Department of Nutrition and Food Safety, World Health Organization, Geneva, Switzerland.
Senior Consultant Pediatrics and Clinical Epidemiology, Sitaram Bhartia Institute of Science and Research, New Delhi, India.
Am J Clin Nutr. 2024 Oct;120(4):769-772. doi: 10.1016/j.ajcnut.2024.08.006. Epub 2024 Sep 10.
The participants in this debate agreed that: 1) target-based advocacy is required for ensuring countries' engagement and political commitments toward reducing child malnutrition, and the tools used for monitoring progress should be accurate and pose no risk of harmful consequences; and 2) physical growth is not the only dimension of nutritional status to be monitored in clinical and public health practice; anthropometry is thus only one of the diagnostic indicators of nutritional status. Key disagreements included methodological approaches for developing a single growth standard to evaluate nutritional status globally; the relative utility of universal and contextual growth standards for clinical practice and public health; the balance of benefits, harms, and acceptability among stakeholders; and their use as a screening or a definitive tool in individual and public health nutrition. Noteworthy agreements for research priorities included comparison of benefits and harms of using universal compared with contextual growth standards/references and different stakeholders' perception of expectations from and utility of growth standards.
1)为确保各国参与和对减少儿童营养不良作出政治承诺,需要进行以目标为导向的宣传,并且用于监测进展的工具应该准确,不会造成有害后果;2)在临床和公共卫生实践中,衡量营养状况的维度不仅限于身体生长,因此人体测量学只是营养状况的诊断指标之一。主要分歧包括制定单一生长标准以在全球评估营养状况的方法学方法;通用和背景生长标准在临床实践和公共卫生中的相对效用;利益相关者之间的利弊和可接受性之间的平衡;以及它们在个体和公共卫生营养中作为筛选或明确工具的使用。值得注意的是,研究重点包括比较使用通用与背景生长标准/参考的益处和危害,以及不同利益相关者对生长标准的期望和效用的看法。