PDF(Pubmed)
Abstract：
Poor diet quality (diet diversity and animal-source food [ASF] consumption) during childhood negatively affects growth, development, behaviour and physiologic function in later life. Relatively less is known about the impact of poor diet on the growth of school-age children compared to children <5 years of age, especially in low/middle-income countries. A better understanding of delivery strategies for effective interventions to improve diet and hence growth in school-age children is needed. A 36-month longitudinal controlled impact evaluation in rural Nepal assessed the nutrition and growth of children <5 years of age in families assigned via community clusters to full package intervention (community development, training in nutrition [during pregnancy and for children <5 years] and livestock husbandry), partial package (training only) or control (no inputs). Concurrent data were collected prospectively (baseline plus additional four rounds) on school-age children (5-8 years at baseline) in these households; the present study analysed findings in the cohort of school-age children seen at all five study visits (n = 341). Diet quality improved more in the full package school-age children compared to those in partial package or control households. full package children consumed more ASF (β +0.40 [CI 0.07,0.73], p < 0.05), more diverse diets (β +0.93 [CI 0.55,1.31], p < 0.001) and had better head circumference z-scores (β +0.21 [CI 0.07,0.35], p < 0.01) than control children. In conclusion, a multi-sectoral community development intervention was associated with improvements in diet and growth of school-age children in rural Nepal even though the intervention focused on the diet of children <5 years of age. The diet and growth of school-age children can be favourably influenced by community-level interventions, even indirectly.
摘要：
儿童时期饮食质量差（饮食多样性和动物源食物[ASF]消费）对生长产生负面影响，发展,在以后的生活中的行为和生理功能。与5岁以下儿童相比，人们对不良饮食对学龄儿童成长的影响知之甚少，特别是在中低收入国家。需要更好地了解有效干预措施的交付策略，以改善饮食，从而改善学龄儿童的成长。在尼泊尔农村进行的一项为期36个月的纵向受控影响评估评估了通过社区集群分配到全面干预措施的家庭中5岁以下儿童的营养和生长（社区发展，营养[怀孕期间和5岁以下儿童]和畜牧业培训)，部分包（仅训练）或控制（无输入）。前瞻性地收集了这些家庭中学龄儿童（基线时5-8岁）的同时数据；本研究分析了在所有五次研究访问（n=341）中看到的学龄儿童队列的结果。与部分包装或对照家庭相比，完整包装的学龄儿童的饮食质量改善更多。全包儿童消耗更多的ASF(β+0.40[CI0.07,0.73]，p<0.05)，更多样化的饮食(β+0.93[CI0.55,1.31]，p<0.001)，头围z评分更好(β+0.21[CI0.07,0.35]，p<0.01）比对照儿童。总之,多部门社区发展干预与尼泊尔农村地区学龄儿童的饮食和成长改善相关,尽管该干预的重点是5岁以下儿童的饮食.社区一级的干预措施可以对学龄儿童的饮食和成长产生有利的影响，甚至间接。
