云南省5岁以下儿童营养现状与实现可持续发展目标预测分析

Nutritional status of children under 5 years of age in Yunnan and the prediction of achieving nutrition related accomplishment outlined by Sustainable Development Goals

目的分析云南省5岁以下儿童营养不良的现状及变化趋势,预测能否实现可持续发展目标(Sustainable Development,SDGs)中的营养相关目标。方法采用2016全球疾病负担研究(GBD 2016)中1990—2016年(每五年一个数据)云南省5岁以下儿童生长迟缓率、低体质量率和消瘦率,1~4岁儿童超重率、肥胖率和超重肥胖率,7~28 d新生儿纯母乳喂养率等指标描述儿童营养状况,采用趋势外推法预测指标到目标年份的情况。结果2016年云南省5岁以下儿童的生长迟缓率、消瘦率和低体质量率分别为13.41%、3.34%和4.69%;1~4岁儿童超重率、肥胖率和超重肥胖率分别为7.20%、4.22%和11.42%;7~28d新生儿纯母乳喂养率为33.02%。2016年云南省5岁以下儿童低体质量率和消瘦率已达到低于5%的目标。预测显示:2020年5岁以下儿童的生长迟缓率为11.28%,2030年为7.20%,较难实现"到2020年<7%和2030年<5%"目标;预计2025年5岁以下生长迟缓人数为162038人,相比2016年293914人下降了44.87%,可以实现"生长迟缓儿童数量减少40%"的目标;预计2025年1~4岁儿童的超重率和肥胖率分别增至8.32%和8.00%,实现保持零增长目标面临巨大挑战;预计2025年7~28 d新生儿纯母乳喂养率为33.99%,与50%的目标差距较大。结论云南省儿童低体质量和消瘦的状况有所改善,但超重和肥胖的上升趋势明显。由于5岁以下儿童身高的改善滞后于体质量的增加,出现生长迟缓型肥胖,面临生长迟缓和超重肥胖的双重负担。应采取综合措施来改善儿童营养状况。

Objective To understand the current nutritional status of children under 5 years of age in Yunnan and to predict the possibility of achieving nutrition related targets outlined by Sustainable Development Goals(SDGs). Methods Nutrition related data of children under 5 years of age were retrieved from the Global Disease Burden Study Database in 2016, including the stunting, underweight and wasting rate of children under 5 years of age, the overweight and obesity rate of children aged 1-4 years, and the exclusive breastfeeding rate of 7-28 days old newborns, which were used to describe the nutritional status of children and also to predict the values of the above indicators in target years by using trend extrapolation. Results In 2016, the rates of stunting, wasting and underweight of children under 5 years of age in Yunnan were 13.41%, 3.34% and 4.69% respectively;the rates of overweight and obesity of children aged 1-4 years were 7.2% and 4.22%, respectively.The exclusive breastfeeding rate of 7-28 days old newborns was 33.02%.In 2016, the rates of underweight and wasting of children under 5 years of age reached the year target of "less than 5%".The prediction showed that the stunting rate of children under 5 years of age would be 11.28% in 2020 and 7.2%in 2030,which were way higher than the goal of<7%by 2020 and<5%by 2030.It was predicted that in 2025,the number of children under 5 years of age with stunting would decrease by 44.9%(the goal was40%)from 293,914 in 2016 to 162,038,the rates of overweight and obesity of children aged 1-4 years would increase to 8.32% and 8%,the exclusive breastfeeding rate of 7-28 days newborns would be 33.99%,it was challengeable to reach the target of"zero growth"and the goal of 50% by 2025. Conclusions The underweight and wasting rates of children under 5 years of age in Yunnan decrease,while the overweight and obesity rates increase.The"growth-retardation obesity"in children is mainly caused by the lagging increase of body height versus body weight,therefore,comprehensive intervention should proposed to improve the nutritional status of children in Yunnan.