乳母膳食和乳汁成分与婴儿生长发育的关系分析
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摘要
目的:调查吉林省长春市乳母膳食、乳汁成分和婴儿生长发育情况,探讨母乳营养水平与婴儿生长发育的关系,为促进婴儿健康发育提供理论依据。方法:募集138例健康乳母,在产后40～45d面对面调查研究对象基本信息及婴儿生长发育信息,并采用"二十四小时膳食回顾法"调查乳母膳食情况。提供标准食物图片估算研究对象的膳食品种及数量。应用《金钥匙营养专家系统软件-孕产妇版》分析乳母膳食摄入的能量和营养素水平,并与《中国孕期哺乳期妇女0～6岁儿童膳食指南(2007)》和《中国居民膳食营养素参考摄入量(2013版)》比较,评价乳母的膳食摄入水平。收集母乳并测量婴儿的生长发育指标,采用乳汁成分分析仪测定乳汁宏量营养素水平。分析乳母膳食、乳汁成分与婴儿生长发育之间的关系。结果:乳母平均能量摄入为(1 698.74±406.23)kcal·d~(-1),蛋白质、脂类和碳水化合物提供的能量比例分别为14.06%、33.83%和52.09%。乳汁平均能量为(61.18±13.04)kcal·100g~(-1),蛋白质含量为(0.94±0.19)g·100g~(-1),脂类含量为(3.55±1.27)g·100g~(-1),乳糖含量为(6.38±0.82)g·100g~(-1)。乳母膳食蛋白质摄入量与乳汁蛋白质含量有关联(r=0.203,P=0.017)。控制喂养方式、乳汁能量、婴儿性别和婴儿年龄的影响,偏相关分析显示乳汁各成分与婴儿身长增量和体质量增量之间均无关联(P>0.05)。结论:乳母膳食营养素摄入量存在不足及不均衡现象;乳母膳食蛋白质摄入量会影响乳汁蛋白质含量,乳汁脂类和乳糖含量与乳母膳食营养素之间无关联,且母乳成分与婴儿生长发育之间也无关联。
Objective:To investigate the diet of lactating mothers,breast milk components and the growth of infants in Changchun City,Jilin Province and explore the relationships between the nutritional status of breast milk and the growth of infants,and to provide the theoretical basis for the development of the infant health.Methods:A total of 138 healthy nursing mothers were selected.Within 40-45 dafter the delivery,face-to-face investigations were conducted to obtain the basic information of the subjects and the growth and development information of the infants.The 24-hour dietary review method was adopted to investigate the dietary status of the lactating mothers,the standard food pictures were provided to estimate the dietary variety and the quantities of the subjects.Golden key maternal nutrition expert system software was applied to analyze the energy and nutrients of dietary intake,and they were compared with Dietary Guidelines of Pregnant,Lactating Women and 0-6 Years Old Children in China(2007)and Chinese Dietary Reference Intake of Nutrients(2013);the diet intake level of the lactating mothers was evaluated.The breast milk was collected and the infant growth and development indicators were measured.The compositions of breast milk were analyzed by milk composition analyzer.The relationships between the lactating mother's diet,the breast milk composition and the infant growth and development were analyzed.Results:The average energy intake of the lactating mothers was(1 698.7±406.23)kcal·d~(-1),and the energy proportions of proteins,lipids,and carbohydrates were 14.06%,33.83%,and 52.09%,respectively.The average energy content of breast milk was(61.18±13.04)kcal·100 g~(-1),the average protein content was(0.94±0.19)g·100 g~(-1),the average lipid content was(3.55±1.27)g·100 g~(-1),and the average lactose content was(6.38±0.82)g·100 g~(-1).The dietary protein intake was associated with the protein content of breast milk(r=0.203,P=0.017).When the influence of feeding patterns,energy of breast milk,infant gender,and age were controlled,the partial correlation analysis result showed that the breast milk composition had no correlations with the increases in body lengths and weights of the infants(P>0.05).Conclusion:There are insufficience and imbalance in the general dietary intakes in the lactating mothers.The dietary protein intake of lactating mothers may influence the protein content of breast milk.The lipid and carbohydrate contents in milk have no significant correlations with the dietary nutrients of the lactating mothers.The breast milk compositions of lactating mothers have no effects on the growth and development of infants.
Objective:To investigate the diet of lactating mothers,breast milk components and the growth of infants in Changchun City,Jilin Province and explore the relationships between the nutritional status of breast milk and the growth of infants,and to provide the theoretical basis for the development of the infant health.Methods:A total of 138 healthy nursing mothers were selected.Within 40-45 dafter the delivery,face-to-face investigations were conducted to obtain the basic information of the subjects and the growth and development information of the infants.The 24-hour dietary review method was adopted to investigate the dietary status of the lactating mothers,the standard food pictures were provided to estimate the dietary variety and the quantities of the subjects.Golden key maternal nutrition expert system software was applied to analyze the energy and nutrients of dietary intake,and they were compared with Dietary Guidelines of Pregnant,Lactating Women and 0-6 Years Old Children in China(2007)and Chinese Dietary Reference Intake of Nutrients(2013);the diet intake level of the lactating mothers was evaluated.The breast milk was collected and the infant growth and development indicators were measured.The compositions of breast milk were analyzed by milk composition analyzer.The relationships between the lactating mother's diet,the breast milk composition and the infant growth and development were analyzed.Results:The average energy intake of the lactating mothers was(1 698.7±406.23)kcal·d~(-1),and the energy proportions of proteins,lipids,and carbohydrates were 14.06%,33.83%,and 52.09%,respectively.The average energy content of breast milk was(61.18±13.04)kcal·100 g~(-1),the average protein content was(0.94±0.19)g·100 g~(-1),the average lipid content was(3.55±1.27)g·100 g~(-1),and the average lactose content was(6.38±0.82)g·100 g~(-1).The dietary protein intake was associated with the protein content of breast milk(r=0.203,P=0.017).When the influence of feeding patterns,energy of breast milk,infant gender,and age were controlled,the partial correlation analysis result showed that the breast milk composition had no correlations with the increases in body lengths and weights of the infants(P>0.05).Conclusion:There are insufficience and imbalance in the general dietary intakes in the lactating mothers.The dietary protein intake of lactating mothers may influence the protein content of breast milk.The lipid and carbohydrate contents in milk have no significant correlations with the dietary nutrients of the lactating mothers.The breast milk compositions of lactating mothers have no effects on the growth and development of infants.
引文
[1]中国营养学会膳食指南修订专家委员会妇幼人群指南修订专家工作组.哺乳期妇女膳食指南[J].临床儿科杂志,2016,34(12):958-960.
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[9]张晓阳,周美龄,徐幽琼,等.福州市哺乳期妇女膳食营养调查研究[J].现代预防医学,2015,42(15):2722-2725.
[10]杨媞媞,张玉梅,马德福,等.中国3城市乳母营养素摄入情况调查[J].营养学报,2014,36(1):84-86.
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[12]李响,丁珍,刘国良,等.长春市251例乳母膳食营养的分析评价[J].中国妇幼保健,2014,29(27):4473-4475.
[13]陈雪妍,吴义霞,刘国良,等.514例乳母乳汁中AA和DHA水平及其影响因素分析[J].吉林大学学报:医学版,2016,42(2):390-394.
[14]杨华,刘黎明.297例乳母膳食对乳汁成分的影响[J].中国妇幼健康研究,2017,28(8):897-899,907.
[15]王宝珍,孙永静,张慧.母乳成分调查及影响因素分析[J].宁夏医学杂志,2016,38(8):758-759.
[16]陈红慧,江蕙芸,杨万清,等.广西三江县侗族、南宁市汉族乳母膳食与乳汁中营养素含量调查分析[J].广西医科大学学报,2007,24(4):644-647.
[17]KEIKHA M,BAHREYNIAN M,SALEKI M,et al.Macroand micronutrients of human milk composition:Are they related to maternal diet?A comprehensive systematic review[J].Breastfeed Med,2017,12(9):517-527.
[18]BRAVI F,WIENS F,DECARLI A,et al.Impact of maternal nutrition on breast-milk composition:a systematic review[J].Am J Clin Nutr,2016,104(3):646-662.
[19]冯围围,黄小娜,王惠珊,等.农村4月龄内婴儿体格生长的影响因素分析[J].中国儿童保健杂志,2017,25(1):18-20.
[20]刘建.石家庄市乳母的乳成分动态变化与婴儿生长发育的影响因素研究[D].石家庄:河北医科大学,2013.
[21]李贺莉.母乳成分对纯母乳喂养婴幼儿早期生长发育速率的影响[J].河北医学,2016,22(4):697-699.
[2]LIM S X,TOH J Y,VAN LEE L,et al.Food sources of energy and macronutrient intakes among infants from 6to 12months of age:the growing up in Singapore towards healthy outcomes(GUSTO)study[J].Int J Environ Res Public Health,2018,15(3):E488.
[3]郭艳红,苏米亚,刘翠平,等.中国乳母膳食营养研究现状[J].乳业科学与技术,2015,38(2):20-22.
[4]王双佳,韦力仁,李永进,等.乳母膳食营养素摄入量与母乳渗透压的关系研究[J].中国食物与营养,2012,18(7):74-78.
[5]王宇,李宏田,于丽霞,等.中国沿海、湖区和内陆地区孕妇水产品摄入情况调查[J].中国生育健康杂志,2018,29(2):110-116.
[6]江蕙芸,陈红慧,杨万清,等.广西三江侗族乳母膳食营养与乳汁成分的调查分析[J].南方医科大学学报,2009,29(7):1474-1476.
[7]WANG Z J,DANG S N,XING Y,et al.Dietary patterns and their associations with energy,nutrient intake and socioeconomic factors in rural lactating mothers in Tibet[J].Asia Pac J Clin Nutr,2017,26(3):450-456.
[8]张艳秋.乳母膳食状况与母乳营养素含量及婴儿生长发育水平的前瞻性观察[D].济南:山东大学,2016.
[9]张晓阳,周美龄,徐幽琼,等.福州市哺乳期妇女膳食营养调查研究[J].现代预防医学,2015,42(15):2722-2725.
[10]杨媞媞,张玉梅,马德福,等.中国3城市乳母营养素摄入情况调查[J].营养学报,2014,36(1):84-86.
[11]邓娟.长春市311例乳母膳食评价及乳汁多不饱和脂肪酸水平影响因素分析[D].长春:吉林大学,2014.
[12]李响,丁珍,刘国良,等.长春市251例乳母膳食营养的分析评价[J].中国妇幼保健,2014,29(27):4473-4475.
[13]陈雪妍,吴义霞,刘国良,等.514例乳母乳汁中AA和DHA水平及其影响因素分析[J].吉林大学学报:医学版,2016,42(2):390-394.
[14]杨华,刘黎明.297例乳母膳食对乳汁成分的影响[J].中国妇幼健康研究,2017,28(8):897-899,907.
[15]王宝珍,孙永静,张慧.母乳成分调查及影响因素分析[J].宁夏医学杂志,2016,38(8):758-759.
[16]陈红慧,江蕙芸,杨万清,等.广西三江县侗族、南宁市汉族乳母膳食与乳汁中营养素含量调查分析[J].广西医科大学学报,2007,24(4):644-647.
[17]KEIKHA M,BAHREYNIAN M,SALEKI M,et al.Macroand micronutrients of human milk composition:Are they related to maternal diet?A comprehensive systematic review[J].Breastfeed Med,2017,12(9):517-527.
[18]BRAVI F,WIENS F,DECARLI A,et al.Impact of maternal nutrition on breast-milk composition:a systematic review[J].Am J Clin Nutr,2016,104(3):646-662.
[19]冯围围,黄小娜,王惠珊,等.农村4月龄内婴儿体格生长的影响因素分析[J].中国儿童保健杂志,2017,25(1):18-20.
[20]刘建.石家庄市乳母的乳成分动态变化与婴儿生长发育的影响因素研究[D].石家庄:河北医科大学,2013.
[21]李贺莉.母乳成分对纯母乳喂养婴幼儿早期生长发育速率的影响[J].河北医学,2016,22(4):697-699.
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