Table of Content

10 August 2024, Volume 32 Issue 8

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Guideline

Infancy tummy time guideline

WU Qiong, WANG Xiaotong, HUANG Yiwen, ZHANG Yanfeng, YANG Yufeng, ZHANG Ting, ZHU Zonghan

2024, 32(8):  813-820.  DOI: 10.11852/zgetbjzz2024-0433

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Tummy time is defined as awake prone positioning with unrestricted movement of limbs, which is encouraged and supervised by adults. As one of the most important physical activities during early stages of life, tummy time plays a critical role in promoting gross motor and cognitive development, preventing plagiocephaly and decreasing overweight and obesity. Recently, the World Health Organization and many countries worldwide issued guidelines on tummy time for infants; however, there is no tummy time guideline in China. To fill in this gap, the Capital Institute of Pediatrics, together with experts from sports science, pediatrics and child health care, has jointly developed the Infancy Tummy Time Guideline. As the first tummy time guideline for infants under one year old in China, it aims to provide professional recommendations for both child care professionals and parents. The guideline raises recommendations from four aspects, including principles for tummy time, duration and frequency, types of tummy time activities, and monitoring and evaluation, which gives professional guidance on scientific and safe tummy time activities for infants to meet their developmental needs.

Professional Forum

Advances in understanding epigenetic motor regulation mechanisms in early childhood development

ZHANG Ting

2024, 32(8):  821-825.  DOI: 10.11852/zgetbjzz2024-0840

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The health quality of early childhood development is closely related to the balanced diet and active physical activity in children's daily life. With the progress of life science research, the scientific comprehension of this interrelation becomes increasingly profound. Therefore, under the premise of a nutritionally balanced diet for children, this paper describes the influence of body movement on the epigenetic modification of the body. The orderly regulation of downstream functional genes plays a supporting role in the homeostasis of cell communication and tissue communication in the body, so as to ensure the good development of children's bodies. Among them, the mechanism of exercise epigenetics, including DNA methylation, histone modification, non-histone modification, epigenetic modification reader, exercise lactate metabolism and lactoacylation modification and other research progress are introduced, and the molecular basis of children's scientific physical activity is systematically clarified.

Original Articles

Association between 24-hour activity behavior and cardiorespiratory endurance in children and adolescents based on isochronous substitution models

TANG Yi, SONG Yunfeng, DU Yimin, CAO Liquan

2024, 32(8):  826-831.  DOI: 10.11852/zgetbjzz2024-0041

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Objective To explore the comprehensive effect of 24-hour activity behavior on cardiorespiratory fitness (CRF) in children and adolescents and the practical effect of component isochronous substitution by component analysis, in order to provide scientific evidence for improving CRF in children and adolescents. Methods From May to June 2023, a total of 143 students from a junior high school in Tianjin were recruited in this study. ActiGraph GT3X+ accelerometer was used to assess participants' 24-hour activity behavior, and the fifth National Physical Fitness Monitoring Power Test Level 2 load experiment was conducted to test CRF. Compositional analysis was employed to analyze the relationships between different components and CRF, and a 15-minute isochronous substitution model was established to predict the impact of substituting various activity behaviors on outcome variables. Results For children aged 12 - 15, the average daily durations of moderate-to-vigorous physical activity (MVPA), light physical activity (LPA), sedentary behavior (SB), and sleep (SLP) were 49.91, 146.31, 643.19, and 600.59 minutes, respectively. The relative distribution of 24-hour activity behaviors in children and adolescents was closely associated with CRF, with MVPA showing relatively stable durations and the lowest probability of transitioning to other activity behaviors. Component results indicated that after controlling for age and gender, the proportion of time spent on MVPA (β=5.28, P<0.01) was positively correlated with CRF, while the proportion of time spent on SB (β=-4.02, P<0.01) was negatively correlated with CRF. In the 15-minute isochronous substitution model, replacing LPA, SB, and SLP with MVPA, as well as replacing SB with SLP, resulted in significant increases in CRF. Conversely, substituting MVPA with LPA, SB, and SLP led to a significant decrease in CRF. The dose-response relationship revealed an asymmetrical effect of isochronous substitution. With an increase in MVPA replacing other behaviors, the CRF levels in children and adolescents would gradually improve, while the opposite situation would lead to a rapid decline. Among the substitutions, MVPA replacing other behaviors for an average of 10 minutes per day yielded the most prominent effect. Conclusions Reducing SB while increasing MVPA is the best way to improve CRF in children and adolescents. It is recommended that students try to replace their original SB with MVPA as much as possible within the 10min recess to better promote CRF in children and adolescents.

Effect of exercise and behavior intervention on reducing overweight and obesity in children

LU Wenying, BAI Pinqing, XU Huaping, REN Yaping, HU Hui, XIE Hui

2024, 32(8):  832-837.  DOI: 10.11852/zgetbjzz2024-0364

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Objective To investigate the effectiveness of a combined intervention model incorporating physical activity and health behavior guidance on childhood overweight and obesity, in order to provide evidence for obesity intervention strategies in children. Method From April to June 2023, 466 overweight and obese children from grade two to four in three primary schools in Pudong New Area, Shanghai, were selected as study subjects. Two schools were randomly designated as intervention schools and one as a control school. Children in intervention schools underwent a 3-month program of physical activity and health behavior guidance, whereas those in the control school received standard health education and basic weight monitoring. Physical examinations and physical fitness indicators test were assessed pre- and post-intervention. Independent samples t-tests and stratified analysis by grade and gender were conducted to compare the outcomes. Results Compared to the control school, children in intervention schools exhibited a significant decrease in body mass index (BMI) post-intervention, with statistically significant differences observed across grade two and four, and both genders (t＝2.25, 2.33, 2.64, 2.25, P＜0.05). Waist circumference (t＝1.77, 2.34, 3.01, 3.16, 2.72, P＜0.05) and waist-to-height ratio (t＝2.71, 3.19, 4.16, 4.47, 4.14, P＜0.05) also significantly decreased post-intervention in all grades and genders at intervention schools. Furthermore, blood pressure showed more notable reductions post-intervention in intervention schools, with statistically significant differences in systolic blood pressure across grades two and three, and both genders (t＝2.26, 2.83, 3.03, 2.59, P＜0.05), and in diastolic blood pressure for grades two and four, as well as boys (t＝2.41, 3.88, 4.10, P＜0.05). Conclusion The joint intervention of exercise and health behavior guidance demonstrates a substantial positive effect on improving obesity-related indicators in children.

Exercise status and influencing factors of school-age Uygur children with asthma in Kashgar area

SUBINUER·shayiti, GAO Wenying, GUO Xinyu, REN Zijin, LI Yunling, ZHANG Ying

2024, 32(8):  838-843.  DOI: 10.11852/zgetbjzz2024-0238

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Objective To investigate the influencing factors of exercise level of asthmatic children in Kashi area, and to analyze the pathways between these influencing factors, so as to provide basis for promoting exercise intervention of asthma children. Methods FromOctober 2022 to December 2023, school-age Uygur asthmatic children and their parents in pediatric outpatient department of a tertiary hospital and 4 secondary hospital were selected in Kashgar area, XinjiangUygur Autonomous Region by a convenient sampling method. The investigation tools included General Demographic Questionnaire, the International Physical Activity Questionnaire (IPAQ short volume), the National Parents of Asthmatic Children Knowledge Attitude and Practice Questionnaire, Childhood Asthma Control Test (C-ACT). Univariate analysis and Spearman correlation analysis were used to analyze the data, and AMOS 26.0 was used to construct the path analysis model. Results A total of 214 school-age Uygur children with asthma were included, of whom 14.5% (31/214) had high exercise level, 40.7% (87/214) had moderate exercise level, and 44.8% (96/214) had low exercise level. Parents' education level, disease severity, family monthly income, asthma control level, lung function, parents' knowledge and behavior were influencing factors for exercise level of school-age children with asthma (χ²=9.318, 49.911, 25.467, 80.554, H=7.550, 15.495,P<0.05). Path analysis results showed that gender, family monthly income and asthma control level (β= 0.142, 0.176, 0.508, respectively) had directly positive effects on children's exercise level (P<0.05), and parents' knowledge, attitude and practice, as well as disease severity had indirectly effects on children's exercise level, with the indirect effect values of 0.127 and -0.285 (P<0.05). Conclusions The exercise level of school-age Uyghur children with asthma in Kashgar area is low. Clinical medical staff should pay attention to the effects of children's gender, family monthly income, asthma control level, disease severity, parents' knowledge, attitude and practice on the exercise level of children with asthma, and implement scientific and precise exercise intervention, so as to improve the exercise level of children with asthma.

Correlation between body composition and bone mineral density in children and adolescents aged 5 - 14 years

CHENG Ke, WANG Baoxi, WANG Chunhui, SONG Lijia, XI Ying, GUO Wei, YANG Xi, LAN Li

2024, 32(8):  844-849.  DOI: 10.11852/zgetbjzz2024-0387

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Objective To understand the current situation of bone mineral density and body composition of children and adolescents aged 5 - 14 years, and to analyze the correlation of muscle, fat, fat distribution, fat muscle ratio with bone mineral density. Methods A cross-sectional study was conducted on 1 618 children and adolescents aged 5 - 14 years who were treated in the Second Affiliated Hospital of Air Force Military Medical University from 2021 to 2023 by convenience sampling. Physical examination, body composition and bone mineral density (BMD) of all parts of the body were detected by dual energy X-ray absorptiometry. Fat mass index (FMI), muscle mass index (MMI), Android abdominal fat percentage (AWR), Gynoid hip fat percentage (GWR), limb fat percentage (LWR), and fat to muscle ratio (F/M) were then calculated. Multiple linear regression analysis stratified by weight status was used to explore the relationship between body composition and BMD after adjusting for confounders. Results 1) The BMD of both boys and girls increased steadily with age (boys: F=67.741, P＜0.001; girls: F=112.780, P＜0.001). The accumulation of BMD in adolescence increased, and the increase of BMD in girls was earlier than that in boys. The BMD of overweight and obese children and adolescents was higher than that of non-overweight children and adolescents (boys: t=9.028, P＜0.001; girls: t=12.315, P＜0.001). 2) Stratified by non-overweight and overweight obesity groups, MMI was positively correlated with BMD in male and female students (P<0.05), and FMI was positively correlated with BMD in male and female students (male: B=0.009, P＜0.001; female: B=0.014, P＜0.001). No correlation was observed in the overweight and obesity group. The F/M ratio of male students was negatively correlated with BMD both in non-overweight group (B=-0.105, P＜0.001) and overweight obesity group (B=-0.188, P＜0.001), while AWR was only found to be negatively correlated with BMD in the overweight and obesity group (B=-0.801, P＝0.018). F/M (B=-0.153, P＜0.001) and AWR (B=-1.030, P= 0.011) was negatively correlated with BMD in overweight and obese female students. The best fitting model between BMD and F/M was the cubic curve model (male: R²=0.104, P<0.001; female: R²=0.226, P<0.001). The F/M of boys and girlswas within 0.8, and the BMD gradually increased with the increase of F/M, but when the F/M exceeded 0.8, the BMD slowly decreased. Conclusions Muscle and bone mineral density are always positively correlated. There is a threshold effect of fat on bone mineral density. Abdominal fat is negatively correlated with bone mineral density in overweight and obese children and adolescents.

Influence of maternal feeding practice, eating behaviors and temperament of infants and toddlers on childhood overweight and obesity

ZHOU Qiong, LIU Haibo, HU Bimei, GUO Yuqing

2024, 32(8):  850-855.  DOI: 10.11852/zgetbjzz2024-0085

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Objective To examine the influence of maternal feeding practice, eating behaviors and temperament of infants and toddlers on childhood overweight and obesity, in order to provide insights for early prevention and control of childhood overweight and obesity. Methods A purposive sampling method was used to recruit 956 mothers and their children aged 6 to 24 months from two hospitals and two healthcare centers in Xuzhou. Mothers completed the Infant Feeding Style Questionnaire, the Child Eating Behavior Questionnaire for Toddlers, the Infant Behavior Questionnaire-Revised and the Early Childhood Behavior Questionnaire. Body mass index-for age Z-score (BMIZ) was calculated based on recumbent length and weight to determine overweight and obesity (BMIZ >+2). Binary Logistic regression was used to analyze the influence of maternal feeding practice, eating behaviors and temperament of infants and toddlers on childhood overweight and obesity. Results The prevalence of overweight and obesity was 15.06%(144/956). Binary Logistic regression showed that restrictive feeding (OR=2.257), indulgent feeding (OR=1.760), food responsiveness (OR=2.936), negative emotions (OR=1.907) and extraversion temperament (OR=1.859) were risk factors for childhood overweight and obesity; while responsive feeding (OR=0.289), satiety responsiveness (OR=0.476), slowness in eating(OR=0.654), and effortful control(OR=0.548) were protective factors for childhood overweight and obesity (P<0.05). Conclusions Childhood overweight and obesity are influenced by maternal feeding practice, eating behaviors and temperament of infants and toddlers. Child healthcare providers should guide mothers to adjust feeding practices, improve eating behaviors and temperament of infants and toddlers, which may promote the healthy weight development of children.

Effect of new forest parenting programe in children with attention deficit hyperactivity disorder

DENG Liangqiong, LIANG Yuanyuan, CEN Shi, HU Min, LI Honghui, ZENG Xuan, LIAO Linyan

2024, 32(8):  856-861.  DOI: 10.11852/zgetbjzz2024-0094

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Objective To investigate the feasibility and effectiveness of New Forest Parenting Program (NFPP) in the intervention of children with attention deficit hyperactivity disorder(ADHD), in order to provide evidence for non-pharmacological treatments for ADHD. Methods A total of 45 children aged 6 to 9 years diagnosed with ADHD at a tertiary hospital in Liuzhou from February to October 2023, along with their primary caregivers, were selected as subjects and were divided into control group (n=24) and intervention group (n=21) based on informed consent. The control group received routine health education, while the intervention group participated in weekly NFPP sessions for 8 weeks additionally. The SNAP-Ⅳ rating scale, Strengths and Difficulties Questionnaire (SDQ), and Weiss Functional Impairment Rating Scale-Parent (WFIRS-P) were used to assess core symptoms and social functional impairment before and after the intervention in both groups. Results Ultimately, 18 participants in the intervention group and 23 in the control group completed the intervention and follow-up. Before the intervention, there were no statistically significant differences in scores on the SNAP-Ⅳ, SDQ, and WFIRS-P scales between the intervention and control groups (P>0.05). After 8 weeks of intervention, the intervention group had significantly lower scores than the control group on the SNAP-Ⅳ for inattention (Z=-2.232), hyperactivity/impulsivity (t=-3.598), and oppositional defiance (t=-2.053), with all scores also lower than pre-intervention levels (P<0.05). Similarly, the intervention group scored lower on the SDQ for conduct problems (Z=-2.513) and hyperactivity problems (Z=-3.719), as well as the total difficulties score (Z=-3.231) compared to the control group, with all six dimensions scoring lower than post-intervention (P<0.05). Scores on the WFIRS-P for family (Z=-2.332), school and learning (t=-10.734), life skills (Z=-3.667), self-management (t=-3.471), and the total WFIRS-P score (t=-5.251) were significantly lower in the intervention group than in the control group and pre-intervention(P<0.05). Conclusion The NFPP program effectively improves core symptoms of ADHD and reduces associated social functional impairment.

Oral health-related quality of life and associated factors among 12-year-old children in Guizhou

ZHANG Xutong, LI Na, WU Juanjuan, CHEN Xinyue, ZHAO Nanyang, CHEN Liming, DAI Taiming

2024, 32(8):  862-867.  DOI: 10.11852/zgetbjzz2024-0157

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Objective To evaluate the status of oral health-related quality of life and associated factors of 12-year-old children in Guizhou Province, so as to provide reference for health education and prevention of oral diseases in school-age children. Methods A total of 1 777 children aged 12 in Guizhou Province were recruited by a multi-stage stratified sampling method. Oral examination was performed according to WHO oral health examination criteria, and child oral health-related quality of life was assessed using Child-Oral Impact on Daily Performance(Child-OIDP). Chi-square test, non-parametric test and binary Logistic regression model were used to analyze the associated factors. Results Totally 73.3% (1 303/1 707) children showed at least one impact on their oral health in the last 6 months, with diet being the most affected (52.6%) and schooling being the least affected(16.0%). Living in rural areas (OR=0.483, 95%CI: 0.322 - 0.723) was a protective factor for the impact on oral health-related quality of life(P＜0.001). Being the second-class economic tier (OR=1.926,95%CI:1.404 - 2.642) and third-class economic tier (OR=5.347, 95%CI:3.295 - 8.677), consuming sweet food 2 - 6 times per week (OR=1.518,95%CI:1.143 - 2.015) and once or more daily (OR=1.433, 95%CI:1.098 - 1.871), having good oral health knowledge (OR=1.693, 95%CI:1.145 - 2.502), having moderate oral health attitude (OR=1.830, 95%CI: 1.143 - 2.928) and positive oral health attitude (OR=2.121, 95%CI:1.353 - 3.324) were positively associated with the impact on oral health-related quality of life (P＜0.05). Conclusion The daily life of 12-year-old children in Guizhou Province is significantly affected by oral health conditions, albeit to a relatively mild extent.

Original Articles

Current situation and health influencing factors of adolescent scoliosis among primary and middle school students aged 6 to 20 in Nantong City

REN Qingxin, AN Na, HUANG Jianping, CHEN Rui, ZHANG Weibing, WU Yue

2024, 32(8):  868-874.  DOI: 10.11852/zgetbjzz2024-0174

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Objective To understand the detection rate of scoliosis and its influencing factors among primary and secondary students in Nantong City, Jiangsu Province, so as to provide reference basis for the development of scoliosis intervention. Methods A stratified cluster random sampling method was used to select 4 196 students from 12 primary and middle schools in Chongchuan and Qidong District of Nantong City in 2021. The students were investigated for spinal examinations and influencing factors of adolescent scoliosis. Multivariate Logistic regression model was used to analyze the risk and protective factors of adolescent scoliosis in students. Results The detection rate of adolescent scoliosis in primary and middle school students in Nantong was 3.69% (155/4 196), and the detection rates of thoracic, lumbar thoracic and lumbar scoliosis were 1.36% (57/4 196), 1.67% (70/4 196) and 1.91% (80/4 196), respectively. The detection rate of adolescent scoliosis significantly varied among primary and middle school students, which was related to whether myopia or not, different grades and different frequency of physical education classes, days with high-intensity exercise above 60min in the past week, daily outdoor time, sleep time, indoor sedentary time, as well as students' different self-requirements for sitting and standing positions(P＜0.05). Multivariate Logistic regression analysis showed that junior high school (OR=2.781) and senior high school (OR=2.819) were risk factors for adolescent scoliosis, while physical education classes frequency ≥ 4 sessions a week (OR=0.432), days with high-intensity exercise above 60min in the past week≤3days and daily sleep duration of 7 - <9 hours (OR=0.551) were protective factors against scoliosis. Conclusions The situation of adolescent scoliosis among primary and middle school students in Nantong City should not be ignored.The influencing factors for adolescent scoliosis include academic grade, frequency of physical education classes and sleep time etc. Interventions are of great significance to be targeted at these factors to reduce the incidence of scoliosis among students.

Review

Progress in behavioral intervention for obese children

CHEN Yujie, LI Xiaonan

2024, 32(8):  875-880.  DOI: 10.11852/zgetbjzz2024-0239

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Obesity is widespread around the world, and its prevalence is closely related to unhealthy lifestyle. Clearly, behavior is the center of diet, physical activity, sleep, and other aspects of life. Now how to promote and maintain behavioral change has become the key to manage childhood obesity. In recent years, the theories and technologies of behavioral change are widely used in behavioral intervention for obese children, aiming to change the unhealthy lifestyle, improve cognitive levels, reduce negative emotions, and promote the effectiveness of obesity management.

Advances in metabolomics of childhood obesity

LIU Lujie, XU Dong, YIN Chunyan, XIAO Yanfeng

2024, 32(8):  881-885.  DOI: 10.11852/zgetbjzz2024-0266

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Obesity is a disease characterized by the accumulation of adipose tissue and metabolic dysregulation. The prevalence of childhood obesity is on the rise; however, the intricate mechanisms underlying changes in body weight and metabolism remain elusive. Metabolomics, a high-throughput and highly sensitive detection method, enables comprehensive analysis and identification of small molecules or metabolites in biological samples, thereky elucidating the relationship between childhood obesity and metabolism, facilitating the discovery of potential biomarkers and therapeutic targets while providing insights into the pathogenesis of childhood obesity and its associated complications. This review summarizes recent advances in metabolomics research pertaining to childhood obesity.

Role of telomeres in the relationship between early life adverse environments and metabolic diseases

HE Yuhua, XIONG Fei

2024, 32(8):  886-890.  DOI: 10.11852/zgetbjzz2024-0143

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Numerous epidemiological and animal experimental studies have shown that in addition to lifestyle and genetic inheritance, exposure to adverse factors in early life may increase the risk of metabolic diseases in adult offspring by affecting fetal telomere length. However, the mechanism by which early exposure to adverse factors increases the risk of metabolic diseases is still unclear. Exploring telomere biological information may provide new avenues for predicting adverse environmental exposure in early life and postnatal health issues.

Assessment methods of children with sarcopenia

ZOU Yifei, YANG Yizhuo, GUO Jianjun

2024, 32(8):  891-896.  DOI: 10.11852/zgetbjzz2023-1104

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Sarcopenia in children is an emerging concept. Recent researches have shown that sarcopenia also occurs in children. The etiology of sarcopenia in children is complex, primarily due to pathologic factors, but also in a healthy population of children and adolescents, where underactivity and sedentary behavior can lead to reduction in skeletal muscle mass, decline in muscle function, and ultimately, the emergence of sarcopenia. The methods of assessing sarcopenia in children are still not well researched, and are mainly divided into two techniques: functional assessment and body composition analysis. Studies on sarcopenia have so far been conducted mainly in the context of the elderly or chronically ill, and there is a serious lack of research on sarcopenia in children. For the sake of children's healthy development, in-depth research on sarcopenia in children should be strengthened to formulate effective assessment tools and treatment strategies to improve the physical fitness of children in China.

Meta Analysis

Meta-analysis on the relationship between serum vitamin D level and nonalcoholic fatty liver disease in adolescents

LU Guoguo, HUANG Xiaojin, LI Guohua, ZHAO Yongli

2024, 32(8):  897-901.  DOI: 10.11852/zgetbjzz2024-0122

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Objective To systematically evaluate the correlation between vitamin D level and nonalcoholic fatty liver disease (NAFLD) in adolescents, in order to provide new ideas for the treatment of the disease. Methods The literatures regarding the correlation between NAFLD and vitamin D in adolescents from January 2013 to December 2022 were searched in PubMed, Embase, Cochrane Library, China knowledge Network and Wanfang database. Quality of the literature was evaluated by the Newcastle-Ottawa scale (NOS) and the adapted NOS quantitative change, and the Meta-analysis was carried out by Stata15.0. Results A total of 12 studies were included, including 922 adolescent NAFLD patients. Meta-analysis results showed that the level of 25(OH)D in NAFLD adolescents significantly decreased (SMD=-1.02, 95%CI: -1.54 - -0.49, I²=96.9%). The source of heterogeneity was not found in the subgroup analysis on the type of study and the degree of national development,but the vitamin level in each subgroup decreased. Sensitivity analysis excluded each study one by one, and the results did not change in essence, suggesting that the results were stable. No obvious publication bias was found. Conclusion The level of Vitamin D is decreased in adolescent patients with NAFLD, which may be involved in the development of NAFLD.

Clinical Research

Status quo and influencing factors of motor development in 12-month full-term infants

CHEN Xiujin, JIANG Xiaolan, CHEN Hongyi, WU Mingshui, LYU Min, CHEN Junlin

2024, 32(8):  902-907.  DOI: 10.11852/zgetbjzz2024-0290

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Objective To analyze the status quo and influencing factors of motor development in 12-month full-term infants, in order to provide guidance for future clinical work. Methods Infants who were followed up in Jianyang Maternal and Child Health Hospital from January 2022 to January 2024 were selected into this study. Data on the sex, gestational age and birth weight of the infants were recorded. A self-designed questionnaire was used to collect relevant information for parents, and Peabody Developmental Motor Scale-2 (PDMS-2) was used to evaluate motor development level of infants. Results A total of 2 184 cases were obtained, and the detection rate of motor development deviation was 17.3%. Non-first delivery (OR=0.690), taking folic acid as required (OR=0.564) and breastfeeding (OR=0.245) were protective factors of motor development deviation(P<0.05). Girls (OR=2.353), maternal age of delivery≥35 years old (OR=1.582), delivery hospitalclassified as grade B,level 3 or lower(OR=1.452), living in rural areas (OR=2.524), nursing staff as non-parents (OR=2.696), access to development knowledge through network we-media (OR=1.494), education level of the parents below the college level (OR=2.198), the age of nursing staff ＞35 years old (OR=3.181), and the annual income per capita of the family≤100 000 yuan were risk factors for motor development deviation (P＜0.05). Conclusions The motor development level of infants is influenced by many factors, such as living environment and family income. It is necessary to strengthen relevant health education and carry out early intervention measures to reduce the probability of motor development deviation of infants.

Effects of different feeding methods on intestinal microbiota in infants with cow's milk protein allergy

LUO Guangyue, LU Wei, XU Deyong, QIU Zhengfei, LI Zonglong

2024, 32(8):  908-913.  DOI: 10.11852/zgetbjzz2024-0109

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Objective To explore the effects of various feeding methods on the gut microbiota of infants with cow's milk protein allergy (CMPA), in order to provide theoretical guidance for the rational selection of intestinal microecological treatment for infants with CMPA. Methods Fecal samples of 24 infants with CMPA and 26 healthy infants were collected from September 2020 to October 2021 in the Affiliated Hospital of Zunyi Medical University. Bacterial DNA was extracted from these samples, followed by PCR amplification of the V3-V4 region of the 16S rDNA. High-throughput sequencing was then conducted for bacterial classification. The structure and diversity of intestinal flora of CMPA infants with different feeding methods were analyzed from four aspects: beta diversity analysis, alpha diversity analysis, species composition analysis and species difference analysis. Results Infants with CMPA who were exclusively breastfed exhibited greater gut microbiota diversity compared to healthy breastfed infants (P<0.05). Conversely, there was no significant difference in intestinal microflora diversity between mixed-fed CMPA infants and mixed-fed healthy infants, formula-fed CMPA infants and formula-fed healthy infants(P＞0.05). Notable distinctions included enriched populations of Bifidobacterium and Escherichia-Shigella in breastfed CMPA infants, Streptococcus and Rothia in mixed-fed CMPA infants, and unclassified Enterobacteriaceae and Citrobacter in formula-fed CMPA infants. Conclusion Intestinal flora disorder exists in infants with different feeding patterns of CMPA, which may provide some theoretical basis for the study of pathogenesis and microecological intervention of CMPA with different feeding patterns.

Correlation between different types of dietary fiber and nutritional status of in children

WANG Shasha, ZHENG Shuangshuang, XU Xin, LYU Lina, ZHU Bingquan

2024, 32(8):  914-917.  DOI: 10.11852/zgetbjzz2024-0046

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Objective To describe the relationship between different dietary fiber sources and nutritional status of children, in order to provide evidence for the prevention of childhood nutritional disease. Methods The body mass index (BMI) of 372 children aged 6 to 18 years who went to the nutrition clinic of the Children's Health Department of the Children's Hospital Affiliated to Zhejiang University School of Medicine for nutrition consultation due to nutritional imbalance from 2019 to 2023 was calculated, and the Z-value of BMI was obtained. Then children were divided into three groups: Low weight group, normal weight group and overweight group. Dietary intakes were also obtained based on previous use of a 3-day food diary, and dietary software was used to automatically determine the type of dietary fiber consumed. Children's dietary fiber intake and the three groups of children were analyzed by one-way ANOVA and Logistic regression analysis. Results In the normal weight group, the overweight group and the low weight group, total dietary fiber, grain fiber, legumes fiber and other types of fibers were statistically significant among all groups (F=4.55, 10.67, 3.53,6.68, P<0.05). Pairwise comparison showed that compared with normal weight children, the intake of total dietary fiber, grain fiber and other types of fiber was significantly higher in overweight children (P <0.05), and there was no statistical difference in the intake of dietary fiber in children between low weight group and normal weight children (P>0.05). Logistic analysis found that children with a higher intake of grain fiber and other types of fiber were more likely to be overweight compared to normal children (OR=2.04, 1.96,P<0.05), and children with a higher intake of soy fiber were less likely to be overweight (OR=0.25,P<0.05). Conclusions Different kinds of fiber have different effects on the nutritional status of children. It is recommended that overweight children reduce their intake of grain fiber and other types of fiber, and appropriately increase their intake of legumes fiber, which may help control the occurrence of overweight.

Mediating effect of maternal feeding behavior on the relationship between maternal feeding anxiety and growth and development of infants

WANG Xue, LI Zhihui, KONG Yan, YU Guiling

2024, 32(8):  918-923.  DOI: 10.11852/zgetbjzz2024-0255

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Objective To analyze the association between maternal feeding anxiety, feeding behavior, and weight-for-length Z score (WLZ) of infants, so as to provide reference for the development of effective intervention strategies to improve maternal feeding anxiety and behavior. Methods By convenient sampling method,331 infants and their mothers from the Child Health Care Department a Grade-A tertiary hospital in Qingdao, Shandong Province were selected as the study subjects in September 2023. Maternal Feeding Anxiety Scale, Parents' Feeding Practice Scale were used as assessment tools, and infant physical indicators were used to investigate. The association between variables was analyzed by Pearson correlation, and the mediating effect was tested by the Bootstrap program software. Results The score of maternal feeding anxiety was (39.592±8.173). Positive correlations were found between feeding behaviors and maternal feeding anxiety, including pressuring to eat, concerning about infant underfeeding, emotional and instrumental feeding, and parent-led eating (r＝0.591, 0.650, 0.398, 0.317, P<0.01), which were also positively correlated with infants' WLZ (r＝0.512, 0.428, 0.218, 0.258, P<0.01). Maternal feeding anxiety was positively correlated with infant's WLZ (r＝0.442, P<0.01). Pressuring to eat, concerning about infant underfeeding, and parent-led eating all played a partial mediating role between maternal feeding anxiety and infants' WLZ, and the mediation effect values were 0.272, 0.191 and 0.050 (50.8%, 35.7% and 9.3% of the total effect), respectively. Conclusions Maternal feeding anxiety can directly affect infants' WLZ, or indirectly influence infants' WLZ through practices like pressuring to eat, concerning about infant underfeeding, and parent-led eating. In order to improve the growth and development status of infants, feeding behavior of mothers should be improved at beginning. Medical staff should provide personalized guidance based on the maternal feeding anxiety level to promote the long-term healthy development of infants.