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粮食不安全及其对巴西儿童健康的负面影响——为何粮食安全对我们未来的繁荣至关重要?巴西全国调查(2006/07年家庭预算调查)

Food Insecurity and the Negative Impact on Brazilian Children's Health-Why Does Food Security Matter for Our Future Prosperity? Brazilian National Survey (PNDS 2006/07).

作者信息

Poblacion Ana Paula, Cook John T, Marín-León Leticia, Segall-Corrêa Ana Maria, Silveira Jonas A C, Konstantyner Tulio, Taddei José Augusto A C

机构信息

Unit of Nutrology, Department of Pediatrics, Universidade Federal de São Paulo, São Paulo, Brazil

Children's HealthWatch, Department of Pediatrics, Boston University, Boston, MA, USA.

出版信息

Food Nutr Bull. 2016 Dec;37(4):585-598. doi: 10.1177/0379572116664167. Epub 2016 Sep 7.

Abstract

BACKGROUND

Food insecurity (FI) refers to limited or uncertain access to food resulting from financial constraints. Numerous studies have shown association between FI and adverse health outcomes among adults and children around the world, but in Brazil, such information is scarce, especially if referring to nationally representative information.

OBJECTIVE

To test for an independent association between FI and health outcomes.

METHODS

Most recent Brazilian Demographic and Health Survey using nationally representative complex probability sampling. Participants were 3923 children <5 years of age, each representing a household. Data from the validated Brazilian Food Insecurity Scale were dichotomized as food secure (food security/mild FI) or food insecure (moderate FI/severe FI). Poisson regression was used to test for associations between FI and various health indicators.

RESULTS

Models adjusted for socioeconomic and demographic variables showed that children hospitalized for pneumonia or diarrhea were 30% more prevalent in FI households (adjusted prevalence ratio [aPR]: 1.3; 1.1-1.6). Underweight children were 40% more prevalent in FI households (aPR: 1.4; 1.1-1.7). Children who didn't eat meat and fruits and vegetables every day were 20% and 70% more prevalent in FI households (aPR: 1.2; 1.1-1.4 and aPR: 1.7; 1.3-2.3), respectively.

CONCLUSION

Children who grow up in food-insecure households have been shown to have worse health conditions than those in food-secure households. Consequently, their human capital accumulation and work-life productivity are likely to be reduced in the future, leading them into adulthood less capable of generating sufficient income, resulting in a cycle of intergenerational poverty and FI.

摘要

背景

粮食不安全是指由于经济限制导致获取食物的机会有限或不确定。众多研究表明,全球范围内成人和儿童的粮食不安全与不良健康结果之间存在关联,但在巴西,此类信息匮乏,尤其是缺乏具有全国代表性的信息。

目的

检验粮食不安全与健康结果之间的独立关联。

方法

采用具有全国代表性的复杂概率抽样方法进行的最新巴西人口与健康调查。参与者为3923名5岁以下儿童,每名儿童代表一个家庭。来自经过验证的巴西粮食不安全量表的数据被分为粮食安全(粮食安全/轻度粮食不安全)或粮食不安全(中度粮食不安全/重度粮食不安全)。使用泊松回归检验粮食不安全与各种健康指标之间的关联。

结果

经社会经济和人口变量调整后的模型显示,因肺炎或腹泻住院的儿童在粮食不安全家庭中的患病率高30%(调整患病率比[aPR]:1.3;1.1 - 1.6)。体重不足的儿童在粮食不安全家庭中的患病率高40%(aPR:1.4;1.1 - 1.7)。每天不吃肉、水果和蔬菜的儿童在粮食不安全家庭中的患病率分别高20%和70%(aPR:1.2;1.1 - 1.4和aPR:1.7;1.3 - 2.3)。

结论

事实表明,在粮食不安全家庭中成长的儿童的健康状况比粮食安全家庭中的儿童更差。因此,他们未来的人力资本积累和工作生活生产力可能会降低,导致他们成年后赚取足够收入的能力下降,从而形成代际贫困和粮食不安全的循环。

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