children has not been studied. The objectives were to describe children aged 6-59 months who consume dairy milk in India and determine if dairy milk consumption was associated with lower odds of stunting, underweight and anthropometric failure among Indian children. This was a cross-sectional study based on the fourth Indian National Family Health Survey (NFHS-4), which was a national survey conducted between 2015 and 2016 by the Ministry of Health and Family Welfare. The primary exposure was the consumption of dairy milk within the past day or night. The primary outcomes were stunting (height-for-age z score < -2), underweight (weight-for-age z score < -2) and the composite index of anthropometric failure (CIAF), which is a combination of weight-for-age, weight-for-height and height-for-age. Multivariable logistic regression models and coarsened exact matching (CEM) were used to determine the relationship between dairy milk and odds ratios of each outcome. Setting was in India. Participants were children (N = 107,639) aged 6-59 months. Children who consumed dairy milk in the past day or night had an odds ratio of 0.95 for underweight (95% CI 0.92-0.98, P = .0005), 0.93 for stunting (95% CI 0.90-0.96, P < .0001) and 0.96 for CIAF (95% CI 0.93-0.99, P = .004), compared with children who did not consume dairy milk after adjusting for relevant covariates. When CEM was used among a subset (n = 28,207), evidence for relationships between dairy milk and anthropometric outcomes was consistent but slightly weaker. Widespread, equitable access to dairy milk among childhood may be part of an effort to lower the risk of anthropometric failure among children in India.
在许多国家,牛奶已被证明有助于儿童成长,但印度儿童的牛奶摄入量与人体测量结果之间的关系尚未得到研究。目的是描述印度6至59个月大饮用牛奶的儿童,并确定饮用牛奶是否与印度儿童发育迟缓、体重不足和人体测量失败几率较低有关。这是一项基于第四次印度全国家庭健康调查(NFHS - 4)的横断面研究,该调查是由卫生与家庭福利部在2015年至2016年期间进行的全国性调查。主要暴露因素是过去一天或一晚内饮用牛奶。主要结果是发育迟缓(年龄别身高Z评分< -2)、体重不足(年龄别体重Z评分< -2)和人体测量失败综合指数(CIAF),它是年龄别体重、身高别体重和年龄别身高的组合。使用多变量逻辑回归模型和粗化精确匹配(CEM)来确定牛奶与各结果的比值比之间的关系。研究地点在印度。参与者为6至59个月大的儿童(N = 107,639)。在调整相关协变量后,过去一天或一晚饮用牛奶的儿童体重不足的比值比为0.95(95%置信区间0.92 - 0.98,P = .0005),发育迟缓的比值比为0.93(95%置信区间0.90 - 0.96,P < .0001),CIAF的比值比为0.96(95%置信区间0.93 - 0.99,P = .004),与未饮用牛奶的儿童相比。当在一个子集(n = 28,207)中使用CEM时,牛奶与人体测量结果之间关系的证据是一致的,但略弱。在儿童时期广泛、公平地获取牛奶可能是降低印度儿童人体测量失败风险努力的一部分。