Department of Nutrition and Program in International and Community Nutrition, University of California, Davis, California 95616, USA.
Matern Child Nutr. 2011 Oct;7 Suppl 3(Suppl 3):129-42. doi: 10.1111/j.1740-8709.2011.00357.x.
It is well known that the relationship between child nutrition and infection is bidirectional, i.e. frequent illness can impair nutritional status and poor nutrition can increase the risk of infection. What is less clear is whether infection reduces the effectiveness of nutrition interventions or, vice versa, whether malnutrition lessens the impact of infection control strategies. The objective of this paper is to review the evidence regarding this interaction between nutrition and infection with respect to child growth in low-income populations. Even when there are no obvious symptoms, physiological conditions associated with infections can impair growth by suppressing appetite, impairing absorption of nutrients, increasing nutrient losses and diverting nutrients away from growth. However, there is little direct evidence that nutrition interventions are less effective when infection is common; more research is needed on this question. On the other hand, evidence from four intervention trials suggests that the adverse effects of certain infections (e.g. diarrhoea) on growth can be reduced or eliminated by improving nutrition. Interventions that combine improved nutrition with prevention and control of infections are likely to be most effective for enhancing child growth and development.
众所周知，儿童营养与感染之间的关系是双向的，即频繁的疾病会损害营养状况，而营养不良会增加感染的风险。不太清楚的是，感染是否会降低营养干预措施的效果，或者营养不良是否会减轻感染控制策略的影响。本文的目的是回顾有关营养与感染在低收入人群儿童生长方面相互作用的证据。即使没有明显的症状，与感染相关的生理状况也会通过抑制食欲、影响营养吸收、增加营养流失和将营养从生长中转移来损害生长。然而，几乎没有直接证据表明感染普遍存在时营养干预措施的效果会降低；需要对此问题进行更多的研究。另一方面，四项干预试验的证据表明，通过改善营养，可以减轻或消除某些感染（如腹泻）对生长的不利影响。将改善营养与预防和控制感染相结合的干预措施可能对促进儿童生长和发育最为有效。
