School of Sport, Exercise and Nutrition, Massey University, Auckland, New Zealand.
School of Psychology, University of Leeds, Leeds, England, UK.
Am J Clin Nutr. 2022 Jul 6;116(1):111-121. doi: 10.1093/ajcn/nqac080.
Starting complementary feeding (CF) with vegetables only may improve vegetable acceptance throughout childhood.
We aimed to test whether exposure to vegetables only during the first 4 wk of CF increases later vegetable acceptance compared with a control group receiving fruit and vegetables.
In this randomized, controlled, parallel-group study, 117 Auckland infants received either vegetables only (veg-only, n = 61) or a combination of fruit and vegetables (control, n = 56) for a duration of 4 wk, starting from the first day of CF at ∼4-6 mo of age. The primary outcome measure was intake of target vegetables (broccoli, spinach) provided by the study at 9 mo of age. Daily intake of vegetables (FFQs) at 9 mo was a supporting measure. Infants' iron status (serum ferritin, hemoglobin) was examined at all time points.
The veg-only infants consumed more broccoli and spinach than controls [mean difference (95% CI): 11.83 (0.82, 22.84) g, P = 0.036 and 10.19 (0.50, 19.87) g, P = 0.039, respectively]. Intake of pear was comparable among intervention groups (P = 0.35). At 9 mo, veg-only infants consumed target vegetables at a faster rate [mean difference (95% CI): broccoli, 3.37 (1.26, 5.47), P = 0.002; spinach, 4.12 (0.80, 7.45), P = 0.016] and showed greater acceptance for target vegetables [mean difference (95% CI): broccoli, 0.38 (0.07, 0.70), P = 0.019; spinach, 032 (0.04, 0.60), P = 0.024] than controls. The rate of eating and acceptance of pear was comparable among intervention groups (P = 0.42 and P = 0.98, respectively). Also, veg-only infants consumed more vegetables than controls [86.3 (52.5, 146.3) compared with 67.5 (37.5, 101.3) g, respectively, P = 0.042]. Introducing vegetables as the first food was not associated with 9-mo iron status.
Providing vegetables as first foods increased vegetable intake at 9 mo of age and may be an effective strategy for improving child vegetable consumption and developing preferences for vegetables in infancy.
从最初开始添加辅食时仅提供蔬菜，可能有助于儿童在整个儿童期增加对蔬菜的接受程度。
我们旨在测试在添加辅食的最初 4 周内仅接触蔬菜是否会比接受水果和蔬菜的对照组相比，增加儿童日后对蔬菜的接受程度。
在这项随机对照平行组研究中，117 名奥克兰婴儿在约 4-6 月龄时开始添加辅食，其中 61 名婴儿仅接受蔬菜（纯蔬菜组），56 名婴儿接受水果和蔬菜（对照组），持续 4 周。主要结局测量指标为 9 月龄时提供的目标蔬菜（西兰花、菠菜）的摄入量。9 月龄时通过每日蔬菜摄入量（FFQs）来作为辅助测量指标。所有时间点均检测婴儿的铁状态（血清铁蛋白、血红蛋白）。
与对照组相比，纯蔬菜组婴儿摄入更多的西兰花和菠菜[平均差异（95%置信区间）：11.83（0.82，22.84）g，P=0.036 和 10.19（0.50，19.87）g，P=0.039]。干预组间梨的摄入量无差异（P=0.35）。9 月龄时，纯蔬菜组婴儿以更快的速度摄入目标蔬菜[平均差异（95%置信区间）：西兰花，3.37（1.26，5.47），P=0.002；菠菜，4.12（0.80，7.45），P=0.016]，并且对目标蔬菜的接受程度更高[平均差异（95%置信区间）：西兰花，0.38（0.07，0.70），P=0.019；菠菜，0.32（0.04，0.60），P=0.024]。干预组间梨的进食率和接受率无差异（P=0.42 和 P=0.98）。此外，纯蔬菜组婴儿的蔬菜摄入量多于对照组[分别为 86.3（52.5，146.3）g 与 67.5（37.5，101.3）g，P=0.042]。首先引入蔬菜作为食物与 9 月龄的铁状态无关联。
将蔬菜作为第一食物可增加 9 月龄儿童的蔬菜摄入量，可能是改善儿童蔬菜摄入和培养儿童对蔬菜喜好的有效策略。
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