苏北贫困农村学龄前儿童生长发育及营养状况调查

目的 :了解苏北贫困农村学龄前儿童生长发育状况及影响因素 ,为制定儿童健康保障机制提供科学依据。方法 :采用WHO推荐的Z评分方法对儿童生长发育状况进行评价 ,并对儿童的家庭状况、膳食模式等影响因素进行分析。结果 :苏北贫困农村儿童的身高、体重均低于WHO推荐的体格生长标准的第 5 0百分位 ,身高和体重均低于第 3百分位的人数百分比为 4 .2 0 % ,身高低于第 3百分位的人数百分比为 1 7.2 9% ,体重低于第 3百分位的人数百分比为 6 .97%。结论 :母亲文化程度、职业和膳食模式是影响贫困农村学龄前儿童生长发育的主要因素     

学龄前儿童膳食管理现状及干预效果评价

了解学龄前儿童膳食中营养素摄入状况,探讨钙摄入量与生长发育的关系.方法 在武汉市中心城区三餐制示范性幼儿园中随机抽取16所幼儿园儿童5 664名作为研究对象,回顾性调查前3个月的膳食钙摄入量及其他重要营养素摄人量,测量儿童身高、体重,分析钙摄入量与身高、体重五级评价分布关系;采用前瞻性调查分析方法将其中4所低钙摄入量幼儿园分为实验组(113人)和对照组(121人),干预研究1 a后,比较两组膳食中钙摄人量水平以及儿童身高、体重年增长平均值.结果 16所幼儿园横断面现场调查表明,按照我国制定的推荐摄入量RNI标准,幼儿膳食中蛋白质、能量、铁、锌摄入量符合标准,钙摄入量较低(41.9%~81.0%);膳食中钙摄人量占RNI比例<50%组与≥80%组中儿童身高五级评价分布差异有统计学意义(P<0.01).干预后,实验组与对照组儿童平均身高增长值分别为(7.25±0.96),(5.69±0.85) cm,差异有统计学意义(P<0.05),实验组钙摄入水平明显提高.结论 膳食中长期严重缺钙可影响儿童体格发育,并使身高生长速率减缓.幼儿园儿童膳食中钙的摄人量应达到标准供给量80%以上.     

2015年阿坝州学龄前儿童体格生长现状分析

目的 了解阿坝州学龄前儿童生长现状,为改善少数民族地区儿童营养状况提供依据。方法 2015年按整群随机抽样的方法选择阿坝州8个县的城区和乡镇幼儿园,用统一的仪器和方法对4 368名学龄前儿童进行身高、体重、头围和胸围的测量,采用2006年世界卫生组织(WHO)推荐使用的参考标准用Z评分方法,对儿童体格发育及营养状况进行评价。结果 在体格测量值方面,大多数年龄组男童的体重、头围、胸围和BMI均大于女童(P<0.05),不同民族在身高、头围、胸围和BMI方面差异均有统计学意义(P<0.05);学龄前儿童的男女童HAZ和女童WAZ总的平均值均为负值。不同民族和不同城乡儿童身高Z评分(HAZ)和体重Z评分(WAZ)差异具有统计学意义(P<0.05)。结论 阿坝州学龄前儿童体格发育水平落后于WHO标准,应加强托幼机构儿童保健工作。     

裕固族140名3～6岁儿童膳食营养及营养状况评价

目的了解3~6岁裕固族儿童膳食营养及营养状况,为少数民族地区开展营养指导和干预提供基础资料。方法采用随机整群分层抽样的方法,抽取甘肃省肃南裕固族自治县140名3~6岁裕固族儿童,通过24 h回顾法结合记账法进行膳食调查,并测量身高、体重,采用Z评分法进行营养状况评价。结果除维生素A、维生素C摄入量较低外,其他能量及多种营养素的摄入量与中国其他民族儿童比较接近;体格发育状况也比较乐观,基本达到2005年中国9个城市儿童体格发育调查结果及WHO的标准;调查对象存在消瘦和超重现象,未出现生长迟缓及肥胖。结论裕固族学龄前儿童营养状况基本接近中国其他民族儿童及WHO标准。建议增加该群体新鲜蔬菜、水果、肉类等食物的摄取,结合营养教育,加强平衡膳食理念的宣传,以进一步改善营养状况。     

江苏贫困地区学龄前儿童生长状况及影响因素

以WHO推荐的NCHS体格生长参考标准,用SPSS软件对苏北贫困地区的2000名0～5岁学龄前儿童的生长发育情况及影响因素作了分析。结果表明:贫困地区农村儿童的身高、体重均低于NCHS第50百分位,身高和体重都低于第3百分位的人数百分比为4.2％,身高低于第3百分位的人数百分比为17.29％,体重低于第3百分位的人数百分比为6.97％。母亲文化程度、职业和膳食模式是影响贫困地区学龄前儿童生长发育的主要因素。     

唐山市学龄前儿童生长发育监测结果分析

目的:了解唐山市第一幼儿园学龄前儿童生长发育和营养状况,以便为制定学龄前儿童保健措施提供依据,改善儿童营养状况,促进生长发育。方法:采用分层抽样方法抽取唐山市第一幼儿园3～6岁的儿童144人,进行身高和体重测量。采用Z评分法和Kaup指数进行营养状况评价。结果:唐山市第一幼儿园学龄前儿童身高和体重均明显高于WHO推荐的标准值,低体重和消瘦的发生率分别为1.4%和2.1%,肥胖和超重的发生率分别为5.6%和3.5%,生长迟缓的发生率0.7%。结论:唐山市第一幼儿园学龄前儿童体格生长发育总体良好。     

温州市1～7岁儿童生长发育指标的调查

[目的]为了准确地了解温州市1～7岁儿童的生长发育及营养情况.[方法]收集了温州市不同城区的82所幼儿园的17133例儿童,由专业人员进行严格的身高、体重测量.[结果]与全国九城市(1995年)标准比较:身高方面:男性儿童2岁组,女性儿童18月、2.5岁身高均值高于全国9城市标准.体重方面:男性儿童2.5岁,女性儿童18月、4岁体重均值高于全国九城市标准.与WHO推荐的标准(1997年)比较:身高方面:男性儿童除3岁、4岁组,女性儿童除3.5岁组无差异外,其余均高于WHO推荐的标准.体重方面:男性儿童除3.5岁无差异外,其余均高于WHO推荐的标准.[结论]该市1-7岁儿童的身高、体重呈快速增长趋势,营养状况处于优质水平.反映了近年来该市1～7岁儿童体格发育水平和营养水平有了很大提高,而WHO推荐(1997年)的身高和体重标准已难以适应现阶段我国儿童生长发育的评价.     

幼儿园膳食进餐模式优化与儿童体格发育情况的观察研究

目的探讨不同膳食进餐模式对幼儿园儿童生长发育及营养状况的影响。方法选取某幼儿园2014年9月至2016年6月的1 379名学龄前儿童作为传统组(实施三餐一点制,午后起床吃点心),以该幼儿园2016年9月至2018年6月的1 220名学龄前儿童作为观察组(实施三餐一点制,上午九点半吃点心),比较两组学龄前儿童的身高、体重、贫血发生率等体质发育情况。结果观察组学龄前儿童身高、体重等指标优于传统组(P0.05),而两组在肥胖、消瘦、贫血的发生率和发育迟缓方面的差异无统计学意义(P0.05)。结论优化三餐一点制,上午9点半吃点心的膳食进餐模式可促进学龄前儿童的体格发育,儿童点心如何做到更加个性化的营养搭配,还需要进一步探讨和实践。     

2007年学龄前儿童体格发育状况及评价

目的:了解城乡学龄前儿童体格发育、营养状况及缺点疾病发生情况。方法:按照《中国0～7岁儿童体格发育调查实施方案》对35所托幼机构的2789名3～6岁儿童进行身高、体重等测量。结果:城区学龄前儿童体格发育达均值的占94.39%,农村学龄前儿童达均值的占88.3%,两者差异有显著性(P0.01);农村学龄前儿童体重、身高达均值率、缺点疾病发生率与城区比较有显著性差异。结论:城乡学龄前儿童体格发育状况与WHO标准仍有一定差距,应加大对公共教育事业的投入,为儿童的身心健康营造良好的环境。     

上海市7岁以下儿童30年身高、体重变化的研究

【目的】观察30年来上海男女儿童体重身高的变化,研究儿童体重身高增长的规律。【方法】于1975、1985、1995、2005年在上海19个区县开展正常0~6岁儿童体格发育调查研究。将0~6岁分成22个年龄组,按随机整群抽样原则,调查城、郊、男、女,每个年龄组>200名以上,按规范进行体重身高的测定,采用SPSS10.0软件包进行数据分析。【结果】①30年来上海儿童体重、身高呈持续和显著地增长;②市区男女童体重身高增长值幅度最大是第二个10年(1985~1995),增长值幅度最小2岁前是第三个10年(1995~2005),2岁后第一个10年(1975~1985)。郊区男女童体重身高增长值幅度最大是第三个10年,余依次为第二个10年、第一个10年。③2005年上海城区体重和身高指标基本超过WHO指标(1997年),郊区基本达标大部分超过WHO指标(1997年),少量年龄组未达WHO指标;④上海儿童体重、身高测量值仍存在城郊差异,城郊体重、身高差在1985、1995比1975年有上升,但2005年差值明显下降,2005年体重、身高城郊差的差值与1975、1985、1995年相比显著缩小。【结论】①上海儿童体重身高的增长呈现生长发育的长期趋势,城区增长速度已下降,郊区仍处于持续快速增长阶段;②上海儿童各年龄组体重身高的测定值大多数≥WHO指标(1997年);身高别体重,在婴儿期、学龄前均超过WHO标准;③上海儿童体重身高测量值仍存在城郊差异。     

不同方式补充铁对学龄前儿童生长发育和铁营养状况的影响

目的　观察每日补充铁与间歇性补充铁对学龄前儿童生长发育和铁营养状况的影响。方法　选择日托幼儿园 3～ 6岁儿童 35 3名 ,按整群随机的原则按班分为 3组 ,分别为每日补充组 ( 1周 5次 ,周一至周五 ) ,每周补充一次组 ,安慰剂对照组。补充期为 14周。结果　每日补充组和每周补充一次组儿童的血红蛋白和血清铁蛋白含量均显著升高 (P <0 0 5 ) ,其中每周补充一次组儿童血红蛋白显著高于对照组 (P <0 0 5 ) ,红细胞游离原卟啉含量显著低于对照组 (P <0 0 5 )。干预结束后 ,两个补充组儿童的铁缺乏率显著低于对照组 ;每日补充组儿童的体重增长 ( 0 74± 0 5 5 )kg ,显著高于对照组的 ( 0 5 6± 0 5 7)kg。结论　补充多种微量营养素可以改善儿童的生长发育状况。对于铁缺乏较轻的儿童 ,可采用间歇性补充铁替代每日补充铁来改善铁营养状况     

不同剂量维生素A强化饼干对学龄前儿童健康影响的研究

【目的】　比较三种不同剂量强化维生素A(VA)对改善学龄前儿童维生素A和铁营养状况的效果 ,探索预防VA缺乏性疾病 (VADD)的强化饼干的理想剂量。　【方法】　将 75 3名观察对象随机分为 4组 ,前两组分别给3 0 %RNI和 10 0 %RNIVA强化饼干每天一次 ,后两组分别每周给VA2万IU强化饼干一次及补充VA2 0万IU胶丸一次 ,除 3 0 %RNI组补充 9个月外 ,其余三组补充 3个月。干预前后观察血清VA、Hb、血清前白蛋白 (PA)、血清视黄醇结合蛋白 (RBP)、身高和体重的变化。　【结果】　干预前后 ,各组儿童VADD和贫血的检出率明显降低 (P <0 .0 5 ) ;补充 3月后自身对照除 3 0 %RNI组PA和Hb外 ,四组其余指标均明显升高 (P <0 .0 5 ) ;组间比较 ,2万IU组血清VA升高幅度明显大于其余组 ,3 0 %RNI组Hb、PA和身高的增加幅度明显小于其它组 (P <0 .0 5 ) ;补充 9月后 ,3 0 %RNI组Hb和PA的升高明显大于其余组 (P <0 .0 5 )。　【结论】　补充三种不同剂量VA强化饼干和 2 0万IUVA胶丸 ,均可明显改善VA和铁营养状况 ,长期补充 ,3 0 %RNI和 10 0 %RNI强化剂量可能更佳     

Vitamin A supplementation selectively improves the linear growth of indonesian preschool children: results from a randomized controlled trial

BACKGROUND: Vitamin A deficiency is associated with stunting and wasting in preschool children, but vitamin A supplementation trials have not shown a consistent effect on growth. OBJECTIVE: We examined the effect of vitamin A supplementation on height and weight increments among Indonesian preschool children. DESIGN: Data were obtained from a randomized, double-masked, placebo-controlled trial of rural Javanese children aged 6-48 mo. Children received 206000 IU vitamin A (103000 IU if aged <12 mo) or placebo every 4 mo. RESULTS: High-dose vitamin A supplementation modestly improved the linear growth of the children by 0.16 cm/4 mo. The effect was modified by age, initial vitamin A status, and breast-feeding status. Vitamin A supplementation improved height by 0.10 cm/4 mo in children aged <24 mo and by 0.22 cm/4 mo in children aged >/=24 mo. The vitamin A-supplemented children with an initial serum retinol concentration <0.35 micromol/L gained 0.39 cm/4 mo more in height and 152 g/4 mo more in weight than did the placebo group. No growth response to vitamin A was found among children with an initial serum retinol concentration >/=0.35 micromol/L. In non-breast-fed children, vitamin A supplementation improved height by 0.21 cm/4 mo regardless of age. In breast-fed children, vitamin A supplementation improved linear growth by approximately 0.21 cm/4 mo among children aged >/=24 mo, but had no significant effect on the growth of children aged <24 mo. CONCLUSION: High-dose vitamin A supplementation improves the linear growth of children with very low serum retinol and the effect is modified by age and breast-feeding.     

Effect of zinc supplementation on the dietary intake and weight gain of Bangladeshi children recovering from protein-energy malnutrition

Sixty severely malnourished children aged between 5 and 60 months were studied during nutritional rehabilitation. They all received a rice-based diet ad libitum plus vitamins and iron supplementation. Thirty children received zinc supplements (10 mg/kg/d for those weighing less than 6 kg and 50 mg daily for those over 6 kg) on a random basis. Zinc was started from the 15th hospital day when they were free of infection and continued for a period of 3 weeks. Both groups had a mean energy intake of 200 kcal/kg/d, but the majority of the supplemented children had a better rate of weight gain: 66 per cent of the supplemented compared with 33 per cent of the controls gained more than 10 g/kg body weight/d. Moreover, 76 per cent of the supplemented children compared with 23 per cent of the controls were over 90 per cent of Harvard median weight for height on discharge. It appears from this study that zinc supplementation promotes growth and enhances the rate of clinical recovery from severe PEM.     

Severe linear growth retardation in rural Zambian children: the influence of biological variables

BACKGROUND: The prevalence of stunting in preschool children in Zambia is high; stunting has detrimental effects on concurrent psychomotor development and later working capacity. OBJECTIVE: Our objective was to investigate biological variables that may contribute to linear growth retardation in preschool children in Samfya District, Zambia. DESIGN: Children aged 6-9 mo (n = 108) and 14-20 mo (n = 102) attending mother-and-child health clinics were included. With a mixed-longitudinal design, they were followed up 9 and 21 mo later. Height and weight of children and their mothers were measured. Biochemical measures (eg, serum zinc, retinol, thyrotropin, iron, and acute phase protein concentrations), malaria parasitemia, and intestinal parasitosis were assessed. RESULTS: Height-for-age z scores (HAZ) were low, indicating a high prevalence of stunting (36-79%). Ninety percent of the children were anemic, 53-71% had elevated acute phase proteins, and 80% had malaria parasitemia. Regression analyses showed that maternal height predicted the children's height at 6-9 mo (regression coefficient = 0.05; 95% CI: 0.02, 0.08). The children's height at an early age (6-9 and 14-20 mo) showed a strong relation with their height at later ages (22-30 and 34-41 mo). Serum micronutrient status did not show a significant relation with later HAZ. CONCLUSION: Unlike other studies, we did not identify specific biological factors, such as health and micronutrient status, which contribute to the retardation of linear growth. The normal zinc and iodine statuses of the children suggest that at least these factors are not causal.     

补锌等微量营养素对儿童体格发育的影响

目的：探讨不同补锌方法对学龄前儿童体格发育的影响。方法：480名6～7岁儿童（城乡各半,男女各半）分为三组：单纯朴锌组（Zn组）,不含锌的微量营养素组（M组）和锌加微量营养素组（Zn＋M组）。受试儿童均摄入正常膳食,实验期间（10周）每人每天补充药丸一粒。实验于1994年春、1994年秋、1995年春和1995年秋分四次进行。结果：发现补充多种微量营养素对促进儿童身高体重的增长的效果明显优于单纯补锌（P＜0．05）。结论:说明复合微量营养素的补充能明显促进儿童的生长发育,在补锌的同时必须注意其它营养素的均衡补充。     

Vitamin A and zinc supplementation of preschool children.

OBJECTIVE: To determine whether supplementation of vitamin A and/or zinc (Zn) improved serum levels of these nutrients and/or height and weight gains in preschool children, 22 to 66 months, living in Belize, Central America. METHODS: Subjects received either Zn, vitamin A, Zn and vitamin A or a placebo, (70 mg Zn and/or 3030 RE vitamin A, once per week) for 6 months in a 2x2 factorial design. Forty-three children, from a population of 104 prescreened, completed the study; they were selected, prior to treatment, for low/marginal serum concentrations of these micronutrients. RESULTS: Serum Zn levels were greater (16%, p<0.001) for those who received Zn. In contrast, after vitamin A treatment there were no differences in serum vitamin A among groups. Although increases in height (+4.4 cm, p<0.001) and weight (+0.79 kg, p<0.001), compared with baseline values, were numerically greatest for children who received both supplements, only the vitamin A supplementation effect was significant, resulting in increased height (+1.4 cm, p<0.002) and greater weight gain (+0.15 kg, p<0.03) compared to those receiving no vitamin A. Vitamin A supplementation alone significantly increased (p<0.001) hemoglobin concentration. CONCLUSION: The results suggest that the preschool children in this study, prescreened for low/marginal serum concentrations from a larger population prior to treatment, were enduring inadequate vitamin A and, to a lesser degree, Zn nutriture. Height and weight gain were significantly increased in the subjects who received a single weekly supplement 3030 RE of vitamin A.     

Effect of zinc supplementation on growth and body composition in children with sickle cell disease

BACKGROUND: Poor growth and delayed maturation in children with sickle cell disease (SCD) may be due, in part, to mild zinc deficiency. OBJECTIVE: The objective was to determine the effects of zinc supplementation on growth and body composition in children with SCD. DESIGN: Forty-two prepubertal children (20 girls and 22 boys) aged 4-10 y with SCD-SS were randomly assigned to receive 10 mg elemental Zn/d in cherry syrup (zinc group) or cherry syrup alone (control group). The 2 groups were stratified by sex and initial height status. Dietary intakes were evaluated and anthropometric, high-precision knee-height, and plasma zinc measurements were made at baseline and at 3, 6, and 12 mo. Body composition was determined every 6 mo with dual-energy X-ray absorptiometry, and z scores for anthropometric variables were computed from national reference data. Longitudinal-mixed-effects analysis was used to test for differences between the groups over the 12-mo observation period. RESULTS: Thirty-eight children completed the study. No significant differences were observed at baseline. After 12 mo, the zinc group had significantly greater mean (+/- SE) increases in height (0.66 +/- 0.29 cm/y), sitting height (0.97 +/- 0.40 cm/y), knee height (3.8 +/- 1.2 mm/y), and arm circumference z scores (0.27 +/- 0.12 cm/y). Height-for-age and weight-for-age z scores decreased significantly by 0.11 +/- 0.04 and 0.13 +/- 0.05, respectively, in the control group but did not change significantly in the zinc group. CONCLUSIONS: Prepubertal children with SCD-SS may have zinc deficiency and may benefit from zinc supplementation to improve linear growth and weight gain.     

Benefit of vitamin A supplementation on ascaris reinfection is less evident in stunted children

Despite the common coexistence of vitamin A deficiency and Ascaris infection in preschool children in developing countries, and despite the widespread use of vitamin A supplements, remarkably little is understood about the impact of vitamin A supplementation on this gastrointestinal nematode. The Ministry of Health of Panama recently initiated a vitamin A supplementation program in rural indigenous populations. We took advantage of this initiative to assess the benefit of 200,000 IU (60 mg retinol) vitamin A on reinfection with Ascaris following deworming. Baseline stool exams, anthropometry, and socio-economic data were collected for 328 preschool children from 12-60 mo of age (106 supplemented within previous 3 mo and 222 unsupplemented within previous 6 mo). All children were dewormed with albendazole, and reinfection levels were monitored 3 and 5 mo later. Baseline prevalence of Ascaris was 79.5%. Stepwise regression showed that Ascaris intensity was lower in Vit A-supplemented children at baseline and 3 mo after deworming, but not after 5 mo. As 61% of the children were stunted, the impact of supplementation on Ascaris reinfection was examined separately for stunted and children of normal height. Prevalence and intensity of Ascaris at baseline and 3 mo after deworming were lower in children of normal height, but in stunted children the benefit was restricted to those who were dewormed within 6 wk of supplementation. Our study provides evidence that combined vitamin A supplementation and deworming reduces Ascaris reinfection in children living in areas of chronic parasitosis, but that the duration of the benefit is less in stunted children.     

The efficacy of micronutrient supplementation in reducing the prevalence of anaemia and deficiencies of zinc and iron among adolescents in Sri Lanka

OBJECTIVE: To determine the effectiveness of combined iron and zinc over the iron or zinc-only supplementation in correcting deficiency and possible interactive effects in a group of adolescent school children. SUBJECTS AND METHODS: Schoolchildren (n=821) of 12-16 years of age were randomized into four groups and supplemented with iron (50 mg/day), zinc (14 mg/day), iron+zinc or placebo capsules 5 days per week for 24 weeks. Anthropometry, and haemoglobin (Hb), serum zinc (SZn) and serum ferritin (SF) concentrations were determined before and after the intervention. RESULTS: There were no significant effects between-groups in their weight, height and Hb concentrations with the intervention when compared with the placebo group. Iron-only and combination-supplemented groups had reached mean SF concentrations of 55.1 microg/l with no difference between them (P=0.99). The zinc-only group had a mean change of 4.3 micromol//l whereas the combine-supplemented group had a mean change of 4.0 micromol/l (P=0.82). The prevalence of anaemia was found to be 70.3% in the iron group at baseline; this was reduced to 14.5% after the supplementation. In the combine-supplemented group anaemia, prevalence was reduced from 64.8 to 19.3%. CONCLUSIONS: Zinc alone or in combination with iron has not shown a significant improvement in growth in adolescence. Severe and moderate forms of anaemia were successfully treated in children who received iron supplementation. Initial high prevalence of low SZn and iron stores was significantly improved with micronutrient supplementation.