Objective To analyze the trend of height(length) for age Z score [HAZ(LAZ)] of Chinese children under 5 years old in 2002 and 2013, so as to provide scientific evidence for determining critical window period for improving stunting. Methods Data were extracted from Chinese national nutrition and health survey in 2002 and Chinese National Nutrition and Health Surveillance in 2013. Two-sample t-test was used to analyze the difference of HAZ(LAZ) between 2002 and 2013, and restricted cubic spline regression was used to analyze the trend of HAZ(LAZ) of Chinese children under 5 years old in 2002 and 2013. Results The HAZ(LAZ) were-0.31±1.54 and 0.03±1.36 in 2002 and 2013, respectively, and the difference was significant(t=-23.72, P<0.001). The differences of HAZ(LAZ) were significant between 2002 and 2013 in 0—1 month,6—23 months and 24—59 months groups(t=2.68,-11.21,-18.69,P<0.01). In 2002, the HAZ (LAZ) of children under 5 years old fell to the trough firstly, and then increased slowly. In 2013, the HAZ(LAZ) of children under 5 years old reached the peak firstly, and then declined, especially among 6—23 months. Conclusions Compared with 2002, the HAZ (LAZ) values of Chinese children under 5 years old increase significantly in 2013. And 6 to 23 months old is the critical window for stunting intervention because of the continuously downward trend.
Key words
height(length) for age Z score /
children under 5 years old /
trend analysis /
restricted cubic spline regression
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References
[1] 国务院办公厅.中国食物与营养发展纲要(2014-2020年)[Z]. 2014-01-28.
[2] Leroy JL, Ruel M, Habicht JP,et al. Linear growth deficit continues to accumulate beyond the first 1 000 days in low-and middle-income countries:global evidence from 51 national surveys[J]. J Nutr,2014,144(9):1460-1466.
[3] WHO Multicentre Growth Reference Study Group.WHO child growth standards:length height-for-age,weight-for-age,weight-for-length,weight-for-height and body mass index-for-age:methods and development [M]. Geneva:WHO,2006.
[4] Roth DE, Krishna A, Leung M,et al. Early childhood linear growth faltering in low-income and middle-income countries as a whole-population condition:analysis of 179 demographic and health surveys from 64 countries (1993-2015)[J]. Lancet Glob Health,2017,5(12):e1249-e1257.
[5] 首都儿科研究所,九市儿童体格发育调查协作组.2015年中国九市七岁以下儿童体格发育调查[J].中华儿科杂志,2018,56(3):192-199.
[6] 路新源,王继伟,车贝贝,等.上海市4区0～5岁儿童生长发育水平及营养状况评价[J].中国儿童保健杂志,2020, 28(10):1169-1172.
[7] 荫士安,赖建强. 2002年中国居民营养与健康状况调查:中国0~6岁儿童营养与健康状况[M].北京:人民卫生出版社, 2008.
[8] 常继乐,王宇.中国居民营养与健康状况监测:2010-2013年综合报告[M].北京:北京大学医学出版社, 2016.
[9] WHO. Child growth standards[EB/OL]. [2020-10-22]. https://www.who.int/childgrowth/software/en/
[10] 陈长生,徐勇勇,夏结来. 光滑样条非参数回归方法及医学应用[J].中国卫生统计,1999,16(6):342-345.
[11] Lawrence CM, David RC. Spline regression models[M]. London:SAGE Publications of Thousand Oaks, 2002.
[12] 赵鹏宇,尤莉莉,刘远立. 基于Donabedian质量理论国家基本公共卫生服务项目实施效果评价[J].中国公共卫生,2020,36(5):814-818.
[13] Li C, Zeng L, Wang D, et al. Effect of maternal pre-pregnancy BMI and weekly gestational weight gain on the development of infants[J]. Nutr J,2019,18(1):6.
[14] Kac G, Arnold CD, Matias SL,et al. Gestational weight gain and newborn anthropometric outcomes in rural Bangladesh[J]. Matern Child Nutr,2019,15(4):e12816.
[15] WHO. Global strategy for infant and young child feeding [M]. Geneva:WHO,2003.
[16] 卫生部妇社司.婴幼儿喂养策略[EB/OL].[2007-08-03].http://www.doc88.com/9-781378577216.html
[17] 富振英,常素英,何武,等.1998年中国4个月以内婴儿纯母乳喂养与生长发育[J].卫生研究,2000,29(5):275-278.
[18] 杨振宇. 中国居民营养与健康状况监测报告(2010-2013)之九:0～5岁儿童营养与健康状况[M].北京:人民卫生出版社, 2020.
[19] Bégin F, Aguayo VM. First foods:why improving young children's diets matter[J]. Matern Child Nutr,2017,13 (Suppl 2):e12528.
[20] Prell C, Koletzko B. Breastfeeding and complementary feeding[J]. Dtsch Arztebl Int,2016,113(25):435-444.
[21] Briaux J, Fortin S, Kameli Y, et al. Dissimilarities across age groups in the associations between complementary feeding practices and child growth:evidence from rural Togo[J]. Matern Child Nutr,2019,15(4):e12843.
[22] 中华人民共和国教育部. 2002年全国教育事业发展统计公报[EB/OL].[2003-5-13]. http://www.moe.gov.cn/s78/A03/ghs_left/s182/moe_633/tnull_ 1553.html
[23] 中华人民共和国教育部. 2013年全国教育事业发展统计公报[EB/OL].[2014-7-4]. http://www.moe.gov.cn/srcsite/A03/s180/moe_633/201407/ t20140704_171144. html
[24] 徐轶群,何红茹,徐韬,等.中国托幼机构食品卫生管理现状[J].中国学校卫生,2019,40(1):144-147.
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