在印度尼西亚尼亚斯岛的日常项目中，使用当地生产的谷物/坚果/豆类饼干与花生/牛奶酱来治疗中度至轻度消瘦儿童：这是一个关于接受度和依从性的问题吗？

Locally produced cereal/nut/legume-based biscuits versus peanut/milk-based spread for treatment of moderately to mildly wasted children in daily programmes on Nias Island, Indonesia: an issue of acceptance and compliance?

作者信息

Scherbaum Veronika, Purwestri Ratna Chrismiari, Stuetz Wolfgang, Inayati Dyah Ayu, Suryantan Julia, Bloem Maurice Alexander, Biesalski Hans Konrad

机构信息

Institute for Social Sciences in Agriculture, Department of Gender and Nutrition (430), University of Hohenheim, Schloss, Museumsfluegel, 70593 Stuttgart, Germany. Email:

Institute for Biological Chemistry and Nutrition, University of Hohenheim, Stuttgart, Germany.

出版信息

Asia Pac J Clin Nutr. 2015;24(1):152-61. doi: 10.6133/apjcn.2015.24.1.15.

DOI:10.6133/apjcn.2015.24.1.15

PMID:25740754

Abstract

BACKGROUND

Treatment effects of fortified ready-to-use foods for moderately to mildly wasted children are largely unknown.

METHODS

Two nutritionally comparable forms of locally produced ready-to-use foods for daily feeding programmes of moderately to mildly wasted children (weight-for-height Z-score/WHZ>=-3 to <-1.5SD) were assessed on Nias, Indonesia. The frequencies of reaching target WHZ>=-1.5SD, compliance to the ready-touse food programme, and weight gain until recovery or programme closure among children treated with peanut/ milk-based spreads (n=29) were compared among children receiving cereal/nut/legume-based biscuits (n=44) and a second group treated with cereal/nut/legume-based biscuits whose mothers received intensive nutrition education (n=38).

RESULTS

Children in the cereal/nut/legume-based biscuits groups were younger (31 and 33 vs 39 months, p=0.004) and more likely to be moderately wasted (45 and 39 vs 21% with WHZ<-2, p=0.114) at admission, but had a higher rate in recovery (84 and 79 vs 62%, p=0.086) and showed more frequently a high compliance (>80%) to the ready-to-use (86 and 84 vs 45%, p<0.001) than those children in the peanut/milk-based spreads programme. Multivariable logistic regression revealed high compliance followed by weight gain and a lower degree of wasting at admission as independent and significant predictors of reaching target WHZ>=-1.5SD (all p<0.01). Weight gain was positively associated with the consumption of the biscuits (vs peanut//milk-based spreads: r=0.188, p=0.051) and was highest in the cereal/nut/legume-based biscuits plus intensive education compared with the cereal/nut/legume-based biscuits and peanut/milk-based spreads groups.

CONCLUSIONS

Locally produced ready-to-use foods as biscuits or spreads were similarly effective for rehabilitation of moderately to mildly wasted children.

摘要

背景

强化即食食品对中度至轻度消瘦儿童的治疗效果在很大程度上尚不明确。

方法

在印度尼西亚的尼亚斯，对两种营养成分相当的本地生产的即食食品进行了评估，用于中度至轻度消瘦儿童（身高别体重Z评分/ WHZ >= -3至< -1.5SD）的日常喂养计划。比较了接受花生/牛奶酱治疗的儿童（n = 29）、接受谷物/坚果/豆类饼干治疗的儿童（n = 44）以及接受谷物/坚果/豆类饼干治疗且其母亲接受强化营养教育的第二组儿童（n = 38）达到目标WHZ >= -1.5SD的频率、对即食食品计划的依从性以及直至康复或计划结束时的体重增加情况。

结果

谷物/坚果/豆类饼干组的儿童在入院时年龄更小（分别为31和33个月，而另一组为39个月，p = 0.004），且更有可能是中度消瘦（WHZ < -2的比例分别为45%和39%，而另一组为21%，p = 0.114），但康复率更高（分别为84%和79%，而另一组为62%），并且与接受花生/牛奶酱计划的儿童相比，对即食食品的高依从性（> 80%）更为频繁（分别为86%和84%，而另一组为45%，p < 0.001）。多变量逻辑回归显示，高依从性、随后的体重增加以及入院时较低程度的消瘦是达到目标WHZ >= -1.5SD的独立且显著的预测因素（所有p < 0.01）。体重增加与饼干的摄入量呈正相关（与花生/牛奶酱相比：r = 0.188, p = 0.051），并且与谷物/坚果/豆类饼干组和花生/牛奶酱组相比，在谷物/坚果/豆类饼干加强化教育组中体重增加最高。