Ma et al. BMC Public Health 2012, 12:568 http://www.biomedcentral.com/1471-2458/12/568 Table 7 Association between the components of CS-ICFI at Visit 3 and LAZ, WAZ, WLZ at Visit 3 (18-month-old) Mean LAZ a Mean WAZ a Mean WLZ a Variables Score n Food consistency Feeding frequency b Dietary diversity Low High Beta c Std.Error P value d Low High Beta c Std.Error P value d Low High Beta c Std.Error P value d Low High Beta c Std.Error +1 +2 10 170 +1/+2 51 +3 129 +1 +2 18 162 +1/+2 +3 97 83 Food group frequency b 0.10 0.40 0.079 0.280 0.280 0.39 0.39 -0.002 0.009 0.982 -0.04 0.43 0.156 0.221 0.036 0.25 0.54 0.171 0.123 0.11 0.68 0.167 0.257 0.029 0.71 0.63 -0.047 0.137 0.541 0.44 0.67 0.085 0.207 0.274 0.69 0.60 -0.034 0.116 CS-ICFI Mean SD Median Minimum maximum P value d 0.021 0.658 0.035 aAdjusted for birth weight, mother’s pre-pregnancy height and weight, and annual household income. bSamples with scores of +1 and +2 were combined due to the extremely small size of sample with score +1. cStandardized partial regression coefficient. dAssociations between the components of CS-ICFI at Visit 3 and mean LAZ, WAZ and WLZ at Visit 3 were tested using a linear regression model. the CS-ICFI z values were stable for each child from one visit to the other. Discussion Association of ICFI with Child Growth Status This study constructed modified CS-ICFIs taking into consideration of Chinese diet characteristics for 6- to Table 8 CS-ICFI distribution by visit (n = 180) Visit 1 (6-month-old) 7.19 Visit 2 (12-month-old) 7.99 Visit 3 (18-month-old) 9.01 1.55 7 3 10 0.83 8 5 10 0.09 0.67 0.163 0.270 0.034 0.71 0.60 -0.059 0.144 0.452 0.62 0.63 0.004 0.218 0.959 0.78 0.47 -0.164 0.121 0.87 9 6 10 Page 7 of 9 18-month-old infants by 3 different age groups, mean- while attempted to create an L-ICFI by using data from CS-ICFIs, and further analyzed the association between CS-ICFIs or L-ICFI and infants’ growth status. Despite the homogeneous urban context, our results showed that the CS-ICFI of 18-month-old children at Visit 3 was significantly and positively associated with their LAZ at the same visit. Our findings confirmed the conclusion that ICFI was significantly associated with LAZ especially among 12- to 36-month-old children based on the data from 7 Demographic and Health Sur- veys in 5 Latin American countries [2]. Furthermore, we also found that the CS-ICFI of 6-month-old infants at Visit 1 was significantly and positively associated with their LAZ, WAZ and WLZ measured again a year later at Visit 3. It is suggested that previous feeding practice may have long-term effect on future growth of children. However, there was no significant association between the CS-ICFI of 12-month-old infants and anthropomet- ric indices measured 6 months later at Visit 3. Next, our analysis indicated that longitudinal ICFI constructed using data from the 3 CS-ICFIs was posi- tively and significantly associated with LAZ. It corre- sponded with the result reported by a recent study [9]. In addition, we also found the significant association be- tween L-ICFI and WAZ similar to the result reported in a previous study performed in rural China [6]. Infant and young child feeding practices varying with regions, ethnicities, diet cultures and socio-economy due to vari- ous study settings might contribute to the difference in results. Components of CS-ICFI The percentage of breastfeeding decreased drastically from 48.89% for 6-month-old infants to 1.67% for 18- month-old infants. Only 3 young children were breastfed with the frequency of < 3 times per day at Visit 3 and thus breastfeeding had very little effect on the growth of these children. As a result, we had to remove breastfeed- ing from the components of CS-ICFI at Visit 3. Secondly, bottle feeding will interfere with optimal breastfeeding practices, reducing breast milk intake and energy intake from complementary food, as well as in- creasing risk of infection [6,15]. On the other side, food consistency can indirectly reflect the frequency of bottle feeding because bottle use is limited by the texture of food. Furthermore, food consistency can also reflect the energy density of complementary food. Taking these fac- tors into account, bottle feeding was replaced by food consistency in our study. Our results showed that consistency of complementary food of ICFI at Visit 1 was positively associated with child LAZ and WAZ at Visit 3, and at Visit 3, 18-month-old infants in high score categories of food consistency had over 0.55 higher