Table of Content

10 October 2020, Volume 28 Issue 10

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Effects of food nutrition and complementary food on gut microbiota

CHENG Qian

2020, 28(10):  1069-1071.  DOI: 10.11852/zgetbjzz2020-1756

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Food is a common source of nutrition for both human body and gut microbiota. Various nutrients provided by different foods not only meet the needs of the body, but also affect the composition and abundance of intestinal microorganisms. Complementary foods and feeding in infancy are important for gut microbes to change, and the introduction of new foods and its conversion to family food will increase the diversity of gut microbiota. The intake of a variety of foods and the maintenance of their structure are beneficial to keeping the type and quantity of gut microbes, and have important implication for human health.

Effect of gestational weight gain on colonization of neonatal gut microbiota

JIANG Zi-han, LU Wen-wei, SHI Hui-jing, WEI Qian, ZHANG Yun-hui, WANG Ling

2020, 28(10):  1072-1076.  DOI: 10.11852/zgetbjzz2019-1084

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Objective To understand alpha diversity and composition of neonatal gut microbiota and to explore the effect of gestational weight gain on neonatal gut microbiota acqusition. Methods The study was based on a prospective birth cohort.Totally 323 pregnant women with complete pregnancy follow-up information recruited in the cohort between April 2016 and February 2017 were randomly selected, and meconium of their babies after delivering were collected.16S rDNA gene sequencing was performed on the meconium samples.The sequence of 207 samples where bacteria exit were analyzed.According to the gestational weight gain standard of American Institute of Medicine, the subjects were divided into two groups:non-excessive gestational weight gain(n=129) and excessive gestational weight gain(n=78). Results Gestational weight gain influences the abundance of neonatal gut microbiota.Compared with the group of non-excessive gestational weight gain, the neonatal intestinal Proteobacteria was higher(P<0.05)and Parabacteroides was lower(P<0.05)in group of excessive gestational weight gain.Gestational weight gain was negatively related to Shannon index(β=-0.378,P=0.013;β=-0.502,P=0.041)and Simpson index(β=-0.055,P=0.012;β=-0.073,P=0.039)by adjusting pre-pregnancy BMI, delivery mode, parity, gestational age, antibiotic exposure and stratified by neonatal gender. Conclusion Excessive gestational weight gain influences the composition of neonatal intestinal microbiota and decreases the alpha diversity of gut microbiota of male neonates.

Investigation on the changes of intestinal flora in children with cerebral palsy using high-throughput sequencing

ZHOU Bo-lan, HUANG Cong-fu, PENG Yuan-ping, LI Yin-hu, LI Xiu-yun, WANG Pei-qin, WU Gen-feng, JIAO Guang

2020, 28(10):  1077-1082.  DOI: 10.11852/zgetbjzz2019-1418

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Objective To explore the changes of intestinal flora in children with cerebral palsy by high-throughput sequencing. Methods Thirty-four children with cerebral palsy diagnosed in Longgang District Social Welfare Center and eating normally were selected as the cerebral palsy group,and 14 children with cerebral palsy accompanied by epilepsy and eating normally were selected as the cerebral palsy accompanied by epilepsy group,meanwhile 22 healthy children were selected as the healthy group.Total DNA was extracted and amplified from fecal specimens of all subjects.The 16SrRNA gene was sequenced with high throughput and the sequencing results were analyzed biologically. Results 1) The intestinal flora structure of healthy group was significantly different from that of cerebral palsy group and cerebral palsy accompanied by epilepsy group (R²=0.410,P=0.001;R²=0.450,P=0.001),but the intestinal flora structure of cerebral palsy group was similar to that of cerebral palsy accompanied by epilepsy group (R²=0.025,P=0.272).2) The abundance of Prevotella in children with cerebral palsy and cerebral palsy increased significantly (32.68% in cerebral palsy group and 34.34% in cerebral palsy accompanied by epilepsy group). Conclusions Prevotella abundance increases significantly in children with cerebral palsy and cerebral palsy accompanied by epilepsy who ate normally.Prevotella may be a protective bacteria of children with cerebral palsy who ate normally.

Study on gut microbiota in children with type 1 diabetes mellitus

ZHOU Huan-zhen, YANG Liu, WANG Ai-ping, YANG Yang, ZHANG Hong-hong

2020, 28(10):  1083-1087.  DOI: 10.11852/zgetbjzz2020-0770

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Objective To explore the characteristics of intestinal flora in children with type 1 diabetes mellitus (T1DM) by 16SrRNA gene sequencing method, and to compare the differences on gut microbiota between T1DM patients and healthy controls, so as to provide theoretical basis and evidence for clinical application of probiotics in early intervention for T1DM children. Methods A total of 18 children aged 5 to 14 years who were newly diagnosed with T1DM in the Department of Endocrinology and Metabolism, Kunming Children′s Hospital were enrolled in this study from October 2018 to October 2019.At the same time, 19 healthy children with similar gender and age were selected as controls.After collecting fresh stool samples from two groups, 16SrRNA gene sequencing experiments were performed, and QIIME 2 analysis processes were used for bioinformatics analysis.Then the marked differences of gut microbiota among two groups were compared. Results 1) Totally 3 248 Features with 100% similarity were obtained by using QIIME2 software.2) Most of intestinal bacteria were classified into genus and species after identification and annotation.3) Alpha diversity analysis showed that the sequencing depth was sufficient in this study.Moreover, the richness and diversity of gut microbiota in T1DM children were lower than those in healthy controls (P<0.05).4) In the analysis of beta diversity, the PCoA image indicated that the gut microbiota structure was different between T1DM group and healthy controls.5) At the level of phylum, the abundance of Actinobacteria, Bacteroidetes and Cyanobacteria was increased while the abundance of Proteobacteria and Patescibacteria was decreased in T1DM group(P<0.05).At the genus level, the abundance of Faecalibacterium, Bifidobacterium and Bacteroides was increased in T1DM group, but the abundance of Escherichia_Shigella, Enterococcus and Blautia was reduced (P<0.05). Conclusions The ecology of gut microbiota is imbalanced in T1DM children.Compared with healthy children, the richness and diversity are notably lower in T1DM children as well.Moreover, there are obvious differences on the structure of gut microbiota between T1DM children and healthy children.

Effect of different intensive feeding methods on the physical growth of very preterm and extremely preterm infants after discharge

DONG Ping, FU Shi-yun, TANG Xin-rui, LYU Yu-jing, YAN Dong-yong, XU Xiu

2020, 28(10):  1088-1092.  DOI: 10.11852/zgetbjzz2019-1896

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Objective To investigate the effects of different intensive feeding methods on catch-up growth of very preterm and extremely preterm infants (VPT/EPT) and body composition (BC) development,in order to provide theoretical support for the post-discharge healthcare of VPT/EPT. Methods Totally 91 VPT and EPTs followed up in the outpatient clinic of Children′s Hospital of Fudan University were enrolled in this study from April 2018 to October 2019,and were given individualized intensive feeding guidance.Physical examination and BC assessment were performed monthly after corrected gestational age of 40 weeks. Results Compared with partial breastfeeding and formula feeding groups,the breastfeeding group had a lower weight-for-age Z score at 4,5 and 6 months(P=0.042,0.033,0.037),a lower weight-for-length Z score at the age of 6 months (P=0.016).In terms of BC,the body fat percentage at the age of 4 months was significantly lower than that of partial breastfeeding and formula feeding groups (25% vs.28.1% vs.28.8%,P=0.015).And the fat-free mass index (FFMI) at the age of 6 months in the breastfeeding group was significantly higher than that in the formula feeding group (13.08 vs.11.78,P=0.034). Conclusions Breastfed VPT/EPT in early life may tend to have an impaired weight gain and body fat deposit.Further studies with larger cohorts and research on the long-term consequences of these early differences are warranted.

Evaluation of the effect of badminton exercise intervention on the development of primary motor skills for primary school students

JI Xiao-peng

2020, 28(10):  1093-1096.  DOI: 10.11852/zgetbjzz2019-1613

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Objective To understand the intervention effect of badminton exercise intervention on gross motor skills of primary school students,so as to provide theoretical support for improving gross motor skills. Methods A random sampling method was used to select 68 children in the third and fourth grade as the participants in this study from March to May 2018.The participants were randomly divided into control group and intervention group.The intervention group received the intervention of badminton exercise for 10 weeks,and gross movement coordination ability (KTK) was tested before and after intervention. Results There were no significant differences on gross movements and total score before intervention between the intervention group and control group (P＞0.05).There were no statistically significant differences on test results and total scores between boys and girls in the control group before and after the intervention (P>0.05).After 10 weeks of badminton exercise intervention,all dimensions of gross movements and the total score significantly improved to a certain extent in boys and girls in the intervention group (P<0.05).After intervention,all dimensions and total scores of children and adolescents in the intervention group were significantly higher than those of control group (t=7.085,6.558,3.947,2.352,5.871, P<0.05). Conclusion Badminton exercise intervention has a positive effect on children′s ability to coordinate large movements such as displacement and stability,and will lay the foundation for improving children′s complex motor skills in the future.

Study on the association between exercise and sleep quality in preschool children

LIU Mei-yan, GUO Qian-wen, WU Dan, WANG Xiu-lian, LIANG Tao, SUN Fan-fan, LAN Hong-yan, CHEN Jin-jin

2020, 28(10):  1097-1100.  DOI: 10.11852/zgetbjzz2019-1831

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Objective To analyze the relationship between exercise and sleep quality of preschoolers,and to explore the early life factors affecting sleep quality of preschoolers. Methods A total of 833 preschoolers aged 3-6 years in 4 kindergartens registered in Shanghai were selected as participants from March to June 2018,and 750 valid samples were analyzed.Multivariate non-conditional Logistic regression model was used to analyze the relationship between exercise time,items and sleep quality of preschool children. Results The proportion of less time for exercise on school day and rest day for preschool children was 72.7% (545/750) and 27.2% (204/750),respectively.And the walking participation rate was 73.5% (551/750).Children with good,moderate and poor sleep quality accounted for 23.9% (179/750),65.2% (489/750) and 10.9% (82/750),respectively.After adjusting some interacting factors,it was found that less exercise time on study days (OR=0.430,95%CI:0.205-0.904,P=0.026) and non-participation in walking (OR=0.399,95% CI:0.175-0.908,P=0.028) were positively related to preschool children′s poor sleep quality. Conclusion Less exercise time on study day is associated with poor sleep quality in preschool children.

Serum 25-hydroxy vitamin D status and the influencing factors in 351 healthy preschool children

WANG Xi-rui, YU Xiao-dan, ZHANG Li-shan, XU Lei, YUAN Yi-chun

2020, 28(10):  1101-1105.  DOI: 10.11852/zgetbjzz2019-1882

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Objective To investigate the levels of serum vitamin D and its influencing factors in preschool children in Shanghai,so as to provide theoretical basis for the prevention and treatment of vitamin D deficiency in this area. Methods A total of 351 preschool children (185 boys and 166 girls) aged 3 to 6 years from 3 kindergartens in Pudong New Area,Shanghai,were randomly selected in this study.Serum 25-hydroxyvitamin D[25-(OH)D]levels were measured by liquid chromatography-tandem mass spectrometry (LC-MS/MS) and the data of relevant influencing factors was obtained by standardized questionnaire. Results The average level of 25-(OH)D in preschool children was (28.1±6.7)ng/ml.Vitamin D deficiency (≤20 ng/ml) was observed in 35 children (10.0%),and 316(90.0%) children had optimal vitamin D level (20～100 ng/ml).Multivariate analysis showed that the low frequency of vitamin D supplementation and the older age (≥6 years old) were the risk factors of 25-(OH)D deficiency in preschool children (P＜0.05). Conclusions Age and vitamin D supplementation have significant effect on Vitamin D levels of preschool children.The vitamin D supplement rate is relatively low in the older group (≥6 years old).Considering current vitamin D deficiency in preschool children,popular science education of children′s health care should be strengthened to increase the vitamin D supplementation rate in combination with the actual individual situation,as well as to increase outdoor activity time,thereby promoting the health of preschool children.

Correlation analysis of vitamin D and physical growth of elementary school students in Kunming in summer

YANG Yan-fei, LI Ming, CUI Ji-hua, LI Shu-jin, ZHANG Li-feng, LING Yu

2020, 28(10):  1106-1109.  DOI: 10.11852/zgetbjzz2019-1962

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Objective To study the correlation between vitamin D and physical growth in elementary school students in Kunming in summer,in order to provide clinical data for the prevention of short stature and obesity in children. Methods A stratified random sampling method was used to select 591 research subjects in 4 districts of Kunming from June to August 2018.Physical measurements,serum 25-(OH)D test and ultrasound bone density detection were performed to all participants.Serum 25-(OH)D level,body mass index (BMI) and bone strength Z values of different age groups,as well as vitamin D nutritional status of male and female children at different ages were compared.The correlation between 25-(OH)D levels and BMI,bone strength Z value and height were analyzed. Results Significant differences were found on height,weight and BMI for children with the same age.With the increase of grades,the level of serum 25-(OH)D decreased(F=37.646,P＜0.001),BMI showed an upward trend(F=1 343.002,P＝0.001),and the bone strength Z value showed a downward trend(F=34.489,P＜0.001).With the increase of age,the proportion of vitamin D deficiency had an increasing trend.Overall,the ratio of vitamin D adequacy in boys was 48.38% and that in girls was 48.06%.25-(OH)D level was negatively correlated with BMI (r=-0.673,P<0.01),positively correlated with bone strength Z value and height (r=0.514,0.561, P<0.01). Conclusions More than half of the primary school students in this study are lack of 25-(OH)D.Children are suggested to do more outdoor exercise and take vitamin D supplementation orally so as to reduce childhood short stature and obesity.

Influencing factors of gut microbiota of infants and its function in intestinal immunity

SUN Yan-ting, LIANG Hong-tao, WANG Chen, YAO Yi-bo, LU Jin-gen

2020, 28(10):  1110-1113.  DOI: 10.11852/zgetbjzz2020-0293

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Gut microbiota will experience a series of evolutions to form the final microbial homeostasis once it adapts to colonize in the intestinal tract.This review focuses on the gut microbiota in infants altered by factors in many aspects,for example,the stage of parturition,feeding patterns,dietary structure,living environment,diseases and drug use.In addition,the important role of gut microbiota in the formation of intestinal immunity is discussed.

Intestinal flora′s relationship with feeding and its mechanism of communication with brain

LYU Li-na, LIN Ke-xin, SHAO Jie

2020, 28(10):  1114-1117.  DOI: 10.11852/zgetbjzz2019-1060

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In recent years,the colonization of infant intestinal flora and its related influencing factors have been studied deeply at home and abroad.Intestinal flora plays an irreplaceable role in the development and maturation of function in digestion,metabolism,immune regulation and disease resistance.Infant period is the key period for the establishment of intestinal flora.The mode of delivery,the application of antibiotics,living habits,external environment and feeding types all affect the establishment of intestinal microflora,among which feeding mode is one of the key factors.Recent studies have shown that intestinal flora also has extensive communication with the brain,including via immune regulation pathway,neuroendocrine pathway,metabolic pathway and vagal pathway,which provides ideas for further elucidating the pathogenesis of neuropsychiatric diseases.

Research progress on probiotics in treatment of child malnutrition

SHI Xin-miao, WANG Lin

2020, 28(10):  1118-1121.  DOI: 10.11852/zgetbjzz2020-0524

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Children′s health can be largely affected by malnutrition.Pediatric malnutrition is still an important public health issue globally, especially in poor area.Gut microbiota is closely related to pediatric malnutrition.Appropriate supplementation of probiotics according to the distribution characteristic of gut microbiota is an orientation in future.Thus, the article aims to review the close relationship between malnutrition and gut microbiota, and the progress on the application of probiotics in treating pediatric malnutrition.

Research advances on the role of vitamin D in autism spectrum disorders

XIA Yang, YANG Shu-fen

2020, 28(10):  1122-1125.  DOI: 10.11852/zgetbjzz2019-1760

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Autism spectrum disorders (ASD) is one of the serious public problems affecting children′s health,characterized by social communication disorder,narrow interest or activity range and repetitive stereotyped behavior.In recent years,increasing studies have shown that the level of vitamin D (Vit D) in ASD children is significantly lower than that of healthy children with the same age,and vitamin D deficiency may be related to the pathogenesis of ASD.This paper reviews the research progress on vitamin D and ASD.

Review on school performance and social skills development in children with autism spectrum disorders

KONG Mian, GUO Feng-yi

2020, 28(10):  1126-1130.  DOI: 10.11852/zgetbjzz2019-1305

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Autism spectrum disorders (ASD) are a group of neurodevelopmental disorders characterized by barriers to social interaction in varying degrees, and narrow interests and stereotypes. Symptoms appear early in childhood and usually persist throughout the life cycle. In the Second National Disability Survey and Standards published in 2006 in mainland of China, ASD was included in the category of mental disorders, and the Guidelines for the Diagnosis and Treatment of Children with Autism were established. Despite increasing public awareness of ASD in China, most studies are more focused on early diagnosis and comprehensive intervention. Researches regarding the school placement, performance and social skills of ASD children are still at early stage. This review briefly describes the performance and social skills development of ASD children to future support school-age children with autism in China.

Systematic review of factors related to the duration of breastfeeding in China

HU Shan-shan, WANG Xiao-ye, LI Zheng, TAO Xiu-bin

2020, 28(10):  1131-1134.  DOI: 10.11852/zgetbjzz2020-0309

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Objective To systematically evaluate the factors that affect the duration of breastfeeding in China,in order to provide scientific basis for research and formulating intervention measures. Methods Web of Science,PubMed,EMBASE,Cochrane,CBM,WF,VIP and CNKI databases were searched to collect the literature on the factors affecting the duration of breastfeeding in China.The quality of references was critically appraised and the data were extracted by two investigators independently for systematic review. Results A total of 17 references were included.The protective factors for breastfeeding included smooth breastfeeding of infants,extended maternity leave,mothers′ recognition of reasonable breastfeeding time,and adherence to exclusive breastfeeding to 6 months.The risk factors included premature,cesarean section,supplementary or mixed feeding within 6 months,expected shorter breastfeeding time,delayed lactation Ⅱ,father smoking and lower awareness of breastfeeding among mothers.These related factors were classified into the basic characteristics of children,the basic characteristics of mothers,the Objective factors of society and family,and the attitude towards breastfeeding. Conclusions There are many factors influencing the duration of breastfeeding in China,and there are still different opinions on some factors.And the causal relationship between the factors and the duration of breastfeeding needs to be further verified.

Comparative analysis of nutritional status of left-behind and non-left-behind children and adolescents in Yili area

CAI Xiao-di, LIU Yue-feng

2020, 28(10):  1135-1139.  DOI: 10.11852/zgetbjzz2019-1569

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Objective To understand the nutritional health status of left-behind children and non-left-behind children in Yili,Xinjiang,in order to provide support for the balanced nutrition improvement of left-behind children in this region.Method A total of 3 842 left-behind and non-left-behind children aged 7 to 15 years in 18 primary and secondary schools were randomly surveyed in 3 counties in the Yili area from September to October 2016,and the nutritional status was classified and compared based on height and BMI. Results The height,weight and body mass index (BMI) of 7-15-year-old left-behind children in Yili,Xinjiang relatively lower than those of non-left-behind children.The proportion of left-behind children in stunting and weight loss was significantly higher than that of non-left-behind children (χ²=27.32,314.12,P<0.01).The detection rate of overweight and obesity in non-left-behind children was significantly higher than those of left-behind children (χ²=36.37,24.92,P<0.01). Conclusions The nutritional status of left-behind children in Yili area is relatively poor compared with non-left-behind children.The nutritional status of left-behind children is mainly weight loss,and should be focused on and improved.

Analysis of water consumption and hydration status of school-age obese children in summer

XIA Lu-lu, YANG Wen-li, LI Da, PAN Chang-lu, YAN Jie, QI Ke-min

2020, 28(10):  1140-1143.  DOI: 10.11852/zgetbjzz2019-1726

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Objective To analyze the water consumption,body water content and hydration status of obese school-age children in summer,so as to provide reference for assessing the appropriate consumption of water in obese children. Methods Obese children visited the Department of Nutrition,Beijing Children′s Hospital Affiliated to Capital Medical University from June 2019 to August 2019 were measured for height and weight,and body mass index (BMI) was calculated.Laboratory tests and human body composition analysis were carried out.And questionnaires were used to record the direct water intake and food intake. Results There were 21 male students and 19 female students aged 7-14 years.There were no significant differences on age, height,body weight,BMI and body fat percentage between boys and girls (P＞0.05).The total water intake,direct water intake and food water intake of boys were 2 164 ml/d (644 ml/d),1 069 ml/d (409 ml/d),1 191 ml/d (586 ml/d),and those of girls were 1 943 ml/d (464 ml/d),1 000 ml/d (305 ml/d),973 ml/d (303 ml/d),respectively.The total water consumption of boys was higher than that of girls (P<0.05).No significant differences were found on urine specific gravity and total body water percentage between boys[1.03± 0.01,(45±4)%]and girls[1.03±0.00,(45±4)%],indicating insufficient hydration.Spearman correlation analysis showed that BMI was negatively correlated with body water content(r=-0.575). Conclusions The water consumption of obese boys in school-age boys is higher than that of girls,but their hydration status is insufficient.It is necessary to increase the direct water consumption to improve the hydration status,and children with higher BMI need more water.

Study on feeding difficulty and its determinants of malnourished infants aged 6 to 12 months in Minhang district,Shanghai

CHEN Min, KANG Shu-rong, ZHANG Hong-mei, WANG Hui, XU Xiao-xi, LIU Min, LI Yun

2020, 28(10):  1144-1147.  DOI: 10.11852/zgetbjzz2019-1615

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Objective To investigate the present situation of feeding difficulty and its determinants of malnourished infants aged 6 to 12 months in Minhang district of Shanghai. Methods A total of 137 malnourished infants aged 6 to 12 months,who took physical examination at child care clinic of 4 community health service centers of Minhang district,were selected as subjects.Infants′ parents were investigated by the questionnaires including general demographic characteristics and Montreal Children′s Hospital Feeding Scale (MCH-FS).Univariate and multivariate Logistic regression analysis were adopted to probe the determinants of feeding difficulty. Results The detection rate of feeding difficulty was 30.7%(42/137),of which mild,medium and severe feeding difficulty were 16 cases(11.7%),7 cases(5.1%)and 19 cases(13.9%),respectively.Logistic regression analysis demonstrated that low birth weight (OR=9.700,95%CI:1.913-49.190),abnormal infant growth condition considered by parents (OR=3.828,95%CI:1.178-12.434) and abnormality of infant oral cavity motor function (OR=14.296,95%CI:1.929-105.949) were independent determinants of feeding difficulty. Conclusion Birth weight,growth condition and oral cavity motor function are determinants of malnourished infants aged 6 to 12 months,and targeted intervention should be conducted.

Analysis on nutritional status of infants aged 6 to 24 months in poverty-stricken areas of Xinjiang

GAO Yue, CUI Su-xin, LIAO Jian-jun, GE Fei, CHEN Yong-hui

2020, 28(10):  1148-1152.  DOI: 10.11852/zgetbjzz2019-1949

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Objective To investigate the nutritional status of infants aged 6 to 24 months in Xinjiang areas,in order to provide scientific reference for taking nutritional measures.Method Totally 3 837 infants aged 6 to 24 months were selected from 13 poverty-stricken counties by stratified cluster sampling,and their hemoglobin and physique were measured from March to May 2018. Results The detection rates of underweight,growth retardation,wasting and obesity were 13.5%,23.5%,10.5%,7.8% and 45.0%,respectively,which were significant different among children at different age groups(χ²=20.969,80.878,31.540,11.912,P＜0.01).The rate of growth retardation between male and female infants was significantly different(χ²=8.806,P＜0.05).Caregiver′s knowledge on nutrition and feeding was poor,and it was better in non-anemia group (P<0.01). Conclusions There is still a large gap between the nutritional status of infants and young children in poverty-stricken areas of Xinjiang and the average level the whole nation.In detail,the main nutritional problems faced by infants and young children aged 6-24 months in poverty-stricken areas of Xinjiang are growth retardation and anemia.Therefore,the key to reduce malnutrition and anemia is increasing the propaganda of infant feeding knowledge,taking nutritional supplementation in time and adding supplementary food reasonably.

Effects of complementary-food-making education courses on food exchanges during complementary feeding in preterm infants

HE Xiao-ying, JIANG Zhuo-bin, SUN Ya-lian

2020, 28(10):  1153-1156.  DOI: 10.11852/zgetbjzz2020-0032

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Objective To find out the effects of complementary-food-making education courses on food exchanges during complementary feeding in preterm infants,so as to explore a feasible and effective guiding mode. Methods Preterm infants born in Foshan Women and Children Hospital were enrolled in this study from June to December 2017,with 76 infants in intervention group[12 infants with gestational age (GA)＜32 weeks,20 infants with GA 32-34 weeks,44 infants with GA＞34 weeks]and 191 infants in control group (48 infants with GA＜32 weeks,34 infants with GA 32-34 weeks,109 infants with GA＞34 weeks).The control group received routine complementary feeding education at the corrected age of 4,7 and 10 months,while the intervention group participated in complementary-food-making education courses additionally at the corresponding age.All infants were followed up to the corrected age of 18 months,then the differences on food conversion,physical indexes and nutrients indicators between the two groups were compared. Results 1) For preterm with GA＞34 weeks,the first time for introducing complementary food and starches was later in the intervention group,while the first time for introducing solid food was earlier,the proportions of first introducing complementary food earlier than 4 months old,changing back to low energy density food,introducing semisolid food later than 9 months old,and introducing solid food later than 12 month-old were lower in the intervention group,but the proportions of "face-to-face feeding" and "infants self-feeding allowed" were higher(P<0.05).2) For preterm infants with GA＜32 weeks,the intervention group introduced mashed food later for the first time,the proportions of the first introducing complementary food earlier than 4 months old,and changing back to low energy density food were less(P<0.05).3) The increase of weight and the serum iron level at the corrected age of 18 months in the intervention groups were significantly higher than those in control group(P<0.05). Conclusion Complementary-food-making education courses can positively facilitate introducing complementary food and converting food textures at a more appropriate time,promote responsive feeding,improve growth and iron storage for the preterm.

Study on growth trajectory of low birth weight infants aged 3 years in Shanghai Pudong district

LIN Ling, ZHANG Li-shan, WANG Di, LU Yan-ping, XU Lei, ZHANG Yi-wen

2020, 28(10):  1157-1161.  DOI: 10.11852/zgetbjzz2019-1563

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Objective To investigate the physical growth of low birth weight infants from 0 to 3 years old in Shanghai Pudong district,and to master the different growth trajectories of preterm low birth weight infants and mature low birth weight infants. Methods Totally 387 low birth weight infants born from October 2014 to September 2016 in community health centers in Pudong district were selected as the observation group,and 386 normal infants with the same gender and age in the same community were selected as control group.The weight,body length and height of infants from 0 to 3 years old were compared. Results During the period from 0 to 3 years old,the weight and length/height of low birth weight infants lagged behind the control group (P<0.01).With the increase of age,the weight and height of premature infants at high risk group and low risk group were higher than those at full term infants with statistical significance (P<0.05).While there were no significant differences on weight and length/height between low-risk infants and high-risk infants (P>0.05).There was statistically significant difference on the overall weight among three groups of children with low birth weight from 0 and 3 years old (P<0.05),but no significant difference on height was found (P>0.05).The weight and length/height growth rate of high-risk premature infants and low-risk premature infants were higher than those of mature low birth weight infants and full-term normal infants. Conclusions There is catch-up growth in low birth weight infants from 0 and 3 years old.The growth trajectory of premature low birth weight infants is different from that of full-term infants,and low birth weight preterm infants may have greater growth potential.

Value of real-time shear wave elastography in quantitative evaluation of fatty liver in obese children

HE Xin, JIANG Jue, YIN Chun-yan, XIAO Yan-feng, ZHOU Qi

2020, 28(10):  1162-1165.  DOI: 10.11852/zgetbjzz2020-1204

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Objective To analyze the value of real-time shear wave elastography (SWE) in the quantitative evaluation of fatty liver in obese children, so as to provide more evidence for early diagnosis, intervention and treatment of obese children with fatty liver. Methods From April 2018 to April 2020, a total of 331 obese children who visited the Children and Adolescents Obesity Clinic in the Second Affiliated Hospital of Xi′an Jiaotong University were selected as fatty liver group.Meanwhile, 100 healthy children were selected as control group.Using clinical diagnosis as the reference standard, the shear wave velocity (SWV) and young′s modulus value (EI) of the liver in two groups of children were measured using real-time shear wave elastography, and the difference was compared.ROC curve was then drew to determine the optimal cut-off value for fatty liver in obese children.Additionally, the general data of children were recorded, and the relevant blood biochemical test results were collected to compare the correlation between SWV value, EI value and clinical indicators in children with fatty liver disease. Results There were no statistically significant differences in age, height and alanine amino transferase between obese children and normal children (P>0.05).But the differences in body weight, body mass index(BMI), waist-hip ratio, total cholesterol and serum triglycerides between the two groups were statistically significant (t=3.681, 4.010, 4.587, 3.562, 7.015, P<0.05).The SWV value of the fatty liver group was (1.83±0.24)m/s, significantly higher than that of the control group [(1.01±0.19)m/s].ROC curve indicated that the best diagnostic cut-off point for SWV in obese children with fatty liver was 1.35m/s, the sensitivity and specificity was 0.94 and 0.81, respectively, and the area under the ROC curve was 0.932.The EI value of the fatty liver group was (7.11±0.39)kPa, significantly higher than that in the control group [(5.94±0.26)kPa].ROC curve indicated that the optimal diagnostic cut-off value of EI in obese children with fatty liver was 6.32 kPa, the sensitivity and specificity was 0.96 and 0.72, respectively, and the area under the ROC curve was 0.879.Both SWV and EI values were positively correlated with body weight, and BMI, waist-hip ratio, total cholesterol and serum triglyceride (r_SWV=0.401,0.450,0.488,0.352,0.697; r_EI=0.377,0.463,0.501,0.331,0.611,P<0.05). Conclusion Real-time shear wave elastography can accurately and noninvasively identify the degree of fatty liver in obese children, which is of great significance for the early diagnosis, intervention and treatment of fatty liver in obese children.

Study on the associations of body mass index in maternal pre-pregnancy and gestational weight gain with early childhood asthma

YANG Yan-ping, ZHOU Yan-hong, XUE Lei

2020, 28(10):  1166-1168.  DOI: 10.11852/zgetbjzz2020-0099

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Objective To investigate the associations of body mass index (BMI) in maternal pre-pregnancy and gestational weight gain with early childhood asthma. Methods A total of 170 women born in the Third Hospital of Xi′an from January 2014 to January 2016 were enrolled.According to the pre-pregnancy BMI,the participants were divided into normal body mass group (control group,n=88) and obesity group (n=82).Pre-pregnancy BMI,gestational weight gain and neonatal status were recorded for statistical analysis.Regular follow-ups were conducted every year and the incidence of asthma in children was compared. Results 1) Compared with control group,the proportion of normal weight gain during pregnancy was significantly lower in the obese group,and the proportion of excessive weight gain was significantly increased (χ²=12.61,16.94,P<0.01).2) Compared with control group,the cesarean section rate,the proportion of giant children and the neonatal BMI significantly increased in the obese group (P<0.05).3) Compared with control group,the total incidence of asthma was significantly higher in the obese group than in the control group,and the incidence of asthma in children whose mother with excessive weight gain in the obese group was significantly higher(χ²=5.725,5.067,P<0.05). Conclusions Pre-pregnancy obesity and excessive gestational weight gain are risk factors for asthma in children,which are also the main reasons of increase in cesarean section and the proportion of macrosomia.Reasonable control of pre-pregnancy BMI and weight gain during pregnancy is beneficial to improving pregnancy outcome and effective control of the incidence of childhood asthma.

Growth development and nutritional status of children aged 0-5 years in 4 districts of Shanghai

LU Xin-yuan, WANG Ji-wei, CHE Bei-bei, YAN Rui, ZHANG Ya-xuan, LI Xin-lei, LIU Qian, LYU Bing-hui, WU Peng, YU Jin-ming

2020, 28(10):  1169-1172.  DOI: 10.11852/zgetbjzz2019-1303

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Objective To investigate the growth development and nutritional status of children aged 0-5 years in 4 districts of Shanghai,in order to provide scientific basis for children′s health promotion and nutrition improvement in this region. Methods Stratified cluster random sampling was used to selected 12 community health service centers in 4 districts of Shanghai as survey points,0- to 5-year-old children and their guardians who went to the survey points for physical examination from July 2018 to April 2019 were selected as subjects for health check-up and questionnaires.Z-score method recommended by the 2006 WHO was used for evaluation. Results Except for the 36-60 months old group,the length/height and weight of boys in other age groups were larger than those of girls(P＜0.05).There were significant differences on HAZ values among girls of different age groups(χ²=15.166,P=0.004).There were significant differences on WAZ and WHZ values between boys and girls in different age groups(boys:χ²_WAZ=25.192,χ²_WHZ=25.368,girls:χ²_WAZ=24.378,χ²_WHZ=24.690,P＜0.001).The detection rates of stunting,underweight,wasting,overweight and obese children were 3.4%,2.0%,2.0%,11.4% and 9.5%,respectively. Conclusions The overall level of growth and development of children aged 0-5 years in 4 districts of Shanghai is averaged,while stunting,underweight and wasting are continuing,overweight and obesity have been the most serious problem.Thus,it is supposed to strengthen children′s health promotion and nutrition improvement.

Comparative analysis of the morphological development of primary and secondary school students aged 7 to 18 years in Sichuan Province in 2018 and 2014

SHI Chun-li, ZHOU Liang, CHEN Jian-yu, CHENG Lian, ZHANG Li

2020, 28(10):  1173-1177.  DOI: 10.11852/zgetbjzz2019-1392

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Objective To understand the morphological changes of primary and secondary school students aged 7-18 in Sichuan province in 2018 and 2014,so as to provide basic data for the changes in overweight and obesity among primary and secondary school students in the past five years. Methods Cluster sampling was used in this survey.A total of 28 754 primary and secondary school students aged 7 to 18 were selected in 2018 and 2014.Among them,23 977 primary and middle school students were selected in 2018,4 777 primary and secondary school students were selected in 2014.The height and weight of the students were measured,and body mass index (BMI) was calculated for analysis of overweight and obesity. Results There was no statistically significant difference on average height and average weight between 2018 and 2014 (P>0.05).The detection rate of overweight male students in 2018(12.87%) was slightly lower than that in 2014(14.79%),and the difference was statistically significant (P<0.05).The detection rate of obesity female students in 2018(6.44%) was higher than that in 2014(4.58%),and the difference was statistically significant (P<0.05). Conclusions There has been no significant change in the average height and weight of primary and middle school students in Sichuan Province over the past five years.The detection rate of overweight among male students decreases,and the detection rate of obesity among female students increases.To control the rapid increase in obesity among girls in primary and middle school students in Sichuan Province,improving dietary structure and taking part in more physical activities are encouraged.

Analysis of the status quo and influencing factors of food safety behaviors among students aged 3-8 years

ZHANG Yun-huan, LI Bai-xuan, QIN Tian-yue, LI Na, QIAN Chang-li, LU Pan-ting, CHANG Xue-rong, WANG Yu

2020, 28(10):  1178-1181.  DOI: 10.11852/zgetbjzz2019-0870

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Objective To understand the status quo of food safety behaviors in students aged 3-8 years in Lanzhou City and Longxi County,and to analyze the influencing factors,in order to provide a scientific basis for conducting food safety and health education and guiding students to form healthy behaviors. Methods A self-designed questionnaire was used to investigate parents′ knowledge,attitude and practice (KAP) regarding food safety and children′s food safety behaviors.The factors influencing students′ food safety behaviors were analyzed by multiple linear regression. Results The total food safety behavior rate of students aged 3-8 years was 67.45%,and the formation rate of each behavior ranged from 22.41% to 90.18%.The score of student behavior in Lanzhou City (7.57±0.94) was higher than that in Longxi County (6.98±1.15),girls (7.39±1.04) were higher than boys (7.27±1.09),and ethnic minorities (7.67±0.85) were higher than Han nationality (7.30±1.08).Multiple linear regression analysis found that parents′ knowledge scores,parents′ behavior scores,residence and student gender were positively correlated with student behavioral scores (P<0.05).Student age and ethnicity were negatively related to students′ behavioral scores (P<0.05). Conclusions The overall rate of food safety behaviors among students aged 3-8 years in Gansu is low.Parents are supposed to work with schools to urge students to form healthy food safety behaviors by enriching food safety knowledges and regulating their food safety behaviors.