一项在加纳开展的随机试验表明,农业-营养干预措施改善了儿童的饮食和生长状况。
An agriculture-nutrition intervention improved children's diet and growth in a randomized trial in Ghana.
机构信息
School of Human Nutrition, McGill University, Montreal, Quebec, Canada.
Department of Nutrition and Food Science, University of Ghana, Legon, Ghana.
出版信息
Matern Child Nutr. 2018 Oct;14 Suppl 3(Suppl 3):e12677. doi: 10.1111/mcn.12677.
Stunting in Ghana is associated with rural communities, poverty, and low education; integrated agricultural interventions can address the problem. This cluster randomized controlled trial tested the effect of a 12-month intervention (inputs and training for poultry farming and home gardening, and nutrition and health education) on child diet and nutritional status. Sixteen clusters were identified and randomly assigned to intervention or control; communities within clusters were randomly chosen, and all interested, eligible mother-child pairs were enrolled (intervention: 8 clusters, 19 communities, and 287 households; control: 8 clusters, 20 communities, and 213 households). Intention-to-treat analyses were used to estimate the effect of the intervention on endline minimum diet diversity (≥4 food groups), consumption of eggs, and length-for-age (LAZ)/height-for-age (HAZ), weight-for-age (WAZ), and weight-for-length (WLZ)/weight-for-height (WHZ) z-scores; standard errors were corrected for clustering. Children were 10.5 ± 5.2 months (range: 0-32) at baseline and 29.8 ± 5.4 months (range: 13-48) at endline. Compared with children in the control group, children in the intervention group met minimum diet diversity (adjusted odds ratio = 1.65, 95% CI [1.02, 2.69]) and a higher LAZ/HAZ (β = 0.22, 95% CI [0.09, 0.34]) and WAZ (β = 0.15, 95% CI [0.00, 0.30]). Sensitivity analyses with random-effects and mixed-effects models and as-treated analysis were consistent with the findings. There was no group difference in WLZ/WHZ. Integrated interventions that increase access to high-quality foods and nutrition education improve child nutrition.
加纳的发育迟缓与农村社区、贫困和低教育水平有关;综合农业干预措施可以解决这个问题。这项整群随机对照试验测试了为期 12 个月的干预措施(家禽养殖和家庭园艺的投入和培训,以及营养和健康教育)对儿童饮食和营养状况的影响。确定了 16 个群组并将其随机分配到干预组或对照组;在群组内随机选择社区,所有感兴趣且符合条件的母婴对都被纳入(干预组:8 个群组,19 个社区,287 户;对照组:8 个群组,20 个社区,213 户)。意向治疗分析用于估计干预对终线最低饮食多样性(≥4 种食物组)、鸡蛋消费以及年龄别身长(LAZ)/年龄别身高(HAZ)、年龄别体重(WAZ)和身长别体重(WLZ)/身高别体重(WHZ)Z 评分的影响;对聚类进行了标准错误校正。儿童在基线时的年龄为 10.5 ± 5.2 个月(范围:0-32),在终线时的年龄为 29.8 ± 5.4 个月(范围:13-48)。与对照组儿童相比,干预组儿童达到了最低饮食多样性(调整后的优势比=1.65,95%置信区间[1.02, 2.69]),且 LAZ/HAZ(β=0.22,95%置信区间[0.09, 0.34])和 WAZ(β=0.15,95%置信区间[0.00, 0.30])更高。采用随机效应和混合效应模型以及按治疗分析的敏感性分析结果与上述发现一致。WLZ/WHZ 组间无差异。增加获得高质量食物和营养教育的综合干预措施可以改善儿童营养状况。
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