儿童营养状况评估研究进展

黎海芪

中国当代儿科杂志 ›› 2014, Vol. 16 ›› Issue (1) : 5-10.

PDF(1210 KB)
PDF(1210 KB)
中国当代儿科杂志 ›› 2014, Vol. 16 ›› Issue (1) : 5-10. DOI: 10.7499/j.issn.1008-8830.2014.01.002
专家讲座

儿童营养状况评估研究进展

  • 黎海芪
作者信息 +

Research advance in assessment of nutritional status of children

  • LI Hai-Qi
Author information +
文章历史 +

摘要

儿童营养不良不是单一疾病,而是一种异常的状态,包括营养低下和营养过度。但多数国家学者描述儿童营养不良时仍是指儿童能量-蛋白质营养低下。根据体格发育指标判断儿童营养不良有低体重、生长迟缓和消瘦三种情况。身长(高)的改善比体重的增加更能衡量营养补充状况,体重增加应与身长(高)成比例。因此,近年WHO建议以体重/身长(高)判断儿童人群营养不良流行强度和个体儿童营养不良状况以及评估干预情况。评价儿童营养状况包括人体测量(“A”)、实验室或生化检查(“B”)、临床表现(“C”)、膳食分析(“D”)。营养不良儿童要求保证食物摄入Ⅰ类(功能性、预防性营养素)和Ⅱ类(生长营养素)等30余种营养素使生长加速至正常水平。

Abstract

Malnutrition is not a simple disease, which occurs in the condition when the body does not get the right amount of nutrients to maintain healthy tissues and organ functions. Malnutrition generally refers both to undernutrition and overnutrition, but usually it is used to refer solely to a deficiency of nutrition. Infants and young children are the most vulnerable because of their high nutritional requirements for growth and development. Growth is an important indicator of health and nutritional status of a child. Generally, underweight, studding and wasting are used as the indicators of malnutrition. In fact, a gain in height is a better indicator of the adequacy of a diet than a gain in weight. Rates of weight gain needs to accompany accelerated height gain to maintain normal body proportions (weight-for-height). Now therefore WHO recommends using weight-for-height as the indicator of malnutrition of epidemic intensity in communities and of nutritional condition evaluation, including treatment assessment. The assessment of nutritional status is commonly summarized by the mnemonic "ABCD", which stands for anthropometric measurement (A), biochemical or laboratory tests (B), clinical indicators (C) and dietary assessment (D). Children with malnutrition are required to ingest more than 30 essential nutrients including both functional, protective nutrients (type I) and growth nutrients (type Ⅱ), in order to have a catch-up growth in weight and height.

关键词

营养不良 / 营养评估 / 身高 / 体重 / 儿童

Key words

Malnutrition / Nutrition assessment / Height / Weight / Child

引用本文

导出引用
黎海芪. 儿童营养状况评估研究进展[J]. 中国当代儿科杂志. 2014, 16(1): 5-10 https://doi.org/10.7499/j.issn.1008-8830.2014.01.002
LI Hai-Qi. Research advance in assessment of nutritional status of children[J]. Chinese Journal of Contemporary Pediatrics. 2014, 16(1): 5-10 https://doi.org/10.7499/j.issn.1008-8830.2014.01.002

参考文献

[1] Maqbool A. Clinical assessment of nutritional status[M/OL]//Nutrition in Pediatrics. 4th ed. Hamilton, Ontario, Canada: BC Decker Inc, 2008. [October 7, 2013]. http://anhi.org/learning/pdfs/bcdecker/Clinical_Assessment_of_Nutritional_Status.pdf.
[2] Elamin A. Assessment of nutritional status[EB/OL]. [October 7, 2013]. www.pitt.edu/~super7/19011-20001/19801.ppt.
[3] Quandt SA. Assessment of nutritional status[EB/OL]. [October 7, 2013]. http://www.answers.com/topic/assessment-of-nutritional-status.
[4] Academy Medical.com. Laboratory assessment of nutritional status [EB/OL]. [October 7, 2013]. http://www.academymedical.com/past_Web_Lab-Assessment-Nutritional-Status.asp#1).
[5] Blossner M, de Onis M. Malnutrition: quantifying the health impact at national and local levels. Geneva, World Health Organization, 2005. WHO Environmental Burden of Disease Series, No. 12 [EB/OL]. [October 7, 2013]. http://search.yahoo.com/search;_ylt=ApPc978eWRs_cH0tmuX1AbSbvZx4?p=Bl%C3%B6ssner%2C+Monika%2C+de+Onis%2C+Mercedes.+Malnutrition%3A+quantifying+the+health+impact+at++national+and+local+levels.&toggle=1&cop=mss&ei=UTF-8&fr=yfp-t-901.
[6] 黎海芪, 毛萌. 儿童保健学[M]. 第2版. 北京:人民卫生出版社, 2009.
[7] Allen LH, Gillespie SR. What works? A review of the efficacy and effectiveness of nutrition interventions[EB/OL]. [October 7, 2013]. http://www.unsystem.org/SCN/archives/npp19/index.htm.
[8] Fomon SJ. Assessment of growth of formula-fed infants: evolutionary considerations (Secial article)[J]. Pediatrics, 2004, 113(2): 389-393.
[9] Ashworth A. WHO Technical Background Paper: Dietary counselling in the management of moderately malnourished children. the WHO, UNICEF, WFP and UNHCR Consultation on the Dietary Management of Moderate Malnutrition in Under-5 Children by the Health Sector September 30th October 3rd, 2008[EB/OL]. [October 7, 2013]. http://www.who.int/nutrition/topics/MM_consultation_background.pdf.
[10] Golden MH. Proposed recommended nutrient densities for moderately malnourished children[J]. Food Nutr Bull, 2009, 30(3 Suppl): S267-S342.
[11] Prentice AM, Gershwin ME, Schaible UE, et al. New challenges in studying nutrition-disease interactions in the developing world[J]. J Clin Invest, 2008,118(4):1322-1329.
[12] Avencena IT, Cleghorn G. The nature and extent of malnutrition in children. Nutrition in the infant: Problems and practical procedures[EB/OL]. [October 7, 2013]. www.cambridge.org.
[13] Fyk MK. Malnutrition[EB/OL]. [October 7, 2013]. http://www.answers.com/topic/malnutrition.
[14] Malnutrition From Wikipedia[EB/OL]. [October 7, 2013]. http://en.wikipedia.org/wiki/Child_malnutrition.
[15] O' Sullivan A, Sheffrin SM. Economics: Principles in Action[M]. Upper Saddle River, New Jersey: Pearson Prentice Hall, 2003: 481.
[16] WHO/WFP/UNHCR informal consultation on the management of moderate malnutrition in under-5 children[EB/OL]. [October 7, 2013]. Food Nutr Bull, 2009. http://www.who.int/nutrition/topics/MM_consultation_background.pdf.
[17] Shrimpton R, Victora CG, de Onis M, et al. Worldwide timing of growth faltering: implications for nutritional interventions[J]. Pediatrics, 2001, 107(5): E75.
[18] WHO child growth standards and the identifcation of severe acute malnutritionin infants and children. A Joint Statement by the World Health Organization and the United Nations Children's Fund[EB/OL]. http://www.who.int/nutrition/publications/severema lnutrition/9789241598163_eng.pdf.
[19] Prudhon C, Briend A, Prinzo ZW. WHO, UNICEF, and SCN Informal Consultation on Community-Based Management of Severe Malnutrition in Children[EB/OL]. [October 7, 2013]. http://www.unscn.org/layout/modules/resources/files/Policy_paper_No_21.pdf.
[20] Uauy R, Rojas J, Corvalan C, et al. Prevention and control of obesity in preschool children: importance of normative standards[J]. J Pediatr Gastroenterol Nutr, 2006 (Suppl 3): S26-S37.
[21] Pellett P, Ghosh S. Global nutritional problems with special attention to the role of animal foods in human nutrition. WHO, UNICEF, WFP, UNHCR. Proceedings of the WHO/UNICEF/WFP/UNHCR informal consultation on the management of moderate malnutrition in under-5 children[EB/OL]. [October 7, 2013]. http://www.who.int/nutrition/topics/MM_consultation_background.pdf.
[22] Scheinfeld NS, James WD. The WHO recommends the following laboratory tests: laboratory studies[EB/OL]. [October 7, 2013]. http://emedicine.medscape.com/article/1104623-workup.
[23] Malnutrition[EB/OL]. [October 7, 2013]. http://labtestsonline.org/understanding/conditions/malnutrition/start/2.
[24] 张苏江, 单安山. 营养状况与瘦素水平研究进展[J]. 中国公共卫生, 2008, 24(2):236-238.
[25] Black RE, Allen LH, Bhutta ZA, et al. Maternal and child undernutrition: global and regional exposures and health consequences[J]. Lancet, 2008, 371(3608):243-260.
[26] Michaelsen KF, Hoppe C, Roos N, et al. Choice of food and ingredients for moderately malnourished children 6 months to 5 years of age[EB/OL]. [October 7, 2013]. http://www.who.int/nutrition/publications/moderate_malnutrition/FNBv30n3_suppl_paper2.pdf.
[27] Briend A, Prinzo ZW. Dietary management of moderate malnutrition: time for a change[J]. Food Nutr Bull, 2009, 30(Suppl 3): S265-S266.
[28] F-75-Phase 1 therapeutic milk[EB/OL]. [October 7, 2013]. http://www.msi-germany.com/en/therapeutic_food-f75.html.
[29] Howard C. Protein energy malnutrition[EB/OL]. [October 7, 2013]. http://www.mayo.edu/mayo-edu-docs/mayo-school-of-graduate-medical-education-documents/ProteinEnergyMalnutrition_Howard.ppt.
[30] Seal A, Prudhon C. Nutrition Information in Crisis Situations. Assessing micronutrient deficiencies emergencies. Current practice and future directions[M]. United Nations System Standing Committee on Nutrition, 2007.
[31] Raiten DJ, Namaste S, Brabin B, et al. Executive summary--biomarkers of nutrition for development: building a consensus[J]. Am J Clin Nutr, 2011, 94(2): 633S-650S.
[32] NIH effort seeks to identify measures of nutritional status[EB/OL]. [October 7, 2013]. http://www.nih.gov/news/health/jul2011/nichd-06.html.
[33] Programming Guide: Infant and Young Child Feeding. United Nations Children's Fund (UNICEF)[EB/OL]. [October 7, 2013]. http://www.unicef.org/nutrition/files/Final_IYCF_programming_guide_2011.pdf.
[34] Ruel MT. Can food-based strategies help reduce vitamin A and iron deficiencies? A review of recent evidence. International Food Policy Research Institute. Washington, D.C.2001[EB/OL]. [October 7, 2013]. http://www.idpas.org/pdf/847CanFoodbased.pdf.

PDF(1210 KB)

Accesses

Citation

Detail

段落导航
相关文章

/