Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico.
J Nutr. 2013 May;143(5):656-63. doi: 10.3945/jn.112.162792. Epub 2013 Feb 27.
Mexico's Oportunidades program provides conditional cash transfers, nutrition education, health services, and fortified food supplements for the young children of poor families. We have documented the effects of the program on growth and reduction of anemia. To better understand the impact pathways and disentangle the relative effects on dietary intake of the food supplements compared with other program components, we analyzed data from a randomized effectiveness evaluation of the Oportunidades program in rural children aged 12-59 mo. All Oportunidades beneficiaries received the cash transfers and the health and education components, but some children did not consume the supplements. The children's diet was evaluated using a single 24-h recall. The impact was estimated using multiple linear regression models with community-level random effects. Comparisons were made among children who received all the benefits of Oportunidades, including the fortified food supplement (SG), beneficiaries of the program who did not consume the food supplement (NSG), and the control group (CG). Relative to the NSG and CG, respectively, the SG consumed greater amounts of [mean (95% CI)]: energy, 94 (28, 160) and 111 (43, 180) kcal/d; iron, 7.6 (6.3, 8.9) and 7.7 (6.5, 9.0) mg/d; zinc, 7.5 (6.4, 8.6) and 7.6 (6.5, 8.7) mg/d; and vitamin A, 0.109 (0.071, 0.147) and 0.120 (0.080, 0.159) mg retinol equivalents/d. No differences were found between the NSG and CG (P > 0.05). To conclude, the Oportunidades program had a positive impact on the diet of children. The effects of the program on dietary intake resulted from the food supplement and not from improvements in the home diet. Our findings are useful for identifying which program components contributed to the effects on the nutritional status of children.
墨西哥的 Oportunidades 计划为贫困家庭的幼儿提供有条件的现金转移、营养教育、卫生服务和强化食品补充剂。我们已经记录了该计划对生长和减少贫血的影响。为了更好地了解影响途径,并理清食品补充剂与其他计划组成部分相比对饮食摄入的相对影响,我们分析了农村儿童 12-59 个月大的 Oportunidades 计划随机有效性评估的数据。所有 Oportunidades 的受益者都获得了现金转移和健康与教育部分,但有些儿童没有食用补充剂。儿童的饮食通过单次 24 小时回忆进行评估。使用具有社区水平随机效应的多元线性回归模型估计影响。对接受 Oportunidades 全部福利(包括强化食品补充剂)的儿童(SG)、未食用食品补充剂的计划受益者(NSG)和对照组(CG)进行了比较。与 NSG 和 CG 相比,SG 分别摄入了更多的:能量,94(28,160)和 111(43,180)千卡/天;铁,7.6(6.3,8.9)和 7.7(6.5,9.0)毫克/天;锌,7.5(6.4,8.6)和 7.6(6.5,8.7)毫克/天;和维生素 A,0.109(0.071,0.147)和 0.120(0.080,0.159)毫克视黄醇当量/天。NSG 和 CG 之间没有差异(P > 0.05)。总之,Oportunidades 计划对儿童的饮食产生了积极影响。该计划对饮食摄入的影响源于食品补充剂,而不是家庭饮食的改善。我们的研究结果有助于确定哪些计划组成部分对儿童营养状况的影响做出了贡献。