Association of Breastfeeding Duration with Body Composition in Children Aged 3-5 Years.

Objective: This study aimed to assess the relationship between the body composition of children aged 3-5 years and breastfeeding status and duration. Methods: The study was conducted using data from the National Nutrition and Health Systematic Survey for children 0-17 years of age in China (CNHSC), a nationwide cross-sectional study. Breastfeeding information and potential confounders were collected using standardized questionnaires administered through face-to-face interviews. The body composition of preschool children was measured using bioelectrical impedance analysis. A multivariate linear regression model was used to assess the relationship between breastfeeding duration and body composition after adjusting for potential confounders. Results: In total, 2,008 participants were included in the study. Of these, 89.2% were ever breastfed and the median duration of breastfeeding was 12 months (IQR 7-15 months). Among children aged 3 years, the height-for-age Z-score (HAZ) for the ever breastfed group was lower than that for never breastfed group (0.12 vs. 0.42, P = 0.043). In addition, the weight-for-age Z-score (WAZ) of the ever breastfed group was lower than that of the never breastfed group (0.31 vs. 0.65, P = 0.026), and the WAZ was lower in children aged 4 years who breastfed between 12 and 23 months than in those who never breastfed. Compared to the formula-fed children, the fat-free mass of breastfed infants was higher for children aged 3 years (12.84 kg vs. 12.52 kg, P = 0.015) and lower for those aged 4 years (14.31 kg vs. 14.64 kg, P = 0.048), but no difference was detected for children aged 5 years (16.40 kg vs. 16.42 kg, P = 0.910) after adjusting for potential confounders. No significant difference was detected in the weight-for-height Z-score (WHZ), body mass index (BMI)-for-age Z-score (BAZ), fat-free mass index, and body fat indicators in the ever breastfed and never breastfed groups and among various breastfeeding duration groups for children aged 3-5 years. Conclusion: No obvious associations were detected between breastfeeding duration, BMI, and fat mass indicators. Future prospective studies should explore the relationship between breastfeeding status and fat-free mass.

The Patterns of Complementary Feeding and Growth among 12 to 23 Month-Old Children in China.

OBJECTIVE: This study aimed to understand the characteristics of dietary patterns among children aged 12 to 23 months and discusses the relationship between dietary patterns and the growth of children. METHOD: Cross-sectional data were selected from the National Nutrition and Health Systematic Survey for 0 to 18 year-old children in China ( n = 2,449) to describe the patterns of complementary feeding and the growth of children. Cluster analysis was used to analyze complementary feeding patterns, and an analysis of variance and Bonferroni test were conducted to analyze the relationship between Z scores and complementary feeding patterns. RESULTS: Four dietary patterns were identified among the children via cluster analysis. In Pattern 4 ( n = 104, 4.2%), children still consumed milk as their staple food. They displayed the lowest grain, fruit, vegetable, egg, and flesh foods consumption, a medium frequency of breast milk consumption, and a high frequency of dairy product consumption. Pattern 4 had the lowest length-for-age Z scores and weight-for-age Z scores, with -0.10 ± 1.34 and 0.24 ± 1.00, respectively ( F = 7.940, P < 0.001; F = 5.317, P < 0.001). CONCLUSION: Although China is undergoing rapid urbanization and economic development, there is still a phenomenon of insufficient intake of protein-rich foods and dairy-based dietary patterns at the stage of complementary food introduced among children aged 12 to 23 months.

National Nutrition and Health Systematic Survey for Children 0-17 Years of Age in China.

The main purpose of the National Nutrition and Health Systematic Survey for children 0-17 years of age in China (CNHSC) was to collect basic data on the nutrition, development, and health status for children in different regions across China using evidence-based, reliable, and cost-effective approaches. Children and their parents or guardians from seven regions (south, southwest, north, northwest, eastern, central, and northeast China) in China were recruited. A multi-stage stratified randomized sampling method was used. Two provinces were randomly sampled from each of the seven regions, from which one urban district and one rural country were also randomly sampled, resulting in a total of 28 survey counties/districts. Dietary surveys, health examinations, laboratory testing, and questionnaires were used to collect dietary intake, nutritional status, child development, and health status information. Nutrition, health, and lifestyle assessment of children and their parents was determined using the Knowledge Attitude Practice (KAP) survey. Greater than 100,000 children (38,000 children < 6 years of age and 66,000 children 6-17 years of age) completed the survey. The survey provided comprehensive data on child nutrition and health status for future studies and will serve as the basis for an integrated nutrition and health improvement strategies proposal for children in China.

[Comprehensive evaluation study of complementary feeding frequency for infant and young child in southwestern areas, China, in 2011].

OBJECTIVE: To evaluate the status of complementary feeding frequency (CFF) for infants and young children in southwestern China. METHODS: A total of 3644 infants and young children aged 6 - 24 months from urban and rural areas of Chengdu, Kunming and Guiyang were selected by stratified random cluster sampling from March to June in 2011. Data of CFF in the recent one month were collected through the questionnaires, and assessed quantitatively by a new comprehensive evaluation system. Level and distribution characteristics of CFF for infants and young children among different month groups in urban and rural areas were analyzed. RESULTS: Average CFF score was 8.1 ± 3.1, and the score for all was 54.1% of total score (15 points). The average score of urban and rural groups was 8.9 ± 3.0 (59.3% of total score) and 7.4 ± 3.0 (49.1% of total score) respectively (t = 15.60, P < 0.05). Ratio of ≥ 80.0% of total CFF score was 12.2% (443/3644) for all. The rate of urban and rural group was 18.0% (324/1796) and 6.4% (119/1848) respectively (χ(2) = 136.64, P < 0.05). Average CFF score in 6 - 8, 9 - 11 and 12 - 24 months groups was 7.0 ± 2.9 (46.4% of total score), 8.1 ± 3.0 (54.1% of total score) and 9.0 ± 3.0 (60.1% of total score) respectively (F = 148.27, P < 0.05). The CFF score increased with months growing. CONCLUSION: Status of CFF for infants and young children in southwestern China is generally inadequate, with differences between urban and rural groups. This problem is more serious in early month infants and rural areas and should be emphasized and improved.

[Comprehensive evaluation of complementary feeding behavior for infants in urban and rural areas of Chengdu in 2011].

OBJECTIVE: To study the status and problems of complementary feeding behavior for infants aging between 6 - 24 month-old in urban and rural areas of Chengdu in 2011. METHODS: A total of 1283 infants aging between 6 - 24 month-old, including 601 from urban area and 682 from rural area, were randomly selected by stratified cluster random sampling method, and divided into three groups as 6 - 8, 9 - 11 and 12 - 24 month-old groups, between March and April in 2011. Information of complementary feeding behavior were collected by questionnaire, and then assessed, quantified and compared by standards. The evaluation system was established (the total score was 24), and was used to assess among children aging 6 to 24 month-old in urban and rural areas in Chengdu. RESULTS: The average score for infants in Chengdu was 18.6 ± 2.5, accounting for 77.6% of the total score. The scores of food selection and preparation were highest (90.7% of total score) among the behavior, and the scores of caregiver's behavior, infants behavior, feeding environment and environmental hygiene were low (about 75.2% - 77.6% of total score). The average score in urban and rural groups were separately 19.8 ± 2.1 and 17.6 ± 2.4, the score in urban group was higher than that in rural group (P < 0.05), occupying total score 82.3%, 73.4%, respectively. The average score in 6 - 8 month, 9 - 11 month and 12 - 24 month groups were separately 18.9 ± 2.3, 19.1 ± 2.4, and 18.2 ± 2.6, occupying total score 78.9%, 79.4% and 75.7%, respectively. The score in 6 - 8 and 9 - 11 month groups were higher than that in 12 - 24 month group (P < 0.01). The pass rate (above 60% of total score) was 94.2% and excellent rate (above 80% of total score) was 44.8% in Chengdu. The excellent rate in urban and rural groups were separately 65.7% and 26.4% (χ(2) = 199.825, P < 0.01). CONCLUSION: The complementary feeding behavior for infants was not optimistic in Chengdu, and the behavior was even worse in rural areas and among elder infants groups.