Walker S P, Grantham-McGregor S M, Himes J H, Powell C A, Chang S M
Tropical Metabolism Research Unit, University of the West Indies, Kingston, Jamaica.
J Nutr. 1996 Dec;126(12):3017-24. doi: 10.1093/jn/126.12.3017.
The long-term benefits of early childhood supplementation and the extent to which catch-up growth occurs following linear growth retardation remain controversial. Stunted children (height-for-age < -2 SD of NCHS references, n = 122) recruited from a survey of poor neighborhoods in Kingston, Jamaica, participated in a 2-yr randomized, controlled trial of supplementation beginning at ages 9-24 mo. A group of 32 non-stunted children from the same neighborhoods was also followed. Four years after the intervention ended, when children were 7 to 8 y old, there were no effects of supplementation on any anthropometric measure. From the end of the trial until follow-up, the children who had been supplemented gained 1.2 cm less (P < 0.05) than the non-supplemented children, approximately the same amount as they had gained during the trial compared with the non-supplemented children. After adjustment for regression to the mean, the height-for-age of stunted children (supplemented and non-supplemented combined) increased from enrollment to follow-up by 0.31 Z-score (95% CI 0.17, 0.46). The height-for-age of the non-stunted children also increased (0.96 Z-score; 95% CI 0.70, 1.22). Our results suggest that some catch-up growth is possible even when children remain in poor environments. Long-term benefits of supplementation to growth may not be achieved when intervention begins after age 12 mo in children who have already become undernourished.
幼儿期补充营养的长期益处以及线性生长迟缓后追赶生长发生的程度仍存在争议。从牙买加金斯敦贫困社区调查中招募的发育迟缓儿童（年龄别身高低于美国国家卫生统计中心参考标准的-2标准差，n = 122），从9至24个月大时开始参加一项为期2年的补充营养随机对照试验。还对来自同一社区的32名非发育迟缓儿童进行了跟踪。干预结束四年后，当儿童7至8岁时，补充营养对任何人体测量指标均无影响。从试验结束到随访期间，接受补充营养的儿童比未接受补充营养的儿童少长高1.2厘米（P < 0.05），这与试验期间接受补充营养的儿童与未接受补充营养的儿童相比长高的幅度大致相同。在对均值回归进行调整后，发育迟缓儿童（补充营养组和未补充营养组合并）的年龄别身高从入组到随访增加了0.31个Z评分（95%置信区间0.17, 0.46）。非发育迟缓儿童的年龄别身高也有所增加（0.96个Z评分；95%置信区间0.70, 1.22）。我们的结果表明，即使儿童仍处于贫困环境中，也有可能实现一定程度的追赶生长。对于已经营养不良的儿童，若在12个月龄后开始干预，可能无法实现补充营养对生长的长期益处。
