Shenavar Razieh, Sajjadi Seyedeh Forough, Farmani Azam, Zarmehrparirouy Mina, Azadbakht Leila
Department of Community Nutrition, Shiraz University of Medical Science, Shiraz, Iran.
Department of Community Nutrition, School of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Front Nutr. 2022 Mar 2;9:813449. doi: 10.3389/fnut.2022.813449. eCollection 2022.
Childhood malnutrition could have adverse impacts on the growth of child and eventually on fertility and general economic growth, and still, this issue remains a worldwide priority and a concern. This study aimed to evaluate the effectiveness of the national nutritional interventions program on the improvement and nutritional status of malnourished children children aged 6-59 months.
This community-based intervention study was conducted with 1288 acute and moderately malnourished children aged 6-59 months referred to health centers. Children received combined nutritional education and counseling with the provision of affordable complementary food for 10 months. Anthropometric measurements were assessed monthly according to the standard protocols.
Our results showed the reduction in the risk of malnutrition among children after nutritional interventions for weight-for-height (WHZ) ( < 0.001), height-for-age (HAZ) ( < 0.001), and weight-for-age (WAZ) ( = 0.008). Total malnourished children indicated improvement in HAZ (<-3 SD: OR = 1.10, = 0.026), WAZ (<-2SD: OR = 1.21, < 0.001; <-3SD: OR = 1.60, < 0.001), and WHZ (<-3SD: OR = 1.10, = 0.030). Controlling potential confounders (socioeconomic status, childrens' birth supine length, and weight) showed a significant amelioration in HAZ (<-2 SD: OR = 6.20, = 0.020; <-3 SD: OR = 9, = 0.003) and WAZ (<-2 SD: OR = 5.85, = 0.010; <-3 SD: OR = 7.50, = 0.004). In urban areas, significant amelioration was observed in HAZ (<-3 SD: OR = 1.22, = 0.010) and WAZ (<-2 SD: OR = 1.24, = 0.003; <-3 SD: OR = 1.64, < 0.001). In rural, considerable amelioration was observed in WAZ (<-2 SD: OR = 1.20, = 0.010; <-3 SD: OR = 1.50, < 0.001) and WHZ (<-3 SD: OR = 1.20, = 0.020).
Nutritional training and counseling as well as complementary food intervention among the malnourished children significantly improved the nutritional status of children. So community-based intervention is recommended to reduce the malnutrition among children.
儿童营养不良可能对儿童生长产生不利影响，并最终影响生育能力和总体经济增长，即便如此，这一问题仍是全球的优先事项和关注点。本研究旨在评估国家营养干预计划对改善6至59个月大营养不良儿童营养状况的有效性。
这项基于社区的干预研究针对1288名转诊至健康中心的6至59个月大的急性和中度营养不良儿童开展。儿童接受了营养教育和咨询，并获得了为期10个月的平价辅食。根据标准方案每月进行人体测量评估。
我们的结果显示，营养干预后，儿童体重身高比（WHZ）（<0.001）、年龄别身高（HAZ）（<0.001）和年龄别体重（WAZ）（=0.008）的营养不良风险降低。总体营养不良儿童的HAZ（<-3标准差：优势比=1.10，=0.026）、WAZ（<-2标准差：优势比=1.21，<0.001；<-3标准差：优势比=1.60, <0.001）和WHZ（<-3标准差：优势比=1.10，=0.030）均有所改善。控制潜在混杂因素（社会经济地位、儿童出生时仰卧身长和体重）后，HAZ（<-2标准差：优势比=6.20，=0.020；<-3标准差：优势比=9，=0.003）和WAZ（<-2标准差：优势比=5.85，=0.010；<-3标准差：优势比=7.50，=0.004）有显著改善。在城市地区，HAZ（<-3标准差：优势比=1.22，=0.010）和WAZ（<-2标准差：优势比=1.24，=0.003；<-3标准差：优势比=1.64，<0.001）有显著改善。在农村地区，WAZ（<-2标准差：优势比=1.20，=0.010；<-3标准差：优势比=1.50，<0.001）和WHZ（<-3标准差：优势比=1.20，=0.020）有显著改善。
对营养不良儿童进行营养培训和咨询以及辅食干预可显著改善儿童营养状况。因此，建议开展基于社区的干预措施以减少儿童营养不良。
