中国五省3~5岁儿童辅食添加时间与体成分的关系

Association between timing for introducing complementary foods and body composition of children aged 3-5 years in five provinces of China

目的探索婴儿期不同辅食添加时间与其3~5岁时体成分之间的关系。方法数据来源于"中国0~18岁儿童营养与健康系统调查与应用"项目2019年6月至2020年11月5个省6个调查点数据。采用结构化调查问卷,调查员通过面对面询问3~5岁儿童母亲或其他主要监护人回顾性地收集其在婴儿期首次添加辅食的时间,辅食添加时间分为≤5月龄、6月龄以及≥7月龄。采用生物电阻抗仪测量3~5岁儿童的体成分(瘦体重含量、瘦体重指数以及体脂、体脂指数和体脂率)。按照年龄分层,采用多因素线性回归模型调整潜在混杂因素后分析辅食添加时间与体成分之间的关系。结果对于3岁、4岁和5岁儿童,校正潜在混杂因素后,不同辅食添加时间的儿童体脂含量、体脂指数、体脂率和瘦体重指数差异均无统计学意义。不同辅食添加时间的3岁和5岁儿童瘦体重含量(3岁:12.89 kg vs.12.66 kg vs.12.94 kg,F=4.42,P=0.013;5岁:16.27 kg vs.16.23 kg vs.16.66 kg,F=5.40,P=0.005)差异有统计学意义。其中,6月龄添加辅食的3岁组儿童瘦体重含量[均差=-0.23 kg(95%CI-0.45~-0.02 kg)]低于≤5月龄添加辅食的儿童,≥7月龄添加辅食的5岁组儿童瘦体重含量[均差=0.39 kg(95%CI 0.08~0.70 kg)]高于≤5月龄添加辅食的儿童。结论婴儿期辅食添加时间可能与其3~5岁时体脂无关。婴儿期辅食添加时间与3~5岁儿童瘦体重指标之间关系可能不一致。

OBJECTIVE To explore the association between different timing of introducing complementary foods during infancy and the body composition of children aged 3-5 years.METHODS The data was from National Nutrition and Health Systematic Survey for 0-18 Years Old Children in China.A face-to-face interview to caregivers of children was conducted to retrospectively collect timing of introducing complementary foods of children aged 3-5 years.The bioelectrical impedance analysis was used to measure the body composition of children by professionally trained investigators.The exposure variable of the study was the timing of introducing complementary foods(≤5 months old,6 months old and≥7 months old).The outcome variables were the fat-free mass,fat-free mass index,body fat mass,body fat mass index,and percentage of body fat.According to age stratification,a multivariate linear regression model was used to calculate the mean,mean difference and 95%CI after adjusting for potential confounders.RESULTS After adjusting for potential confounders,there were no statistically significant difference in body fat mass,body fat mass index,percentage of body fat and fat-free mass index among different groups of timing for introducing complementary foods for children aged 3-5 years old.For children aged 3-5 years,after adjusting for potential confounders,the difference of fat free mass was statistically significant among children with different timing for introducing of complementary foods(3 years old:12.89 kg vs.12.66 kg vs.12.94 kg,F=4.42,P=0.013;5 years old:16.27 kg vs.16.23 kg vs.16.66 kg,F=5.40,P=0.005).The fat free mass of children aged 3 years was lower when introducing complementary foods during 6 months of age than at≤5 months of age(mean difference=-0.23 kg(95%CI-0.45--0.02 kg)).The fat free mass of children aged 5 years was higher when introducing complementary foods at≥7 months of age than at≤5 months of age(mean difference=0.39 kg(95%CI 0.08-0.70 kg)).CONCLUSION It is found that the association between timing for introducing complementary foods during infancy and the fat mass indicators of children aged 3 to 5 years was not statistically significant,and the association between timing for introducing complementary foods and fat-free mass may be inconsistent for different fat-free mass indicators.