6～24月龄中国婴幼儿喂养指数评价方法的建立

目的建立6～24月龄中国婴幼儿喂养指数,为综合评价婴幼儿喂养提供有效的工具。方法以2002年Ruel和Menon提出的喂养指数概念为基础,根据世界卫生组织(WHO)喂养建议和中国0～6岁儿童膳食指南,建立喂养指数确定各变量分类及分值,利用四川、河北、黑龙江三地区城乡6～24月龄共1738名婴幼儿年龄别体重(WAZ)、年龄别身长(HAZ)和身长别体重(WHZ),分析喂养指数与婴幼儿Z评分之间的相关性。结果喂养指数由持续母乳喂养、奶瓶使用、过去24小时膳食摄入种类和膳食摄入频率、过去一周辅食添加天数、配方奶首添时间、除配方奶外其他辅食首添时间7部分组成;城市婴幼儿喂养指数评分显著高于农村(P<0.05);城市6～8月龄组婴幼儿喂养指数得分低于9～24月龄组婴幼儿(P<0.05);城市婴幼儿喂养指数与WAZ、WHZ显著负相关(P<0.05),农村喂养指数与HAZ显著正相关(P<0.05),与WHZ显著负相关(P<0.05)。结论本研究建立的喂养指数可有效评价我国6～24月龄婴幼儿的喂养情况。     

贵州省贫困农村地区婴幼儿辅食喂养及体格发育调查

目的了解贵州省贫困农村地区6~23月龄婴幼儿辅食添加情况及对体格发育的影响,探讨改善婴幼儿辅食喂养的途径。方法采用分层多阶段整群随机抽样的方法,进行横断面调查,调查对象为贵州贫困农村地区6~23月龄婴幼儿及其看护人。通过膳食回顾法调查过去24小时婴幼儿食物摄入情况,分析辅食添加时间、辅食种类、喂养频率等。用年龄别身高Z值(HAZ)和年龄别体重Z值(WAZ)判断婴幼儿体格发育水平,分析辅食添加与生长迟缓、低体重的相关关系。结果辅食及时添加率为91.1%;首次添加辅食以谷类泥糊状食物为主,约占75%;摄入频率最高的是谷物、根茎、块茎类食物(94.1%),摄入频率最低的是其他蔬菜水果(30.5%),动物性食物(肉类)摄入率仅33.8%;母乳喂养婴幼儿频次合格率63.8%,种类合格率64.8%,频次和种类同时合格率(即辅食合格)仅43.5%,18~23月龄辅食合格率最高(56.7%);非母乳喂养婴幼儿频次合格率22.5%,种类合格率71.5%,频次和种类同时合格率(即辅食合格)仅16.7%,18~23月龄辅食合格率最高(20.2%)。母乳喂养婴幼儿,辅食不合格者生长迟缓率、低体重率高于辅食合格者,二者差异有统计学意义(P0.05);非母乳喂养婴幼儿,辅食不合格者生长迟缓率高于辅食合格者,二者差异有统计学意义(P0.05);辅食不合格者低体重率略高于辅食合格者,但二者差异无统计学意义。结论贵州省贫困农村地区婴幼儿辅食喂养存在问题,部分婴幼儿辅食添加时间不合理,辅食合格率较低。不合格辅食是导致生长迟缓和低体重的重要原因,应改善辅食营养状况。     

贵阳市6～24月龄婴幼儿生长发育现状及与辅食添加关系研究

目的分析评估贵阳地区6~24月龄婴幼儿生长发育与辅食喂养现状,探讨辅食添加与生长发育的关系,为科学评价婴幼儿喂养和实施营养干预提供依据。方法采用分层整群随机抽样方法,分别抽取贵阳城区和农村不同级别的妇幼保健站,对参加儿保的婴幼儿家长(或看护人)采用面对面的问卷调查方法调查婴幼儿喂养情况;测量婴幼儿的身长、体重,计算并评价年龄别身长LAZ、年龄别体重WAZ。结果 (1)城区和农村婴幼儿的LAZ和WAZ评分随年龄增加逐渐下降,且农村低于城区,差异有统计学意义(P0.05);(2)农村婴幼儿生长迟缓率在12月龄后增加为13.0%,且高于城区同月龄婴幼儿生长迟缓率;(3)农村婴幼儿添加辅食在6月龄~以上比例高于城区组,且添加辅食时间适中婴幼儿的身长、体重均值大多高于添加过早或过晚者,差异有统计学意义(P0.05)。辅食添加的种类城区(4.09±1.96)高于农村(2.89±1.31),差异有统计学意义(P0.01);(4)动物性食品每周零摄取的比例较高(如鱼类城市为63.12%,农村为76.98%)。结论在贵阳地区农村婴幼儿的生长发育较城市婴幼儿差,与部分农村婴幼儿辅食添加过晚、添加辅食种类少及动物性食物摄入频率低有关。及时合理的辅食添加,对婴幼儿的生长发育均有较大的益处。     

汉中市婴幼儿喂养指数与体格发育的相关性研究

目的 采用婴幼儿喂养指数(ICH)评价陕西省汉中市6～ 23月龄婴幼儿的喂养状况及其与体格发育之间的相关性.方法 于2015年6月至2016年2月,按照多阶段分层整群随机抽样的原则,从西安交通大学医学院附属汉中3201医院及城固县、南郑县、洋县妇幼保健院儿保门诊随机抽取1 418名6～23月龄婴幼儿为调查对象,6～8、9～11、12 ～ 23月龄组分别为482、457、479名.采用自行设计的调查问卷收集婴幼儿基本情况及其喂养状况,父母家庭一般情况等信息,测量其身长与体重,进行ICFI评分(满分为16分),计算婴幼儿的身长别体重Z评分(WLZ)、年龄别体重Z评分(WAZ)、年龄别身长Z评分(LAZ),分析ICH与WLZ、WAZ和LAZ的相关性.结果 1 418名婴幼儿ICFI得分为8.98±2.53;6～8、9～11及12 ～ 23月龄组ICFI得分为8.07±2.77、8.99±2.41和9.88±2.01,其合格率分别为32.2％、43.3％和60.1％,差异均有统计学意义(F =67.189,P＜0.05;x2 =76.826,P＜0.05).农村与城市ICFI得分为8.70±2.51、9.20±2.52,农村喂养指数合格率为39.5％,城市喂养指数合格率为49.8％,差异均有统计学意义(t=-3.655,P ＜0.05;x2=15.140,P＜0.05).ICFI得分不合格组的WAZ和LAZ均低于喂养指数合格组(t值分别为2.739、4.056,均P＜0.05).6～8、9～11及12 ～23月龄组ICH得分均与LAZ呈正相关(r值分别为0.127、0.112、0.227,均P＜0.05),6～8、12 ～ 23月龄组ICH得分均与WAZ呈正相关(r值分别为0.179、0.161,均P＜0.05),6～8月龄组ICH得分与WLZ呈正相关(r值为0.152,P＜0.05).结论 ICH在一定程度上反映了该婴幼儿群体的生长发育状况,可综合评价陕西省汉中市6 ～ 23月龄婴幼儿喂养状况.     

陕西省贫困农村婴幼儿辅食添加时间与生长发育相关性

目的探讨辅食添加时间现状及其与婴幼儿生长发育的相关性。方法于2013年采用多阶段群组抽样方法抽取陕西省南部11个国家贫困县的1802名6～12月龄婴幼儿作为基线调查对象,共进行四期调查,每次调查间隔6个月。通过自制问卷收集婴幼儿辅食添加相关资料,利用贝利婴幼儿发展量表测评婴幼儿认知能力发展状况,并利用标准量具衡量婴幼儿身长和体重,生成年龄别身高(HAZ)、年龄别体重(WAZ)以及身高别体重(WHZ)指数。采用方差分析法评估婴幼儿辅食添加时间与生长发育的关系。结果样本地区仅32. 93%的婴幼儿满6月龄开始辅食添加时间,其余样本婴幼儿添加辅食时间过早或过晚。在较长时期来看,辅食添加时间与婴幼儿认知能力得分呈现相关关系,第三和四期追踪调查显示,6月龄以后添加辅食的婴幼儿智力发育指数(MDI)(分别为81. 24和78. 40)更低(F=11. 86,P<0. 05;F=4. 24,P<0. 05),6月龄添加辅食的婴幼儿认知发展优势逐渐显现。辅食添加时间与WAZ、HZA、WHZ均无长期的显著相关关系。结论陕西省南部贫困农村地区仍存在辅食添加不合理的行为。辅食添加时间是影响婴幼儿生长发育的重要变量。     

中国西南城乡6~24月龄婴幼儿辅食添加频率与生长发育相关性研究

目的探讨婴幼儿辅食添加频率与生长发育之间的相关性。方法采用分层整群随机抽样选取成都、昆明和贵阳地区3644名6~24月龄健康婴幼儿作为调查对象,通过问卷调查收集婴幼儿母乳、配方奶及辅食添加相关资料,应用辅食添加频率综合评价体系进行量化评分和分级;测量婴幼儿身长和体重并计算Z评分以评估生长发育状况;采用Spearman秩相关法分析婴幼儿辅食添加频率与生长发育Z评分的相关性,采用线性趋势χ2检验分析婴幼儿辅食添加频率与生长发育不良率的关系。结果城市、农村母乳/配方奶摄入小于3次/天的婴幼儿,辅食添加频率与身长别体重Z评分(WLZ)、年龄别体重Z评分(WAZ)均呈正相关,相关系数城市分别为0.10和0.11(P0.05),农村分别为0.20和0.14(P0.05)。农村婴幼儿消瘦率随辅食添加频率水平升高而降低。城市、农村母乳/配方奶摄入大于等于3次/天的婴幼儿,辅食添加频率与生长发育Z评分均不存在相关。结论辅食添加频率对婴幼儿生长发育有影响,西南农村地区更为明显,可通过改善婴幼儿辅食添加频率,控制婴幼儿人群的消瘦比例。     

陕西省商南县0～5岁儿童生长发育与喂养相关研究

目的 了解陕西省商南县0～5岁儿童生长发育、营养及辅食添加状况,为改善农村儿童营养和健康状况制定相应的干预措施提供依据.方法 在陕西省商南县随机抽取2个乡镇,共调查儿童458名,通过问卷调查了解儿童的生长发育和喂养状况等.结果 陕西省商南县0～5岁儿童生长发育状况良好;儿童低体重占4.0%,生长迟缓占11.5%,消瘦占2.7%.6～23月龄婴幼儿的年龄别体重、年龄别身高在不同辅食添加时间的差异均具有统计学意义(χ2分别为19.339和16.713,均P<0.05),年龄别体重、身高别体重和年龄别身高在不同辅食添加种类间的差异均无统计学意义(均P>0.05).结论 陕西省商南县0～5岁儿童生长发育符合一般规律,营养状况基本良好.     

6～24月龄婴幼儿喂养指数分布以及与生长发育的相关性研究

目的利用2002年全国营养和健康状况调查数据建立我国婴幼儿喂养指数,评价喂养情况与生长发育的关系。方法依据世界卫生组织推荐喂养方式,选择母乳喂养、是否用奶瓶喂养、膳食多样性、食物频率等变量,建立喂养指数评分体系,评价喂养指数评分与年龄别体重(WAZ)、年龄别身长(HAZ)和身长别体重(WHZ)关系。结果城乡婴幼儿喂养指数评分存在显著差异(P<0.001),随着婴幼儿月龄的增加,喂养指数评分显著增加(P<0.05),喂养指数得分与WAZ、HAZ和WHZ显著相关(P<0.05)。结论喂养指数可以作为一项综合判断婴幼儿喂养的方法。     

河南省农村HIV阳性产妇分娩婴儿营养状况评价

目的 了解河南省农村地区艾滋病病毒(HIV)感染母亲分娩婴幼儿的营养状况.方法 使用WHO的Anthro 2010软件,分别计算160名婴幼儿在满1、3、6、9、12、18月龄的年龄别体重、年龄别身高、身高别体重Z值评分,以WHO参考人群为标准评估婴幼儿的营养状况.结果 共调查满18月龄存活婴幼儿160人,其中HIV阳性婴幼儿32例,HIV阴性婴幼儿128人;除3月龄以外,HIV阳性婴幼儿低体重发病率均高于HIV阴性婴幼儿(P＜0.05);6、12、18月龄HIV阳性婴幼儿的生长发育迟缓率均高于HIV阴性婴幼儿(P＜0.05);3月龄以后HIV阴性婴幼儿年龄别体重Z值(WAZ)增长趋势优于HIV阴性婴幼儿(P＜0.05),随访期间阴性婴儿WAZ值为-0.59～0.79,阳性婴儿的WAZ值为-1.41～-0.04;年龄别身长Z值(HAZ)2组婴幼儿在9、18月龄差异均有统计学意义(P＜0.05);随访期间阴性婴儿HAZ值为-1.22～-0.17,阳性婴儿HAZ值为-1.89 ～-0.90;HIV阳性产妇分娩的婴幼儿在多个月龄的体重、身高值与正常婴幼儿差异有统计学意义.结论 河南省农村地区HIV阳性产妇分娩婴幼儿的营养不良发病率较高,HIV阳性婴幼儿更为严重.     

我国0～5岁儿童营养不良与婴幼儿辅食添加状况

母乳喂养与合理辅食添加两者是互为补充的统一体,对6月龄以后婴儿的生长发育均同等重要.我国儿童营养不良发生率从开始添加辅食起迅速上升,农村高于城市,贫困农村地区尤为明显;婴幼儿缺铁性贫血发病率持续处于较高水平,而且还存在一定比例的生长发育迟缓等长期营养缺乏导致的问题,这与开始添加辅食的时机不合理、添加辅食的质差量不足、喂养不合理等密切相关.因此应重视6月龄开始的辅食喂养,除了提供多样化高质量的工业化生产的辅食,还应加强普及儿童看护人的科学育儿知识与技巧.该文总结了我国0～5岁儿童营养不良发生率、微量营养素营养状况、主要微量营养素摄入量及我国婴幼儿辅食添加情况.     

A summary index of infant and child feeding practices is associated with child growth in urban Shanghai

ABSTRACT: BACKGROUND: Recently, an infant and child feeding index (ICFI) constructed on brief recalls of breastfeeding, feeding frequency and food diversification was assumed to provide long-term prediction about child feeding practices. The aim of this study was to investigate the association between the cross-sectional ICFI (CS-ICFI) or longitudinal ICFI (L-ICFI) and child anthropometric indices in downtown Shanghai, China. METHODS: The prospective cohort study included 180 infants aged 5-7 mo with their main caregivers who were visited 3 times every 6 months over 12 months. A CS-ICFI was constructed for each visit by using data on feeding practices based on 24-h and 7-d recalls. An L-ICFI was constructed with use of the 3 CS-ICFIs. The associations between ICFI and length-for-age z score (LAZ), weight-for-age z score (WAZ), and weight-for-length z score (WLZ) were examined. The stability of the CS-ICFI was assessed by using repeatability coefficient (RC). RESULTS: The L-ICFI was positively associated with LAZ and WAZ at Visit 3 (beta=0.151, P=0.040 and beta=0.173, P=0.024, respectively). Moreover, the CS-ICFI at Visit 1 was positively associated with LAZ, WAZ and WLZ (beta=0.160, P=0.029; beta=0.191, P=0.009; beta=0.176, P=0.020) at Visit 3, and the CS-ICFI at Visit 3 was also positively associated with LAZ (beta=0.176, P=0.016). Stability of the CS-ICFI was shown by the value of 0.14 (95% CI: 0.07, 0.31) of the RC, which differed significantly from 0 (P<0.05). CONCLUSIONS: The ICFI constructed on brief recalls based on cross-sectional studies can be used to evaluate the effects of child feeding practice on child growth.     

Undernutrition Among Infants and Children in Nepal: Maternal Health Services and Their Roles to Prevent it

Objectives Appropriate infant and young child feeding (IYCF) for children aged 6–23 months includes adequate dietary diversity, appropriate meal frequency, and continued breastfeeding. Mothers receiving antenatal care (ANC) and postnatal care (PNC) may adopt better IYCF. This study examined the association of ANC or PNC attendance with IYCF and child nutrition status. Methods A cross-sectional study was performed on 400 mother–child pairs in rural Nepal. Mothers were interviewed about their history of ANC and PNC attendance and IYCF; the height and weight of their children were measured. IYCF was measured with infant and child feeding index (ICFI) aggregating scores of dietary diversity, meal frequency, continued breastfeeding, and dietary variety. Lower ICFI scores indicated poorer IYCF practices. Multiple regression and logistic regression examined the association of ANC and PNC attendance with ICFI scores and undernutrition, respectively. Results Absence of ANC (β = ?1.01, P = 0.011) and absence of PNC (β = ?1.01, P = 0.011) were negatively associated with ICFI scores. Additionally, absence of ANC was positively associated with underweight (AOR 3.37; 95 % CI 1.42–9.92 for children 6–11 months, AOR 3.43; 95 % CI 1.41–8.32 for children 12–23 months) and stunting (AOR 6.51; 95 % CI 2.11–20.10 for children 6–11 months, AOR 3.32; 95 % CI 1.50–7.31 for children 12–23 months). Similarly, children tended to be underweight and stunted if their mothers did not receive any PNC. Conclusion Absence of ANC and PNC were associated with poor IYCF, underweight, and stunting in children.     

营养强化辅助食品补充物对甘肃贫困农村婴幼儿体格生长的影响

目的探讨补充含有蛋白质、微量营养素的辅助食品对婴幼儿身长和体重的影响。方法从甘肃省5个贫困县选取1478名4~12个月的婴幼儿分成2组,所有儿童均在保持其家庭习惯辅助食品添加的前提下,每天再补充1包不同配方的营养补充物,其中配方1组补充了蛋白质和微量营养素,配方2组补充了与配方1组同等的能量,每隔6个月对全部儿童补充一次大剂量维生素A。补充期间,每3个月进行一次体格测量,两组儿童观察到满24个月为止。结果基线调查时,配方2组LAZ和WAZ要优于配方1组,配方1组儿童的营养不良率均高于配方2组,但差异无显著性(P>0.05)。补充12个月以后,配方1组和配方2组儿童LAZ、WAZ和营养不良率已经没有差别。如果比较同一个儿童随访调查与其基线调查时的LAZ差值、WAZ差值的变化,配方1的作用要优于配方2,效用尺度是0.17。对于基线调查不同营养状况的儿童,配方1组均有正的效用。所有儿童满24个月时,儿童身长和体重Z评分的变化值在配方1组和配方2组之间有显著意义(P<0.05),配方1组婴幼儿身长的变化值要显著大于配方2组(P<0.05),如果只分析基线调查时月龄小于7个月的儿童,配方1组儿童身长Z评分的变化值要显著优于配方2组(P<0.005),儿童平均身长要多增加1.3cm(P<0.005)。结论辅食补充物可以促进婴幼儿的体格发育,家庭水平强化辅食在中国贫困农村是可行的。     

Index for Measuring the Quality of Complementary Feeding Practices in Rural India

This community-based cross-sectional study was undertaken to develop a complementary feeding index (CFI) to assess the adequacy of complementary feeding (CF) practices and determine its association with growth of infants, aged 6–12 months, in rural Indian population. The study was conducted in six villages of Ghaziabad district, Uttar Pradesh, India. A structured interview schedule was used for eliciting information from 151 mothers of infants, aged 6–12 months, on CF practices. Data on CF practices were scored using the CFI developed. Measurements of weight and length were taken. Bivariate and multivariate analyses were done using the SPSS software (version 13). The results revealed that the CF practices were suboptimal in the sample. The mean±standard deviation (SD) CFI scores ranged from a low value of 7.09±3.21 in 6–8 months old infants to a comparatively-higher value of 9.69±2.94 in 9–12 months old infants. Using the CFI it could be identified that infants (n=151) had poor dietary diversity, with only 31% and 18% of the infants reportedly being fed the recommended number of food-groups during 6–8 and 9–12 months respectively. The food-frequency scores of the CFI showed that cereals and diluted animal milk were the major food-groups fed to the infants in this setting. Analysis of nutritional status revealed that 24.5% of the infants were stunted (length-for-age [LAZ] <-2SD), 25% were underweight (weight-for-age [WAZ] <-2SD), and 17% were wasted (weight-for-age [WLZ] <-2SD). Significant associations (p<0.05) were observed between the meal-frequency and the dietary diversity of the CFs of infants aged 6–8 months and 9–12 months and the WAZ and LAZ indices of their nutritional status. On multivariate analysis of factors affecting the LAZ, WAZ and WLZ scores, the CFI was significantly associated (p<0.05) with LAZ whereas maternal education and breastfeeding frequency were significantly (p<0.01) associated with WAZ and WLZ. Per-capita income, parity, and birth-order were the significant (p<0.05) determinants of the CFI. The CFI developed is an exploratory attempt to summarize and quantify the key CF practices into a composite index, which would reflect the CF practices holistically. This index can be used as an easy tool by programme planners for identifying, targeting, and monitoring the deficient CF practices and also advocating the importance of the CF at policy level.Key words: Community-based studies, Complementary feeding index, Complementary feeding practices, Cross-sectional studies, Infant nutritional status, India     

A summary index of feeding practices is positively associated with height-for-age, but only marginally with linear growth, in rural Senegalese infants and toddlers

Several studies have shown an association between an infant and young child feeding index (ICFI) and height-for-age Z-score (HAZ) in Latin America and Africa. A previous study was unable to reproduce these findings in 500 rural Senegalese 12-42-mo-old children. The relationship of ICFI, dietary diversity index (DDI), food variety index (FVI), meal frequency index (MFI), and breastfeeding (BF) to HAZ and growth in height/length over 6 mo was studied in 1060 6-36-mo-old Senegalese children during 2 visits. List-based food frequencies were recalled for the past 24 h, and height/length and weight measurements were taken. Indicators were transformed into tertiles in age-specific subgroups. DDI, FVI, MFI, and ICFI were poorly concordant across visits at all ages (weighted κ: 0.02-0.25). In cross-sectional analyses that pooled children from the 2 visits, HAZ was positively associated with DDI and FVI at 6-12, 12-18, and 18-24 mo and with ICFI at 6-12 and 18-24 mo (P < 0.001 and P < 0.05, respectively) but was negatively associated with BF at 12-18, 18-24, and 24-30 mo. The length increment between visits was positively associated with MFI and ICFI, measured during the first visit in 18-24-mo-olds (P < 0.001 and P < 0.05, respectively) but not with DDI, FVI, or BF at any age. In conclusion, ICFI, DDI, and FVI were associated with HAZ, particularly during infancy, whereas no indicator was associated with linear growth in this age group. Therefore, the strong association between HAZ and ICFI during infancy may be partly due to maternal adaptation to infant clues, i.e., greater appetite for and interest in non-breast-milk foods among taller infants.     

Association between infant- and child-feeding index and nutritional status: results from a cross-sectional study among children attending an urban hospital in Bangladesh

Integration of infant- and child-feeding index (ICFI) addressing the multidimensional child-feeding practices into one age-specific summary index is gaining importance. This cross-sectional study was aimed at understanding the association between the ICFI and the nutritional status of 259 children, aged 6-23 months, who attended the paediatric outpatient department of the Dhaka Medical College Hospital in Bangladesh. The mean length-for-age z-score (LAZ) of children aged 12-23 months was significantly (p < 0.05) higher among those who were at the upper ICFI tercile compared to those who were at the middle or lower ICFI tercile (-2.01 and -3.20 respectively). A significant correlation was found between the ICFI and the LAZ (r = 0.24, p = 0.01 and r = 0.29, p = 0.01) in children aged 6-8-months and 12-23-months. Multivariable analysis, after adjusting for potential confounders, also found a significant association between the ICFI and the LAZ (beta = 0.13, p = 0.03). The predictive capability of the proposed ICFI on nutritional status of children, especially length-for-age, needs to be further evaluated prospectively among healthy children in the community.     

广东省6～18月龄婴幼儿喂养指数分布及与体格发育的相关性研究

目的分析广东地区6—18月龄婴幼儿喂养指数（ICFI）及与体格发育指标之间的相关性,以探讨ICFI应用于定量评估和比较婴幼儿喂养习惯的有效性。方法整群抽取广东省广州市荔湾区（城市）、佛山市南海区（城镇）、江门市新会区（农村）所有已建立健康档案的6—18月龄婴幼儿,问卷凋查喂养现况及测查体格发育。以中国疾病预防控制中心营养与食品安全所提出的ICFI评分体系为依据,计算评价ICFI。使用WHO推荐的Anthro软件计算婴幼儿的年龄别身长z评分（HAZ）、年龄别体重z分（wAz）、身长别体重z分（WHZ）。分析ICFI与各类z评分的相关性。结果共调查6～18月龄婴幼儿1771人,其中男997人,女774人。全省ICFI为（7．05±2．47）,高于全国平均值（5．9±2．6）,其中城市（474人）、城镇（658人）ICFI分别为（7．29±2．25）和（7．39±2．53）,明显高于农村（639人）ICFI（6．52±2．49）（P〈0．05）。6—8月龄（606人）、9～11月龄（317人）、12—18月龄（848人）ICFl分别为（6．59±2．47）、（6．87±2．45）、（7．44±2．42）,ICFI随月龄增加而增加（P〈0．01）。ICFI总合格率49．2％（872／1771）,其中城市、城镇和农村分别为53．0％（251／474）、56．7％（373／658）和38．8％（248／639）,城市、城镇合格率高于农村（P〈0．01）,6—8、9～11、12～18月龄合格率分别为37．6％、46．7％和58．5％,随月龄增加,合格率明显提高（P〈0．01）。城市ICFI与HAZ、WHZ相关（r=0．108、0．117,均P〈0．05）,城镇ICFI与WHZ相关（r=0．104,P〈0．01）。12～18月龄组ICFI与WAZ和HAZ相关（,=0．110、0．136,均P〈0．01）。结论广东省6～18月龄婴幼儿ICFI高于全国平均值。ICFI可在一定程度上反映出婴幼儿群体的生长发育状况,并可用于婴幼儿喂养方法的综合评判,但其应用效度有待改善。     

Assessment of child feeding practices using a summary index: stability over time and association with child growth in urban Madagascar

BACKGROUND: Previous studies investigating the association between an infant and child feeding index (ICFI) and length-for-age were based on a cross-sectional design and on the assumption that data collected with brief recalls could provide information about more enduring processes. OBJECTIVES: The objectives were to test the stability of the individual ICFI values over time and to investigate how they relate to length-for-age z score (LAZ) and weight-for-length z score (WLZ) at the end of the study. DESIGN: This prospective cohort study included 363 children aged 6-17 mo who were visited 3 times over 6 mo. A cross-sectional ICFI (CS-ICFI) was constructed for each visit by using data on feeding practices and data from quantitative 24-h recalls. A longitudinal ICFI (L-ICFI) was constructed with use of the 3 CS-ICFIs. The stability of the CS-ICFI was assessed by using the variance of the repeatability coefficient (s(2)r). RESULTS: Stability of the CS-ICFI was shown by the value of 0.704 (95% CI: 0.625, 0.805) of the s(2)r, which differed significantly from 1 (P < 0.0001). There was no significant association between the CS-ICFIs and LAZ or WLZ at visit 3. In contrast, when moving from low to high L-ICFI, there was a highly significant 0.5 z score difference in mean LAZ at visit 3 (P = 0.0008). The L-ICFI was not associated with WLZ. CONCLUSIONS: The ICFI constructed by using data collected with brief recalls can provide information about feeding in the long term. However, the absence of association with LAZ suggests a lack of precision that can be reduced by using an ICFI based on repeated measurements.     

An infant and child feeding index is associated with the nutritional status of 6- to 23-month-old children in rural Burkina Faso

The measurement of child feeding practices is complex and the relation between the quality of feeding and children's nutritional status is difficult to establish. We examined this relation in rural Burkina Faso, West Africa, using an adapted version of the Infant and Child Feeding Index (ICFI). A cross-sectional study was conducted on a random sample of children (n = 2466) aged 6-35 mo in 2002. Feeding practices were assessed through a qualitative 24-h recall. ICFIs were made age specific for children aged 6-11 mo (n = 614), 12-23 mo (n = 987), 24-35 mo (n = 865), and were divided into terciles. The association between height-for-age Z-scores (HAZ), weight-for-height Z-scores (WHZ), and ICFIs were examined separately in each age group. Multivariate analyses were performed to control for sociodemographic and economic factors. Adjusted mean HAZ in low, medium, and high categories of ICFI were, respectively, -1.67, -1.53, and -1.21 (P = 0.003) among children aged 6-11 mo; -2.54, -2.24, and -2.11 (P = 0.0002) among children aged 12-23 mo; and -2.18, -2.20, and -2.45 (P = 0.05) among children aged 24-35 mo. There was also a positive association between ICFI and WHZ in children aged 12-23 mo (P = 0.05) but a negative association in children aged 6-11 mo (P = 0.02). Among the components of ICFI, dietary diversity or variety scores and frequency of meals or snacks supported the positive associations with anthropometric indices, except for WHZ in children aged 6-11 mo, whereas breast-feeding exhibited a reverse association among older children. A suitable ICFI and/or some of its components could be used to identify vulnerable age groups and to monitor interventions in similar rural areas of Africa.