Bloem Martin W, de Pee Saskia, Hop Le Thi, Khan Nguyen Cong, Laillou Arnaud, Moench-Pfanner Regina, Soekarjo Damayanti, Solon J Antonio, Theary Chan, Wasantwisut Emorn
World Food Programme, Rome, Italy.
Food Nutr Bull. 2013 Jun;34(2 Suppl):S8-16. doi: 10.1177/15648265130342S103.
To further reduce stunting in Southeast Asia, a rapidly changing region, its main causes need to be identified.
Assess the relationship between different causes of stunting and stunting prevalence over time in Southeast Asia.
Review trends in mortality, stunting, economic development, and access to nutritious foods over time and among different subgroups in Southeast Asian countries.
Between 1990-2011, mortality among under-five children declined from 69/1,000 to 29/1,000 live births. Although disease reduction, one of two direct causes of stunting, has played an important role which should be maintained, improvement in meeting nutrient requirements, the other direct cause, is necessary to reduce stunting further. This requires dietary diversity, which is affected by rapidly changing factors: economic development; urbanization, giving greater access to larger variety of foods, including processed and fortified foods; parental education; and modernizing food systems, with increased distance between food producers and consumers. Wealthier consumers are increasingly able to access a more nutritious diet, while poorer consumers need support to improve access, and may also still need better hygiene and sanitation.
In order to accelerate stunting reduction in Southeast Asia, availability and access to nutritious foods should be increased by collaboration between private and public sectors, and the Association of Southeast Asian Nations (ASEAN) can play a facilitating role. The private sector can produce and market nutritious foods, while the public sector sets standards, promotes healthy food choices, and ensures access to nutritious foods for the poorest, e.g, through social safety net programs.
东南亚地区变化迅速，为进一步降低该地区的发育迟缓率，需要确定其主要原因。
评估东南亚地区发育迟缓的不同原因与发育迟缓患病率随时间的关系。
回顾东南亚国家不同亚组以及随时间推移的死亡率、发育迟缓、经济发展和获取营养食品情况的趋势。
1990年至2011年间，五岁以下儿童死亡率从每1000例活产69例降至29例。虽然作为发育迟缓两个直接原因之一的疾病减少起到了重要作用且应持续保持，但满足营养需求这一另一个直接原因的改善对于进一步降低发育迟缓率是必要的。这需要饮食多样化，而饮食多样化受快速变化的因素影响：经济发展；城市化，使人更容易获得更多种类的食品，包括加工食品和强化食品；父母教育；以及食品系统现代化，食品生产者与消费者之间的距离增加。较富裕的消费者越来越有能力获得更营养的饮食，而较贫穷的消费者需要得到支持以改善获取途径，并且可能仍然需要更好的卫生和环境卫生条件。
为了加速东南亚地区发育迟缓率的降低，应通过私营部门和公共部门之间的合作增加营养食品的供应和获取，东南亚国家联盟（东盟）可发挥促进作用。私营部门可以生产和销售营养食品，而公共部门则制定标准、推广健康的食品选择，并确保最贫困人群能够获得营养食品，例如通过社会安全网计划。
