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| 维生素A复合其他微量营养素对3～6岁儿童营养状况的影响 |
| 刘永芳1,2,陈立1,龚敏1,刘友学1,陈洁1,瞿平1,李廷玉1* |
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(1. 重庆医科大学附属儿童医院营养研究中心,儿童发育疾病研究省部共建教育部重点实验室,重庆市认知与学习记忆障碍重点实验室,儿科学重庆市重点实验室,重庆市儿童发育重大疾病诊治与预防国际科技合作基地,重庆 400014
2. 重庆医科大学附属儿童医院临床营养科,重庆 400014
*通信作者) |
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| 摘要: |
| 目的 观察维生素A复合其他微量营养素对儿童营养状况的影响。方法 采用分层与整群抽样相结合的方法,在重庆市近郊7所幼儿园中随机选取3所,将所有3～6岁、符合纳入标准的350名学龄前儿童作为受试对象。按分层随机的方法,将350名受试儿童随机分成单独补维生素A组(A组)、补维生素A加锌组(AZ组)及补维生素A与多种微量营养素复合物组(AMM组)。3组受试儿童同时连续补充6个月。干预前后分别测量儿童身高、体质量,计算儿童体格发育Z评分,评价儿童营养不良的发生率；检测血清维生素A、锌、铁、钙和血红蛋白水平；在营养素干预前采用问卷方式调查儿童的一般情况、家庭状况及饮食习惯等；在营养素干预期间采用 24 h 膳食回顾法调查受试儿童膳食营养素摄取情况。结果 24 h膳食回顾调查结果显示,该地区3～6岁儿童膳食中维生素A、锌和钙摄入不足。营养素干预6个月后,3组儿童血清锌和铁水平较干预前差异均有统计学意义(P均<0.01),AZ组血清锌水平的升高幅度高于AMM组(P<0.05)。AZ组及AMM组干预后血清维生素A水平分别升高了(0.05±0.23) μmol/L及(0.09±0.28) μmol/L(P<0.05,P<0.01)；单独补充维生素A组血清维生素A水平升高了(0.03±0.27) μmol/L，但差异无统计学意义(P>0.05)。AMM组儿童血清维生素A水平升高幅度高于A组和AZ组(P均<0.05)；AMM组儿童血红蛋白水平升高幅度高于A组(P<0.05)。A组、AZ组及AMM组中儿童营养不良的比例均有不同程度的下降,但3组间变化值差异均无统计学意义(P均>0.05)。结论 复合多种微量营养素的补充对3～6岁儿童营养状况的作用较两种微量营养素的补充未见显著性差异,儿童微量营养素的补充应根据其存在的主要营养问题选择最优营养素组合，以改善儿童营养健康状况。 |
| 关键词: 贫血 维生素A 锌 微量营养素 营养保健品 |
| DOI： |
| 投稿时间：2013-03-28修订日期：2013-05-08 |
| 基金项目:瑞士SIGHT AND LIFE 研究基金(2007-2009). |
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| Effects of vitamin A combined with other micronutrients on nutritional status of 3-6 years old children |
| LIU Yong-fang1,2,CHEN Li1,GONG Min1,LIU You-xue1,CHEN Jie1,QU Ping1,LI Ting-yu1* |
(1. Children’s Nutrition Research Center, Key Laboratory of Developmental Diseases in Childhood of Ministry of Education, Key Laboratory of Translational Medical Research in Cognitive Development and Learning and Memory Disorders, Key Laboratory of Pediatrics of Chongqing, Chongqing International Science and Technology Cooperation Center for Children Development and Disorder, Children’s Hospital of Chongqing Medical University, Chongqing 400014, China
2. Department of Clinical Nutrition, Children’s Hospital of Chongqing Medical University, Chongqing 400014, China
*Corresponding author.) |
| Abstract: |
| Objective To explore the effects of vitamin A combined with other micronutrients on the nutritional status in children. Methods According to the method of stratified random cluster sampling, three kindergartens were randomly selected out of 7 in the suburbs of Chongqing. A total of 350 preschool children who met the eligibility criteria, aged between 3-6 years old in the selected kindergartens, were randomly assigned to 3 treatment groups: the vitamin A group (A group), the vitamin A plus Zn group (AZ group), and the vitamin A supplementation with multiple micronutrients group (AMM group). The supplementation lasted for 6 months in the three groups. The height and weight of the participants were measured and the Z-score value was calculated before and after supplementation to evaluate the incidence of malnutrition. Serum vitamin A, Zn, Fe, Ca and hemoglobin levels were also measured before and after the intervention. A questionnaire survey of the general situation, family status and dietary habit of the children was performed before the supplementation; also the dietary nutrient intake of the children during intervention was investigated by a 24-hour dietary recall method. Results The 24-hour dietary recall results showed that vitamin A, Zn and Ca were inadequate in the diet of the 3-6 years old children in our study. Compared with before supplementation, the serum Zn and Fe levels were significantly different in the three groups 6 months after supplementation (all P<0.01), with the increment of Zn level in AZ group being significantly higher than that in the AMM group (P<0.05). The serum vitamin A level in AZ group and AMM group were significantly increased by (0.05±0.23) μmol/L and (0.09±0.28) μmol/L (P<0.05, P<0.01), respectively; however, the increase was (0.03±0.27) μmol/L in A group (P>0.05). The increment of serum vitamin A in AMM group was significantly greater than those in A and AZ groups (all P<0.05); the increment of hemoglobin level in AMM group was also significantly greater than that in A group (P<0.05).The malnutritions rates were decreased in the A, AZ and AMM groups to different degrees, and the decreases were not significantly different between the three groups (P>0.05). Conclusion The effect of multiple micronutrient supplementation shows no significant difference on nutritional status in 3-6 aged children compared with the two micronutrient supplementations. Micronutrient supplement for children should be based on the main nutritional problems of them, and the best combination of nutrients should be chosen to improve nutrition and health status of children. |
| Key words: anemia vitamin A zinc micronutrients dietary supplements |
