CitationWright, Melecia J.; Bentley, Margaret E.; Mendez, Michelle A.; & Adair, Linda S. (2015). The Interactive Association of Dietary Diversity Scores and Breast-Feeding Status with Weight and Length in Filipino Infants Aged 6-24 Months. Public Health Nutrition, 18(10), 1762-1773. PMCID: PMC4888074
AbstractObjective: To assess how breast-feeding and dietary diversity relate to infant length-for-age Z-score (LAZ) and weight-for-age Z-score (WAZ). Design: Breast-feeding, dietary and anthropometric data from the Cebu Longitudinal Health and Nutrition Survey were analysed using sex-stratified fixed-effects longitudinal regression models. A dietary diversity score (DDS) based on seven food groups was classified as low (<4) or high (≥4). The complementary feeding patterns were: (i) non-breast-fed with low DDS (referent); (ii) breast-fed with low DDS; (iii) non-breast-fed with high DDS; and (iv) breast-fed with high DDS (optimal). Interactions between age, energy intake and complementary feeding patterns were included. Setting: Philippines. Subjects: Infants (n 2822) measured bimonthly from 6 to 24 months. Results: Breast-feeding (regardless of DDS) was significantly associated with higher LAZ (until 24 months) and WAZ (until 20 months). For example, at 6 months, breast-fed boys with low DDS were 0·246 (95 % CI 0·191, 0·302) sd longer and 0·523 (95 % CI 0·451, 0·594) sd heavier than the referent group. There was no significant difference in size between breast-fed infants with high v. low DDS. Similarly, high DDS conferred no advantage in LAZ or WAZ among non-breast-fed infants. There were modest correlations between the 7-point DDS and nutrient intakes but these correlations were substantially attenuated after energy adjustment. We elucidated several interactions between sex, age, energy intake and complementary feeding patterns. Conclusions: These results demonstrate the importance of prolonged breast-feeding up to 24 months. The DDS provided qualitative information on infant diets but did not confer a significant advantage in LAZ or WAZ.
Reference TypeJournal Article
Journal TitlePublic Health Nutrition
Author(s)Wright, Melecia J.
Bentley, Margaret E.
Mendez, Michelle A.
Adair, Linda S.