Stein Aryeh D, Wang Meng, Digirolamo Ann, Hoddinott John, Martorell Reynaldo, Ramirez-Zea Manuel, Yount Kathryn
Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA.
J Nutr. 2009 Feb;139(2):365-9. doi: 10.3945/jn.108.098343. Epub 2008 Dec 17.
Promotion of optimal growth while preventing the emergence of obesity in childhood requires an understanding of the dynamics over time of linear growth and weight for height. To assess long-term secular trends in height-for-age and BMI for age in children <6 y old, we analyzed a series of cross-sectional surveys conducted between 1968 and 2007 in 4 villages in eastern Guatemala. We used height and weight of children <6 y old (n = 507, 606, 627, 704, 526, and 502 for survey years 1968, 1972, 1977, 1988, 1997, and 2005-7, respectively) to compute height-for-age Z-score (HAZ) and BMI-for-age Z-score (BMIZ) based on WHO growth standards. HAZ was -2.73 +/- 1.12 (mean +/- SD) in 1968 and -1.16 +/- 1.16 in 2005-7 (P < 0.001). The prevalence of stunting (HAZ <-2.0) was 73.0% in 1968 and 23.1% in 2005-7 (P < 0.001). Among children 57-63 mo old, HAZ in 2005-7 was 1.20 (95% CI, 0.79, 1.62) SD units higher than in 1968, corresponding to 5.6 cm in boys and 5.7 cm in girls. For all survey years except 2007, BMIZ increased through age 36 mo, then declined; for the 2005-7 sample, BMIZ did not vary by age. The prevalence of BMIZ >1.00 was 21.1% in 1968 and 19.6% in 2005-7 (P > 0.05); for BMI <-1.00, the respective prevalences were 7.9% and 5.2% (P > 0.05). There have been long-term improvements in child growth, as measured by HAZ, without concurrent increases in BMI over successive generations of children.
在促进儿童最佳生长的同时预防肥胖症的出现，需要了解身高线性增长和身高别体重随时间的动态变化。为了评估6岁以下儿童年龄别身高和年龄别BMI的长期长期趋势，我们分析了1968年至2007年期间在危地马拉东部4个村庄进行的一系列横断面调查。我们使用了6岁以下儿童的身高和体重（1968年、1972年、1977年、1988年、1997年以及2005 - 2007年调查年度的儿童人数分别为507、606、627、704、526和502），根据世界卫生组织生长标准计算年龄别身高Z评分（HAZ）和年龄别BMI Z评分（BMIZ）。1968年HAZ为 -2.73 ± 1.12（均值 ± 标准差），2005 - 2007年为 -1.16 ± 1.16（P < 0.001）。发育迟缓（HAZ < -2.0）的患病率在1968年为73.0%，2005 - 2007年为23.1%（P < 0.001）。在57 - 63月龄的儿童中，2005 - 2007年的HAZ比1968年高1.20（95%可信区间，0.79，1.62）标准差单位，相当于男孩增高5.6厘米，女孩增高5.7厘米。除2007年外的所有调查年份，BMIZ在36月龄前上升，之后下降；对于2005 - 2007年的样本，BMIZ不随年龄变化。BMIZ > 1.00的患病率在1968年为21.1%，2005 - 2007年为19.6%（P > 0.05）；对于BMI < -1.00，相应患病率分别为7.9%和5.2%（P > 0.05）。以HAZ衡量，儿童生长状况有长期改善，且连续几代儿童的BMI没有同时增加。
