大量营养素摄入不平衡，多种微量营养素缺乏和腹泻强调了巴拿马土著学龄前儿童的低年龄身高

IF 3.2 Q2 NUTRITION & DIETETICS

Current Developments in Nutrition Pub Date : 2025-10-01 DOI:10.1016/j.cdnut.2025.107547

Marilyn E Scott , Dorian Irwin Kristmanson , Eduardo Ortega-Barria , Kristine G Koski

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引用次数: 0

摘要

背景：在偏远的巴拿马土著自给农业社区，不良饮食、腹泻和蛔虫可能是学龄前儿童发育迟缓高发率的不同季节性因素。目的：本研究探讨了巴拿马Comarca Ngäbe-Buglé干旱和雨季期间食物、营养摄入和感染（腹泻和肠道线虫）对身高年龄z分数（HAZ）的相对贡献。方法本前瞻性社区研究收集了328,12 - 59岁儿童在旱季和雨季的社会人口学和健康数据。对非母乳喂养儿童的饮食进行了评估，使用食物频率问卷和两个季节的24小时召回。对发育不良儿童和非发育不良儿童以及旱季和雨季儿童进行了双变量比较。逐步线性回归模型确定了社会人口状况、感染、食物组和估计的营养摄入量与HAZ的关联。结果低脂高糖饮食缺乏微量营养素。丰水期儿童的食物和营养摄取量低于旱季（P < 0.05），发育迟缓儿童的乳制品摄取量低于非发育迟缓儿童（P < 0.05）。雨季腹泻发生率较高（P < 0.05）。旱季和雨季影响热影响区的决定因素不同。在旱季模型中（P < 0.0001）， HAZ与收入和脂肪摄入量呈正相关，与总糖摄入量负相关。相比之下，雨季模型（P < 0.0001）显示，谷物/谷物和脂肪的摄入量与HAZ呈正相关，水果和总糖摄入量以及腹泻与HAZ呈负相关。结论学龄前儿童线性生长迟缓的多因素性质因季节而异。腹泻的负面影响仅在雨季出现，但糖摄入的负面影响和脂肪摄入的积极影响在两个季节都出现。

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Unbalanced Macronutrient Intakes, Multiple Micronutrient Inadequacies, and Diarrhea Underscore Low-Height-for-Age in Indigenous Panamanian Preschool Children

Background

In remote indigenous Panamanian subsistence farming communities, poor diet, diarrhea, and Ascaris may have seasonally distinct contributions to high rates of stunting in preschool children.

Objectives

This study explored the relative contributions of food, nutrient intakes, and infections (diarrhea and intestinal nematodes) to height-for-age z-scores (HAZ) during a dry and rainy season in Panama’s Comarca Ngäbe-Buglé.

Methods

This prospective community-based study collected sociodemographic and health data from 328, 12‒59-mo-old children in both the dry and rainy seasons. Diets were assessed in nonbreastfeeding children using a food frequency questionnaire and a 24-h recall during both seasons. Bivariate comparisons between stunted and nonstunted children and between the dry and rainy seasons were conducted. Stepwise linear regression models identified associations of sociodemographic status, infections, food groups, and estimated nutrient intakes with HAZ.

Results

The diet characterized as low fat, high sugar was deficient in micronutrients. Food and nutrient intakes were lower in the rainy than the dry season (P < 0.05), and stunted children had fewer servings of dairy than nonstunted children (P < 0.05). The incidence of diarrhea was higher in the rainy season (P < 0.05). Determinants of HAZ differed between dry and rainy seasons. In dry season models (P < 0.0001), HAZ was positively associated with income and fat intake and negatively associated with total sugar intake. In contrast, rainy season models (P < 0.0001) revealed that servings of grains/cereals and fat were positively associated with HAZ, and fruit and total sugar intake and diarrhea were negatively associated with HAZ.

Conclusions

The multifactorial nature of linear growth faltering in these preschool children differed by season. The negative impact of diarrhea emerged only in the rainy season, but the negative impact of sugar intake and the positive impact of fat intake emerged in both seasons.

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