目的:在卢旺达参与补充喂养计划的一组艾滋病毒暴露儿童中,随着时间的推移,研究营养状况与喂养方式的性别差异。
方法:我们对基线时6-12个月大的参加补充喂养计划的婴儿进行了纵向设计,测量间隔2-3个月。使用早期喂养方法和婴儿和儿童复合喂养指数(ICFI)作为膳食模式的指标,我们使用横断面时间序列进行了多变量分析,以评估营养状况的性别差异,并确定是否与饮食模式的差异有关.
结果:在222名男孩和258名女孩中,发育迟缓的平均(±SD)Z评分,消瘦和体重不足为-2.01(±1.59),-0.15(±1.46),男孩为-1.19(±1.29);女孩为-1.46(±1.56),0.22(±1.29),-0.63(±1.19);所有三个指标的性别差异均具有统计学意义(P<0.001)。然而,早期喂养方式仅有微小差异,ICFI按性别分类无差异.
结论:在资源较少的国家,与女性相比,暴露于艾滋病毒的男性儿童可能面临更高的营养不良风险。然而,至少在提供补充食品的环境中,解释可能超出了饮食模式的范围。
OBJECTIVE: To examine sex differences in nutritional status in relation to feeding practices over time in a cohort of HIV-exposed children participating in a complementary feeding programme in Rwanda.
METHODS: We applied a longitudinal design with three measurements 2-3 months apart among infants participating in a complementary feeding programme who were 6-12 months old at baseline. Using early feeding practices and a composite infant and child feeding index (ICFI) as indicators of dietary patterns, we conducted a multivariate analysis using a cross-sectional time series to assess sex differences in nutritional status and to determine whether there was a link to discrepancies in dietary patterns.
RESULTS: Among 222 boys and 258 girls, the mean (±SD) Z-score of stunting, wasting and underweight was -2.01 (±1.59), -0.15 (±1.46), -1.19 (±1.29) for boys; for girls they were -1.46 (±1.56), 0.22 (±1.29), -0.63 (±1.19); all sex differences in all three indicators were statistically significant (P < 0.001). However, there were only minor differences in early feeding practices and none in the ICFI by sex.
CONCLUSIONS: HIV-exposed male children may be at higher risk of malnutrition in low-resource setting countries than their female counterparts. However, at least in a setting where complementary foods are being provided, explanations may lie outside the sphere of dietary patterns.