van Stuijvenberg Martha E, Nel Jana, Schoeman Serina E, Lombard Carl J, du Plessis Lisanne M, Dhansay Muhammad A
Nutritional Intervention Research Unit, South African Medical Research Council, Cape Town, South Africa; Currently Non-communicable Diseases Research Unit, South African Medical Research Council, Tygerberg, South Africa.
Integrated Nutrition Programme, Department of Health, Northern Cape, South Africa.
Nutrition. 2015 Jun;31(6):841-6. doi: 10.1016/j.nut.2014.12.011. Epub 2014 Dec 31.
This cross-sectional study examined the nutritional factors associated with the high levels of stunting in 2- to 5-y-old children in an impoverished South African setting where liver is frequently eaten and vitamin A deficiency known to be absent.
Children's dietary intake was assessed by a single 24-h recall. Heights and weights were measured and information was obtained on breast-feeding history, the child's habitual milk intake, as well as substance use by the mother during pregnancy (n = 150).
The overall prevalence of stunting was 36.9% (CI 29.2, 44.6) and increased with age, being 49% in the 4- to 5-y-old age category. Birth weight correlated significantly with height-for-age z-scores (HAZ; r = 0.250, P = 0.003), and was lower in children whose mothers smoked and used alcohol during pregnancy than in children whose mothers abstained (P < 0.0001). Median intake of energy, carbohydrate and protein was adequate. Median intake for all micronutrients was at least 90% of the estimated average requirement, except for calcium, vitamin D and vitamin E, which was 21%, 15%, and 32%, respectively. Intake of fat, calcium, phosphorous, vitamin D, riboflavin, and vitamin B12 (nutrients that typically occur in milk) was significantly lower in stunted than in non-stunted children (P < 0.05). When excluding children with low birth weight, intake of calcium, vitamin D, and riboflavin were still significantly lower (P < 0.05). HAZ was higher in children who habitually drank milk compared to those who did not (P = 0.003).
Inadequate calcium and vitamin D intake, presumably because of low intake of milk after weaning, may have contributed to stunting in this population.
本横断面研究调查了南非贫困地区2至5岁儿童发育迟缓率高的相关营养因素，该地区居民经常食用肝脏且不存在维生素A缺乏问题。
通过单次24小时膳食回顾评估儿童的饮食摄入量。测量身高和体重，并获取母乳喂养史、儿童习惯性牛奶摄入量以及母亲孕期物质使用情况的信息（n = 150）。
发育迟缓的总体患病率为36.9%（置信区间29.2, 44.6），且随年龄增长而增加，在4至5岁年龄组中为49%。出生体重与年龄别身高Z评分（HAZ；r = 0.250，P = 0.003）显著相关，母亲在孕期吸烟和饮酒的儿童出生体重低于母亲不吸烟和饮酒的儿童（P < 0.0001）。能量、碳水化合物和蛋白质的摄入量中位数充足。除钙、维生素D和维生素E外，所有微量营养素的摄入量中位数至少为估计平均需求量的90%，钙、维生素D和维生素E的摄入量分别为21%、15%和32%。发育迟缓儿童的脂肪、钙、磷、维生素D、核黄素和维生素B12（通常存在于牛奶中的营养素）摄入量显著低于非发育迟缓儿童（P < 0.05）。排除低出生体重儿童后，钙、维生素D和核黄素的摄入量仍然显著较低（P < 0.05）。习惯性饮用牛奶的儿童HAZ高于不饮用牛奶的儿童（P = 0.003）。
断奶后牛奶摄入量低可能导致钙和维生素D摄入不足，这可能是该人群发育迟缓的原因。
