巴西6至59月龄儿童的粮食不安全、贫血和维生素A缺乏症：巴西全国儿童营养调查（ENANI-2019）
Food Insecurity, Anemia and Vitamin A Deficiency in Brazilian Children Aged between 6 and 59 Months of Age: Brazilian National Survey on Child Nutrition (ENANI-2019).
作者信息
Silva Letícia Ramos da, Normando Paula, Schincaglia Raquel Machado, Castro Inês Rugani Ribeiro de, Andrade Pedro Gomes, Berti Talita Lelis, Lacerda Elisa Maria de Aquino, Alves-Santos Nadya Helena, Carneiro Letícia Barroso Vertulli, Kac Gilberto
机构信息
Instituto de Nutrição Josué de Castro, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil.
Faculdade de Nutrição, Universidade Federal de Goiás, Goiás, Brazil.
出版信息
Curr Dev Nutr. 2025 Feb 17;9(3):104567. doi: 10.1016/j.cdnut.2025.104567. eCollection 2025 Mar.
BACKGROUND
Anemia and vitamin A deficiency (VAD) can be related to poverty and food insecurity (FI), which can increase risk of stunting and delayed child development.
OBJECTIVES
This study aims to assess the association between FI and the occurrence of anemia and VAD in Brazilian children aged 6-59 months.
METHODS
Data from 6020 children from the Brazilian National Survey on Child Nutrition (2019) were used. FI was assessed using the Brazilian Food Insecurity Scale, classifying households into food security (FS) and FI levels. The outcomes were anemia [hemoglobin <10.5 g/dL (6-23 months) and hemoglobin <11 g/dL (24-59 months)] and VAD (retinol corrected by C-reactive protein <0.7 μmol/L). FI frequencies, anemia, and VAD prevalences were calculated according to FI levels, 95% confidence intervals (CIs), and -trend. The adjusted prevalence ratio (PR) was estimated using quasi-Poisson regression.
RESULTS
The prevalence of mild, moderate, and severe FI was 37.7% (95% CI: 32.0%, 43.4%), 6.2% (95% CI: 4.8%, 7.6%), and 4.2% (95% CI: 3.1%, 5.3%), respectively. The prevalence of anemia was 7.1% (95% CI: 5.9%, 8.3%), and VAD was 3.0% (95% CI: 2.5%, 3.6%). A significant linear trend (-trend < 0.001) was observed in the prevalence of anemia according to the degree of FI: severe (15.5%; 95% CI: 8.1%, 22.9%), moderate (10.0%; 95% CI: 5.4%, 14.6%), mild (6.6%; 95% CI: 4.9%, 8.3%), and FS (6.4%; 95% CI: 4.7%, 8.1%). Children living in households with severe FI had an 82% higher prevalence of anemia (PR: 1.82; 95% CI: 1.40, 4.17) than those living in FS. A significant linear trend (-trend < 0.001) was observed in the prevalence of VAD according to the degree of FI: severe (3.3%; 95% CI: 0.0%, 6.7%), moderate (5.8%; 95% CI: 2.3%, 9.2%), FI (2.8%; 95% CI: 1.9%, 3.7%), and FS (2.9%; 95% CI: 2.1%, 3.7%). No association was observed between FI and VAD.
CONCLUSIONS
Severe FI was associated with anemia among Brazilian children aged 6-59 months.
背景
贫血和维生素A缺乏症（VAD）可能与贫困和粮食不安全（FI）有关，这可能会增加发育迟缓及儿童发育延迟的风险。
目的
本研究旨在评估巴西6至59个月大儿童中FI与贫血和VAD发生之间的关联。
方法
使用了巴西全国儿童营养调查（2019年）中6020名儿童的数据。使用巴西粮食不安全量表评估FI，将家庭分为粮食安全（FS）和FI等级。结果指标为贫血[血红蛋白<10.5 g/dL（6至23个月）和血红蛋白<11 g/dL（24至59个月）]和VAD（经C反应蛋白校正的视黄醇<0.7 μmol/L）。根据FI等级、95%置信区间（CI）和趋势计算FI频率、贫血和VAD患病率。使用准泊松回归估计调整后的患病率比值（PR）。
结果
轻度、中度和重度FI的患病率分别为37.9%（95%CI：32.0%，43.4%）、6.2%（95%CI：4.8%，7.6%）和4.2%（95%CI：3.1%，5.3%）。贫血患病率为7.1%（95%CI：5.9%，8.3%），VAD患病率为3.0%（95%CI：2.5%，3.6%）。根据FI程度，贫血患病率呈现显著的线性趋势（趋势<0.001）：重度（15.5%；95%CI：8.直，22.9%）、中度（10.0%；95%CI：5.4%，14.6%）、轻度（6.6%；95%CI：4.9%，8.3%）和FS（6.4%；95%CI：4.7%，8.1%）。生活在重度FI家庭中的儿童贫血患病率比生活在FS家庭中的儿童高82%（PR：1.82；95%CI：1.40，4.17）。根据FI程度，VAD患病率呈现显著的线性趋势（趋势<0.001）：重度（3.3%；95%CI：0.0%，6.7%）、中度（5.8%；95%CI：2.3%，9.2%）；FI（2.8%；95%CI：1.9%，3.7%）和FS（2.9%；95%CI：2.1%，3.7%）。未观察到FI与VAD之间存在关联。
结论
重度FI与巴西6至59个月大儿童的贫血有关。
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