汶川大地震一年后灾区农村60月龄以下儿童的营养状况

The nutritional status among children under 60 months year-old after one year of the Earthquake in Wenchuan

目的了解汶川大地震对受灾地区儿童营养和生长发育状况的影响，以及灾后1年灾区儿童的维生素A、D缺乏及营养性贫血的流行状况及原因。方法于2009年4月中旬调查了466名灾区农村60月龄以下儿童（其中0－月龄儿童162名，24～59月龄儿童304名）的生长发育状况、贫血发生率，以及24—59月龄儿童的铁缺乏发生率、维生素A、D、B12和叶酸的营养状况，并与2002年中国居民营养与健康状况调查中农村相应年龄儿童的结果进行比较。结果灾区6月龄以下婴儿的基本纯母乳喂养率仅为58．8％（30／51）。在0～23月龄儿童中，1h内开奶率仅为10．7％（16／150），有92．0％（149／162）的儿童从未使用过营养素补充剂。灾区24～59月龄儿童的谷薯类平均摄入量为（267．2±154．3）g／d，高于2002年全国农村儿童水平（178．75g／d；u=9．995，P〈0．01）；蔬菜、水产和禽肉类的摄入量分别为（63．6±56．7）、（2．6±7．9）和（19．4±24．0）g／d，低于2002年全国农村儿童水平（135．05、8．82和32．23g/d；u值分别为21．971、13．728和9．321，P值均〈0．01）；水果、乳制品和豆类食品的摄入量分别为（102．2±110．8）、（65．2±123．8）和（20．5±29．0）g／d，高于2002年的调查结果（分别为32．81、2．87和6．50g／a；u值分别为10．919、8．778和8．417，P值均〈0．01）。维生素A缺乏和边缘缺乏率分别为15．4％（29／188）和30．3％（57／188），维生素D缺乏和不足合计为92．0％（183／199），0～月龄儿童和24—59月龄儿童的贫血发生率分别为47．5％（77／162）和21．5％（60／279），24—59月龄儿童铁缺乏率为45．7％（86／188），锌缺乏率为65．5％（129／197）。儿童的身高发育迟缓，24～59月龄儿童的生长迟缓率为13．6％（38／279）。结论地震影响地区儿童的膳食结构不合理，供热食物和供蛋白质（植物来源）食物的摄入量基本能满足要求，但是存在肉、豆、奶、水产和蔬菜类食物摄入不足。维生素A、D、铁、锌缺乏较为普遍。

Objective To evaluate the effects of Wenchuan Earthquake on the nutritional status, growth, and the prevalence nutritional anemia, vitamin A deficiency （VAD） and vitamin D deficiency among children under 60 months old living in the disaster areas. Methods A nutritional survey was conducted in April 2009. The survey recruited 466 under 60 months old children,including 162 children aged 0 months old and 304 children aged 24 -59 months old. The children＇s growth status, prevalence of anemia, and the iron deficiency prevalence, vitamin A, D, B12, folic acid status were measured. The study findings were compared to the results from 2002 Chinese Nutritional and Health Survey. Results The exclusive breast milk feeding rate among infants under 6 - months was 58.8% （ 30/51 ）. Among the 0 - 23 months old children, only 10.7% （16/150） got breast feeding within one hour after delivery. Ninety-two per cent （149/162） 0 -23 months old children never received any nutrient supplements. The average cereals and roots intakes of the 24 -59 months old children living in the disaster area were （267. 2 ± 154. 3 ）g/d, higher than the result of rural children average （ 178.75 g/d） of 2002 National Nutrition and Health Survey （ u = 9. 995, P 〈 0. 01 ）.The average intakes of vegetables, aquatic products, meat and poultries were （63.6 ± 56. 7 ）, （2. 6± 7.9 ）, （ 19. 4 ± 24. 0） g/d, respectively, significantly lower than 2002 results 135.05,8.82 and 32. 23 g/d （ u = 21. 971,13. 728 and 9. 321,P 〈 0. 01 ）. Fruits, dairy products and legumes intakes were （ 102. 2 ± 110. 8 ）, （65.2 ± 123.8）and （20. 5 ±29. 0） g/d,respectively,higher than 2002 results （32. 81,2. 87 and 6. 50 g/d; u = 10. 919,8. 778 and 8.417,P 〈0. 01 ）. The prevalence of vitamin A deficiency and marginal deficiency was 15.4% （ 29/188 ） and 30. 3% （ 57/188 ）, respectively. The sum of vitamin D deficiency and insufficiency was 92.0% （183/199）. The prevalence of anemia of the 0 - months old children and 24 -59 months old children was 47.5% （77/162） and 21.5% （60/279） ,respectively. The prevalence of iron and zinc deficiencies was 45.7% （ 86/188 ） and 65.5% （ 127/197 ） . The prevalence of stunt was 13.6% （38/279） among the 24 - 59 months old children. Conclusion The results indicated that the dietary structure of the children living in the disaster area was not ideal. Although, the intakes of energy and protein supporting foods could meet the requirements, but the dietary lacks of meats, poultries, dairy products, legume products, aquatic products and vegetables. The vitamin A, vitamin D deficiency,iron and zinc deficiencies are of a high prevalence in the disaster area.