Barbosa Catarina, Costa Alexandra, Hetherington Marion M, Oliveira Andreia
EPIUnit - Instituto de Saúde Pública da Universidade do Porto [Institute of Public Health of the University of Porto], Rua das Taipas nº135, 4050-600, Porto, Portugal.
EPIUnit - Instituto de Saúde Pública da Universidade do Porto [Institute of Public Health of the University of Porto], Rua das Taipas nº135, 4050-600, Porto, Portugal; Laboratory for Integrative and Translational Research in Population Health (ITR), Rua das Taipas nº135, 4050-600, Porto, Portugal.
Appetite. 2022 Apr 1;171:105909. doi: 10.1016/j.appet.2021.105909. Epub 2022 Jan 2.
Early feeding practices have been related to child's body mass index (BMI), however, their role in establishing dietary patterns is less well understood. The aim of this study was to examine the association of parent-reported early feeding practices (breastfeeding duration, type of foods and timing of complementary feeding) and dietary patterns identified at age 7 to explain BMI z-scores at 10 years of age. Participants were children from the Generation XXI cohort, evaluated at 4, 7 and 10 years of age (n = 3673). At 7 years-old, dietary intake was assessed with a validated food-frequency questionnaire. Two dietary patterns were previously derived: "Energy-dense foods" (higher in energy-dense foods, and lower in vegetable soup, significantly associated with BMI z-score at 10 years-old, and the "Fish-based" dietary pattern (higher in fish consumption and low in energy-dense foods). Adjusted sex-stratified associations were estimated by generalized linear models. Boys and girls who were never breastfed or were breastfed for a very short duration had lower scores in the "Fish-based" dietary pattern, compared to those with longer breastfeeding durations (Boys: β = -0.219; 95%CI: 0.361; -0.077; Girls: β = -0.223; 95%CI: 0.358; -0.088). No significant associations between breastfeeding and the "Energy-dense foods" dietary pattern were found. Boys and girls who were offered cereals as a first food during complementary feeding, in comparison with soup, presented lower scores in the "Energy-dense foods" dietary pattern (Boys: β = -0.183; 95%CI: 0.292; -0.074; Girls: β = -0.155; 95%CI: 0.259; -0.050), but only girls presented higher scores in the 'Fish-based' dietary pattern (β = 0.137; 95%CI: 0.006; 0.267). The age of introduction of complementary feeding was not significantly associated with the dietary patterns. Parents should be supported in their infant feeding decisions, given the potential effects of breastfeeding duration and first foods at complementary feeding on shaping longer term dietary patterns of young children.
早期喂养方式与儿童的体重指数（BMI）有关，然而，它们在建立饮食模式中的作用却鲜为人知。本研究的目的是调查家长报告的早期喂养方式（母乳喂养持续时间、食物类型和辅食添加时间）与7岁时确定的饮食模式之间的关联，以解释10岁时的BMI z评分。研究对象是来自二十一世纪队列研究的儿童，在4岁、7岁和10岁时进行评估（n = 3673）。在7岁时，通过一份经过验证的食物频率问卷评估饮食摄入量。先前得出了两种饮食模式：“能量密集型食物”模式（能量密集型食物含量较高，蔬菜汤含量较低，与10岁时的BMI z评分显著相关）和“鱼类为主”的饮食模式（鱼类消费量较高，能量密集型食物含量较低）。通过广义线性模型估计调整后的性别分层关联。与母乳喂养时间较长的儿童相比，从未母乳喂养或母乳喂养时间非常短的男孩和女孩在“鱼类为主”的饮食模式中得分较低（男孩：β = -0.219；95%置信区间：0.361；-0.077；女孩：β = -0.223；95%置信区间：0.358；-0.088）。未发现母乳喂养与“能量密集型食物”饮食模式之间存在显著关联。与汤类相比，在辅食添加时首先食用谷物的男孩和女孩在“能量密集型食物”饮食模式中得分较低（男孩：β = -0.183；95%置信区间：0.292；-0.074；女孩：β = -0.155；95%置信区间：0.259；-0.050），但只有女孩在“鱼类为主”的饮食模式中得分较高（β = 0.137；95%置信区间：0.006；0.267）。辅食添加的年龄与饮食模式没有显著关联。鉴于母乳喂养持续时间和辅食添加时的第一种食物对塑造幼儿长期饮食模式的潜在影响，应支持家长做出婴儿喂养决策。
