Winichagoon Pattanee
Institute of Nutrition, Mahidol University, Salaya, Thailand.
Curr Opin Clin Nutr Metab Care. 2015 May;18(3):312-7. doi: 10.1097/MCO.0000000000000158.
This article reviews the maternal and child nutrition situation in Asia in transition and its public health implications.
Countries in Asia are facing a double burden of malnutrition. Accessibility to high energy, less nutrient-dense foods or processed foods affects current dietary patterns, whereas industrialization is leading to more sedentary lifestyles both in rural and urban areas. Stunting and wasting among young children persist but have declined in severity, whereas overweight and obesity have risen rapidly. Growth faltering in height during the first 2 years of life has affected muscle mass accretion, but rapid weight gain after 2 years of age has led to more fat accretion, imposing risks of childhood obesity and consequent metabolic disorders. The number of women entering pregnancy with low BMI has decreased, but increasing BMI is noticeable. Prepregnancy BMI and gestational weight gain are important determinants of maternal nutrition during pregnancy, the risk of gestational diabetes and postpartum weight retention, as well as obesity and diet-related noncommunicable diseases in later adulthood.
Asia in transition is faced with persistent undernutrition and increasing trends of obesity and metabolic disorders among children and women. The first 1000 days from conception is a critical period, but it is also a window of opportunity for preventing double burden of malnutrition in Asian countries characterized by a nutrition transition.
本文综述了亚洲转型期的母婴营养状况及其对公共卫生的影响。
亚洲国家正面临营养不良的双重负担。获取高能量、营养密度较低的食物或加工食品影响了当前的饮食模式,而工业化导致农村和城市地区的生活方式更加久坐不动。幼儿发育迟缓与消瘦问题依然存在,但严重程度有所下降,而超重和肥胖问题迅速增加。生命最初两年身高增长迟缓影响了肌肉量的积累,但两岁后体重快速增加导致脂肪积累更多,增加了儿童肥胖及随之而来的代谢紊乱风险。孕期体重指数(BMI)较低的孕妇数量有所减少,但BMI上升的情况较为明显。孕前BMI和孕期体重增加是孕期母体营养、妊娠期糖尿病风险、产后体重滞留以及成年后期肥胖和饮食相关非传染性疾病的重要决定因素。
转型期亚洲面临着儿童和妇女持续存在的营养不良以及肥胖和代谢紊乱不断增加的趋势。从受孕开始的头1000天是一个关键时期,但也是预防以营养转型为特征的亚洲国家营养不良双重负担的机遇之窗。