Reinbott Anika, Schelling Anna, Kuchenbecker Judith, Jeremias Theresa, Russell Iean, Kevanna Ou, Krawinkel Michael B, Jordan Irmgard
1Justus Liebig University Giessen,Wilhelmstr 20,35392 Giessen,Germany.
2Food and Agriculture Organization of the United Nations,Nutrition Education and Consumer Awareness Group (ESNE),Nutrition Division (ESN),Viale delle Terme di Caracalla,00153,Rome,Italy.
Br J Nutr. 2016 Oct;116(8):1457-1468. doi: 10.1017/S0007114516003433. Epub 2016 Oct 5.
Poor infant and young child feeding (IYCF) practices are major determinants of chronic malnutrition. The main objective of this study was to assess the impact of a nutrition education (NE) programme aimed at promoting improved IYCF behaviours in combination with an agriculture intervention on children's dietary diversity and nutritional status. From 2012 to 2014, a cluster randomised trial was rolled out in Cambodia in the context of an agriculture and nutrition project of the FAO of the UN. The cross-sectional baseline study was carried out in sixteen pre-selected communes in 2012. Restricted randomisation allotted the communes to either intervention (NE and agriculture intervention) or comparison arms (agriculture intervention only). The impact survey was conducted as a census in all FAO project villages in 2014. Caregivers of children aged 0-23 months were interviewed using standardised questions on socio-economic status and dietary diversity (24-h recall). Anthropometric measurements were taken. A difference-in-differences model was applied. The sample comprised 743 households with children ≥6 months of age at baseline and 921 at impact. After 1 year of NE, 69 % of the intervention households reported to have participated in the NE. Estimated mean child dietary diversity was significantly different at impact between comparison and intervention (3·6 and 3·9, respectively). In particular, the consumption of pro-vitamin A-rich foods and other fruits and vegetables increased. No treatment effects on height-for-age Z-scores could be shown. NE led to improvements in children's diets. For effects on growth, it is assumed that longer NE activities are required to achieve sustainable behaviour change of age-appropriate infant feeding.
婴幼儿喂养（IYCF）方式不当是导致慢性营养不良的主要因素。本研究的主要目的是评估一项营养教育（NE）计划的影响，该计划旨在促进改善婴幼儿喂养行为，并结合农业干预措施，以提高儿童的饮食多样性和营养状况。2012年至2014年期间，在联合国粮农组织的一个农业与营养项目背景下，柬埔寨开展了一项整群随机试验。2012年，在16个预先选定的公社进行了横断面基线研究。采用受限随机化方法将这些公社分为干预组（营养教育和农业干预）或对照组（仅农业干预）。2014年，在粮农组织所有项目村庄进行了普查式的影响调查。使用关于社会经济状况和饮食多样性（24小时回顾法）的标准化问题，对0至23个月大儿童的照料者进行了访谈。同时进行了人体测量。应用了差异-in-差异模型。样本包括基线时743户有6个月及以上儿童家庭，以及影响调查时921户家庭。经过1年的营养教育，69%的干预组家庭报告参与了营养教育。在影响调查时，对照组和干预组儿童的估计平均饮食多样性存在显著差异（分别为3.6和3.9）。特别是富含维生素A原的食物以及其他水果和蔬菜的消费量有所增加。未显示出对年龄别身高Z评分的治疗效果。营养教育改善了儿童的饮食。关于对生长的影响，据推测需要更长时间的营养教育活动，以实现与年龄相适应的婴儿喂养行为的可持续改变。
