北京大学学报(医学版) ›› 2022, Vol. 54 ›› Issue (3): 526-531. doi: 10.19723/j.issn.1671-167X.2022.03.019

• 论著 • 上一篇    下一篇

北京市和湖南省郴州市4~8月龄婴儿蔬菜水果添加情况的追踪性调查

李玭1,赵艾2,武薇1,张健1,王培玉1,蓝航莲3,张玉梅1,*()   

  1. 1. 北京大学公共卫生学院营养与食品卫生学系,北京 100191
    2. 清华大学万科公共卫生与健康学院,北京 100084
    3. 内蒙古乳业技术研究院,北京 100022
  • 收稿日期:2020-11-04 出版日期:2022-06-18 发布日期:2022-06-14
  • 通讯作者: 张玉梅 E-mail:zhangyumei@hsc.pku.edu.cn
  • 基金资助:
    “十三五”国家重点研发计划项目(2017YFD0400600)

A follow-up study on the introduction of vegetables and fruits during infants aged 4-8 months in Beijing and Chenzhou City of Hunan Province

Pin LI1,Ai ZHAO2,Wei WU1,Jian ZHANG1,Pei-yu WANG1,Hang-lian LAN3,Yu-mei ZHANG1,*()   

  1. 1. Department of Nutrition and Food Hygiene, Peking University School of Public Health, Beijing 100191, China
    2. Vanke School of Public Health, Tsinghua University, Beijing 100084, China
    3. Inner Mongolia Dairy Technology Research Institute, Beijing 100022, China
  • Received:2020-11-04 Online:2022-06-18 Published:2022-06-14
  • Contact: Yu-mei ZHANG E-mail:zhangyumei@hsc.pku.edu.cn
  • Supported by:
    the 13th Five-Year Plan for Economic and Social Development of the People's Republic of China(2017YFD0400600)

RICH HTML

  

摘要:

目的: 追踪调查北京市和湖南省郴州市两地4~8月龄婴儿的蔬菜、水果添加时间与添加种类,探索与蔬果添加行为有关的母婴特征。方法: 采用方便抽样,在婴儿12~16周龄招募228对健康母婴,婴儿4月龄时正式进入研究,对其进行为期4个月的随访(n=204)。记录母婴对的基本信息以及婴儿的蔬菜、水果首次添加时间和添加种类等信息。使用秩和检验分析与蔬菜、水果添加有关的母婴因素,运用多重线性回归分析部分母婴因素与首次蔬菜添加时间以及8月龄婴儿蔬果添加种类数的关系。结果: 参与调查的204名婴儿的蔬菜添加时间集中在7月龄,水果添加时间主要集中在6月龄,水果添加时间早于蔬菜(P < 0.001),添加水果的种类数高于蔬菜(P=0.045)。48%(n=98)的8月龄婴儿添加的蔬果不超过3种,仅9.8%(n=20)的婴儿在8月龄时已添加10种以上的蔬果。菠菜等绿叶蔬菜是最常添加的蔬菜,苹果是最常添加的水果。多重线性回归显示,35岁以上的乳母给婴儿添加蔬菜的时间比35岁及以下的乳母晚0.6个月,4月龄纯母乳喂养的婴儿首次添加蔬菜的时间比混合喂养的婴儿晚0.4个月,受教育程度为大学本科及以上的乳母给婴儿添加蔬果的种类数比学历为初中及以下的乳母多2~3种。结论: 调查结果显示婴儿的水果添加时间早于蔬菜,绿叶蔬菜和苹果是最常添加的蔬果,纯母乳喂养、母亲分娩年龄较高的婴儿蔬菜添加时间较晚,母亲文化程度较低的婴儿蔬果添加种类较少,故分娩年龄较高以及文化程度较低的乳母应受到婴儿合理辅食添加健康宣教的重点关注。

关键词: 水果, 蔬菜, 婴儿, 婴儿营养生理学现象

Abstract:

Objective: To investigate the introduction of vegetables and fruits in 4-8 months old infants, and to describe the maternal and infants' characteristics associated with the introduction of vegetables and fruits. Methods: Mother-infant dyads (n=228) were recruited from 12 to 16 weeks postpartum and formally entered the study at 4 months of age. Data collected via face to face interview at 4-8 months postpartum, including the timing and types of added vegetables and fruits, as well as a variety of maternal and infant characteristics (n=204). Rank sum test and multiple linear regression were used to analyze the maternal and infant characteristics related to the introduction of vegetables and fruits. Results: The time of introducing vegetables was concentrated at the age of 7 months, and the time of adding fruits was mainly at 6 months. Fruits were added earlier than vegetables (P < 0.001), and the variety of the added fruits was higher than that of vegetables (P=0.045). 48% (n=98) of infants had no more than three types of fruits and vegetables at 8 months. Only 9.8% (n=20) had added more than 10 kinds of fruits and vegetables at 8 months. Green leafy vegetables were the most commonly added vegetable, and apple was the most popular fruit. Compared with women who were 35 years of age or younger, women beyond 35 years old introduced vegetables to their babies 0.6 months later. 4-month-old exclusively breastfed infants had vegetables 0.4 months later than mixed-fed infants. Women with a bachelor's degree or above added 2-3 more types of fruits and vegetables to their babies than those with junior high school education and below. Conclusion: The adding time of fruits was earlier than that of vegetable. Apples and green leafy vegetables are commonly added. Women with lower educational backgrounds add fewer types of fruits and vegetables to their babies. Mothers who choose exclusive breastfeeding and those over 35 years of age at childbirth add vegetables to their babies later than others. They should be targeted for health promotion programs that aim to improve the intake of fruits and vegetables among infants.

Key words: Fruit, Vegetables, Infant, Infant nutritional physiological phenomena

中图分类号: 

  • R153.1

表1

蔬菜、水果添加时间与添加率"

Infant's age/monthsVegetable Fruit
n (%) Cumulative percentage/% n (%) Cumulative percentage/%
4 1 (0.5) 0.5 6 (2.9) 2.9
5 7 (3.4) 3.9 17 (8.3) 11.3
6 43 (21.1) 25.0 67 (32.8) 44.1
7 61 (29.9) 54.9 48 (23.5) 67.6
8 38 (18.6) 73.5 36 (17.6) 85.3

表2

最常添加的蔬菜、水果种类"

Types n %
Vegetable
  Green leafy vegetables 75 36.8
  Carrot 66 32.4
  Potatoes 61 29.9
  Pumpkin 51 25.0
  Broccoli 43 21.1
  Sweet potato 43 21.1
Fruit
  Apple 146 71.6
  Banana 120 58.8
  Orange 36 17.6
  Pear 30 14.7
  Strawberry 28 13.7
  Kiwi fruit 31 15.2

表3

蔬菜、水果添加时间与种类数的秩和检验"

Variable Timing of vegetables/months Variety of vegetables, n Timing of fruits/months Variety of fruits, n Variety of fruits and vegetables, n
M(P25, P75) P M(P25, P75) P M(P25, P75) P M(P25, P75) P M(P25, P75) P
City
  Chenzhou 7.0(7.0, 9.0) 0.403 1.0(0, 2.0) 0.011 7.0(6.0, 8.0) 0.138 2.0(1.0, 3.0) 0.039 3.0(2.0, 5.0) 0.014
  Beijing 7.0(6.0, 8.0) 2.0(1.0, 4.0) 7.0(6.0, 8.0) 2.0(1.0, 4.0) 5.0(2.0, 8.0)
Gender
  Male 7.0(7.0, 9.0) 0.73 1.5(1.0, 4.0) 0.115 7.0(6.0, 8.0) 0.274 2.0(1.0, 4.0) 0.103 4.5(2.0, 8.0) 0.128
  Female 7.0(6.0, 9.0) 1.0(0, 3.0) 7.0(6.0, 8.0) 2.0(1.0, 3.0) 3.0(2.0, 6.0)
Parity
  1 7.0(6.0, 8.0) 0.001 2.0(1.0, 4.0) < 0.001 7.0(6.0, 8.0) 0.384 2.0(1.0, 4.0) 0.153 5.0(2.0, 8.0) 0.009
  2 8.0(7.0, 9.0) 1.0(0, 2.0) 7.0(6.0, 8.0) 2.0(1.0, 3.0) 3.0(1.0, 4.0)
  3 9.0(8.0, 9.0) 2.0(0, 4.0) 6.0(5.0, 7.0) 1.0(1.0, 3.0) 3.0(2.0, 7.0)
Delivery method
  Vaginal 7.0(6.0, 8.0) 0.181 1.0(1.0, 4.0) 0.095 7.0(6.0, 8.0) 0.644 2.0(1.0, 3.5) 0.386 4.0(2.0, 7.0) 0.161
  Caesarean 8.0(7.0, 9.0) 1.0(0, 3.0) 7.0(6.0, 8.0) 2.0(1.0, 4.0) 3.0(1.0, 6.5)
Feeding pattern at 4 months
  Exclusive breastfeeding 7.0(7.0, 9.0) 0.027 1.0(0, 4.0) 0.164 7.0(6.0, 8.0) 0.469 2.0(1.0, 4.0) 0.299 3.0(2.0, 7.0) 0.183
  Mixed feeding 7.0(6.0, 8.0) 2.0(1.0, 3.0) 6.0(6.0, 8.0) 3.0(1.0, 4.0) 5.0(2.0, 8.0)
Duration of breastfeeding/months
  ≤8 7.0(6.0, 8.0) 0.064 3.0(1.0, 4.0) 0.048 6.0(6.0, 8.0) 0.302 3.0(1.0, 4.0) 0.366 5.0(2.0, 9.0) 0.122
  >8 7.0(7.0, 9.0) 1.0(0, 4.0) 7.0(6.0, 8.0) 2.0(1.0, 4.0) 4.0(2.0, 7.0)
Maternal age/years
  ≤35 7.0(6.0, 8.0) 0.013 1.0(1.0, 4.0) 0.009 7.0(6.0, 8.0) 0.162 2.0(1.0, 4.0) 0.145 4.0(2.0, 7.0) 0.038
  >35 8.5(7.0, 9.0) 0.5(0, 2.0) 7.0(6.0, 8.5) 2.0(1.0, 3.0) 2.5(1.0, 5.0)
Maternal education level
  Primary school and below 7.0(7.0, 9.0) 0.045 1.0(0, 1.0) 0.001 6.0(5.0, 8.0) 0.259 1.0(1.0, 2.0) 0.007 2.0(1.0, 4.0) 0.001
  Secondary school 8.0(7.0, 9.0) 1.0(0, 3.0) 7.0(6.0, 8.0) 1.5(1.0, 3.0) 2.0(1.0, 5.0)
  College 7.0(6.0, 8.0) 2.0(1.0, 4.0) 7.0(6.0, 8.0) 3.0(1.5, 4.0) 5.0(2.0, 8.0)
  Postgraduate and above 7.0(6.0, 8.0) 2.0(1.0, 4.0) 7.0(6.0, 8.0) 2.0(1.0, 4.0) 4.0(2.0, 7.5)
Family monthly income/yuan
   < 3 000 8.0(6.0, 9.0) 0.285 1.0(0, 3.0) 0.015 7.0(6.0, 8.0) 0.853 2.0(1.0, 3.0) 0.076 2.0(1.0, 5.5) 0.022
  3 000-8 000 7.0(7.0, 9.0) 1.0(0, 3.0) 7.0(6.0, 8.0) 2.0(1.0, 3.0) 3.0(1.0, 6.0)
  >8 000 7.0(7.0, 8.0) 2.0(1.0, 4.0) 7.0(6.0, 8.0) 3.0(1.0, 4.0) 5.0(2.0, 9.0)

表4

蔬菜首次添加月龄影响因素的多重线性回归分析"

Variable β (95%CI) S${\bar x}$ Std. β t value P value
Constant 7.152 (6.220, 8.085) 0.473 15.128 < 0.001
Maternal age
  >35 years 0.616 (0.092, 1.139) 0.266 0.161 2.319 0.021
Feeding pattern at 4 months
  Exclusive breastfeeding 0.423 (0.026, 0.819) 0.201 0.145 2.102 0.037
Maternal education level
  Secondary school 0.250 (-0.453, 0.953) 0.356 0.088 0.703 0.483
  College -0.145 (-0.813, 0.524) 0.339 -0.060 -0.427 0.670
  Postgraduate and above -0.254 (-0.948, 0.441) 0.352 -0.096 -0.720 0.473
Family monthly income/yuan
  3 000-8 000 0.065 (-0.619, 0.749) 0.347 0.027 0.187 0.852
  >8 000 -0.143 (-0.836, 0.551) 0.352 -0.060 -0.406 0.685

表5

蔬果添加种类数影响因素的多重线性回归分析"

Variable β (95%CI) S Std. β t value P value
Constant 2.288 (-1.542, 6.119) 1.942 1.178 0.240
City
  Beijing 0.401 (-1.086, 1.888) 0.754 0.043 0.532 0.595
  Parity -0.219 (-1.311, 0.873) 0.554 -0.031 -0.396 0.693
Maternal age
  >35 years -1.770 (-3.648, 0.109) 0.952 -0.133 -1.858 0.065
Maternal education level
  Secondary school 1.261 (-1.259, 3.780) 1.278 0.128 0.987 0.325
  College 2.652 (0.197, 5.106) 1.245 0.316 2.131 0.034
  Postgraduate and above 2.735 (0.138, 5.332) 1.317 0.297 2.077 0.039
Family monthly income/yuan
  3 000-8 000 -0.027 (-2.422, 2.368) 1.214 -0.003 -0.022 0.982
  >8 000 1.193 (-1.267, 3.653) 1.247 0.144 0.957 0.340
1 中国营养学会膳食指南工作委员会, 妇幼人群膳食指南工作组. 7~24月龄婴幼儿喂养指南[C]// 0~24月龄婴幼儿科学喂养研讨会资料汇编. 北京: 中国营养学会, 2015: 6.
2 中华预防医学会儿童保健分会. 婴幼儿喂养与营养指南[J]. 中国妇幼健康研究, 2019, 30 (4): 392- 417.
doi: 10.3969/j.issn.1673-5293.2019.04.001
3 徐晓清, 肖翔鹰, 张伶俐. 婴幼儿膳食营养状况及与生长发育的相关性调查[J]. 中国妇幼保健, 2020, 35 (2): 321- 324.
4 张小凤, 雷方良, 高婧媛, 等. 婴幼儿喂养指数与生长发育状况的多重对应分析[J]. 中国妇幼保健, 2017, 32 (4): 717- 720.
5 U.S. Department of Agriculture, U.S. Department of Health and Human Services. Dietary Guidelines for Americans, 2020-2025. 9th ed. [EB/OL]. (2020-12-05)[2021-02-15]. https://www.dietaryguidelines.gov/sites/default/files/2021-03/Dietary_Guidelines_for_Americans-2020-2025.pdf.
6 付昕阳, 冒东林, 耿永勇, 等. 图木舒克市婴幼儿结石高危因素的调查研究[J]. 中国医学创新, 2019, 16 (26): 63- 67.
7 杜侃, 栾佐, 屈素清, 等. 反复上呼吸道感染与婴幼儿饮食结构的相关性研究[J]. 中国医学前沿杂志: 电子版, 2015, 7 (1): 81- 84.
8 岳莉, 黄蕾, 李佳樾, 等. 兰州地区0~3岁婴幼儿骨密度水平与膳食影响因素相关分析[J]. 中国妇幼保健, 2019, 34 (17): 3966- 3969.
9 刘芳丽, 宁一冰, 马德福, 等. 中国八城市0~36月龄婴幼儿自报过敏、食物过敏与不耐受状况调查与影响因素分析[J]. 中华儿科杂志, 2013, 51 (11): 801- 806.
doi: 10.3760/cma.j.issn.0578-1310.2013.11.001
10 Roess AA , Jacquier EF , Catellier DJ , et al. Food consumption patterns of infants and toddlers: Findings from the Feeding Infants and Toddlers Study (FITS) 2016[J]. J Nutr, 2018, 148 (suppl 3): 1525S- 1535S.
11 Koh GA , Scott JA , Woodman RJ , et al. Maternal feeding self-efficacy and fruit and vegetable intakes in infants. Results from the SAIDI study[J]. Appetite, 2014, 81, 44- 51.
doi: 10.1016/j.appet.2014.06.008
12 Arora A , Manohar N , Hector D , et al. Determinants for early introduction of complementary foods in Australian infants: Findings from the HSHK birth cohort study[J]. Nutr J, 2020, 19 (1): 16.
doi: 10.1186/s12937-020-0528-1
13 周旭, 方俊群, 罗家有, 等. 2015年湖南省贫困农村地区6~8月龄婴儿辅食添加率相关因素[J]. 卫生研究, 2018, 47 (1): 46- 50.
14 栾超, 于冬梅, 赵丽云. 婴幼儿辅食添加、辅食质量评价及影响因素[J]. 卫生研究, 2018, 47 (6): 1022- 1027.
15 冷文辉, 汪俊华, 牟鸿江. 6~23月龄婴幼儿辅食添加现状及影响因素研究进展[J]. 中国妇幼卫生杂志, 2016, 7 (5): 67- 69.
16 Wang L , van Grieken A , van der Velde L A , et al. Factors associated with early introduction of complementary feeding and consumption of non-recommended foods among Dutch infants: the BeeBOFT study[J]. BMC Public Health, 2019, 19 (1): 388.
17 Vercammen KA , Moran AJ , Zatz LY , et al. 100% juice, fruit, and vegetable intake among children in the special supplemental nutrition program for women, infants, and children and nonparticipants[J]. Am J Prev Med, 2018, 55 (1): e11- e18.
18 Okeke JO , Ekanayake RM , Santorelli ML . Effects of a 2014 statewide policy change on cash-value voucher redemptions for fruits/vegetables among participants in the supplemental nutrition program for women, infants, and children (WIC)[J]. Matern Child Health J, 2017, 21 (10): 1874- 1879.
19 Bensley RJ , Anderson JV , Brusk JJ , et al. Impact of internet vs traditional special supplemental nutrition program for women, infants, and children nutrition education on fruit and vegetable intake[J]. J Am Diet Assoc, 2011, 111 (5): 749- 755.
[1] 焦莶如, 龚潘, 牛悦, 徐兆, 周宗朴, 杨志仙. 以婴儿癫痫性痉挛综合征为表型的吡哆醇依赖性癫痫[J]. 北京大学学报(医学版), 2024, 56(5): 781-787.
[2] 李洋洋,侯林,马紫君,黄山雅美,刘捷,曾超美,秦炯. 孕期因素与婴儿牛奶蛋白过敏的关系[J]. 北京大学学报(医学版), 2024, 56(1): 144-149.
[3] 姚晓莹,刘志科,李宁,马瑞,赵薛飞,张良,许国章,詹思延,方挺. 2015—2019年宁波市0~36月龄婴幼儿癫痫发病的流行病学研究[J]. 北京大学学报(医学版), 2021, 53(3): 485-490.
[4] 李秀兰,吴艳,钟晓云,王敏,黄利. 新生儿重症监护室早产儿母乳喂养促进策略研究[J]. 北京大学学报(医学版), 2019, 51(4): 711-715.
[5] 包菊,刘佳,曲元,穆东亮. 脐动脉血气pH值对剖宫产新生儿住院期间并发症的预测价值[J]. 北京大学学报(医学版), 2019, 51(1): 159-164.
[6] 杨夕樱,朱灵平,刘雪芹,张春雨,姚勇,吴晔. 基因诊断Caroli综合征合并常染色体隐性遗传性多囊肾1例及文献回顾[J]. 北京大学学报(医学版), 2018, 50(2): 335-339.
[7] 张欣, 茹喜芳, 王颖, 李星, 桑田, 冯琪. 新生儿重症监护病房中新生儿真菌败血症的临床特点[J]. 北京大学学报(医学版), 2017, 49(5): 789-793.
[8] 王姝琪, 杨志仙, 李慧. Williams-Beuren综合征的临床及遗传学特点:2例报道[J]. 北京大学学报(医学版), 2017, 49(5): 899-903.
[9] 吴艳, 钟晓云, 蒋静, 龚华. 住院早产超低和极低出生体重儿强化母乳喂养的前瞻性对照研究[J]. 北京大学学报(医学版), 2016, 48(1): 143-148.
[10] 李子一1, 王金子, 张雅蓉, 余恺, 司徒文佑, 尤莉莉, 陈程, 李文军, 王培玉, 张玉梅. 家长自报4~36月龄婴幼儿挑食行为的准确性评价[J]. 北京大学学报(医学版), 2014, 46(3): 383-388.
[11] 周文娟, 梁爱民, 王凤芝, 崔文红, 王秀云, 刘秋明, 游红, 贺春燕, 彭金荣, 张迎武, . 北京市四区/县18月龄儿童发育迟缓的流行病学研究[J]. 北京大学学报(医学版), 2013, 45(2): 211-.
[12] 姜毅, 侯新琳, 李昕, 林志淼, 崔晨. 新生儿遗传性营养不良性大疱性表皮松解症基因诊断1例[J]. 北京大学学报(医学版), 2013, 45(2): 202-.
[13] 冯琪. 早产儿院内营养策略进展及其意义[J]. 北京大学学报(医学版), 2013, 45(2): 333-.
[14] 叶华, 陈适, 安媛. 系统性红斑狼疮患者的妊娠结局:41例患者情况分析[J]. 北京大学学报(医学版), 2012, 44(2): 233-235.
[15] 陈智滨, 和璐, 康军, 黄振, 沙月琴, 朱万孚, 闫玲 . 早产低体重儿与母亲唾液中牙周致病菌的关系[J]. 北京大学学报(医学版), 2012, 44(1): 29-33.
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed   
No Suggested Reading articles found!