营养强化辅助食品补充物对甘肃贫困农村婴幼儿体格生长的影响

Effects of nutrient fortified complementary food supplements on growth of infants and young children in poor rural area in Gansu Province

目的探讨补充含有蛋白质、微量营养素的辅助食品对婴幼儿身长和体重的影响。方法从甘肃省5个贫困县选取1478名4～12个月的婴幼儿分成2组，所有儿童均在保持其家庭习惯辅助食品添加的前提下。每天再补充1包不同配方的营养补充物，其中配方1组补充了蛋白质和微量营养素，配方2组补充了与配方1组同等的能量，每隔6个月对全部儿童补充一次大剂量维生素A。补充期间，每3个月进行一次体格测量，两组儿童观察到满24个月为止。结果基线调查时，配方2组LAZ和WAZ要优于配方1组，配方1组儿童的营养不良率均高于配方2组，但差异无显著性（P〉0．05）。补充12个月以后，配方1组和配方2组儿童LAZ、WAZ和营养不良率已经没有差别。如果比较同一个儿童随访调查与其基线调查时的LAZ差值、WAZ差值的变化．配方1的作用要优于配方2，效用尺度是0．17。对于基线调查不同营养状况的儿童，配方1组均有正的效用。所有儿童满24个月时，儿童身长和体重Z评分的变化值在配方1组和配方2组之间有显著意义（P〈0．05），配方1组婴幼儿身长的变化值要显著大于配方2组（P〈0．05），如果只分析基线调查时月龄小于7个月的儿童。配方1组儿童身长Z评分的变化值要显著优于配方2组（P〈0．005），儿童平均身长要多增加1．3cm（P〈0．005）。结论辅食补充物可以促进婴幼儿的体格发育，家庭水平强化辅食在中国贫困农村是可行的。

Objective To investigate the effects of complementary food supplements with protein and multimicronutrients on growth of infants and yound children in poor rural area in Gansu Province, China. Methods In 5 poor counties of Gansu Province, 1478 children aged 4-12 months were enrolled and divided into two groups, In addition to the usual home-made complementary food, all the children were fed one sachet of either formula Ⅰor formula Ⅱ per day, protein and micronutrient were supplemented in formula Ⅰ group, fomulaⅡ group got energy supplement corresponding with same energy intake as formula Ⅰ, a massive dose of vitamin A was supplemented to both groups every 6 months interval. Weight and height measurements were done every 3 months until they were 24 months old. Results At baseline survey, LAZ and WAZ of children in formula Ⅱgroup was better than those of formula Ⅰ group, the prevalence of under nutrition in formula Ⅰ was higher than those in formula Ⅱgroup, but not statistically significant. After 12 months supplementation, the differences of LAZ and WAZ between the two groups diminished, the stunting prevalence of the two groups was close, it demonstrated that formula Ⅰ was slightly more effective than formula Ⅱ, the effect size was 0.17. Formula I has positive effect independently with the nutrition status of children. When all children were 24 months, formula Ⅰwas better than formula Ⅱin LAZ and WAZ changes P 〈 0.05）, the length changes were bigger in formula Ⅰgroup （P 〈 0.05）. If takeing the children initiating supplementation at under age of 7 month, LAZ changes in formula Ⅰ group and formula Ⅱgroup was statistically significant （ P 〈 0.005）. The average length increased in formula Ⅰ group was 1.3cm longer.Conclusion Multinutrient-fortified complementary food supplement could be effective for children aged 4-12 month in terms of growth promotion. The study proved that application of home-level fortification of supplementation into the regular complementary feeding in poor rural China may be feasible.