Campbell Rebecca K, Aguayo Víctor M, Kang Yunhee, Dzed Laigden, Joshi Vandana, Waid Jillian, Gupta Suvadra Datta, Haselow Nancy, West Keith P
Center for Human Nutrition, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
UNICEF, New York, New York, USA.
Matern Child Nutr. 2018 Nov;14 Suppl 4(Suppl 4):e12762. doi: 10.1111/mcn.12762.
In South Asia, childhood undernutrition persists while overweight is increasing. Internationally recommended infant and young child feeding (IYCF) practices promote healthy nutritional status; however, little is known about IYCF in Bhutan, investigated here using 2015 National Nutrition Survey data. WHO/UNICEF IYCF indicators, anthropometry and household socio-economic status were available for 441 children <24 months. Stunting, wasting, and underweight prevalence (<-2Z length-for-age [LAZ], weight-for-age, [WAZ] and weight-for-length [WLZ], respectively) were 15%, 9%, and 5%, respectively, whereas overweight (WLZ >2) prevalence was 6%. In survey-design-adjusted analyses, 52% of mothers of 0- to 5-month olds reported exclusive breastfeeding (EBF), with EBF less common for girls than boys (OR: 0.2 [95% CI: 0.1-0.9]). Although 61% of children were breastfed at 2 years and 75% of children >6 months met a minimum daily meal frequency, only 18% of children 6-23 months met minimum dietary diversity. IYCF was unassociated with risk of stunting, wasting, or underweight, possibly due to relatively low prevalence of anthropometric failure and small sample size. However, currently-breastfed children were less often overweight [OR: ~0.1 (95% upper limit ≤1.0)]. Neither breastfeeding nor most complementary feeding practices differed by socio-economic status, but children in the highest two fifth of a wealth index had 7.8 (1.3-46.9) and 5.3 (1.1-25.2) times greater odds than children in the lowest fifth of meeting minimum dietary diversity criteria. Low rates of EBF, given possible protection of breastfeeding against overweight, and inadequate dietary diversity offer evidence to guide future program interventions to improve nutritional status of young children.
在南亚，儿童营养不良问题依然存在，同时超重现象却在增加。国际推荐的婴幼儿喂养（IYCF）做法有助于促进健康的营养状况；然而，不丹的婴幼儿喂养情况鲜为人知，本文利用2015年全国营养调查数据对此进行了调查。对441名24个月以下儿童提供了世界卫生组织/联合国儿童基金会的婴幼儿喂养指标、人体测量数据和家庭社会经济状况。发育迟缓、消瘦和体重不足的患病率（分别为年龄别身长低于-2Z [LAZ]、年龄别体重[WAZ]和身长别体重[WLZ]）分别为15%、9%和5%，而超重（WLZ>2）患病率为6%。在经过调查设计调整的分析中，52%的0至5个月婴儿的母亲报告进行了纯母乳喂养（EBF），女孩进行纯母乳喂养的情况比男孩少见（比值比：0.2 [95%置信区间：0.1 - 0.9]）。虽然61%的儿童在2岁时仍在接受母乳喂养，75%的6个月以上儿童达到了最低每日进餐频率，但6至23个月的儿童中只有18%达到了最低饮食多样性标准。婴幼儿喂养情况与发育迟缓、消瘦或体重不足的风险无关，这可能是由于人体测量指标不达标的患病率相对较低且样本量较小。然而，目前仍在接受母乳喂养的儿童超重的情况较少[比值比：约0.1（95%上限≤1.0）]。母乳喂养和大多数辅食添加做法在社会经济状况方面并无差异，但财富指数最高的五分之二的儿童达到最低饮食多样性标准的几率分别是最低五分之一儿童的7.8（1.3 - 46.9）倍和5.3（1.1 - 25.2）倍。鉴于母乳喂养可能对预防超重有保护作用，纯母乳喂养率较低以及饮食多样性不足为指导未来改善幼儿营养状况的项目干预措施提供了依据。
