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

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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)

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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
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