Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA.
Department of Pediatrics, New York University Grossman School of Medicine, New York, NY, USA.
J Nutr. 2021 Nov 2;151(11):3516-3523. doi: 10.1093/jn/nxab260.
The American Academy of Pediatrics recommends that if parents choose to introduce juice, they wait until ≥12 months, citing concerns of obesity and dental caries.
We sought to identify correlates of early juice introduction (<6 months) and determine whether early introduction establishes a pattern of sugary beverage intake in childhood.
Upstate KIDS is a prospective birth cohort study with follow-up through 7 years (n = 4989). The age of juice introduction was assessed from responses on periodic questionnaires from 4-18 months and categorized as <6, 6 to <12, and ≥12 months. Sociodemographic information was reported using vital records or maternal questionnaires. At 24, 30, and 36 months and 7 years, mothers reported their child's regular juice, soda, water, and milk intakes. The analysis was restricted to singletons and 1 randomly selected twin from each pair with information on juice introduction (n = 4067). We assessed associations of sociodemographic correlates with juice introduction using Cox proportional hazard models. The relations of juice introduction with beverage intake were evaluated using Poisson or logistic regression for adjusted risk ratios (aRR) or ORs, adjusting for sociodemographic covariates and total beverage intake.
Of the mothers, 25% and 74% introduced juice prior to 6 and 12 months, respectively. Younger maternal age; black or Hispanic race/ethnicity; lower educational attainment; Special Supplemental Nutrition Program for Women, Infants, and Children participation (yes); smoking during pregnancy; a higher pre-pregnancy BMI; a lower household income; and living in a townhouse/condominium or mobile home were associated with earlier juice introduction. Earlier juice introduction was related to a higher childhood juice intake, any soda intake, and lower water intake, holding total beverage intake constant [aRR, 1.5 (95% CI: 1.3-1.7; P-trend < 0.0001); adjusted OR 1.6 (95% CI: 1.0-2.4; P-trend = 0.01); aRR 0.9 (95% CI: 0.8-0.9; P-trend < 0.0001), respectively].
Markers of lower socioeconomic status are strongly associated with earlier juice introduction, which, in turn, relates to sugary beverage intake in childhood, potentially replacing water.
美国儿科学会建议，如果父母选择给孩子喝果汁，应等到孩子≥12 个月大时再提供，其主要顾虑是肥胖和龋齿问题。
本研究旨在确定早期（<6 个月）引入果汁的相关因素，并确定早期引入是否会形成儿童时期含糖饮料摄入的模式。
Upstate KIDS 是一项前瞻性出生队列研究，随访至 7 岁（n=4989）。在 4-18 个月期间，通过定期问卷调查评估果汁的引入年龄，并分为<6、6-<12 和≥12 个月。社会人口学信息通过生命记录或母亲问卷报告。在 24、30、36 个月和 7 岁时，母亲报告了孩子的常规果汁、苏打水、水和牛奶摄入量。分析仅限于有信息的单胎和每对双胞胎中的 1 个随机双胞胎（n=4067）。我们使用 Cox 比例风险模型评估社会人口学相关因素与果汁引入的相关性。使用泊松或逻辑回归评估果汁引入与饮料摄入的关系，调整了社会人口学协变量和总饮料摄入量，得到调整后的风险比（aRR）或比值比（OR）。
25%的母亲在<6 个月时引入果汁，74%的母亲在 12 个月时引入果汁。较年轻的母亲年龄；黑种人或西班牙裔种族/民族；较低的教育程度；参与特殊补充营养计划（妇女、婴儿和儿童营养补充计划）（是）；怀孕期间吸烟；较高的孕前 BMI；较低的家庭收入；以及居住在联排别墅/公寓或活动房屋中与较早的果汁引入相关。在保持总饮料摄入量不变的情况下，较早引入果汁与儿童时期果汁摄入量较高、任何苏打水摄入量较高和水摄入量较低有关[aRR，1.5（95%CI：1.3-1.7；P-趋势<0.0001）；调整后的 OR，1.6（95%CI：1.0-2.4；P-趋势=0.01）；aRR，0.9（95%CI：0.8-0.9；P-趋势<0.0001）]。
较低社会经济地位的标志物与较早引入果汁密切相关，而较早引入果汁又与儿童时期含糖饮料的摄入有关，这可能会取代水的摄入。
