中国儿童营养状况15年变化分析——5岁以下儿童生长发育变化特点

The Growth characteristics of children under 5 in the past 15 years

目的利用中国食物与营养监测系统1990～2005年的数据，对中国经济快速发展时期儿童生长发育特点进行分析，确定当前主要的儿童营养问题，为制定营养改善对策提供科学依据。方法本文用WHO推荐的NCHS标准评价儿童的身高体重发育状况，用Z评分方法，比较1990～2005年中国城乡5岁以下儿童的生长发育变化。结果1990年至2005年，中国5岁以下儿童的低体重率由22．6％降低到8．6％，生长迟缓率由41．4％降至13．1％。城乡儿童的生长迟缓率的差值由1990年的32个百分点降到了2005年的10．6个百分点。但中国贫困农村儿童的低体重率和生长迟缓率分别为12．3％与17．6％。由于中国儿童身高的改善滞后于体重的改善，在1992年前后出现了“生长迟缓型肥胖”现象。1995年，儿童“生长迟缓型肥胖”率最高，达12．6％。1995年后，中国城乡儿童的身高体重发育开始均衡发展，到2005年，中国儿童的身高体重均衡性有了显著的改善。结论15年来中国5岁以下儿童生长发育状况已有很大改善，城乡差距缩小。但是贫困地区儿童的营养不良患病率仍在较高水平，虽然近几年来有了较大的改善。作者提出了在保证6个月龄以下儿童纯母乳喂养的同时，采取适合中国国情的家庭内辅助食品的营养强化等综合干预措施的建议，并强调加强6～24月龄婴幼儿的辅食添加质量以及提高2岁以上儿童的膳食质量，将是进一步有效的提高中国5岁以下儿童营养状况的关键所在。

Objective To describe the changes of the nutritional status of children under 5 in China in the past 15 years for evidence-based policy making. Method The datasets of China Food and Nutrition Surveillance during 1990-2005 were analyzed to compare the growth development of Chinese children under 5. Z scores and prevalence of underweight, prevalence of stunting were used as the indicators and WHO standard is applied. Results The prevalence of underweight and stunting of children steadily reduced from 22.6% in 1990 to 8.6% in 2005 and from 41.4% in 1990 to 13.1% in 2005 respectively. The disparity of stunting prevalence between urban and rural has been narrowed form 32 percentage points to 10.6 percentage points from during 1990 - 2005. But the underweight prevalence and stunting prevalence of children in poor rural areas was 12.3% and 17.6% respectively in year 2005. As the improvement of weight growth speed was faster than the height growth, the ＇stunted obesity＇ has been emerging among rural children, during 1992- 1995, which was as high as 12.6% . The height growth of children improved quickly during 200- 2005 and better matched with weight growth. Conclusion The growth of Chinese children has been dramatically improved during the past 15 years. The disparity of prevalence of underweight and stunting between urban and rural narrowed. But malnutrition in poor rural areas is still serious even it improved in recent years. Recommendation on comprehensive intervention including improving quality of complementary feeding for children aged 6 - 24 month by country-specific home level fortification and quality of the diet for older children should be the key strategies parallel with breastfeeding is made.