Email Alert | RSS

Journal of Peking University (Health Sciences) ›› 2022, Vol. 54 ›› Issue (3): 526-531. doi: 10.19723/j.issn.1671-167X.2022.03.019

Previous Articles     Next Articles

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

   

PDF (PC)

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

CLC Number: 

  • R153.1

Table 1

Timing of vegetables and fruits"

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

Table 2

Types of vegetables and fruits"

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

Table 3

Association between demographic factors and the introduction of fruits and vegetables"

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)

Table 4

Multiple linear regression analysis of the associated factors and the timing of vegetables"

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

Table 5

Multiple linear regression analysis of the associated factors and the variety of fruits and vegetables"

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] Xianru JIAO, Pan GONG, Yue NIU, Zhao XU, Zongpu ZHOU, Zhixian YANG. Phenotype of infantile epileptic spasm syndrome in pyridoxin-dependent epilepsy [J]. Journal of Peking University (Health Sciences), 2024, 56(5): 781-787.
[2] Yangyang LI,Lin HOU,Zijun MA,Shanyamei HUANG,Jie LIU,Chaomei ZENG,Jiong QIN. Association of pregnancy factors with cow's milk protein allergy in infants [J]. Journal of Peking University (Health Sciences), 2024, 56(1): 144-149.
[3] YAO Xiao-ying,LIU Zhi-ke,LI Ning,MA Rui,ZHAO Xue-fei,ZHANG Liang,XU Guo-zhang,ZHAN Si-yan,FANG Ting. Epidemiological study of infantile epilepsy incidence density among infants under 36 months of age in Ningbo City from 2015 to 2019 [J]. Journal of Peking University (Health Sciences), 2021, 53(3): 485-490.
[4] HU Di,ZHANG Miao,KANG Hui-ying,PENG Yun. Investigation and validation of magnetic resonance white matter atlas for 0 to 2 years old infants [J]. Journal of Peking University (Health Sciences), 2021, 53(2): 341-347.
[5] Xiu-lan LI,Yan WU,Xiao-yun ZHONG,Min WANG,Li HUANG. Breastfeeding promotion strategies study on preterm infants in the neonatal intensive care unit [J]. Journal of Peking University(Health Sciences), 2019, 51(4): 711-715.
[6] Ju BAO,Jia LIU,Yuan QU,Dong-liang MU. Predictive value of umbilical arterial cord pH on complications during hospitalization in neonates after cesarean section [J]. Journal of Peking University(Health Sciences), 2019, 51(1): 159-164.
[7] YANG Xi-ying, ZHU Ling-ping, LIU Xue-qin, ZHANG Chun-yu, YAO Yong, WU Ye. Genetic diagnosis of Caroli syndrome with autosomal recessive polycystic kidney disease: a case report and literature review [J]. Journal of Peking University(Health Sciences), 2018, 50(2): 335-339.
[8] WANG Shu-qi, YANG Zhi-xian, LI Hui. Clinical and genetic characteristics of Williams-Beuren syndrome: 2 cases report [J]. Journal of Peking University(Health Sciences), 2017, 49(5): 899-903.
[9] ZHANG Xin, RU Xi-fang, WANG Ying, LI Xing, SANG Tian, FENG Qi. Clinical characteristics of neonatal fungal sepsis in neonatal intensive care unit [J]. Journal of Peking University(Health Sciences), 2017, 49(5): 789-793.
[10] WU Yan, ZHONG Xiao-yun, JIANG Jing, GONG Hua. Prospective and controlled study on effect of fortified human milk feeding on infants with extremely and very low birth weight during hospital stay [J]. Journal of Peking University(Health Sciences), 2016, 48(1): 143-148.
[11] LI Zi-Yi-1, WANG Jin-Zi, ZHANG Ya-Rong, YU Kai, SI Tu-Wen-You, YOU Li-Li, CHEN Cheng, LI Wen-Jun, WANG Pei-Yu, ZHANG Yu-Mei. Assessment of accuracy of parents’ perception of their 4-36 months old children’s picky eating behavior [J]. Journal of Peking University(Health Sciences), 2014, 46(3): 383-388.
Viewed
Full text


Abstract

Cited
  Shared   
  Discussed   
No Suggested Reading articles found!
Copyright © Journal of Peking University (Health Sciences), All Rights Reserved.
Powered by Beijing Magtech Co. Ltd