Translational Medicine Program, The Hospital for Sick Children, Toronto, Ontario, Canada.
Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
Appl Physiol Nutr Metab. 2022 Jul 1;47(7):737-748. doi: 10.1139/apnm-2021-0434. Epub 2022 Feb 23.
Very low birth weight (VLBW, <1500 g) infants are at an elevated risk of neurodevelopmental disorders, later obesity and cardiometabolic disease; if and how neurodevelopmental disorders impact chronic disease risk is poorly understood. The most common neurodevelopmental disorders experienced by VLBW children are those of social-emotional functioning. We compared dietary patterns and body composition between VLBW children with poor vs. typical social-emotional functioning using linear mixed models adjusted for sex, gestational age, cognitive impairment, parental education, and body mass index (BMI). VLBW children (=158) attending the Donor Milk for Improved Neurodevelopmental Outcomes trial with 5.5-year follow-up participated. Poor social-emotional functioning was based on standardized parent-rated questionnaires and/or parent-reported physician diagnosis of autism spectrum or attention-deficit/hyperactivity disorders. Most children had diets categorized as "needs improvement" (67%) or "poor" (27%) and 29% of children exhibited poor social-emotional functioning. Poor social-emotional functioning was positively associated with 100% fruit juice (β=0.3 cup equivalents/day; 95% CI 0.1, 0.5) and energy intake (β=118.1 kcal/day; 95% CI 0.9, 235.2). Children with poor social-emotional functioning were more likely to have a limited food repertoire (0.02), but less likely to exceed dietary fat recommendations (=0.04). No differences in overall diet quality or body composition were observed. Diet counselling and research are essential to improving the nutrition of VLBW children to mitigate chronic disease risk. Trial registration - Optimizing Mothers' Milk for Preterm Infants Program of Research: Study 1 - Impact of Donor Milk at Kindergarten, NCT02759809, https://clinicaltrials.gov/ct2/show/NCT02759809. Overall diet quality and body composition did not differ between VLBW children with poor vs. typical social-emotional functioning. Most had diets "needing improvement" or "poor" according to the Healthy Eating Index-2010. Diet counselling may help mitigate chronic disease risk in this vulnerable population.
极低出生体重（VLBW，<1500g）婴儿患神经发育障碍、后期肥胖和心血管代谢疾病的风险较高；神经发育障碍如何影响慢性疾病风险尚不清楚。VLBW 儿童最常见的神经发育障碍是社交情感功能障碍。我们使用线性混合模型比较了社会情感功能较差与典型 VLBW 儿童的饮食模式和身体成分，模型调整了性别、胎龄、认知障碍、父母教育程度和体重指数（BMI）。共有 158 名参加改善神经发育结局捐赠母乳试验的 VLBW 儿童接受了 5.5 年的随访。较差的社会情感功能是基于标准化的父母评分问卷和/或父母报告的自闭症谱系或注意缺陷多动障碍的医生诊断。大多数儿童的饮食被归类为“需要改进”（67%）或“较差”（27%），29%的儿童表现出较差的社会情感功能。较差的社会情感功能与 100%果汁（β=0.3 杯当量/天；95%CI0.1，0.5）和能量摄入（β=118.1kcal/天；95%CI0.9，235.2）呈正相关。社会情感功能较差的儿童更有可能饮食范围有限（0.02），但不太可能超过膳食脂肪推荐量（=0.04）。未观察到整体饮食质量或身体成分的差异。饮食咨询和研究对于改善 VLBW 儿童的营养状况以减轻慢性疾病风险至关重要。试验注册 - 优化母亲对早产儿的哺乳计划研究 1 - 捐赠母乳在幼儿园的影响，NCT02759809，https://clinicaltrials.gov/ct2/show/NCT02759809。VLBW 儿童中，社会情感功能较差与典型儿童之间的整体饮食质量和身体成分无差异。根据健康饮食指数-2010，大多数人的饮食为“需要改进”或“较差”。饮食咨询可能有助于减轻这一弱势群体的慢性疾病风险。
