Faerber Emily C, Stein Aryeh D, Webb Girard Amy
Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA.
Matern Child Nutr. 2021 Apr;17(2):e13121. doi: 10.1111/mcn.13121. Epub 2021 Feb 2.
We evaluated whether novel portion size and consistency indicators can identify children with low complementary food energy intake in southern Ethiopia. We conducted 24-h dietary recalls with caregivers of 548 children aged 6-13 months; additionally, caregivers estimated their child's usual portion size using uncooked rice and selected which of five photographs of porridges of varying consistencies most closely matched the food their child usually ate. Complementary food energy and density from the 24-h recall were used as reference values. We computed correlation coefficients and areas under receiver operating characteristic curves (AUC) and conducted sensitivity and specificity analyses to classify children with low complementary food energy intake. The median complementary food energy intakes for children 6-8, 9-11 and 12-13 months were 312, 322 and 375 kcal; median estimated portion sizes were 50, 58 and 64 ml, respectively. Estimated portion size correlated with total complementary food energy intake and with average energy and quantity consumed per feeding (r = 0.42, 0.46 and 0.45, respectively, all p < 0.001). Reported food consistency was weakly correlated with total complementary food energy intake (r = 0.18) and density (r = 0.10), and energy density of porridge only (r = 0.24, all p < 0.05). Predicted energy intake combining feeding frequency and portion size predicted inadequate energy intake better than did feeding frequency alone in infants 6-8 months [∆AUC = 0.16, 95% confidence interval (CI) 0.04, 0.28] and 9-11 months (∆AUC = 0.09, 95% CI 0.04, 0.14). Caregiver estimates of portion size can improve identification of infants with low complementary food energy intake when more robust dietary assessment is not feasible.
我们评估了新的食物分量和稠度指标能否识别埃塞俄比亚南部辅食能量摄入低的儿童。我们对548名6至13个月大儿童的照料者进行了24小时饮食回顾；此外，照料者用生米估计孩子平常的食物分量，并从五张不同稠度粥的照片中选出最符合孩子平常所吃食物的那张。24小时饮食回顾中的辅食能量和密度用作参考值。我们计算了相关系数和受试者工作特征曲线下面积（AUC），并进行了敏感性和特异性分析，以对辅食能量摄入低的儿童进行分类。6至8个月、9至11个月和12至13个月儿童的辅食能量摄入中位数分别为312、322和375千卡；估计的食物分量中位数分别为50、58和64毫升。估计的食物分量与辅食总能量摄入以及每次喂养的平均能量和摄入量相关（r分别为0.42、0.46和0.45，均p<0.001）。报告的食物稠度与辅食总能量摄入（r=0.18）和密度（r=0.10）以及仅与粥的能量密度（r=0.24，均p<0.05）弱相关。在6至8个月（∆AUC=0.16，95%置信区间（CI）0.04，0.28）和9至11个月（∆AUC=0.09，95%CI0.04，0.14）的婴儿中，结合喂养频率和食物分量预测能量摄入不足比仅用喂养频率预测得更好。当更可靠的饮食评估不可行时，照料者对食物分量的估计可改善对辅食能量摄入低的婴儿的识别。
