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Examination of growth development, diet and nutrition for toddlers with different birth weights until four years old
relative high birth weight infants
relative low birth weight infants
nutrition of infants and toddlers
growth status of infants and toddlers
|Abstract:||良好的營養支持是嬰幼兒健全生長發展的關鍵因素，且嬰幼兒出生體重的不同對於生長速度亦有所影響。本研究利用長期追蹤前瞻性研究方式，持續收集不同出生體重的新生兒其飲食營養攝取狀況與生長發展資料至四歲，並深入探討各因素間之相關性。本研究招募對象主要來自兩世代，分別各於民國91及93年間於台北市立婦幼醫院及台大醫院進行招募，研究之初招募人數各為151及150位；兩世代採用相同的問卷調查方法，問卷內容包括24小時飲食回憶、健康狀況、體位發展等資料。研究合併兩世代嬰幼兒至四歲的資料(n=165)，依出生體重第25及第75百分位分成相對低出生體重(relative low birth weight infants, rLBW)、相對適當出生體重(relative adequate birth weight infants, rABW)、相對高出生體重(relative high birth weight infants, rHBW)三組。資料使用SPSS 12.0及 STATA 8.0版進行統計分析。
Proper nutrition is the essential factor for growth of healthy children and birth weight may also affect growth rate. This study collected information from birth to 4 years old with different birth weight ranges and focused on analyzing the relationship between the dietary intakes and the growth development of healthy children. These analyses included the first cohort of 130 and the second cohort of 150 children recruited from the Taipei Municipal Women’s and Children's Hospital and the National Taiwan University Hospital from 2002 to 2004. The methodology adopted the questions asked in the two cohorts were identical. Our analyses combined information from the two cohorts consisting of total 165 subjects from birth to 4 years old. These participants were divided into three groups according to the 25th and 75th percentile cut points: relative low birth weight infants group (rLBW), relative adequate birth weight infants group (rABW), and relative high birth weight infants group (rHBW). The software packages of SPSS 12.0 and STATA 8.0 were employed for the statistical analyses. The result indicated that the growth indicators (weight, height and BMI) of infants between the three groups are significantly different from age 0 to 4. The rHBW group had higher means for weight, height and BMI and the rLBW group was still the smallest of the three groups. However, the differences between the rABW and rLBW group had become smaller. The assessments of the growth rates by multiplier of figures, weight gain percentages and the WHO Anthropometric calculator indicated that the growth speeds were also significantly different between the three groups. The rLBW group had faster growth speed than therHBW group, especially from age 0 to 1. The mean weight, height and BMI of boys from birth to 4 years old were significantly higher than the girls. The mean daily caloric intake of 4-year-old was 1390 Kcal, compared to the DRIs of 1300~1450 Kcal. The average dietary intakes of protein, fat and carbohydrate were 48g, 46g and 194g, respectively. The total energy was 14% from protein, 29% from fat, and 56% from carbohydrates. The mean calcium intake was 337 mg compared to the DRIs of 600 mg, and the mean dietary fiber intake was 8 g compared to the IOM of 25 g. The dietary pattern of 4-year-old toddler tended to three meals with three snacks because most of them already attend the kindergarten. Only 60% of children had daily consumption of dairy products (whole milk and milk powders) and the average intake was less than one serving portion. We also found that the intake of carbonated beverage and fried food increased with age, while the dairy intake decreased with age. In addition, the intakes of vegetable and fruit were insufficient at 4 years old. These conditions were similar to the nutrition survey in Taiwan ten years ago, indicated that the nutritional problems of children still remained. The daily energy and most nutrient intakes of boys from birth to 4 years old were significantly higher than the girls. There was no significant difference for nutrient intakes among the three birth weight groups at any ages. By multiple regression analysis for the related factors of children growth at 4 years old, the hereditary genetic factors such as birth length and maternal height were the better predictor for the height of the 4-year-old children. The acquired diet intakes such as energy and the candy intake were the better predictor for the weight at 4-year-old. Further by multiple regression analysis for the related factors of children growth from 1 to 4 years old, the maternal weight (especially mother) influenced on the weight of children age 1 to 4, and the effect of the energy intake appeared at 4 years old. The influence of hereditary genes on the height of children was higher than the acquired diet intakes. Moreover, this analysis found that the protein intake during earlier years had influenced on the weight and height at 4-year-old. The protein intake also was associated with the growth rate indicators including weight gain, height gain, and multiplier of figures. The assessment of growth rates indicated that the timing associated with the weight gain were appeared during 2 to 3 and 3 to 4 years old, while the association with the height gain appeared during 1 to 2 years old. In conclusion, this study not only added percentiles and z-scores calculated by the WHO Anthropometric calculator to assess the growth rates of children, but also quantified the factors affecting the growth of children from 1 to 4 years old compared to previous study. In addition, the study first used a “developmental plasticity” hypothesis to discuss the growth among the children of different birth weights. We hoped that the concepts for “modest growth ” and “compared themselves with their own” can be gradually extended to the general public. By building a balanced dietary pattern, children could have better growth performance to prevent obesity and undernutrition.
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