生命第一年的喂养行为和饮食多样性：预防 ADALL，一项斯堪的纳维亚随机对照试验和出生队列研究。
Feeding Practices and Dietary Diversity in the First Year of Life: PreventADALL, a Scandinavian Randomized Controlled Trial and Birth Cohort Study.
机构信息
University of Oslo, Faculty of Medicine, Institute of Clinical Medicine, Oslo, Norway; Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway.
University of Oslo, Faculty of Medicine, Institute of Clinical Medicine, Oslo, Norway; Department of Dermatology, Oslo University Hospital, Oslo, Norway.
出版信息
J Nutr. 2023 Aug;153(8):2463-2471. doi: 10.1016/j.tjnut.2023.06.015. Epub 2023 Jun 17.
BACKGROUND
Breastmik is considered the optimal source of nutrition in early infancy. However, recommendations and practices for when and how complementary food should be introduced in the first year of life vary worldwide. Early introduction of allergenic foods may prevent food allergies, but if early food introduction influences infant feeding practices is less known.
OBJECTIVES
We sought to assess infant feeding practices in the first year of life and to determine if early interventional food introduction influences breastfeeding and dietary diversity.
METHODS
Dietary intake was assessed in infants from the population-based clinical trial Preventing Atopic Dermatitis and ALLergies (PreventADALL) in children study. A total of 2397 infants were cluster-randomized at birth into 4 different groups: 1) control, 2) skin intervention, 3) introduction to 4 allergenic foods between 3 and 4 mo of age: peanut, cow milk, wheat, and egg, as small tastings until 6 mo, and 4) combined skin and food interventions. Dietary data were available from at least one of the 3-, 6-, 9-, and 12-mo questionnaires in 2059 infants. In the present analysis, groups 1 and 2 constitute the No Food Intervention group, whereas groups 3 and 4 constitute the Food Intervention group. We used the log-rank test and Cox regression to assess the impact of food intervention on age of breastfeeding cessation. Mixed effects logistic regression was used to compare dietary diversity, defined as the number of food categories consumed, between intervention groups.
RESULTS
At 3, 6, 9, and 12 mo, 95%, 88%, 67%, and 51% were breastfed, respectively, and breastfeeding duration was not affected by the food intervention. In the No Food Intervention group, mean age of complementary food introduction was 18.3 wk (confidence interval [CI]: 18.1, 18.5). In the Food Intervention group, the dietary diversity score was 1.39 units (CI: 1.16, 1.62) higher at 9 mo (P < 0.001) and 0.7 units (CI: 0.5, 0.9) higher at 12 mo (P < 0.001) compared to the No Food Intervention group.
CONCLUSIONS
Early food intervention did not affect breastfeeding rates and increased dietary diversity at 9 and 12 mo.
背景
母乳被认为是婴儿早期最理想的营养来源。然而，全球范围内关于何时以及如何引入补充食物的建议和做法存在差异。早期引入过敏原食物可能预防食物过敏，但如果早期食物引入会影响婴儿喂养方式则知之甚少。
目的
我们旨在评估婴儿在生命第一年的喂养方式，并确定早期干预性食物引入是否会影响母乳喂养和饮食多样性。
方法
在基于人群的临床试验“预防特应性皮炎和过敏症（PreventADALL）儿童研究”中，评估了婴儿的饮食摄入量。共有 2397 名婴儿在出生时被分为 4 个不同的组：1）对照组，2）皮肤干预组，3）在 3 至 4 个月时引入 4 种过敏原食物：花生、牛奶、小麦和鸡蛋，作为小份量品尝物直至 6 个月，以及 4）皮肤和食物联合干预组。在 2059 名婴儿中，至少有 1 份来自 3、6、9 和 12 个月的调查问卷中提供了饮食数据。在本分析中，组 1 和组 2 构成无食物干预组，而组 3 和组 4 构成食物干预组。我们使用对数秩检验和 Cox 回归评估食物干预对母乳喂养停止年龄的影响。混合效应逻辑回归用于比较干预组之间的饮食多样性，定义为摄入的食物类别数。
结果
在 3、6、9 和 12 个月时，分别有 95%、88%、67%和 51%的婴儿母乳喂养，母乳喂养持续时间不受食物干预的影响。在无食物干预组中，补充食物引入的平均年龄为 18.3 周（置信区间 [CI]：18.1，18.5）。在食物干预组中，9 个月时的饮食多样性评分高 1.39 分（CI：1.16，1.62）（P < 0.001），12 个月时高 0.7 分（CI：0.5，0.9）（P < 0.001）与无食物干预组相比。
结论
早期食物干预并未影响母乳喂养率，并提高了 9 个月和 12 个月时的饮食多样性。
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