China Academy for Rural Development, School of Public Affairs, Zhejiang University, 866 Yuhangtang Rd, Hangzhou 310058, China.
International Food Policy Research Institute, East and Central Asia Office, 12 Zhongguancunnandajie, Beijing 100081, China.
Nutrients. 2021 Apr 16;13(4):1322. doi: 10.3390/nu13041322.
Existing empirical evidence suggests that the prevalence of undernutrition in remote and poor, rural areas is still high among Chinese children. While evidence reveals that undernutrition may detrimentally affect child development, studies focusing on rural Chinese preschoolers are sparse. Using the baseline survey of a preschool's free nutritious lunch pilot program, this study examined the relationship between child undernutrition and developmental outcomes among a preschool-aged sample in poor, rural areas of China. We conducted the baseline survey in Hunan province in south central China in September 2018. A total of 1293 preschoolers living in two (then) nationally designated poverty counties in rural Hunan served as our study sample. Children's nutritional statuses were measured using height-for-age z-score, weight-for-age z-score, and anemia, while their cognitive and socio-emotional skills were assessed using the Wechsler Preschool and Primary Scale of Intelligence (WPPSI) and Strengths and Difficulties Questionnaire (SDQ), respectively. We find that 33% of sample preschoolers were anemic, whereas the incidences of stunting and wasting were 11% and 2%, respectively. About 54% of the sample children had delay in at least one of the developmental domains measured in this study. Our findings provide suggestive evidence supporting that children from certain backgrounds tend to experience worse nutritional and developmental outcomes than their counterparts. After controlling for socioeconomic status, we observed that both anemia and stunting were negatively associated with children's cognitive performance; however, they were not associated with socio-emotional performance. As such, this study suggests that free lunch programs have the potential to change children's developmental trajectory in preschool. We believe that our results will contribute to the debate surrounding whether the nutritious lunch program in China should be expanded to the preschool education level.
现有实证证据表明，中国偏远贫困农村地区儿童营养不良的患病率仍然很高。虽然有证据表明营养不良可能对儿童发育造成不利影响，但针对中国农村学龄前儿童的研究却很少。本研究利用一所幼儿园免费营养午餐试点计划的基线调查数据，考察了贫困农村地区学龄前儿童营养状况与发育结果之间的关系。我们于 2018 年 9 月在中国中南部的湖南省进行了基线调查。共有 1293 名居住在湖南两个国家级贫困县的学龄前儿童作为研究样本。儿童的营养状况通过身高年龄 z 评分、体重年龄 z 评分和贫血来衡量，而他们的认知和社会情感技能则分别通过韦氏学前和小学智力量表（WPPSI）和长处和困难问卷（SDQ）进行评估。我们发现，33%的样本儿童贫血，发育迟缓率和消瘦率分别为 11%和 2%。约 54%的样本儿童在本研究测量的至少一个发育领域存在延迟。我们的研究结果提供了有说服力的证据，表明某些背景的儿童比其他儿童更容易出现营养和发育不良的情况。在控制社会经济地位后，我们观察到贫血和发育迟缓均与儿童的认知表现呈负相关；但它们与社会情感表现无关。因此，本研究表明免费午餐计划有可能改变儿童在幼儿园的发展轨迹。我们相信，我们的研究结果将有助于围绕中国的营养午餐计划是否应扩大到学前教育阶段展开讨论。
