西北部分贫困地区儿童喂养和体格发育现状研究

利用1999年卫生部一联合国儿童基金会在中国西部5省40个项目县调查资料,着重分析3岁以下儿童喂养和生长发育现状以及影响儿童中重度低体重和中重度生长迟缓的因素。结果显示：3岁以下儿童母乳喂养率高,但纯母乳喂养率偏低。4个月和6个月及时添加辅食率较低,分别为18.4%和45.1%。4～6个月以内儿童年龄别体重和年龄别身高基本高于世界卫生组织相应的标准。年龄别体重男童从8个月开始到35个月,女童从11月到35个均低于世界卫生组织的相应标准。影响儿童中重度低体重和中重度生长迟缓的主要因素有：民族、母亲年龄、家庭经济来源、孩子年龄、喂养方式、饮用水和两周腹泻患病。     

四川省6岁以下儿童营养与健康状况分析

目的了解四川省农村6岁以下儿童的营养与健康状况,为进一步实施儿童营养干预提供科学依据。方法利用整群随机抽样的方法,有效抽取2852名6岁以下儿童,对其营养与健康状况进行调查。采用WHO营养不良诊断标准,对儿童体格发育进行评价。结果受调查儿童年龄别身高（HA）、年龄别体重（WA）、身高别体重（WH）Z评分分别为-0．95、-0．72、-0．13,生长发育迟缓率、低体重率、消瘦率、贫血患病率分别为17．5％、9．7％、2．I％和17．7％,从年龄看1岁以前儿童生长发育迟缓、低体重、消瘦患病率较低,1岁以后相对较高,生长发育迟缓、低体重患病率在1岁前后存在显著性差异。儿童6个月内母乳喂养率、混合喂养率、人工喂养率分别为61．6％、32．5％和5．9％。结论四川省农村6岁以下儿童营养与健康状况不容乐观,以1岁组儿童营养问题较为突出,应尽早采取干预措施。     

四川省农村6岁以下儿童营养与健康状况分析

[目的]了解四川省农村6岁以下儿童的营养与健康状况,为进一步实施儿童营养干预提供科学依据。[方法]利用整群随机抽样的方法,有效抽取2852名6岁以下儿童,对其营养与健康状况进行调查。采用WHO营养不良诊断标准,对儿童体格发育进行评价。[结果]受调查儿童年龄别身高(HA)、年龄别体重(WA)、身高别体重(WH)Z评分分别为-0.95、-0.72、-0.13,生长发育迟缓率、低体重率、消瘦率、贫血患病率分别为17.5%、9.7%、2.1%和17.7%,从年龄看1岁以前儿童生长发育迟缓、低体重、消瘦患病率较低,1岁以后相对较高,生长发育迟缓、低体重患病率在1岁前后存在显著性差异。儿童6月内母乳喂养率、混合喂养率、人工喂养率分别为61.6%、32.5%和5.9%。[结论]四川省农村6岁以下儿童营养与健康状况不容乐观,以1～岁组儿童营养问题较为突出,应尽早采取干预措施。     

太原市3所幼儿园儿童生长发育状况调查

【目的】 调查太原市3所幼儿园儿童生长发育状况,提出改进意见。 【方法】 采用全国统一的测量方法,测量3所幼儿园772名儿童(男383,女389)的身高和体重。使用SPSS16.0进行分析,运用2006WHO儿童生长发育标准和2009年我国7岁以下儿童生长发育参照标准分别计算Z评分,与2002年中国居民营养与健康调查结果比较。 【结果】 营养不良率、生长迟缓率、消瘦率及超重率按照两标准计算所得结果均低于全国城市平均水平,肥胖发生率与2002年全国水平相当。 【结论】 本次调查儿童体格发育总体上优于WHO标准水平和我国2002年标准,生长发育状况良好。另外,运用我国标准与WHO标准所得结论总体上较接近。     

四川省5岁以下儿童营养现状分析

目的 了解四川省5岁以下儿童营养现状。方法 采用随机整群抽样方法,在四川省范围内抽取8 006名5岁以下儿童,测量身高体重,用2006年WHO生长发育标准进行评价。结果 四川省5岁以下儿童生长迟缓率、低体重率、消瘦率分别为7.26%、 2.74%、2.87%。儿童超重率及肥胖率分别为12.93%、5.17%。营养不良和营养过剩水平存在城乡、性别和年龄差异。结论 四川省5岁以下儿童营养不良水平较低,营养过剩水平较高。制定不同年龄阶段相应的措施,降低儿童的营养不良和肥胖是今后营养改善工作的重点。     

2006年贵州农村7岁以下儿童体格发育调查

目的:了解贵州省农村7岁以下儿童生长发育的情况,为制定农村妇幼保健政策提供参考。方法:采取随机整群抽样方法,调查清镇、独山、长顺、金沙4个县市7岁以下儿童体格发育指标。分22个年龄组,共调查健康儿童7742例,调查结果与1985年同方法调查的资料进行比较。结果:2006年贵州省农村7岁以下儿童体格发育水平较1985年明显提高,各项指标增幅明显,呈持续增长趋势;身高、体重与2005年全国九市郊区儿童生长发育指标比较明显落后,差异有统计学意义(P0.01);采用WHO2006标准计5岁以下儿童体重、身高2评分值(SDS),显示体重低于WHO2006标准0.59～0.69个标准差,身高低于此标准1.03～1.19个标准差。结论:农村经济的落后影响了儿童的生长发育水平;需改善生活条件,加强保健意识、提高保健质量、注重喂养指导以充分发掘贵州省农村儿童的生长潜力。     

我国6县农村5岁以下儿童生长发育公平性分析

[目的]研究我国6个县农村地区5岁以下儿童生长发育公平性状况及其程度. [方法]利用2007年联合国儿童基金会中国办事处在中国开展"儿童发展行动项目妇幼卫生子项目"的6个县的基线调查资料,采用2006年WHO新的儿童生长发育标准,计算生长迟缓、低体重、消瘦和营养不良的患病率,利用集中曲线和集中指数定量分析调查地区5岁以下儿童体格发育公平程度. [结果]家庭收入水平越低儿童营养不良性疾病的患病率越高,尤以低体重患病的不公平程度最高. [结论]调查地区5岁以下儿童体格发育存在不公平性.为降低不公平程度,应把减少慢性营养不良和提高低收入家庭的经济状况视作为主要的考虑因素.     

中国西部14县3岁以下儿童低体重患病率及相关因素分析

目的 了解中国西部14县3岁以下儿童的低体重患病状况,探索儿童低体重危险因素,为改善儿童营养状况提供科学依据。方法 采用按容量比例概率抽样法(PPS),于2011年9-10月调查了我国西部14个县2 999名3岁以下儿童看护人并测量了3 051名3岁以下儿童的体重,低体重采用世界卫生组织2006年的标准作为评价标准。结果 被调查地区3岁以下儿童的低体重患病率为5.8%,家庭人均年纯收入越高,儿童的低体重患病率越低(趋势χ²=30.729,P<0.001),生活在Ⅳ类农村的儿童的低体重患病率高于生活在Ⅰ、Ⅱ类型农村的儿童,差异有统计学意义(OR=4.14,95%CI:1.88~9.14),膳食摄入没有达到多样性的儿童更易患低体重(OR=1.63,95%CI:1.09~2.43)。结论 被调查地区儿童低体重患病状况与以往调查相比有所改善,但仍处于较高水平,改善当地经济状况,同时宣传教育儿童看护人科学合理地喂养儿童是改善被调查地区儿童低体重患病状况的关键。     

宜宾市3岁以下儿童喂养及生长发育情况调查

目的调查四川省宜宾市3岁以下儿童生长发育状况及喂养情况,分析该群体生长发育异常的原因,为今后制定儿童营养干预方案提供理论依据。方法随机选取2015年1月-2016年1月在四川省宜宾市某医院进行儿童保健的3岁以下儿童1 426人作为研究对象,采用统一儿童保健程序对研究对象进行生长发育相关指标的测量,同时使用3岁以下儿童生长发育及喂养情况调查表记录儿童喂养方式和照顾方式。采用标准差法,根据年龄别身高、年龄别体质量、身高别体质量对研究对象的生长发育状况进行评价。结果研究对象中生长发育异常者共269人,检出率为18.9%。研究对象中生长迟缓者95人,检出率为6.7%;低体质量者44人,检出率为3.1%;消瘦者57人,检出率为4.0%;肥胖者73人,检出率为5.1%,不同性别研究对象肥胖检出情况比较,差异有统计学意义(P0.05)。而不同喂养方式、居住地儿童的生长发育异常检出情况比较,差异有统计学意义(P0.05)。两两比较发现,母乳喂养儿童的生长发育异常检出率低于代乳品喂养儿童及混合喂养儿童,农村儿童的生长发育异常检出率高于城市及乡镇儿童,差异均有统计学意义(P0.025)。结论本次调查发现四川省宜宾市3岁以下儿童生长发育异常检出率较高,其中非母乳喂养及居住在农村的儿童生长发育异常检出率较其他儿童偏高,因此需要进一步加强儿童喂养人员的健康教育,提高该人群的儿童科学喂养意识及其科学喂养知识技能等,以期改善宜宾市3岁以下儿童的生长发育状况。     

广东省2002年学龄前儿童生长发育状况及评价

目的 了解广东省学龄前儿童生长发育状况，为进一步改善学龄前儿童生长发育水平提供科学依据。方法 利用2002年广东省居民营养与健康状况调查，获取6岁以下儿童共3569名体检资料，并进行描述性分析。采用世界卫生组织(WHO)推荐使用的参考标准，对儿童体格发育进行评价。结果 男童生长发育状况优于女童。城市儿童优于农村儿童。肥胖发生率城市高于农村，其中0-1岁女童及4-6岁男童肥胖率较高，分别为7．8％，9．8％；消瘦率、低体重率、生长发育迟缓率农村明显高于城市，其中消瘦率以0-1岁年龄段最高；低体重、生长发育迟缓发生情况相似，男童均以4-6岁年龄段最高，女童均以2-3岁年龄段最高。结论 6岁以下农村儿童生长发育和营养状况令人担忧，应尽早采取干预措施，改善环境因素。     

Secondary Analysis of Anthropometric Data from a South African National Food Consumption Survey, Using Different Growth Reference Standards

The National Center for Health Statistics (NCHS) references were used to analyse anthropometric data from the 1999 National Food Consumption Survey (NFCS) of South Africa. Since then, however, The Centers for Disease Control and Prevention (CDC) 2000 reference and the World Health Organization (WHO) 2006 standards were released. It was anticipated that these reference and standards may lead to differences in the previous estimates of stunting, wasting, underweight and obesity in the study population. The aim was to compare the anthropometric status of children using the 1977 NCHS, the 2000 CDC growth references and the 2006 WHO standards. All children 12–60 months of age with a complete set of anthropometric data were included in the analyses. Data for 1,512 children were analysed with SAS 9.1 for Windows. A Z-score was calculated for each child for weight-for-age (W/A), weight-for-length/height (W/H), length/height-for-age (H/A) and body mass index (BMI)-for-age, using each of the three reference or standards for comparison. The prevalence of stunting, obesity and overweight were significantly higher and the prevalence of underweight and wasting were lower when using the WHO standards compared to the NCHS and the CDC references. The higher than previously established prevalence of stunting at 20.1% and combined overweight/obesity at 30% poses a challenge to South African policy makers to implement nutrition programmes to decrease the prevalence of both stunting and overweight. The 2006 WHO growth standard should be the standard used for assessment of growth of infants and children younger than 5 years in developing countries.     

Pilot testing of WHO Child Growth Standards in Chandigarh: implications for India��s child health programmes

Objective

To compare the prevalence of underweight as calculated from Indian Academy of Paediatrics (IAP) growth curves (based on the Harvard scale) and the new WHO Child Growth Standards.

Methods

We randomly selected 806 children under 6 years of age from 45 primary anganwadi (childcare) centres in Chandigarh, Punjab, India, that were chosen through multistage stratified random sampling. Children were weighed, and their weight for age was calculated using IAP curves and WHO growth references. Nutritional status according to the WHO Child Growth Standards was analysed using WHO Anthro statistical software (beta version, 17 February 2006). The χ² test was used to determine statistical significance at the 0.05 significance level.

Findings

The prevalence of underweight (Z score less than –2) in the first 6 months of life was nearly 1.6 times higher when calculated in accordance with the new WHO standards rather than IAP growth curves. For all ages combined, the estimated prevalence of underweight was 1.4 times higher when IAP standards instead of the new WHO standards were used. Similarly, the prevalence of underweight in both sexes combined was 14.5% higher when IAP standards rather than the new WHO growth standards were applied (P < 0.001). By contrast, severe malnutrition estimated for both sexes were 3.8 times higher when the new WHO standards were used in place of IAP standards (P < 0.001).

Conclusion

The new WHO growth standards will project a lower prevalence of overall underweight children and provide superior growth tracking than IAP standards, especially in the first 6 months of life and among severely malnourished children.     

Nutritional status of Kaingáng Indians enrolled in 12 indigenous schools in the State of Rio Grande do Sul, Brazil

The study's objective was to characterize the nutritional status of 3,254 Kaingáng Indians in indigenous schools in Rio Grande do Sul State, Brazil. This was a school-based study. Weight (W), height (H), and waist circumference (WC) were measured according to World Health Organization guidelines (1995). Children's nutritional status classification included H/A, W/A, and W/H according to the National Center for Health Statistics (WHO, 1995) and H/A, W/A, and body mass index/age (BMI/A) according to WHO (2006). Adolescents were classified for BMI/A (WHO, 1995 and 2006) and H/A (WHO, 2006). Adults were classified for BMI (WHO, 1995) and WC (WHO, 2003). Adolescents represented 56% of the sample, children 42.5%, adults 1.4%, and elderly 0.1%. Prevalence rates for stunting were 15.1% (WHO, 1983) and 15.5% (WHO, 2006) in children and 19.9% in adolescents. Prevalence rates for overweight were 11% (WHO, 1983) and 5.7% (WHO, 2006) in children, 6.7% in adolescents, and 79.2% in adults. 45.3% of adults were at increased risk of metabolic diseases. A nutritional transition was observed in the group, characterized by significant prevalence of stunting in children and adolescents and prominent overweight in all age groups.     

中国西部10省市农村3岁以下儿童贫血状况分析

目的 根据项目地区儿童血红蛋白的测量结果,了解中国西部农村3岁以下儿童的贫血状况,筛选相关因素进行分析并制定干预措施.方法 采用分层随机抽样法,于2005年对中国西部10省46个项目县的9616名3岁以下儿童及其家庭进行调查和血红蛋白测定.应用SPSS 11.5统计软件完成所有资料分析.根据世界卫生组织和联合国儿童基金会提出6月龄至6岁以下儿童血红蛋白＜110 g/L的儿童贫血诊断标准.结果 中国西部10省项目地区3岁以下儿童贫血患病率为33.8%,儿童贫血随月龄变化,12～18月龄是3岁以下儿童贫血患病率的高峰,以后贫血患病率随月龄增加而下降;多因素logistic回归分析显示,儿童月龄、性别、民族、母亲贫血、生长迟缓、铁锅做饭和单独为儿童做饭与儿童贫血有统计学联系.结论 应针对相关影响因素开展干预措施,降低西部农村地区儿童的贫血患病率.     

关爱儿童试点对降低中国西部农村地区3岁以下儿童营养不良的效果分析

目的:分析关爱儿童试点对中国西部农村地区儿童营养不良患病率的影响效果。方法:利用项目基础调查和终末调查中儿童体格测量资料,采用Z评分法评价试点地区和非试点地区3岁以下儿童的营养状况。利用EpiInfo6.0和SPSS13.0软件进行纠错和统计分析。结果:基础调查和终末调查比较,试点地区3岁以下儿童的低体重、生长迟缓患病率均显著降低,低体重患病率的降低幅度显著高于非试点地区;3岁以下儿童消瘦患病率的降低也与非试点地区差异显著。结论:关爱儿童试点对中国西部地区3岁以下儿童营养不良状况的改善有积极作用。     

7岁以下农村儿童体格发育调查

目的:了解江西省农村儿童体格发育水平及营养不良的患病率。方法:通过整群抽样调查江西省农村9238例儿童,所有儿童均由统一培训人员测量身高、体重,以WHO/NCHS标准为参数评价儿童体格发育水平,计算年龄别身高Z值(HAZ)、年龄别体重Z值(WAZ)和身高别体重Z值(WHZ)。分别计算儿童生长迟缓、低体重、消瘦的患病率。结果:我省农村儿童体格发育水平6月以内可达甚至超过WHO标准,6月龄后开始滞后。6月龄内儿童Z值主要分布在0～1和-1～0两个区间;6月龄后逐渐向左移,Z值主要分布于-1～0和-1～-2两个区间。儿童HAZ和WAZ主要分布在-1～0和-1～-2两个区间;而WHZ则以0～1和-1～0两个区间为主。生长迟缓、低体重和消瘦的患病率分别是13.2%、13.0%和2.9%,出生后6月内营养不良检出率最低,以后随年龄增长检出率逐渐增加,生长迟缓率在18～24月龄时达高峰。结论:我省农村儿童体格发育水平与WHO标准仍有一定差距,提示应进一步提高农村卫生水平和加强健康教育,有效改善农村儿童营养状况。     

Patterns of stunting and wasting: potential explanatory factors

We investigated the causes of stunting and wasting using nationally representative data on preschool children from India (2005-2006, N = 41,306) and Guatemala (2008-2009, N = 10,317). We estimated stunting and wasting using the 2006 WHO standard and the 1976 WHO/National Center for Health Statistics (NCHS) reference. India and Guatemala had high levels of stunting; wasting was common in India but rare in Guatemala. Use of the WHO standard (based on breast-fed children) increased the prevalence of stunting in both countries but dramatically changed the pattern of wasting by age in India. In Indian children 0-5 mo of age, wasting more than tripled, from 8% to 30%, leading to the highest prevalence of wasting. Using the NCHS reference, the lowest and highest prevalence among Indian children occurred in children 0-5 and 12-23 mo, respectively. Also, we showed that household wealth and the condition of women were related to both stunting and wasting; review of the literature on wasting failed to identify factors that were not also related to stunting (e.g., seasonality, infections, and intrauterine growth retardation). Possible explanations for high levels of wasting in India include the poor status of women, the "thin-fat" infant phenotype, chronic dietary insufficiency, poor dietary quality, marked seasonality, and poor levels of sanitation. Use of the WHO standard calls for urgent attention to improving prenatal and infant nutrition and uncovers an alarming level of wasting in the young infant in India that use of the NCHS growth reference (based on bottle-fed infants) had masked.     

江苏省4地区0~3岁儿童生长发育及营养状况分析

目的 分析江苏省0~3岁儿童生长发育现况及营养不良状况,为进一步做好江苏省0~3岁儿童保健工作提供参考依据。方法 基于多中心、大样本的动态队列,利用全国儿童营养与健康监测系统资料,选取江苏省4个监测区县,每个区县抽取4个街道(乡镇),将街道(乡镇)辖区内在2016年1月—2019年12月接受健康监测的3岁以下常住健康儿童做为研究对象,利用监测数据对其进行生长发育分析,并与WHO儿童生长发育标准比较,分析和评价儿童体重和身长/高的生长速率,采用Z评分法进行营养状况评价。结果 共收集0~3岁健康儿童体检数据43 518例,各月龄儿童的平均体重、身长/高均显著高于2006年WHO标准(P<0.05);男童各月龄平均体重、身长/高均显著高于女童(P<0.05);男童体重在8月龄前、身长在6月龄前生长速率快于女童(P<0.05)。儿童总体低体重率为0.14%,生长迟缓率为0.28%,消瘦率为0.55%,超重率为3.88%,肥胖率为0.55%;男童的低体重率、生长迟缓率、超重率以及肥胖率均显著高于女童(χ²=6.612, P=0.01; χ²=13.287、89.339、18.732, P<0.001)。结论 江苏省4地区0~3岁儿童生长发育状况良好,营养不良情况仍存在,低体重、消瘦、生长迟缓发生率较低,但儿童超重和肥胖仍是今后儿童保健需要重点关注的问题。     

Growth of breastfed and bottle-fed infants up to 2 years of age: CLACYD (Lactation, Alimentation, Growth and Development) study 1993-1995]

Studies done in various countries show important differences in the growth of breastfed and bottle-fed children. In addition, it has been found that breast-fed children grow more slowly beginning at the age of 2 or 3 months in comparison with the reference pattern of the U.S. National Center for Health Statistics (NCHS) and the World Health Organization (WHO). These results cast doubt on whether maximum growth is the same as optimal growth. The objective of this study was to compare the growth in weight and length, from birth to 24 months, for a group of children who were breast-fed with that of a group who were bottle-fed. The study was also intended to describe the growth of the breastfed group in relation to the NCHS/WHO norms and a WHO "12-month breast-fed pooled data set." For this research, data were analyzed from the "Cordoba: lactation, feeding, growth, and development" study (or CLACYD study, for its Spanish-language acronym). That study looked at a representative cohort, stratified by social class, of children born in 1993 in the city of Cordoba, Argentina. The researchers analyzed anthropometric data on 74 children who were breast-fed during the first year of life and on 108 bottle-fed children. The data had been recorded, using standardized techniques, at birth and at 6, 12, and 24 months of age. Both groups were homogenous with respect to the age and schooling of the parents, social stratum, birth order, maternal height, and child's weight and length at birth. The living conditions (housing construction and availability of water and sewer services) were better among the group that was bottle-fed (P = 0.04). The breast-fed children had a lower weight and a shorter length at 6, 12, and 24 months than did the bottle-fed children. The breast-fed children also showed a slowing in growth with respect to the NCHS/WHO guidelines beginning in the second semester. This indicates that the NCHS/WHO norms are not totally adequate for evaluating the growth of breast-fed children in Cordoba, Argentina. In the high and middle social strata, the values for the breast-fed group resembled those for the WHO "pooled data set," both in weight and length. In the low and very low social strata, weight values were satisfactory, but the figures for length were less than those of the "pooled data set." The gap in length found among the low and very low social strata does not reduce the validity of the WHO "pooled data set" reference, but rather indicates the influence of living conditions on linear growth.