幼童體重反彈與熱量供應營養素攝取之關係

Abstract

目的：由小型世代追蹤研究分析1至6歲幼童體重反彈現象，並探討營養攝取及哺餵狀況與此現象之關係。方法：分析48位1至6歲具完整24小時飲食回憶記錄及生長發育體位資料之幼童，每時期之BMI連續線性變化以目測法判斷幼童體重反彈現象，反彈年齡於3～5歲定義為「前期體重反彈」（前期組），6歲以後則為「晚期體重反彈」（晚期組）。體位及飲食資料以SPSS 12.0分析，以ANOVA進行分組分析，連續變項數值以平均值（mean）表示，並以獨立樣本t考驗（independent sample t test），統計差異定P< 0.05。結果：此研究之幼童平均體重反彈年齡約為5歲。無論性別，幼童6歲時「前期組」之BMI（n = 28）顯著大於「晚期組」（n= 20）（p < 0.05）。熱量供應營養素攝取在2組間雖無統計差異，但1歲時的熱量攝取及三大熱量供應營養素皆以「前期組」為較高。也發現停止哺餵母乳或介入配方奶的時間低於4個月之幼童熱量攝取皆較高，並且「前期組」之熱量攝取亦大於「後期組」，因此推論早期嬰兒母乳哺餵及配方奶介入時間的長短對日後幼童體重反彈具有影響力。結論：此長期追蹤台灣嬰幼兒營養攝取及體位研究發現體重反彈之現象與幼童早期哺餵狀況相關。

Objective: To examine dietary factors including nutrient intakes and infant feeding practices associated with adiposity rebound（AR）in children aged 1～6 years. Methods: We analyzed data from 48 subjects 1～6 years old with complete 24-h recall and anthropometric measures. Timing of AR was assessed by visual inspection from continuous linear body-mass index（BMI）changes. Children were divided into two groups based on the AR stage: early AR（3～5 years）and later AR （after 6 years）groups. A statistical analysis was performed using SPSS 12.0, ANOVA was used to perform comparisons between subgroups, continuous variables are presented as the mean and were compared by an independent-sample -test, and p< 0.05 was accepted as the significance level. Results: The mean age of AR was 5 years for children in this study. Regardless of gender, children in the early AR group（n = 28）had a significantly higher BMI than the later AR group（n = 20）. Nutrient intake levels in the two groups did not significantly differ, but the mean energy intake of the early AR group was higher than that of the later AR group at 1 year old. We also found that there was higher energy intake at less than 4 months old in analyses of children who stopped being breastfed and those who began to use formula. Within each sub-analysis, the mean energy intake in the early AR group was higher than that of the later AR group. Therefore, these findings suggest that the AR status was related to early infant feeding practices. Conclusions: Results suggest that infant feeding practices affected AR in children in this prospective cohort.