The interactive association of dietary diversity scores and breast-feeding status with weight and length in Filipino infants aged 6-24 months.
OBJECTIVE
To assess how breast-feeding and dietary diversity relate to infant length-for-age Z-score (LAZ) and weight-for-age Z-score (WAZ).


METHODS
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.


METHODS
Philippines.


METHODS
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.
Department of Nutrition,University of North Carolina at Chapel Hill,135 Dauer Drive,Chapel Hill,NC 27599,USA.
Melecia J
MJ
Wright
Department of Nutrition,University of North Carolina at Chapel Hill,135 Dauer Drive,Chapel Hill,NC 27599,USA.
Margaret E
ME
Bentley
Department of Nutrition,University of North Carolina at Chapel Hill,135 Dauer Drive,Chapel Hill,NC 27599,USA.
Michelle A
MA
Mendez
Department of Nutrition,University of North Carolina at Chapel Hill,135 Dauer Drive,Chapel Hill,NC 27599,USA.
Linda S
LS
Adair
D000886:Anthropometry; D001942:Breast Feeding; D002675:Child, Preschool; D004032:Diet; D005260:Female; D006128:Growth; D006801:Humans; D007223:Infant; D007225:Infant Food; D007227:Infant Nutritional Physiological Phenomena; D008297:Male; D008895:Milk, Human; D010679:Philippines
Breast-feeding; Diet diversity; Infant nutrition; Weight- and length-for-age Z-scores