孕期食物摄入与婴儿湿疹关联的队列研究

  目的  探讨孕期各大类食物摄入量与婴儿湿疹发病风险之间的关联。  方法  采用前瞻性出生队列研究方法,选取广州市某区妇幼保健院常规孕检的孕20~28周孕妇523名。采用具有81个条目的半定量食物频率问卷调查孕妇过去一个月的膳食摄入情况,根据中国膳食指南划分食物摄入类别,并计算各大类别食物摄入量。于产后6个月通过电话随访调查婴儿湿疹的发病情况。将孕期各类食物摄入量进行四等分（Q1-Q4）,采用多因素Logistic回归分析模型分析其与婴儿湿疹之间的关联。  结果  产后6个月婴儿湿疹累计发病率为51.8%。在孕期各类食物摄入方面,湿疹组的禽肉类摄入量高于非湿疹组（27.62±25.20 vs.22.03±22.63 g/d,P=0.022）;谷类、蔬菜类、水果类、红肉类、蛋类、奶类、大豆、坚果的摄入在两组间差异均无统计学意义（均有P>0.05）。多因素Logistic回归分析结果显示,母亲孕期较高的禽肉类摄入（Q4）和鱼类摄入（Q3）与最低四分位数组（Q1）相比,婴儿湿疹发生风险增加（OR=2.71,95% CI=1.24~4.81;OR=2.38,95% CI=1.23~4.59）。  结论  孕期禽肉类或鱼类摄入过多与更高的婴儿湿疹发生风险有关。     

婴幼儿湿疹影响因素分析:一项五省市的前瞻性队列研究

  目的  了解婴幼儿湿疹的发病现状,从多角度探索其发病因素。  方法  以中国孕产妇队列研究-子代项目中的681名婴幼儿为研究对象,在孕期收集父母亲的一般人口学信息、孕期膳食摄入及婴幼儿出生信息,随访调查其家居环境和婴幼儿湿疹状况,应用多因素非条件logistic回归分析模型分析婴幼儿湿疹发病的影响因素。  结果  研究对象婴幼儿湿疹的发生率为23.79%。logistic回归分析模型分析结果显示,相比初产妇,经产妇(OR=0.601, 95% CI:0.398~0.908)所分娩的孩子患湿疹风险会降低47.6%。母亲有过敏史(OR=2.191, 95% CI:1.393~3.447)和父亲有过敏史(OR=2.008, 95% CI:1.244~3.239)的孩子更容易患湿疹。相比于母乳喂养,人工喂养(OR=4.165, 95% CI:1.450~11.963)和混合喂养(OR=8.151, 95% CI:5.165~12.866)增加婴幼儿患湿疹的风险。孕期禽肉摄入频率越高的孕妇,产后孩子患湿疹的风险增高(OR=1.145, 95% CI:1.011~1.297)。家庭地板、窗台、墙壁有褪色、变黑或霉变(OR=2.051, 95% CI:1.094~3.843)会使婴幼儿湿疹的发病风险增高。  结论  产次、喂养方式、父母过敏史、孕期禽肉摄入频率及居家环境对于婴幼儿湿疹发病有影响,应加强开展针对性宣传指导,有效预防婴幼儿湿疹发生。     

母亲孕期铁营养与子代先天性心脏病关系的病例对照研究

  目的  探讨母亲孕期铁营养与子代先天性心脏病(congenital heart disease,CHD)的关系。  方法  数据来源于陕西省2014年1月―2016年12月开展的CHD病例对照研究,对纳入孕妇进行膳食营养问卷调查。采用条件logistic回归分析模型分析母亲孕期铁营养与子代CHD及其各亚型的关系,并进行亚组分析探索其稳定性。  结果  在调整了混杂因素后,母亲孕期增补铁剂降低了子代CHD的发生风险(< 30 d:OR=0.54, 95% CI: 0.37~0.79;≥30 d:OR=0.25, 95% CI: 0.16~0.38),孕期膳食铁摄入量较高(≥29 mg/d)降低了子代CHD的发生风险(OR=0.69, 95% CI: 0.54~0.88),亚组分析结果显示,母亲孕期铁营养和子代CHD的关系稳定。此外,母亲孕期增补铁剂≥30 d子代在室间隔缺损(ventricular septal defect, VSD)、房间隔缺损(atrial septal defect, ASD)、动脉导管未闭(patent ductus arteriosus, PDA)、法洛四联症(tetralogy of fallot, TOF)上发生风险均降低,增补铁剂 < 30 d子代在ASD发生风险降低,孕期膳食铁摄入量较高(≥29 mg/d)子代在VSD、PDA发生风险均降低。  结论  母亲孕期铁营养水平升高降低了子代CHD的发生风险,孕妇孕期应注意机体铁营养的摄入和补充,促进母婴健康。     

孕期膳食维生素C摄入与子痫前期及其临床亚型的关系

  目的  探讨孕期膳食维生素C摄入与子痫前期(preeclampsia,PE)及其临床亚型的关系。  方法  选取2012年3月1日—2016年9月30日于山西医科大学第一医院妇产科住院分娩的孕妇为研究对象,其中861例PE孕妇作为病例组,7 987例非PE孕妇作为对照组,收集其一般人口学特征、疾病史、家族史及孕期膳食摄入情况等。采用非条件logistic回归分析模型分析孕期膳食维生素C摄入对PE及其临床亚型的发生风险的影响。  结果  调整孕妇年龄、文化程度等影响因素后,孕妇孕早期膳食维生素C摄入达到Q₃水平(OR=0.80, 95% CI: 0.64~0.99)、孕晚期达到Q₃水平(OR=0.78, 95% CI: 0.63~0.97)会降低PE的发生风险。按照孕前BMI进行分层后,孕前BMI < 24.0 kg/m2的孕妇孕早期膳食维生素C摄入达到Q₃水平(OR=0.73, 95% CI: 0.55~0.96)、孕中期达到Q₃水平(OR=0.71, 95% CI: 0.54~0.93)、孕晚期达到Q₃水平(OR=0.67, 95% CI: 0.51~0.88)是PE的保护因素。进一步探讨不同孕前BMI孕妇膳食维生素C摄入与PE临床亚型的关系后发现,孕前BMI < 24.0 kg/m2的孕妇孕晚期膳食维生素C摄入达到Q₃水平(OR=0.66, 95% CI: 0.47~0.93)会降低晚发型子痫前期(late-onset preeclampsia, LOPE)的发生风险。  结论  孕前BMI < 24.0 kg/m2的孕妇Q₃水平的膳食维生素C摄入可降低PE的发生风险,尤其是对于LOPE。     

中国7~17岁儿童青少年宏量营养素摄入与超重肥胖的关系

  目的  探讨7~17岁儿童青少年宏量营养素摄入与超重肥胖的关系。  方法  1997—2011年基于“中国居民健康与营养调查”的6轮调查数据,纳入膳食及BMI数据完整的7~17岁儿童青少年为研究对象。依照中国肥胖问题工作组制定标准判定超重肥胖,采用Logistic回归分析模型分析宏量营养素摄入与儿童青少年超重肥胖的关系。  结果  最终纳入6 360名研究对象,其中7~＜12岁儿童青少年3 529人(55.5%),男生3 360人(52.8%),超重肥胖1 060人(16.7%)。校正相关混杂因素后,与脂肪供能比 < 25%组相比,≥30%组增加20%肥胖风险(OR=1.20, 95% CI:1.03~1.41, P=0.023);与蛋白质供能比 < 10%组相比,≥15%组增加61%肥胖风险(OR=1.61, 95% CI:1.25~2.04, P < 0.001);与碳水化合物供能比 < 55%组相比,55%~ < 65%组降低20%肥胖风险(OR=0.80, 95% CI:0.68~0.95, P=0.011),≥65%组降低21%肥胖风险(OR=0.79, 95% CI:0.66~0.94, P=0.010);脂肪及蛋白质供能比越高、碳水化合物供能比越低,发生超重肥胖的风险越高(P < 0.05);男生摄入过量蛋白质更可能发生肥胖(P=0.034)。  结论  儿童青少年摄入过量脂肪和蛋白质可增加超重肥胖发生风险。     

中链饱和脂肪酸与口腔癌发病风险的关联性

  目的  探讨膳食中链饱和脂肪酸与口腔癌发病的关联。  方法  本病例对照研究以面访式问卷的形式调查2013年11月14日至2019年3月21日在福建医科大学附属第一医院口腔颌面外科确诊的225例新发口腔癌患者及527例健康对照。以对照组中能量校正后的各类脂肪酸每日摄入量的中位数进行分组,进行非条件Logistic回归分析模型分析、分层分析及相乘交互作用分析。  结果  高水平组的总中链饱和脂肪酸、辛酸、癸酸、十一烷酸及月桂酸等与口腔癌的发病风险呈正相关,其调整后的OR值及其95% CI值分别为3.19(95% CI: 2.17~4.69)、2.54(95% CI: 1.75~3.69)、2.56(95% CI: 1.76~3.71)、5.00(95% CI: 3.27~7.64)和3.09(95% CI: 2.10~4.54)。在不吸烟者中,辛酸和癸酸与口腔癌发生风险呈正相关,且无论是否饮酒,其均能增加口腔癌的发病风险;各亚组均发现高总中链饱和脂肪酸、十一烷酸及月桂酸摄入量与口腔癌发生风险呈正相关。此外,中链饱和脂肪酸与吸烟、饮酒存在相乘交互作用。  结论  较高水平的膳食中链饱和脂肪酸可能会增加口腔癌的发病风险。     

新疆伊犁州35~74岁人群膳食炎症指数与超重/肥胖的关系

  目的  分析膳食炎症指数(dietary inflammatory index,DⅡ)与超重/肥胖之间的关联,为研究肥胖的炎症机制提供科学依据。  方法  2019年1月―5月在新疆伊犁州霍城县招募35~74岁队列成员并完成基线调查,采用统一制定的调查问卷,收集研究对象一般人口特征、行为方式等信息。采用食物频率调查表(food frequency questionnaires,FFQ),调查研究对象膳食摄入情况,计算DⅡ,评估膳食的炎症潜能。  结果  研究对象2 241人,超重的检出率为38.51%,肥胖的检出率为32.04%;总研究对象DⅡ评分以正值为主,总体膳食属于促炎性膳食;调整年龄、民族、性别、文化程度、家庭收入后,Log-binomial回归分析模型结果显示DⅡ与超重及肥胖存在相关性,最大促炎组患超重及肥胖的风险是最大抗炎组的1.32倍(PR=1.32,95% CI:1.10~1.57,P=0.015),其中DⅡ与超重仅在Q1(最大抗炎)与Q4(最大促炎)组间发现相关性(PR=1.26,95% CI:1.09~1.47,P=0.002),DⅡ与肥胖在每组均存在相关性,随着DⅡ评分的增加,研究对象患肥胖的风险增加。  结论  膳食炎症指数与超重/肥胖之间存在相关性,膳食的肥胖效应可以从炎症的角度进行深入分析。     

1982年与2012年中国6~17岁学龄儿童膳食维生素A的摄入比较

  目的  了解中国6~17岁学龄儿童(以下简称学龄儿童)膳食维生素A、视黄醇和胡萝卜素摄入水平,为促进儿童营养改善和健康成长提供基础数据。  方法  通过分析1982年全国营养调查和2012年中国居民营养与健康状况监测中的膳食调查数据,计算学龄儿童每人每天各种食物及调味品摄入量。根据1982年与2012年的食物成分表,分别计算动物性食物来源的视黄醇和植物性食物来源的胡萝卜素摄入量,并将二者折合计算维生素A总量,与维生素A的推荐摄入量(recommended nutrient intake, RNI)进行比较。  结果  中国学龄儿童膳食维生素A摄入总量(μg RAE)从1982年的(333.3±15.9)μg RAE下降到2012年的(215.3±9.5)μg RAE(F=61.95, P < 0.001);其中,视黄醇摄入量从(28.4 ±2.0)μg增加到(107.6±4.8) μg(F=225.36, P < 0.001),胡萝卜素摄入量从(3 673.9±217.3)μg下降到(1 297.4±82.0)μg(F=214.98, P < 0.001)。1982年儿童膳食维生素A摄入总量为农村高于城市(F=5.28, P=0.022),2012年则为城市高于农村(F=14.85, P < 0.001)。2012年仅有四分之一的儿童膳食维生素A摄入量达到80%RNI以上。  结论  1982—2012年中国学龄儿童膳食维生素A摄入水平整体有所下降,动物性食物贡献率有所增加,植物性食物贡献率大幅度降低。建议加强膳食指导,丰富农村儿童食物供应的种类,改善儿童的维生素A营养状况。     

中国65岁及以上老年人日常生活活动能力与死亡的关系

  目的  探讨老年人日常生活活动能力(activities of daily living, ADL)与中短期死亡之间的关系。  方法  本研究使用了来自中国老年健康影响因素跟踪调查(Chinese Longitudinal Healthy Longevity Survey, CLHLS)的数据。分析样本包括37 173名CLHLS项目历次调查中的新人群,生存结局来自研究对象2~4年后首次跟踪随访调查结果。失能情况是通过ADL能力量表进行测量。计算ADL总分并进行分组之后,本研究通过多种统计建模策略,探讨不同失能水平对老年人死亡的影响。  结果  调整人口学、健康行为、膳食摄入特征等混杂因素后,ADL总分人群死亡风险存在着统计学关联(RR=1.09, 95% CI:1.08~1.09, P < 0.001)。以6分组作对照,得分高于6分组的人群发生死亡的风险增加69%(RR=1.69, 95% CI:1.65~1.74, P < 0.001)。以正常组作为对照组,低级失能组和高级失能组的人群发生死亡的风险分别增加52%和92%(RR=1.52, 95% CI:1.47~1.56, P < 0.001; RR=1.92, 95% CI: 1.86~1.97, P < 0.001)。  结论  基于CLHLS样本发现,失能会增加老年人发生死亡的风险,短期随访、低年龄段的失能老年人发生死亡的风险更大。     

中国7~17岁儿童青少年宏量营养素摄入与中心性肥胖的关系

  目的  探讨三大宏量营养素供能比对儿童青少年中心性肥胖前期/中心性肥胖的影响。  方法  本研究采用横断面研究,对象为1997—2011年中国营养与健康调查6轮调查中膳食及腰围数据完整的7~17岁的儿童青少年。根据中国疾病预防控制中心营养与食品安全所的研究标准判定儿童青少年中心性肥胖前期/中心性肥胖。采用多因素Logistic回归分析模型分析宏量营养素供能比与中心性肥胖前期/中心性肥胖的关系。  结果  调整相关混杂因素后,与脂肪供能比 < 25%组相比,≥30%组增加中心性肥胖前期/中心性肥胖风险(OR=1.29, 95% CI: 1.12~1.48);与蛋白质供能比 < 10%组相比,≥15%组增加中心性肥胖前期/中心性肥胖风险(OR=1.47, 95% CI: 1.19~1.82);与碳水化合物供能比 < 55%组相比,55%~ < 65%组(OR=0.75, 95% CI: 0.64~0.87)与≥65%组(OR=0.68, 95% CI: 0.58~0.80)都降低了中心性肥胖前期/中心性肥胖风险。男生蛋白质供能比≥15%增加中心性肥胖前期/中心性肥胖的风险与女生相比更大(OR=1.78, 95% CI: 1.31~2.41, 交互作用P=0.012)。   结论  儿童青少年膳食结构中,脂肪和蛋白质供能比越高、碳水化合物供能比越低会增加中心性肥胖前期/中心性肥胖发生风险。     

Maternal antioxidant intake in pregnancy and wheezing illnesses in children at 2 y of age

BACKGROUND: Low intakes of dietary antioxidants may contribute to increases in asthma and allergy. OBJECTIVE: We investigated the association of maternal total intakes (foods + supplements) of 10 antioxidant nutrients during pregnancy with wheezing and eczema in 2-y-old children. DESIGN: Subjects were 1290 mother-child pairs in an ongoing cohort study. Maternal dietary and supplement intakes were assessed by using a validated food-frequency questionnaire administered in the first and second trimesters. Antioxidant nutrient intakes were calculated, and the mean for each nutrient was considered to be the exposure during pregnancy. The outcomes of interest were any wheezing by the child during either the first or second year of life, recurrent wheezing in both years, and eczema in either the first or second year. RESULTS: No association was observed between maternal total intake of any antioxidant nutrient and eczema. In multivariate logistic regression models, the highest quartile compared with the lowest quartile of maternal total intakes of vitamin E [odds ratio (OR): 0.70; 95% CI: 0.48, 1.03] and zinc (OR: 0.59; 95% CI: 0.41, 0.88) was inversely associated with any wheezing at 2 y of age (P for trend = 0.06 and 0.01 over quartiles of intake for vitamin E and zinc, respectively). Similar results were obtained for recurrent wheezing at 2 y of age with vitamin E (OR: 0.49; 95% CI: 0.27, 0.90) and zinc (OR: 0.49; 95% CI: 0.27, 0.87) (P for trend = 0.05 and 0.06 over quartiles of intake for vitamin E and zinc, respectively). CONCLUSION: Our results suggest that higher maternal total intakes of antioxidants during pregnancy may decrease the risks for wheezing illnesses in early childhood.     

The Association between Maternal Sugar-Sweetened Beverage Consumption and Infant/Toddler Added Sugar Intakes

Intake of added sugars during early life is associated with poor health outcomes. Maternal dietary intake influences the intake of their children, but little research investigates the relationship between maternal sugar sweetened beverage (SSB) and infant/toddler added sugar intakes. Our objective was to explore the relationship between maternal total sugars and SSB intakes and infant/toddler added sugar intakes. This cross-sectional study (n = 101) of mother-infant dyads measured maternal dietary intake by food frequency questionnaire and infant intake by three 24-h dietary recalls. Pearson’s correlations explored the relations between maternal total sugars and SSB intakes and infant added sugar intakes. Hierarchical stepwise regressions determined if maternal total sugars and SSB intakes explained the variation in infant added sugar intakes after accounting for known risk factors for early introduction of added sugars. Maternal total sugars (r = 0.202, p = 0.043) and SSB (r = 0.352, p < 0.001) intakes were positively correlated with infant/toddler added sugar intakes. In the hierarchical models, maternal total sugar intakes did not account for more variance in infant added sugar intakes (β = 0.046, p = 0.060), but maternal SSB intake was a significant contributor of infant added sugar intakes (β = 0.010, p = 0.006) after accounting for confounders. Interventions to reduced maternal SSB consumption may help reduce infant/toddler added sugar intakes.     

Associations between Maternal Antioxidant Intakes in Pregnancy and Infant Allergic Outcomes

Antioxidant intakes in pregnancy may influence fetal immune programming and the risk of allergic disease. We investigated associations between maternal intakes of β-carotene, vitamin C, vitamin E, copper and zinc, and infant allergic outcomes. Antioxidant intakes of pregnant women (n = 420) assessed prospectively by a food frequency questionnaire, were examined in relation to allergic outcomes at 1 year of age (n = 300). The main relationships with allergic outcomes were seen with dietary vitamin C and copper. Specifically, higher maternal dietary vitamin C intake was associated with a reduced risk of any diagnosed infant allergic disease and wheeze. After adjustment for potential confounders the relationship with wheeze remained statistically significant. There was also an inverse linear relationship between vitamin C and food allergy. Higher dietary copper intake was associated with reduced risk of eczema, wheeze and any allergic disease. The relationship with wheeze and any allergic disease remained statistically significant in multivariate analysis, and there was also an inverse linear relationship between copper and food allergy. However, these relationships were only seen for nutrients present in food. There were no relationships between β-carotene, vitamin E or zinc and any allergic outcomes. In summary, this study suggests that maternal diet of fresh foods rich in vitamin C is associated with reduced risk of infant wheeze, and that copper intake is associated with reduced risk of several allergic outcomes.     

Maternal diet rich in saturated fat during breastfeeding is associated with atopic sensitization of the infant

OBJECTIVE: To investigate the impact of maternal diet during breastfeeding on atopic sensitization of infants at risk. DESIGN: Prospective cohort study. SETTING: Turku University Central Hospital, Finland. SUBJECTS AND METHODS: Altogether 114 infants with a family history of atopic disease were followed during their first year of life. The mothers completed a 4 day food record during breastfeeding just before the infants were 3 months old. Atopic sensitization of the infants was determined by a positive skin prick test result at 12 months. RESULTS: Positive skin prick test reactivity to at least one antigen was detected in 27/114 (24%) infants at 12 months. The energy intake of the mothers was low, mean 8.0 MJ/day (95% CI 7.7-8. 3), and the proportion of energy derived from fat was high, mean 36. 6 E% (95% CI 35.6-37.6). Atopic mothers had a higher intake of total fat and saturated fat and a lower intake of carbohydrate as a percentage of total energy intake than non-atopic mothers; P=0.017, P=0.050, P=0.004 respectively. Maternal intake of saturated fat during breastfeeding was associated with atopic sensitization of the infant, OR=1.16 (95% CI 1.001-1.36); P=0.048 irrespective of the maternal atopic status. CONCLUSIONS: Our results show that an unbalanced maternal diet during breastfeeding may be a risk factor underlying the later development of atopic sensitization of the infant regardless of maternal atopic disease. The observation thus extends findings implying that early nutrition programmes the subsequent health of the child to the risk of developing atopic disease. SPONSORSHIP: Academy of Finland and National Technology Agency.     

Plasma Metabolite Profiles of Red Meat,Poultry, and Fish Consumption,and Their Associations with Colorectal Cancer Risk

Background: Red and processed meat consumption has been consistently associated with increased risk of colorectal cancer (CRC), but the association for fish intake is unclear. Evidence using objective dietary assessment approaches to evaluate these associations is sparse. Objectives: We aim to investigate the plasma metabolite profiles related to red meat, poultry, and fish consumption and examine their associations with CRC risk. Methods: We measured plasma metabolites among 5269 participants from the Nurses’ Health Study (NHS), NHSII, and Health Professionals Follow-Up study (HPFS). We calculated partial Spearman correlations between each metabolite and self-reported intake of seven red meat, poultry, and fish groups. Metabolite profile scores correlated to self-reported dietary intakes were developed using elastic net regression. Associations between self-reported intakes, metabolite profile scores, and subsequent CRC risk were further evaluated using conditional logistic regression among 559 matched (1:1) case-control pairs in NHS/HPFS and replicated among 266 pairs in Women’s Health Study. Results: Plasma metabolites, especially highly unsaturated lipids, were differentially associated with red meat and fish groups. Metabolite profile scores for each food group were significantly correlated with the corresponding self-reported dietary intake. A higher dietary intake of processed red meat was associated with a higher risk of CRC (pooled OR per 1 SD, 1.15; 95% CI: 1.03, 1.29). In contrast, higher metabolite profile scores for all fish groups, not dietary intakes, were consistently associated with a lower CRC risk: the pooled OR per 1 SD was 0.86 (95% CI: 0.78, 0.96) for total fish, 0.86 (95% CI: 0.77, 0.96) for dark meat fish, and 0.87 (95% CI: 0.78, 0.97) for canned tuna fish. No significant associations were found for other food groups. Conclusions: Red meat and fish intake exhibited systematically different plasma metabolite profiles. Plasma metabolite profile of fish intake was inversely associated with CRC risk.     

母乳喂养和辅食添加与儿童亚临床VitA缺乏的关系

目的:探讨母乳喂养和辅食添加与儿童亚临床Vit A缺乏的关系。方法:对于6~71个月儿童Vit A营养状况进行横断面研究,荧光法测定血清Vit A含量。半定量频率问卷收集调查前2周内儿童辅食情况,同时调查儿童的家庭经济、围生期保健及疾病情况等。结果:单因素分析表明母乳喂养为亚临床Vit A缺乏的危险因素(OR=3·52,95%CI为2·02~6·12);多因素Logistic回归在控制性别、月龄、儿童排行、母亲文化水平、母亲职业、Vit A增补剂、腹泻等因素后,仍然有显著意义(OR=2·39,95%CI为1·22~4·69)。单因素分析添加鲜奶或奶制品、蛋类、豆类及豆制品、蔬菜以及鱼虾等辅食对亚临床VitA缺乏有保护作用,OR均小于1;在控制已知协变量和混杂变量后,只有豆类及豆制品辅食添加有统计学意义(OR=0·41,95%CI为0·18~0·94)。结论:6个月以后母乳喂养不能成为亚临床Vit A缺乏的保护因素,辅食添加不足与亚临床Vit A缺乏关系有待进一步研究。     

产褥期妇女膳食行为及其相关因素

目的：了解产褥期妇女的膳食行为及其相关影响因素。方法采用方便抽样的方法抽取306名处于分娩之后3个月之内的妇女作为研究对象,分别对其进行问卷调查和膳食调查,获有效问卷290份。结果98％以上的妇女认为产褥期应该禁忌某些食物,其中14％认为应该禁忌水果。将产褥期妇女各类食物的每日摄入量与哺乳期妇女推荐摄入量相比,奶类和水果摄入不足的比例达到87．9％和87．2％,有75．9％的妇女蔬菜的摄入量不达标。 Logistic回归分析结果显示,文化程度为大专和高中以下是奶类摄入的阻碍因素（OR值分别为0．482、0．405,均P＜0．05）,家庭人均月收入6000元以下和禁忌水果是水果摄入的阻碍因素（OR值分别为0．446、0．345、12．728,均P＜0．05）,文化程度在高中以下是蔬菜摄入的阻碍因素（OR＝0．321,P＜0．05）。结论产褥期妇女的膳食行为还存在诸多亟待改善之处,应针对产褥期妇女及其家人进行科学的健康宣教,帮助产褥期妇女走出传统习俗的一些误区,做到科学护理,健康保健。     

Moderate Freshwater Fish Intake,but Not n-3 Polyunsaturated Fatty Acids,Is Associated with a Reduced Risk of Small for Gestational Age in a Prospective Cohort of Chinese Pregnant Women

BackgroundAlthough previous studies have found that maternal fish intake is associated with fetal growth, the role of freshwater fish intake remains unknown.ObjectiveOur aim was to examine the relationships of freshwater fish and n-3 polyunsaturated fatty acids (PUFAs) intake with the risk of small for gestational age (SGA) in Chinese pregnant women.DesignThis was a prospective analysis of data from the Tongji Birth cohort in Wuhan, China, from 2018 to 2021.Participants/settingsThis study included 1,701 pregnant women who had completed a food frequency questionnaire dietary assessment during mid-pregnancy.Main outcome measuresIntake of fish was assessed by a semi-quantitative food frequency questionnaire. Total intake of n-3 PUFAs was the sum of data collected from both dietary and supplemental sources of n-3 PUFAs. Birth information was extracted from medical records.Statistical analysesMultivariate logistic regression models were applied to estimate odds ratios and 95% CIs.ResultsThe median (interquartile range) intake of freshwater fish and total n-3 PUFAs was 12.1 (4.3 to 26.4) g/d and 68.2 (24.5 to 370.0) mg/d, respectively. Moderate intake of freshwater fish was associated with reduced risk of SGA. Compared with the lowest quintile (0–3.2 g/d), the multivariable-adjusted odds ratio for women in the fourth quintile of freshwater fish intake (17.9 to 30.0 g/d) was 0.50 (95% CI 0.25 to 0.96). We found a nonlinear association between freshwater fish intake and SGA risk (P_nonlinearity = .027). However, maternal n-3 PUFAs intake was not significantly associated with SGA risk, either from total intake or from dietary sources alone.ConclusionsModerate freshwater fish intake during pregnancy is associated with lower risk of SGA in a Chinese population. This finding provides supportive evidence for freshwater fish intake during pregnancy, particularly for the inland areas of developing countries.     

Predictors of anticipated breastfeeding in an urban, low-income setting

BACKGROUND: Although the proportion of women who breastfeed is known to vary by demographic group, breastfeeding practices have not been sufficiently studied among urban, lower income African American populations seen in family medicine centers. METHODS: A cross-sectional design was used to examine demographic, clinical, and attitudinal factors that affect anticipated infant feeding practices reported by postpartum women from a low-income, urban family practice setting. Data was analyzed using chi-square, odds ratios (OR), and multiple logistic regression techniques. RESULTS: Among 66 respondents, only 3 subjects (4.5%) indicated that they planned to breastfeed exclusively, while an additional 11 subjects (16.7%) reported plans to use a combination of bottle-feeding and breastfeeding. Based on univariate analyses, women with less than 12 years of education were less likely to report anticipated breastfeeding. Otherwise, breastfeeding plans were not associated with subject demographic features or with reproductive characteristics. Respondents planning to bottle-feed noted that breastfeeding was too complicated. Logistic regression demonstrated an inverse relationship between level of maternal education and anticipated breastfeeding (OR=0.13, 95% confidence interval [CI], 0.05-0.35), and a direct association for encouragement from the baby's father or the woman's mother to breastfeed and anticipated breastfeeding (OR=12.4; 95% CI, 4.92-31.4). CONCLUSIONS: This study reports unique data regarding anticipated infant feeding practices among patients from an urban, low-income community served by a family medicine center. Findings from this study will be used to develop a family-centered educational intervention involving the mothers, grandmothers, and partners of pregnant patients to promote the benefits of breastfeeding in this community.