Childhood Nutrition Research Centre, UCL Great Ormond Street Institute of Child Health, London, United Kingdom,
Ann Nutr Metab. 2019;75(2):103-108. doi: 10.1159/000503666. Epub 2019 Nov 19.
Populations in low- and middle-income countries are increasingly experiencing a double burden of malnutrition (DBM), incorporating both persistent levels of child undernutrition and rising prevalence of overweight/obesity at later ages. A growing number of individuals experience both components of the DBM through the life-course, thereby accumulating high susceptibility to noncommunicable disease (NCD).
Measurements of body composition may prove valuable for assessing NCD risk at the level of the individual. The capacity-load model provides a simple conceptual framework for integrating data on different components of body composition to predict NCD risk. Poor growth in early life, indexed by becoming wasted or stunted, constrains the development of lean mass components such as muscle and organ mass, each of which contribute to the metabolic capacity for homeostasis. Catch-up weight gain in early life, or the development of excess weight from childhood onwards, is associated with elevated adiposity, especially abdominal adiposity, which challenges cardio-metabolic homeostasis and elevates NCD risk. Key Messages: A variety of techniques are now available for the measurement of body composition, helping research the association of the DBM with NCD risk. Reference charts allow raw data to be converted to age- and sex-specific z-scores, aiding interpretation.
中低收入国家的人群正日益面临营养双重负担(DBM),既有持续存在的儿童营养不足问题,又有后期超重/肥胖的患病率上升问题。越来越多的人在整个生命过程中同时经历 DBM 的两个组成部分,从而积累了患非传染性疾病(NCD)的高易感性。
身体成分的测量可能有助于评估个体的 NCD 风险。容量-负荷模型为整合身体成分不同组成部分的数据以预测 NCD 风险提供了一个简单的概念框架。生命早期生长不良,表现为消瘦或发育迟缓,会限制瘦体重成分(如肌肉和器官质量)的发育,这些成分都有助于维持代谢平衡的能力。生命早期的追赶性体重增加,或从儿童期开始的超重发展,与脂肪增多有关,尤其是腹部脂肪增多,这会对心脏代谢平衡造成挑战,并增加 NCD 风险。关键信息:目前有多种技术可用于测量身体成分,有助于研究 DBM 与 NCD 风险的关联。参考图表可将原始数据转换为年龄和性别特异性 z 分数,有助于解释。