西藏0~5岁儿童母乳喂养时间与生长迟缓的关联研究

目的 探讨西藏自治区0~5岁儿童母乳喂养时间与生长迟缓的关联。 方法 采取分层、多阶段、与规模成比例的PPS方法和整群抽样方法抽取3136名0~5岁儿童进行问卷调查和体格检查。采用多因素logistic模型分析母乳喂养时间对儿童生长迟缓的影响。 结果 2020年西藏0~5岁儿童生长迟缓率为15.37%,6个月、12个月和24个月持续母乳喂养率分别为63.10%、28.70%和6.92%。多因素logistic回归模型显示,调整个体特征、家庭因素和社会环境因素后,与母乳喂养时间＜6个月的儿童相比,母乳喂养时间为12~＜24个月和≥24个月的儿童生长迟缓的OR值（95%CI）分别为1.91（1.43~2.53）和1.75（1.15~2.66）。 结论 西藏0~5岁儿童母乳喂养时间≥12个月与生长迟缓患病风险相关,在倡导延长母乳喂养时间的同时,应加强对科学喂养知识和技能的健康教育。     

Nutrition in Chinese-Korean Children and Adolescents

ObjectiveTo study the nutrition habits among Chinese-Korean children and adolescents in Yanbian Autonomous Prefecture, Jilin, China. MethodsData were obtained from the Chinese National Survey on Students’ Constitution and Health in 1995, 2000, 2005, and 2010 for Chinese-Korean children and adolescents aged 7-18 years.The number of the subjects included was 4789, 4704, 5875, and 5315, respectively. ResultsThe rate of the occurrence of stunting showed a declining trend from 1995 to 2010 (for boys:urban, 6.3%; rural, 12.7% in 1995 and 3.5% for both in 2010. For girls: urban, 7.8%; rural, 13.4% in 1995 and 4.2% and 5.5%, respectively, in 2010). Although the ratio of wasting did not show significant differences between the urban and rural children and adolescents in 1995, 2000, 2005, and 2010 respectively, the ratio of occurrence of overweight or obesity increased (for boys: urban, 7.3% and 1.3%in 1995, 17.6% and 12.9% in 2010; rural, 7.0% and 1.3% in 1995, 14.6% and 12.8% in 2010, respectively. For girls: urban, 8.1% and 1.0% in 1995, 17.3% and 8.6% in 2010; rural 5.7% and 0.7% in 1995, 16.4%and 7.4% in 2010, respectively). ConclusionThe ratio of malnutrition in children and adolescents in Chinese-Korean areas declined from 1995 to 2010, and the distinction in malnutrition between the urban and rural areas was negligible in 2010. Further, the ratio of overweight and obesity increased over this period.     

1990年、1995年北京市5岁以下儿童营养状况分析比较

本文采用NCHS/WHO标准为参照人群,以年龄别体重、年龄别身高、身高别体重为评价指标,用Z评分法分别对1990年、1995年北京市5岁以下儿童体格发育及营养状况抽样调查资料进行评价,并分析比较两次调查资料。结果显示5岁以下儿童体重低下、生长迟缓、消瘦3项指标患病率1995年均比1990年下降,下降幅度分别为61.38％、54.19％、44.02％。3项指标各年龄组Z评分均值有所增加(除6～11月龄外),提示1995年北京市5岁以下儿童营养状况比1990年有明显改善。     

Nutritional status of adolescents in rural Wardha

Objective| The objective of the study was to study the nutritional status of adolescents in rural area of Wardha.Methods: The cross-sectional study was carried out in two PHC areas of Wardha district with two stage sampling method. In the first stage, cluster-sampling method was used to identify 30-clusters in each Rural Health Training Centre (RHTC) area separately. In the second stage, systematic random sampling method was used to identify 10 households per cluster. All adolescents in the household thus selected were included in the study. The mean body mass index (BMI) for age was used for classifying the nutritional status with CDC 2000 reference. Data thus generated was entered and analyzed using epi_info 2000.Results: Overall, 53.8% of the adolescents were thin, 44% were normal and 2.2% were overweight. The mean body mass index (BMI) for boys and girls was 16.88 and 15.54 respectively. The difference was statistically significant (p<0.05). The prevalence of thinness was significantly (p<0.05) higher in early adolescence, girls, lower education (<8^th standard) and lower economic status.Conclusion: Majority (53.8%) of the adolescents in this study area are thin and only 2.2% were overweight.     

Association of Anti-Rotavirus IgA Seroconversion with Growth,Environmental Enteric Dysfunction and Enteropathogens in Rural Pakistani Infants

BackgroundThe underperformance of oral vaccines in children of low- and middle-income countries is partly attributable to underlying environmental enteric dysfunction (EED).MethodologyWe conducted a longitudinal, community-based study to evaluate the association of oral rotavirus vaccine (Rotarix®) seroconversion with growth anthropometrics, EED biomarkers and intestinal enteropathogens in Pakistani infants. Children were enrolled between three to six months of their age based on their nutritional status. We measured serum anti-rotavirus immunoglobulin A (IgA) at enrollment and nine months of age with EED biomarkers and intestinal enteropathogens.ResultsA total of 391 infants received two doses of rotavirus (RV) vaccine. 331/391 provided paired blood samples. Of these 331 children, 45% seroconverted at 9 months of age, 35% did not seroconvert and 20% were seropositive at baseline. Non-seroconverted children were more likely to be stunted, wasted and underweight at enrollment. In univariate analysis, insulin-like growth factor (IGF) concentration at 6 months were higher in seroconverters, median (25th, 75th percentile): 26.3 (16.5, 43.5) ng/ml vs. 22.5 (13.6, 36.3) ng/ml for non-seroconverters, p-value = 0.024. At nine months, fecal myeloperoxidase (MPO) concentrations were significantly lower in seroconverters, 3050(1250, 7587) ng/ml vs. 4623.3 (2189, 11650) ng/ml in non-seroconverted children, p-value = 0.017. In multivariable logistic regression analysis, alpha-1 acid glycoprotein (AGP) and IGF-1 concentrations were positively associated with seroconversion at six months. The presence of sapovirus and rotavirus in fecal samples at the time of rotavirus administration, was associated with non-seroconversion and seroconversion, respectively.ConclusionWe detected high baseline RV seropositivity and impaired RV vaccine immunogenicity in this high-risk group of children. Healthy growth, serum IGF-1 and AGP, and fecal shedding of rotavirus were positively associated with RV IgA seroconversion following immunization, whereas the presence of sapovirus was more common in non-seroconverters.Trial registration: Clinical Trials ID: NCT03588013.     

Application of the WHO Growth Reference （2007） to Assess the Nutritional Status of Children in China

Objective To assess the nutrition status of children and adolescents in China using the WHO growth reference （2007） in comparison with that defined by the International Obesity Task Force （IOTF） and the Working Group on Obesity in China （WGOC）. Methods Overweight and obesity were defined by age-, sex-, specific BMI reference developed by WHO （2007）, IOTF （2000）, and WGOC （2004）, respectively. Stunting and thinness were defined as height and BMI less than two standard deviations （SD） of the WHO growth reference （2007）, respectively. Data of children and adolescents aged 5 to 19 years （n=54 857, 28 273 boys, 26 584 girls） from the 2002 China National Nutrition and Health Survey （CNNHS） were used in the study. Results The prevalence of overweight, obesity, stunting and thinness among Chinese children and adolescents aged 5-19 years was 5.0%, 1.2%, 13.8%, and 7.4%, respectively when the WHO growth reference （2007） was used, whereas the estimated absolute total number affected by these 4 conditions were 14.6, 3.7, 40.6, and 21.8 million, respectively. The prevalence of overweight and obesity was 18.1% in large cities, while the stunting prevalence was 25.1% in rural 4. Obesity prevalence assessed by the WHO growth reference was higher than that as assessed by the IOTF reference, and obesity prevalence assessed by the WGOC reference was lower than that as assessed by the IOTF reference. Conclusion The nutritional status of children and adolescents is not equal in different areas of China. Stunting is still the main health problem of the poor, while overweight and obesity are the main health problems in large cities.