de Morais M B, Vítolo M R, Aguirre A N, Medeiros E H, Antoneli E M, Fagundes-Neto U
Departamento de Pediátrica da Universidade Federal de São-Paulo-Escola Paulista de Medicina (UNIFESP-EPM).
Arq Gastroenterol. 1996 Apr-Jun;33(2):93-101.
The aim of this study was to evaluate the dietary fiber intake and the dietary habits of children with and without functional chronic constipation. We enrolled 58 children with functional chronic constipation and 58 controls without constipation matched for sex and age. Food and fiber intake were evaluated by 24 hour dietary recall and a complete clinical history was performed. The age of onset of constipation occurred during the first year of life in 55.4% of the patients while the median age of evaluation was 78 months. Soiling was found in 41.7% of patients. The median period of exclusive breast feeding was shorter (P = 0.002) in the constipation group (one month) than in the control group (three month). The proportion of constipation was similar for mothers of children of both groups as well as for siblings in both groups. The fathers of children with constipation presented higher frequency of constipation (12.3%) than the fathers of children in control group (1.8%), but the difference did not reach statistical significance (P = 0.06). The amount of food measured by 24 hour recall was similar in both groups. The calorie intake of constipated children (1526 +/- 585 calories/day) was lower (P = 0.07) than in the control group (1712 +/- 513 calories/day) but the difference did not reach statistical significance. The intake of protein, fat and iron was lower in the constipation group than in the control group. The volume of cow's milk intake was similar in both groups. The median of total dietary fiber intake in the constipation group (13.5 g/day) was statistically (P = 0.009) lower than in the control group (16.8 g/day). The daily intake of insoluble dietary fiber was also statistically lower (P = 0.001) in the constipation group (6.3 g) than in the control group (9.4 g). The intake of soluble dietary fiber was similar in both groups. The intake of dietary fiber per 1,000 calories of diet was 10.3 g in the constipation group and 10.4 in the control group (P = 0.41). There was a considerable intersection of individual values in fiber intake of the constipation and control groups, suggesting that low fiber intake acts in association with others factors on the genesis of constipation in children. However, the low intake of insoluble fiber, suggests that it plays an important role on the pathogenesis of chronic constipation in children.
本研究的目的是评估功能性慢性便秘患儿与非便秘患儿的膳食纤维摄入量及饮食习惯。我们纳入了58例功能性慢性便秘患儿和58例年龄及性别相匹配的非便秘对照儿童。通过24小时饮食回顾评估食物和纤维摄入量，并进行完整的临床病史采集。55.4%的便秘患者便秘起病于出生后第一年，而评估的中位年龄为78个月。41.7%的患者存在大便失禁。便秘组纯母乳喂养的中位时间（1个月）短于对照组（3个月）（P = 0.002）。两组儿童母亲以及两组儿童兄弟姐妹的便秘比例相似。便秘患儿的父亲便秘发生率（12.3%）高于对照组儿童的父亲（1.8%），但差异未达到统计学显著性（P = 0.06）。通过24小时回顾法测得的两组食物量相似。便秘患儿的热量摄入量（1526±585千卡/天）低于对照组（1712±513千卡/天）（P = 0.07），但差异未达到统计学显著性。便秘组蛋白质、脂肪和铁的摄入量低于对照组。两组牛奶摄入量相似。便秘组总膳食纤维摄入量的中位数（13.5克/天）低于对照组（16.8克/天），具有统计学显著性（P = 0.009）。便秘组不溶性膳食纤维的每日摄入量（6.3克）也低于对照组（9.4克），具有统计学显著性（P = 0.001）。两组可溶性膳食纤维摄入量相似。便秘组每1000千卡饮食的膳食纤维摄入量为10.3克，对照组为10.4克（P = 0.41）。便秘组和对照组的纤维摄入量个体值有相当大的交叉，表明低纤维摄入量与其他因素共同作用于儿童便秘的发生。然而，不溶性纤维的低摄入量表明其在儿童慢性便秘的发病机制中起重要作用。
