安徽省0～5岁儿童亚临床维生素A缺乏患病率及其影响因素

[目的]描述安徽省儿童亚临床维生素A缺乏（sub-clinical vitamin A deficiency,SVAD）患病率分布情况,分析其影响因素,为当地制定维生素A（vitamin A,VA）缺乏防治措施提供科学依据.[方法]抽样调查安徽省1市4县1052名6岁以下儿童.以微量荧光法测定其血清VA含量（SROL）,通过问卷调查儿童的社会家庭因素、喂养情况、近期患病等情况.[结果]加权调整后,0～5岁儿童SVAD患病率为5.8%,农村（7.7%）高于城市（2.1%）;SVAD患病率随年龄组增加有逐渐降低趋势,其中0～岁（11.8%）和1～岁组（8.3%）高发;男女儿童之间患病率差别无显著性.多因素分析结果表明母亲职业为农民（OR=0.30,95%CI：0.12-0.80）,家庭规模（4～5人OR=3.03,95%CI：1.51～6.10;6人及以上OR=4.06,95%CI：1.72～9.58）以及母乳喂养（OR=2.44,95%CI：1.02～5.86）为儿童SVAD影响因子.[结论]SVAD在人群和地区中分布不平衡.将防治重点放在农村、低龄、家庭规模大的儿童,在乳母和母乳喂养儿童增补VA制剂,加强营养知识宣传普及等措施对防治儿童SVAD可能有积极意义.     

武汉市集体儿童维生素A营养水平的现状调查

目的:了解武汉市集体儿童维生素A营养水平的现状,以及维生素A水平与贫血及生长发育的关系。方法:选择武汉市具代表性的14所幼儿园5 467名在园儿童,以微量荧光光度法测定血清维生素A,以及血细胞三分类检测血红蛋白值,按中国生长发育监测标准测量身高、体重。结果:武汉市集体儿童血清维生素A的平均值为(1.83±0.62)μmol/L,高于2000年全国调查的平均水平〔(1.06±0.33)μmol/L〕。亚临床维生素A缺乏患病率为2.09%,可疑亚临床维生素A缺乏患病率为7.96%。儿童血清维生素A水平与性别、年龄有关,维生素A缺乏儿童贫血患病率高,维生素A缺乏儿童身高、体重均值较正常儿童低。结论:武汉市集体儿童维生素A缺乏不容忽视,应根据国家维生素A缺乏防治方案,积极推广科学的喂养知识,给儿童及时添加富含维生素A的食物。     

湖北省0～6岁儿童维生素A营养状况调查

【目的】　了解湖北省 0～ 6岁儿童血清维生素A营养状况及影响因素。　【方法】　采用家庭儿童饮食问卷和血清维生素A值评价 6 2 4例儿童的血清维生素A状况。　【结果】　湖北省 0～ 6岁儿童血清维生素A平均水平为 ( 32 .46± 8.33) μg/dl。低于 2 0 μg/dl者占 4.6 5 %,低于 30 μg/dl者占 35 .2 5 %。血清维生素A水平城乡之间比较有显著性差异 (P <0 .0 1)。儿童维生素A缺乏与父母文化程度高低、家庭经济收入状况和儿童膳食中维生素A供给不足有关。性别和年龄对血清维生素A水平无明显影响。　【结论】　维生素A缺乏病是多因素相互作用的结果 ,是可以预防的疾病。亚临床维生素A缺乏病是今后防治重点。对家长进行科学平衡膳食的健康教育 ,改善儿童膳食行为 ,能有效地降低儿童维生素A缺乏病的患病率。     

武汉市5岁以下儿童维生素A营养状况及其影响因素研究

[目的]了解武汉市5岁以下儿童维生素A营养状况及其影响因素,为制定相应干预措施提供依据。[方法]分层整群抽取武汉市5个中心城区和2个远城区的1270名0～5岁儿童进行问卷调查和血清维生素A含量测定。[结果]5岁以下儿童血清维生素A水平为(1.87±0.77)μmol/L。亚临床维生素A缺乏症发生率为3.39%,可疑亚临床维生素A缺乏症发生率为7.32%。维生素A缺乏在各年龄组之间有统计学差异,性别之间差异无统计学意义。母亲文化程度、家庭人均收入、近1周食用乳、蛋等、近1月服用维生素A制剂、2周内患呼吸系统疾病和腹泻是亚临床维生素A缺乏的影响因素。[结论]亚临床维生素A缺乏是5岁以下儿童维生素A缺乏的主要表现形式,建议将亚临床维生素A缺乏的预防和干预纳入儿童保健工作常规。     

沈阳市城区0—6岁儿童亚临床维生素A缺乏病流行病学调查

【目的】　了解沈阳市城区 0～ 6岁儿童血清维生素A水平。　【方法】　对市内五区的 10 784名儿童采用微量荧光光度法检测血清维生素A含量。　【结果】　血清维生素A平均水平为 (1.2 0± 0 .44) μmol/L ,0 .7～ 1.0 5 μmol/L占 3 3 .10 %。 0 .3 5～ 0 .69μmol/L占 10 .5 0 %。 3岁儿童血清维生素A水平较低。 　【结论】　①亚临床维生素A缺乏病发病率较高。②膳食中含维生素A丰富的食物供给不足是亚临床维生素A缺乏病患病的直接原因。③维生素A缺乏病可影响儿童体格发育     

我国0～6岁儿童血清维生素A水平调查

【目的】　调查我国 0～ 6岁儿童的维生素A(VA)营养状况。　【方法】　以分层抽样法将全国划分为沿海、内地和边远三层 ,抽取 1 4个省、市、自治区的 8669名儿童进行问卷和血清VA含量测定。以FoxBase建立数据库 ,以Epinfo软件统计分析 ,计量资料用F、t检验和多元回归处理。　【结果】　儿童血清VA均值为(1 .0 6± 0 .33) μmol/L ,亚临床维生素A缺乏 (SVAD)患病率为 1 1 .7%。儿童血清VA水平随着年龄的增长 ,富含VA食物摄入频率的增加 ,所在地区呼吸道、发热、腹泻发病率的降低 ,家庭年人均收入和所在地区年人均国民生产总值 (GNP)的升高 ,母亲受教育程度的升高而逐渐升高(P均 <0 .0 0 0 )。儿童血清VA水平 ,取血前 2周内曾患呼吸道感染、发热、腹泻者明显低于未曾患病者。母亲是少数民族者明显低于母亲是汉族者 (P均 <0 .0 0 0 )。多元回归结果表明 :年龄小 ,未食用乳、蛋、鱼虾、肝炎、鱼肝油 ,曾患呼吸道感染、腹泻 ,所在地区及家庭经济状况差 ,母亲文化程度低 ,母亲为少数民族是其血清VA水平低下的危险因素。　【结论】　我国儿童血清VA含量尚处于较低水平     

新乡市0～5岁儿童维生素A水平及其影响因素分析

目的:掌握新乡市0～5岁儿童维生素A状况。方法:测定新乡市0～5岁998名儿童血清Vit A水平,并调查儿童膳食结构、患病情况、父母文化程度等。结果:新乡市儿童VitA整体水平(29.56±7.12)μg/dl,亚临床维生素A缺乏(SVAD)总检出率为7.1%,城市高于农村;SVAD检出率<6个月儿童组最高,随年龄增大,SVAD检出率逐渐下降。采血前1周摄入富含Vit A食物、父母为大专以上文化程度的儿童SVAD检出率较低。结论:新乡市0～5岁儿童VitA轻度缺乏,通过提倡母乳喂养、及时添加辅食、加强健康教育、定期监测儿童Vit A水平等措施来提高儿童VitA水平。     

徐闻县0～5岁儿童血清维生素A营养状况分析

目的了解徐闻县0～5岁儿童血清维生素A(VA)营养状况,分析其影响因素,为干预措施的制订提供切实依据。方法以分层整群方式抽取徐闻县儿童1 268名,开展问卷调查,并测定其血清VA含量。结果在1 268名儿童当中,0～5岁儿童的血清VA水平为(1.86±0.76)μmol/L。亚临床维生素A缺乏(SVAD)发生率为3.31%、可疑SVAD发生率为7.18%。各年龄组间维生素A缺乏(VAD)情况比较,差异有统计学意义(P0.05),所呈现特点为年龄越小,其发生率越高。近1个月服用VA制剂、家庭人均收入、母亲文化程度及近1周食用乳、蛋等是诱发SVAD的主要影响因素。常吃蔬菜水果组SVAD发生率明显低于少吃蔬菜水果组,差异有统计学意义(P0.05)。结论徐闻县0～5岁儿童VAD的典型表现为SVAD,建议将其划归到儿童保健常规工作当中。     

2010年四川省儿童血清维生素A水平分析

目的 了解四川省儿童维生素A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2 182名0～5岁儿童,采用高效液相色谱法检测其血清维生素A含量,评价维生素A缺乏状况.结果 四川省0～5岁儿童血清维生素A平均水平为0.39 μg/ml,城市为0.40 μg/ml,农村为0.38μg/ml,血清维生素A水平存在城乡和年龄差异.儿童血清维生素A缺乏和边缘缺乏率分别为4.95％及19.44％.结论 四川省儿童血清维生素A水平较高,维生素A缺乏率较低.边缘维生素A缺乏病是今后防治工作的重点.建议采取相应措施降低儿童维生素A缺乏.     

内蒙古西部0～5岁儿童血清维生素A水平调查

目的：为了解内蒙古西部0－5岁儿童维生素A水平。方法：按照随机整群抽样的原因，随机抽取我区西部一市、一牧业旗、一农业县共计636名儿童，采用微量血荧光法检测维生素A含量。结果：我区西部0－5岁儿童血清维生素A含量城市，农牧区，总体均值分别为30．8μg/dl,25.6μg/dl,27.4μg/dl(1μg/dl=0.0349μmol/L），均低于全国14省水平。其中城市与农村，城市与牧区间有显著差异，而农村与牧区间无差异。儿童血清维生素A水平与父亲文化程度无关，而随母亲文化程度（文盲组除外）的增高而增高。2周内腹泻和发热的儿童血清维生素A水平明显低于2周内无病儿童，结论：提示我区西部0－5岁儿童维生素A缺乏较多见，消除维生素A缺乏，需从加强儿童营养入手。     

Dietary vitamin A intakes of preschool-age children in South India.

The vitamin A intake of children aged 1-3 y (n = 683) was assessed using a quantitative food-frequency questionnaire in a vitamin A intervention study in South India. Trained field workers interviewed mothers about their children's usual consumption of common sources of vitamin A and collected information on portion sizes using standard cups. Mothers were asked to state the number of months in a year during which specific seasonal foods were available. Information about current breast-feeding was also obtained. Vitamin A intakes from nonbreast milk sources were extremely low at all ages. The median intake of total vitamin A, beta-carotene and retinol was 121, 100 and 21 retinol equivalents (RE), respectively. Maternal education and socioeconomic status (SES) were positively associated with total vitamin A and retinol intakes. Girls had significantly lower intakes than boys even after adjusting for differences in age, maternal education, SES and breast-feeding status. Breast-feeding was common, but declined to 60% by 24 mo and to 15% by 36 mo. Vitamin A intakes from nonbreast milk sources increased with age only for currently breast-fed children, who tended to be of lower SES. After taking into account the potential contribution of breast milk by using published estimates, nonbreast-fed children met only 60% of the Indian recommended dietary allowance (RDA; 250 RE/d), whereas breast-fed children met approximately 90% of the RDA during y 2 of life.     

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.     

Proposed vitamin a fortification levels

Fortified complementary foods could be effective in preventing and controlling vitamin A and other common nutritional deficiencies in young children. Milk from well-nourished women is an excellent source of vitamin A. However, in Latin America many children are weaned prematurely and must receive the entire requirement of vitamin A from food. This paper proposes vitamin A fortification levels for foods targeted for children aged 6-23 mo to meet the existing intake gap among both breast-fed and weaned infants and young children. Estimates assume a nonsignificant contribution of common complementary foods and average levels of human milk intake by breast-fed infants and children. The estimated vitamin A gap for breast-fed infants aged 6-11 mo amounts to 63-92 microg RE [16-23% of recommended daily intake (RDI)] and for breast-fed children reaches 125 microg RE (31% of RDI). Weaned infants and children would have to fully meet the RDI (400 microg RE) from complementary foods. A fortified complementary food with 500 mg RE/100 g of dry product provided daily in a single ration of 40 g would meet 50% of the gap for weaned infants aged 6-11 mo and would raise the total intake above RDI for breast-fed infants aged 6-8 mo (125%) and 9-11 mo (127%). The same fortified food given in a daily ration of 60 mg would meet most of the gap (75%) for weaned children aged 12-23 mo and would increase total intake of breast-fed children aged 12-23 mo well above the RDI (144%), with no risk of exceeding established upper tolerable intake levels.     

中国部分农村地区2～7岁留守儿童膳食营养现况研究

目的 了解中国农村留守儿童膳食营养状况,为农村留守儿童营养干预提供科学依据.方法 采用多阶段分层整群随机抽样方法,随机选择农村2～7岁留守儿童1278名和对照儿童1273名作为调查对象.采用3日膳食称重法和食物摄人频率法进行膳食调查,并以中国营养学会推荐的膳食营养素参考摄入量(DRIs)为依据,评价农村留守儿童膳食能量和各种营养素的摄人状况.结果 农村留守儿童膳食以粮谷类和蔬菜类为主,留守儿童肉禽水产类、水果类及零食类等食物的摄入量低于对照儿童,差异有统计学意义.农村留守儿童能量、三大产热营养素及部分矿物质(钙、锌、硒、钾)和维生素(维生素A、维生素B1、维生素B2)的摄入量均低于推荐摄入量.农村留守儿童能量及主要营养素普遍摄入不足,能量摄入不足率在50%以上,蛋白质摄人不足率达80%以上,而钙、锌等矿物质和维生素B1、维生素B1等维生素的摄入不足率达90%以上.蛋白质来源中,优质蛋白质摄入量仅占总蛋白质摄入量的35%,而植物蛋白质占65%.此外植物性铁的摄入比例明显偏高,达到87%.结论 中国农村留守儿童的膳食结构不尽合理,能量和多种营养素摄入不足,能量、蛋白质及铁的来源不合理,膳食营养状况有待改善.     

中国儿童亚临床维生素A缺乏患病率及其影响因素

目的 探讨儿童亚临床维生素A缺乏（SVAD）的现状及其影响因素。抽取全国14个省、市、自治区的8669名6岁以下儿童。询问其膳食、健康、家庭情况。以微量荧光其血清维生素A（VA）含量。结果 儿童血μmol／L,SVAD患病率为11．7％。可疑SVAD患病率为39．2％。其中SVAD及可疑SVAD患病率随所在地区国内生产总值和家庭年人均收入的增高、母亲受教育程度的提高、儿童年龄的增长而降低。儿童SVAD及可疑SVAD患病率;农村（15．0％）高于城市（5．2％）,母亲是少数民族者（22．6％）高于母亲是汉族者（8．7％）,采血前1周内末摄入富含VA食物者（12．6％－22．6％）均高于每日摄和者（4．1％－10．0％）,采血前2周内曾患呼吸道感染、发热、腹泻者（15．2％－22．6％）非常显著高于未曾患病者（10．1％－11．1％）。logistic回归分析显示,儿童所在地区及家庭的经济状况不好、家居农村、母亲是少数民族、小年龄、未食乳类、采血前2周内曾患呼吸道感染、发热是其SVAD的危险因素。结论 50．9％的儿童存在或可能存在VA营养问题。儿童SVAD是多种因素在不同程度上起作用的结果。     

安徽省巢湖农村地区3岁组儿童生长发育状况及其影响因素分析

目的探讨安徽省巢湖农村地区3周岁儿童生长发育状况及其影响因素。方法采用整群随机抽样方法，以巢湖农村地区3周岁年龄组儿童作为调查对象。调查内容包括：儿童出生／喂养／患病情况、母亲孕期情况、家庭情况及主要照顾者的儿童喂养知识，同时测量儿童的身高、体重及皮脂厚度，并应用年龄别身高、年龄别体重、身高别体重等指标对其进行生长发育状况评价。结果共调查儿童418人，按年龄别身高评价生长发育迟缓儿童为4．3％、正常者为95．7％；按年龄别体重评价低体重儿童发生率为1．9％、超重儿童发生率为0．7％、正常体重者为97．4％；按身高别体重评价消瘦儿童发生率为0．5％、肥胖儿童发生率为14．9％，正常者为84．6％。对影响生长发育指标的因素进行多分类Logistic回归分析，结果性别为男、出生体重较重、父亲身体较高、饭前经常洗手的儿童，其生长发育指标Z评分高；而出生胎次靠后、家庭年收入高、母亲文化程度为文盲、母亲孕期服用保胎药、接触X线、家中分娩儿、主要照顾者为母亲、4个月内喂养方式为母乳和人工混合喂养、添加辅食时间〈3个月、经常吃营养补品、零食和挑食的儿童，其生长发育指标Z评分低。结论该地区3岁组儿童总体发育情况良好，但孕产期保健和儿童期保健仍有待加强。     

Mothers' and children's intakes of vitamin A in rural Bangladesh.

The vitamin A intake of 370 mothers and 183 children 3-27 mo of age in rural Bangladesh was ascertained monthly from January to July in 1986. For mothers, dark green leafy vegetables and fruits were the main sources of vitamin A. Vitamin A from vegetables, the single most important source, did not show consistent associations with wealth or with the other socioeconomic indicators. In May and June, fruits provided wealthier (and more educated) mothers with significantly higher vitamin A intakes than poor mothers, whereas in January the poorer mothers had higher intakes. When breast milk was included, average intakes for children came close to 100% of the recommended dietary allowance; the only other significant source of vitamin A for children was seasonally available mangoes. Fourteen children who had stopped breast-feeding by the end of the study were at very high risk of vitamin A deficiency when fruits were not plentiful.     

中国农村地区婴幼儿辅食添加状况

对较贫困农村地区 146 49名 4～ 2 4月龄婴幼儿的辅食添加情况进行分析 ,结果显示婴幼儿平均从出生后 6个月开始添加食物 ,约 1 3的婴幼儿在 4～ 6个月开始添加 ,有 16 4%的婴幼儿在 4个月以前就添加了谷类食物 ;大多数婴幼儿 (74 4% )从 7个月开始每天进食谷类食物 ,蔬菜水果类食物的摄入频率随着年龄的增加有所增加 ,但 1岁以后也只有 5 0 %的的婴幼儿能够每天食用蔬菜水果。蛋白质类食物的摄入频率较低 ,1岁以上婴幼儿能够每天食用的占 38% ,有 15 8%的婴幼儿从未添加过肉蛋类及豆制品类食物。农村地区的大多数婴幼儿是以母乳喂养的 ,但断奶以后只有 2 0 %的婴幼儿能够每天饮奶 ;婴幼儿的食物摄入情况受家庭食物状况的影响 ,随着年龄的增加 ,影响程度增加 ;婴幼儿辅食添加的状况直接影响婴幼儿的生长发育 ,长期不合理的喂养模式 ,就会造成营养不良。应通过营养教育 ,提高婴幼儿看护人的营养知识 ,及时合理地添加辅食对婴幼儿的生长发育非常重要。     

Designing snacks to address micronutrient deficiencies in rural Kenyan schoolchildren

Three snacks were designed to improve nutrient intakes among school-age children living in rural Kenya. Snacks containing animal-source foods (milk and meat) provided more nutrients than an equicaloric vegetarian snack. The vegetarian snack provided extra vitamin A (primarily from fortified cooking fat; the milk snack was rich in calcium, vitamin A, and vitamin B-12; and the meat snack supplied vitamin B-12, iron, and zinc. When changes in intakes from baseline to the feeding period were compared across the 4 groups, total energy intake increased the most for children in the meat group and the least for children in the control group. Differences in energy intakes across the 3 feeding groups were primarily caused by decreases in home intake for the vegetarian and milk snack groups. It is important to evaluate the change in home intakes as well as intakes from the foods provided by the study when evaluating the effect of feeding programs on nutrient adequacy.     

河北省城乡地区6~24月龄婴幼儿喂养状况研究

目的 了解河北省城乡地区6~24月龄婴幼儿的喂养状况,并应用婴幼儿喂养指数(infant and child feeding index,ICFI)评价城乡地区不同月龄组婴幼儿的喂养行为,为指导婴幼儿喂养提供科学的参考依据。 方法 数据来自2015年中国居民食物消费状况调查。选取6~24月龄婴幼儿作为研究对象,应用ICFI对喂养行为(24 h母乳喂养、24 h奶瓶喂养、24 h膳食种类、1周辅食添加天数)进行评分。 结果 本研究共纳入婴幼儿861名,ICFI平均得分为(10.58±3.18)分,不同月龄组间ICFI平均得分的差异有统计学意义(F=141.119,P=0.000),在6~8月龄组中,城市ICFI平均得分为(7.61±3.15)分,显著高于农村的(5.44±3.04)分(F=11.859,P=0.001)。喂养总合格率为54.94%(473/861),各月龄组的喂养合格率分别为14.16%、38.78%、66.56%,不同月龄组间喂养合格率的差异均有统计学意义(χ²=124.181,P=0.000)。婴幼儿辅食添加满分率较高的为蛋类、谷薯类、水果、蔬菜,较低的为豆类及其制品、奶类及其制品。 结论 河北省农村地区的低月龄婴幼儿喂养较差,建议加强对辅食添加时间、种类及添加频率等方面婴幼儿喂养知识的宣传。