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24-35 月龄韩国儿童一年中母乳喂养状况对生长及膳食和营养素摄入模式的影响差异。

Differences in Growth and Dietary and Nutrient Intake Patterns by Breastfeeding Status Over One Year Among Korean Children Aged 24-35 Months.

机构信息

Department of Pediatrics, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Korea.

Medical Research Collaborating Center, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Korea.

出版信息

J Korean Med Sci. 2023 Nov 13;38(44):e363. doi: 10.3346/jkms.2023.38.e363.

Abstract

BACKGROUND

A previous national study found that Korean children who were breastfed for at least one year had lesser weight gain, lower protein, calcium, and iron intake relative to calories, and different dietary patterns in the second year of life, compared with children weaned before 12 months of age or those who were never breastfed. Therefore, this study aimed to investigate whether growth status, dietary and nutrient intake patterns differed by prolonged breastfeeding (PBF) experience even in the third year of life, when weaning is considered complete.

METHODS

This cross-sectional study was based on the data of children aged 24 to 35 months from the National Health and Nutrition Examination Survey (2010-2020). Data on anthropometry, dietary behavior, food and nutrient intake, maternal education, and household income were extracted to analyze the association between PBF and growth, dietary and nutrient intake patterns.

RESULTS

In the final analysis, 31.6% of the 931 children with a birth weight of ≥ 2.5 kg continued to breastfeed for at least 12 months of age, and their mean breastfeeding (BF) duration was 15.9 months. Children with PBF had significantly less postnatal weight gain than those without ( = 0.006). Regarding food group intake, PBF was significantly associated with lower legume and soy product intake (β [95% confidence interval], -10.688 [-19.314, -2.062], = 0.015) and higher fruit intake (32.978 [3.349, 62.608], = 0.029), after adjusting for sex, age in month, total caloric intake, maternal education and household income. Regarding nutrient intake, after adjusting for these variables, PBF had significantly associated with higher dietary fiber (β [95% CI], 1.607 [0.218, 2.996], = 0.023), iron (0.848 [0.317, 1.380], = 0.002) and niacin (0.728 [0.222, 1.235], = 0.005) intake and was significantly associated with lower saturated fatty acid intake (-1.217 [-2.364, -0.071], = 0.037) and percentage of energy from fat (-1.351 [-2.666, -0.035], = 0.044).

CONCLUSION

Even in the third year of life, children who have been breastfed for over one year continue to have relatively slow growth. However, they do appear to have better intake of some beneficial nutrients, which may be attributed to healthier dietary intake patterns in children with PBF. The results of this study can be used to support the recommendation of long-term BF for Korean infants and toddlers.

摘要

背景

先前的一项全国性研究发现,与 12 个月前断奶或从未母乳喂养的儿童相比,至少母乳喂养 1 年的韩国儿童在第二年的生命中体重增加较少,蛋白质、钙和铁的摄入量相对于热量较低,且饮食模式也不同。因此,本研究旨在调查即使在第三年生命中(此时被认为已完全断奶),延长母乳喂养(PBF)经历是否会导致生长状况、饮食和营养摄入模式不同。

方法

本横断面研究基于 2010-2020 年全国健康和营养检查调查(NHANES)中 24 至 35 个月龄儿童的数据。提取了人体测量学、饮食行为、食物和营养素摄入、母亲教育和家庭收入等数据,以分析 PBF 与生长、饮食和营养摄入模式之间的关联。

结果

在最终分析中,931 名出生体重≥2.5kg 的儿童中,31.6%至少继续母乳喂养 12 个月,其平均母乳喂养(BF)持续时间为 15.9 个月。与无 PBF 的儿童相比,PBF 儿童的产后体重增加明显较少(=0.006)。在食物组摄入方面,PBF 与较低的豆类和豆制品摄入(β[95%置信区间],-10.688[-19.314,-2.062],=0.015)和较高的水果摄入(32.978[3.349,62.608],=0.029)显著相关,调整性别、月龄、总热量摄入、母亲教育和家庭收入后。在调整这些变量后,PBF 与更高的膳食纤维摄入(β[95%CI],1.607[0.218,2.996],=0.023)、铁(0.848[0.317,1.380],=0.002)和烟酸(0.728[0.222,1.235],=0.005)摄入显著相关,与饱和脂肪酸摄入减少(-1.217[-2.364,-0.071],=0.037)和脂肪供能百分比降低(-1.351[-2.666,-0.035],=0.044)显著相关。

结论

即使在第三年生命中,母乳喂养超过 1 年的儿童生长仍然相对缓慢。然而,他们的一些有益营养素的摄入似乎更好,这可能归因于 PBF 儿童更健康的饮食摄入模式。本研究的结果可用于支持对韩国婴儿和幼儿进行长期母乳喂养的建议。

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