Saavedra José M
Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Ann Nutr Metab. 2022;78 Suppl 2:40-50. doi: 10.1159/000524328. Epub 2022 May 24.
Over the last 30-40 years, we have seen an improvement in global child undernutrition, with major reductions in wasting and stunting. Meanwhile, childhood obesity has dramatically increased, initially in high-income populations and subsequently in the more economically vulnerable. These trends are related to significant changes in diet and external factors, including new environmental threats.
Obesity rates first increased in older children, then gradually in infants. And in the next couple of years, there will be more overweight and obese than moderately or severely underweight children in the world. The changes in childhood nutritional landscape are a result of poor diets. Today, almost 50% of the world's population consumes either too many or too few calories. Dietary disparities between countries result in disparities of under- and overnutrition and impact the global health landscape. Most children with obesity, wasting, and micronutrient deficiencies live in lower income countries and in lower income families within any country. High energy-low nutrient diets are contributing to the increase in non-communicable diseases, which will manifest later in this generation of children. In 1990, child wasting was the #1 leading risk factor for mortality for all ages, and high BMI was #16; today, they are #11 and #5, respectively. COVID-19 and climate change are new major threats to global nutrition. Current and future efforts to improve the state of child nutrition require multisectoral approaches to reprioritize actions which address current trends and emerging threats.
在过去30至40年里，我们看到全球儿童营养不良状况有所改善，消瘦和发育迟缓现象大幅减少。与此同时，儿童肥胖率急剧上升，最初出现在高收入人群中，随后在经济上更脆弱的人群中也出现了这种情况。这些趋势与饮食和外部因素的重大变化有关，包括新出现的环境威胁。
肥胖率首先在大龄儿童中上升，然后逐渐在婴儿中上升。在未来几年里，世界上超重和肥胖儿童的数量将超过中度或重度体重不足的儿童。儿童营养状况的变化是不良饮食造成的。如今，世界上近50%的人口摄入的热量要么过多，要么过少。国家之间的饮食差异导致了营养不足和营养过剩的差异，并影响了全球健康状况。大多数肥胖、消瘦和缺乏微量营养素的儿童生活在低收入国家以及任何国家的低收入家庭中。高能量低营养的饮食导致了非传染性疾病的增加，这将在这一代儿童日后显现出来。1990年，儿童消瘦是所有年龄段死亡的首要危险因素，高体重指数排第16位；如今，它们分别排第11位和第5位。新冠疫情和气候变化是全球营养面临的新的重大威胁。当前和未来改善儿童营养状况的努力需要多部门方法，以便重新确定行动重点，应对当前趋势和新出现的威胁。
