Ingram School of Nursing McGill University, Montreal, Canada.
Ingram School of Nursing McGill University, Montreal, Canada; Center for Nursing Research, Jewish General Hospital, Montreal, Canada.
Appetite. 2021 Mar 1;158:104999. doi: 10.1016/j.appet.2020.104999. Epub 2020 Oct 12.
Although several studies have focused on associations between breastfeeding and child obesity, few have focused on associations with dietary intake. We examined associations between breastfeeding duration in infancy and dietary intake in childhood and explored whether associations are still observed in adolescence. The QUALITY (QUebec Adipose and Lifestyle InvesTigation in Youth) cohort includes 630 children aged 8-10 years at baseline (T1) who have at least one parent with obesity. A follow-up assessment was done 7 years later (T2) when participants were aged 15-17 years (n=377). Non-exclusive breastfeeding duration was evaluated at T1 using a parent questionnaire (never, < 3 months, 3-6 months, > 6 months). Dietary intake was assessed at T1 and T2 using three 24-h diet recalls, namely daily servings of vegetables (≥ 2 vs < 2), fruits (≥ 2 vs < 2), vegetables and fruits combined (≥ 5 vs < 5), sugar-sweetened beverages (SSB) (none vs any), and an overall diet quality index (DQI-I) (good vs poor). Multiple logistic regressions, adjusted for age, sex and total kilocalorie intake of the child, for age and body mass index of the mother, and for parental education and income were used. Compared to children breastfed > 6 months (reference group), those never breastfed or breastfed for 3-6 months were 42% (OR = 0.58, 95% CI: 0.34-0.96) and 38% (OR = 0.62, 95% CI: 0.39-1.00) less likely to consume ≥ 2 servings of vegetables per day at 8-10 years, respectively, while no association was found for those breastfed < 3 months. Compared to children breastfed > 6 months, those never breastfed were 1.8 times more likely to drink any SSB (OR = 1.82, 95% CI: 1.03-3.22). No associations were found for other diet indicators, and associations observed in childhood were no longer found by adolescence. In this cohort, breastfeeding was associated with greater vegetable intake and the avoidance of SSB in childhood, but not in adolescence, nor were associations found for fruit intake or overall diet quality.
尽管有几项研究关注母乳喂养与儿童肥胖之间的关联,但很少有研究关注与饮食摄入的关联。我们研究了婴儿期母乳喂养时间与儿童期饮食摄入之间的关联,并探讨了这些关联在青春期是否仍然存在。QUALITY(魁北克青少年肥胖与生活方式调查)队列包括 630 名基线时(T1)年龄在 8-10 岁的儿童,他们的至少一位父母肥胖。7 年后(T2)进行了随访评估,当时参与者的年龄为 15-17 岁(n=377)。在 T1 时使用家长问卷评估非排他性母乳喂养时间(从未、<3 个月、3-6 个月、>6 个月)。在 T1 和 T2 时使用三份 24 小时饮食回忆评估饮食摄入,即蔬菜的每日份(≥2 份与<2 份)、水果(≥2 份与<2 份)、蔬菜和水果的综合份(≥5 份与<5 份)、含糖饮料(SSB)(无与有)和整体饮食质量指数(DQI-I)(好与差)。使用多元逻辑回归,调整了儿童的年龄、性别和总卡路里摄入量、母亲的年龄和体重指数以及父母的教育和收入。与母乳喂养>6 个月的儿童(参考组)相比,从未母乳喂养或母乳喂养 3-6 个月的儿童每天食用≥2 份蔬菜的可能性分别降低了 42%(OR=0.58,95%CI:0.34-0.96)和 38%(OR=0.62,95%CI:0.39-1.00),而母乳喂养<3 个月的儿童与食用≥2 份蔬菜之间没有关联。与母乳喂养>6 个月的儿童相比,从未母乳喂养的儿童饮用任何 SSB 的可能性高 1.8 倍(OR=1.82,95%CI:1.03-3.22)。其他饮食指标没有关联,且在儿童期观察到的关联在青春期时不再存在。在该队列中,母乳喂养与儿童期摄入更多蔬菜和避免 SSB 相关,但与青春期时的 SSB 摄入或整体饮食质量无关,与水果摄入也无关。