Pediatric Growth and Nutrition Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD 20817, USA.
Academy of Nutrition and Dietetics, Chicago, IL 60606, USA.
Nutrients. 2024 Jan 31;16(3):421. doi: 10.3390/nu16030421.
Globally, children are exposed to multiple health risks associated with diet and nutrition. Rather than simply being a condition of having too much or too little food, malnutrition is more a syndrome comprising multiple burdens of coexisting and reciprocal malnutrition, infection, or other conditions. Importantly, children with such syndromes (e.g., stunting and anemia, which are neither specific nor necessarily sensitive to nutritional status) are more likely to also have irreversible functional outcomes such as poor growth, impaired immune function, or cognitive delays. The global health community has identified nutrition-related targets (e.g., Sustainable Development Goals (SDGs) and World Health Organization (WHO) Global Nutrition Targets) that, for multiple reasons, are difficult to address. Moreover, as the complexity of the global health context increases with persistent pandemics of infectious diseases and the rising prevalence of noncommunicable diseases, there is a growing appreciation that conditions selected as nutrition/health targets indeed represent syndromes for which nutritional status serves as both an input and outcome. In recognition of the impact of these combined challenges and the role of the multiple manifestations of malnutrition, we suggest an approach to nutritional assessment that is intended to improve the precision of context-specific, equitable approaches to health promotion, disease prevention, and treatment.
在全球范围内，儿童面临着多种与饮食和营养相关的健康风险。营养不良不仅仅是食物摄入过多或过少的一种状况，而是一种由多种相互关联和相互影响的营养不良、感染或其他状况构成的综合征。重要的是，患有此类综合征的儿童（例如发育迟缓伴贫血，它们既不是营养不良的特异性指标，也不一定敏感）更有可能出现不可逆转的功能后果，如生长不良、免疫功能受损或认知迟缓。全球卫生界已经确定了与营养相关的目标（例如可持续发展目标和世界卫生组织全球营养目标），但由于多种原因，这些目标难以实现。此外，随着传染病持续流行和非传染性疾病患病率上升，全球卫生环境的复杂性不断增加，人们越来越认识到，被选为营养/健康目标的条件实际上代表了综合征，营养状况既是这些综合征的一个投入因素，也是一个结果因素。鉴于这些综合挑战的影响以及营养不良多种表现的作用，我们建议采用一种营养评估方法，旨在提高针对具体情况的、公平的促进健康、预防疾病和治疗方法的准确性。
