Santiago-Vieira Carolina, Velasquez-Melendez Gustavo, de Cássia Ribeiro-Silva Rita, de Jesus Pinto Elizabete, Barreto Maurício L, Li Leah
School of Nursing, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
Center of Data and Knowledge Integration for Health (CIDACS), Fiocruz Bahia, Salvador, Brazil.
Lancet Reg Health Am. 2024 Mar 27;32:100721. doi: 10.1016/j.lana.2024.100721. eCollection 2024 Apr.
There is limited evidence on recent trends in childhood growth trajectories in Low-/middle-income countries. We investigated how age-trajectories for height and Body Mass Index (BMI) have changed among Brazilian children born in two different time periods after 2000.
We used a population-based cohort (part of the "Cohort of 100-Million Brazilians") created by the linkage of three Brazilian administrative databases: the Cadastro Único of the Federal Government, the National System of Live Births and the National Nutritional and Food Surveillance System. We included longitudinal data on 5,750,214 children who were 3 to <10 years of age and born between 2001 and 2014 (20,209,133 observations). We applied fractional polynomial models with random-effects to estimate mean height and BMI trajectories for children.
Compared to children born in 2001-2007, the cohort born in 2008-2014 were on average taller, by a z-score of 0.15 in boys and 0.12 in girls. Their height trajectories shifted upwards, by approximately 1 cm in both sexes. Levels of BMI increased little, by a z-score of 0.06 (boys) and 0.04 (girls). Mean BMI trajectories also changed little. However, the prevalence of overweight/obesity increased between cohorts, e.g., from 26.8% to 30% in boys and 23.9%-26.6% in girls aged between 5 and <10 years.
An increase of 1 cm in mean height of Brazilian children during a short period indicates the improvement in maternal and child health, especially those from low-income families due to the new health and welfare policies in Brazil. Although mean BMI changed little, the prevalence of child overweight/obesity slightly increased and remained high.
This work was supported by National Council for Scientific and Technological Development - CNPq; Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES; National Institute for Health Research (NIHR) Great Ormond Street Hospital Biomedical Research Centre; Society for the Study of Human Biology; Fundação de Amparo à Pesquisa do Estado de Minas Gerais - FAPEMIG; Departamento de Ciência e Tecnologia da Secretaria de Ciência, Tecnologia, Inovação e Complexo da Saúde do Ministério da Saúde - Decit/SECTICS/MS. The study also used resources from the Centre for Data and Knowledge Integration for Health (CIDACS), which receives funding from the Bill & Melinda Gates Foundation, the Wellcome Trust, the Health Surveillance Secretariat of the Ministry of Health and the Secretariat of Science and Technology of the State of Bahia (SECTI-BA).
关于低收入和中等收入国家儿童生长轨迹的近期趋势，证据有限。我们调查了2000年后两个不同时期出生的巴西儿童的身高和体重指数（BMI）随年龄的轨迹变化情况。
我们使用了一个基于人群的队列（“1亿巴西人队列”的一部分），该队列由巴西三个行政数据库链接而成：联邦政府的单一登记册、国家活产系统和国家营养与食品监测系统。我们纳入了5750214名3至未满10岁、2001年至2014年出生儿童的纵向数据（20209133条观测数据）。我们应用随机效应分数多项式模型来估计儿童的平均身高和BMI轨迹。
与2001 - 2007年出生的儿童相比，2008 - 2014年出生的队列平均身高更高，男孩的身高z值高0.15，女孩高0.12。他们的身高轨迹向上移动，两性均约为1厘米。BMI水平略有上升，男孩的z值为0.06，女孩为0.04。平均BMI轨迹变化也不大。然而，不同队列间超重/肥胖患病率有所上升，例如，5至未满10岁男孩的超重/肥胖患病率从26.8%升至30%，女孩从23.9%升至26.6%。
巴西儿童平均身高在短时间内增加1厘米，表明母婴健康状况有所改善，特别是低收入家庭的母婴，这得益于巴西新的健康和福利政策。尽管平均BMI变化不大，但儿童超重/肥胖患病率略有上升且仍处于高位。
本研究得到了巴西国家科学技术发展委员会（CNPq）、高等教育人员素质提升协调办公室（CAPES）、英国国家卫生研究院（NIHR）大奥蒙德街医院生物医学研究中心、人类生物学研究协会、米纳斯吉拉斯州研究资助基金会（FAPEMIG）、巴西卫生部科学技术创新与健康综合司科学技术部（Decit/SECTICS/MS）的支持。该研究还使用了健康数据与知识整合中心（CIDACS）的资源，CIDACS接受比尔及梅琳达·盖茨基金会、惠康信托基金会、巴西卫生部健康监测秘书处以及巴伊亚州科学技术秘书处（SECTI - BA）的资助。
