Adair L, Popkin B M, VanDerslice J, Akin J, Guilkey D, Black R, Briscoe J, Flieger W
Department of Nutrition, University of North Carolina, Chapel Hill 27516-3997.
Eur J Clin Nutr. 1993 Jan;47(1):42-51.
This study examines determinants of growth from birth to 24 months in a sample of approximately 3000 urban and rural Filipino children. Individual, household, and community data were collected bimonthly during the Cebu Longitudinal Health and Nutrition Survey. Separate longitudinal, multivariate models were used to identify determinants of weight in children from birth to 6 months and 6-24 months of age. Previous weight, male gender, mother's height, and season of the year showed significant positive associations with weight in all models. Full and mixed breast-feeding significantly increased weight, but the effects of breast-feeding declined as children got older. Breast-feeding had a direct growth-enhancing effect in addition to its indirect effect through the prevention of diarrheal morbidity. Detrimental effects of recent diarrheal morbidity were particularly important in the older age group, but these effects were mitigated by breast-feeding. Since infant feeding variables are included in the models, the results strongly suggest an effect of diarrheal morbidity on growth independent of its known effects on infant feeding and dietary intake. Febrile respiratory infections had important detrimental effects on weight in both age groups.
本研究调查了约3000名菲律宾城乡儿童从出生到24个月的生长发育决定因素。在宿务纵向健康与营养调查期间,每两个月收集一次个体、家庭和社区数据。分别采用纵向多变量模型来确定出生至6个月以及6至24个月儿童体重的决定因素。在所有模型中,既往体重、男性性别、母亲身高和年份季节与体重呈显著正相关。纯母乳喂养和混合喂养显著增加体重,但随着儿童年龄增长,母乳喂养的效果逐渐下降。母乳喂养除了通过预防腹泻发病率产生间接影响外,还具有直接促进生长的作用。近期腹泻发病率的不利影响在较大年龄组中尤为重要,但母乳喂养可减轻这些影响。由于模型中纳入了婴儿喂养变量,结果有力地表明腹泻发病率对生长有影响,且独立于其对婴儿喂养和饮食摄入的已知影响。发热性呼吸道感染在两个年龄组中对体重均有重要的不利影响。