Xu Fang, Huang Xin, Yu Long, Yang Yadi, Chang Litao
School of Public Health, Kunming Medical University, Kunming, China.
Yunnan Center for Disease Control and Prevention, Kunming, China.
Front Public Health. 2025 May 26;13:1585735. doi: 10.3389/fpubh.2025.1585735. eCollection 2025.
In order to improve the nutrition and health status of rural school-age children and to reduce malnutrition. This study evaluated the effects of the National Nutrition Improvement Program for Rural Compulsory Education Students (NNIP-RCES) in three counties (Midu, Xuanwei, and Xundian) in Yunnan Province, China, in 2019, 2021, and 2023, and the findings highlight regional differences and future nutrition trends.
Anthropometric indicators (height and weight) and biochemical markers (hemoglobin, Vitamin A, and Vitamin D) were measured and analyzed using linear mixed-effects models to identify temporal changes, regional differences, and the overall effectiveness of the program.
The program led to significant improvements in height ( = 0.42, = 0.013), weight ( = 0.66, < 0.001), and Vitamin A levels ( = 0.011, < 0.001), demonstrating notable progress in physical growth and Vitamin A supplementation. However, hemoglobin levels declined significantly ( = -0.38, = 0.005), particularly in Xundian, highlighting ongoing challenges in anemia prevention. Vitamin D levels remained stable with no significant improvements ( = 0.488), possibly influenced by factors such as limited dietary variety and seasonal variations in sun exposure. Additionally, considerable disparities in program outcomes were observed among counties, with Midu generally showing superior improvements compared to Xuanwei and Xundian.
While the NNIP-RCES effectively enhanced physical growth and alleviated Vitamin A deficiency, persistent anemia, unchanged Vitamin D levels, and marked regional disparities underscore critical areas requiring further attention. Future policy refinements should focus on targeted interventions addressing anemia prevention, Vitamin D supplementation, enhanced dietary diversity, and equitable resource allocation across regions. Strengthened monitoring frameworks and comprehensive nutrition education initiatives are also recommended to ensure sustainable improvements and serve as a model for global school-based nutritional interventions.
为改善农村学龄儿童的营养与健康状况并减少营养不良。本研究评估了2019年、2021年和2023年中国云南省三个县（弥渡、宣威和寻甸）的农村义务教育学生营养改善计划（NNIP-RCES）的效果，研究结果突出了地区差异和未来营养趋势。
测量并分析人体测量指标（身高和体重）及生化标志物（血红蛋白、维生素A和维生素D），使用线性混合效应模型来确定时间变化、地区差异及该计划的整体效果。
该计划使身高（β = 0.42，P = 0.013）、体重（β = 0.66，P < 0.001）和维生素A水平（β = 0.011，P < 0.001）有显著改善，表明在身体生长和维生素A补充方面取得了显著进展。然而，血红蛋白水平显著下降（β = -0.38，P = 0.005），尤其是在寻甸，这突出了预防贫血方面持续存在的挑战。维生素D水平保持稳定，无显著改善（P = 0.488），可能受到饮食种类有限和日照季节变化等因素的影响。此外，各县之间在计划成果方面存在相当大的差异，弥渡总体上比宣威和寻甸显示出更好的改善效果。
虽然农村义务教育学生营养改善计划有效促进了身体生长并缓解了维生素A缺乏，但持续存在的贫血、维生素D水平未变以及明显的地区差异凸显了需要进一步关注的关键领域。未来政策的完善应侧重于针对预防贫血、补充维生素D、增加饮食多样性以及跨地区公平资源分配的有针对性干预措施。还建议加强监测框架和全面的营养教育举措，以确保可持续改善，并为全球基于学校的营养干预提供范例。
