新型即食补充食品对轻中度营养不良儿童生长指标的影响。
Effect of a newly developed ready-to-use supplementary food on growth indicators in children with mild to moderate malnutrition.
机构信息
Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran.
Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran.
出版信息
Public Health. 2020 Aug;185:290-297. doi: 10.1016/j.puhe.2020.06.025. Epub 2020 Jul 23.
OBJECTIVES
Malnutrition is one of the leading causes of death among children younger than five years. In this study, we aimed to formulate a ready-to-use supplementary food (RUSF), based on local food products, and investigate its efficacy on growth indicators in children with mild to moderate malnutrition.
STUDY DESIGN
This is a randomized controlled clinical trial.
METHODS
This study was performed in six health centers in Shahr-e-Rey, Tehran, Iran, between April and October 2017. One hundred children, aged 24-59 months, with mild to moderate malnutrition (weight-for-height Z-score [WHZ] between -3 and -1) were randomly assigned to two groups to receive either 1-3 sachets of RUSF or normal diet for 8 weeks. All mothers and caregivers received nutrition education. Growth indicators including weight and height, WHZ, and body mass index (BMI), along with clinical outcomes, were assessed.
RESULTS
Children who received RUSF had a significant increase in weight (1.44 ± 0.38 vs 0.7 ± 0.32 kg, respectively, P < 0.001), and BMI (1.2 ± 0.47 vs 0.35 ± 0.33 kg/m, respectively, P < 0.001) compared with the control group. There was a greater daily weight gain during the first 4 weeks (P < 0.001) and throughout the study (P = 0.013) in the RUSF group. Daily height gain was considerably higher in the RUSF group during the first 4 weeks (P = 0.027). Children in the RUSF group had more improvement in WHZ (1.18 ± 0.41 vs 0.41 ± 0.31, P < 0.001) after supplementation. Besides, 92% of the RUSF and 12% of the control group reached to WHZ > -1 at the end of the study (P < 0.001). There was lower prevalence of diarrhea (12% vs 28.6%, respectively, P = 0.01) and marginally lower fever (16% vs 36.7%, respectively, P = 0.05) in the intervention than in the control group.
CONCLUSIONS
A newly developed RUSF improved growth indicators and clinical outcomes in children with mild to moderate malnutrition.
CLINICAL TRIAL REGISTRY NUMBER
IRCT2017021315536N6 (registered at www.irct.ir).
目的
营养不良是五岁以下儿童死亡的主要原因之一。本研究旨在基于当地食品，研制一种即食补充食品（RUSF），并探讨其对轻度至中度营养不良儿童生长指标的疗效。
研究设计
这是一项随机对照临床试验。
方法
本研究于 2017 年 4 月至 10 月在伊朗德黑兰 Shahr-e-Rey 的 6 个卫生中心进行。100 名 24-59 个月大的儿童，有轻度至中度营养不良（体重身高 Z 评分 [WHZ]在-3 至-1 之间），随机分为两组，分别接受 1-3 包 RUSF 或正常饮食 8 周。所有母亲和照顾者都接受了营养教育。评估生长指标，包括体重和身高、WHZ 和体重指数（BMI），以及临床结果。
结果
接受 RUSF 的儿童体重显著增加（分别为 1.44±0.38kg 和 0.7±0.32kg，P<0.001），BMI 也显著增加（分别为 1.2±0.47kg/m 和 0.35±0.33kg/m，P<0.001）。与对照组相比，RUSF 组在前 4 周（P<0.001）和整个研究期间（P=0.013）的每日体重增加量更大。在 RUSF 组中，在前 4 周（P=0.027）期间，每日身高增长幅度明显更高。RUSF 组 WHZ 改善更为明显（分别为 1.18±0.41 和 0.41±0.31，P<0.001）。此外，研究结束时，RUSF 组 92%的儿童 WHZ>–1，而对照组仅为 12%（P<0.001）。干预组腹泻发生率（分别为 12%和 28.6%，P=0.01）和发热发生率（分别为 16%和 36.7%，P=0.05）略低于对照组。
结论
新研制的 RUSF 改善了轻度至中度营养不良儿童的生长指标和临床结果。
临床试验注册号
IRCT2017021315536N6（在 www.irct.ir 注册）。
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