利用乌干达全国性面板调查分析主食消费对乌干达儿童营养不良的影响。
Using the Uganda National Panel Survey to analyze the effect of staple food consumption on undernourishment in Ugandan children.
作者信息
Amaral Michelle M, Herrin William E, Gulere Grace Bulenzi
机构信息
Department of Economics, University of the Pacific, 3601 Pacific Avenue, Stockton, CA, 95211, USA.
Department of Economics and School of International Studies, University of the Pacific, 3601 Pacific Avenue, Stockton, CA, 95211, USA.
出版信息
BMC Public Health. 2017 Jul 19;18(1):32. doi: 10.1186/s12889-017-4576-1.
BACKGROUND
The United Nations' Millennium Development Goals Report, 2015, documents that, since 1990, the number of stunted children in sub-Saharan Africa has increased by 33% even though it has fallen in all other world regions. Recognizing this, in 2011 the Government of Uganda implemented a 5-year Nutrition Action Plan. One important tenet of the Plan is to lessen malnutrition in young children by discouraging over-consumption of nutritionally deficient, but plentiful, staple foods, which it defines as a type of food insecurity.
METHODS
We use a sample of 6101 observations on 3427 children age five or less compiled from three annual waves of the Uganda National Panel Survey to measure undernourishment. We also use the World Health Organization's Child Growth Standards to create a binary variable indicating stunting and another indicating wasting for each child in each year. We then use random effects to estimate binary logistic regressions that show that greater staple food concentrations affect the probability of stunting and wasting.
RESULTS
The estimated coefficients are used to compute adjusted odds ratios (OR) that estimate the effect of greater staple food concentration on the likelihood of stunting and the likelihood of wasting. Controlling for other relevant covariates, these odds ratios show that a greater proportion of staple foods in a child's diet increases the likelihood of stunting (OR = 1.007, p = 0.005) as well as wasting (OR = 1.011, p = 0.034). Stunting is confirmed with subsamples of males only (OR = 1.006, p = 0.05) and females only (OR = 1.008, p = 0.027), suggesting that the finding is not gender specific. Another subsample of children aged 12 months or less, most of whom do not yet consume solid food, shows no statistically significant relationship, thus supporting the validity of the other findings.
CONCLUSION
Diets containing larger proportions of staple foods are associated with greater likelihoods of both stunting and wasting in Ugandan children. Other causes of stunting and wasting identified in past research are also confirmed with the Uganda data. Finally, the analysis provides clues to other possible causes of undernourishment in young children.
背景
《2015年联合国千年发展目标报告》记录显示，自1990年以来，撒哈拉以南非洲发育迟缓儿童的数量增加了33%，尽管世界其他地区这一数量有所下降。认识到这一点后，乌干达政府于2011年实施了一项为期五年的营养行动计划。该计划的一个重要原则是，通过减少对营养缺乏但丰富的主食的过度消费来减轻幼儿营养不良的状况，政府将这种过度消费定义为一种粮食不安全类型。
方法
我们使用从乌干达全国小组调查的三个年度样本中收集的6101条关于3427名五岁及以下儿童的观测数据来衡量营养不良情况。我们还使用世界卫生组织的儿童生长标准，为每年的每个儿童创建一个表示发育迟缓的二元变量和另一个表示消瘦的二元变量。然后，我们使用随机效应估计二元逻辑回归，结果表明主食摄入量增加会影响发育迟缓和消瘦的概率。
结果
估计系数用于计算调整后的优势比（OR），以估计主食摄入量增加对发育迟缓和消瘦可能性的影响。在控制其他相关协变量后，这些优势比表明，儿童饮食中主食比例增加会增加发育迟缓的可能性（OR = 1.007，p = 0.005）以及消瘦的可能性（OR = 1.011，p = 0.034）。仅对男性子样本（OR = 1.006，p = 0.05）和仅对女性子样本（OR = 1.008，p = 0.027）进行分析时，发育迟缓情况也得到了证实，这表明该发现不存在性别特异性。另一个12个月及以下儿童的子样本，其中大多数儿童尚未食用固体食物，分析结果显示无统计学显著关系，从而支持了其他研究结果的有效性。
结论
在乌干达儿童中，主食比例较高的饮食与发育迟缓和消瘦的可能性增加有关。过去研究中确定的发育迟缓和消瘦的其他原因也在乌干达的数据中得到了证实。最后，该分析为幼儿营养不良的其他可能原因提供了线索。
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