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

doi:10.19723/j.issn.1671-167X.2022.03.019

摘要/Abstract

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

李玭,赵艾,武薇,张健,王培玉,蓝航莲,张玉梅. 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[J]. 北京大学学报（医学版）, 2022, 54(3): 526-531.

Pin LI,Ai ZHAO,Wei WU,Jian ZHANG,Pei-yu WANG,Hang-lian LAN,Yu-mei ZHANG. 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[J]. Journal of Peking University (Health Sciences), 2022, 54(3): 526-531.

图/表 5

表1

表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
Variable	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3

表4

表5

参考文献 19

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Infant's age/months	Vegetable		Fruit
Infant's age/months	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

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

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

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

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