Nutrition counseling increases weight gain among Brazilian children
Nutrition counseling increases weight gain among Brazilian children
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DOI：
10.1093/jn/131.11.2866
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发表时间：
2001-11-01
影响因子：
4.2
通讯作者：
Pelto, G
中科院分区：
文献类型：
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作者：
Santos, I;Victora, CG;Pelto, G
为了评估儿童疾病综合管理（IMCI）战略中营养咨询部分对儿童生长的影响，进行了一项随机试验。巴西南部一个城市的所有28个政府卫生中心根据基线营养指标配对。每对随机选择一个中心，其医生接受20小时的营养咨询培训。纳入33名医生，每位医生招募12-13名年龄< 18个月的患者。研究内容包括对医生的知识进行测试、观察会诊以及在首次会诊后8、45和180 d对患儿进行家访。产妇的知识，做法和坚持营养建议进行了评估，并进行人体测量。一天的饮食摄入量进行了评估的一个子样本的儿童。干预组的医生对儿童营养有更好的了解，并改善了评估和咨询实践。干预组的产妇回忆建议的比例高于对照组，对咨询的满意度也高于对照组。报告的推荐食物的使用也有所增加。干预组的每日脂肪摄入量高于对照组;能量和锌的平均每日摄入量也趋于改善。12个月或以上的儿童体重增加改善，身长增加积极但不显著。营养咨询培训改善了医生的表现、产妇的做法以及儿童的饮食和体重增加。随机设计和盲态结局评价强烈支持因果关系。这些结果应该在其他环境中得到推广。
To assess the impact on child growth of the nutrition-counseling component of the Integrated Management of Childhood Illnesses (IMCI) strategy, a randomized trial was implemented. All 28 government health centers in a Southern Brazil city were paired according to baseline nutritional indicators. One center from each pair was randomly selected and its doctors received 20-h training in nutrition counseling. Thirty-three doctors were included and 12-13 patients < 18 mo of age from each doctor were recruited. The study included testing the knowledge of doctors, observing consultations and visiting the children at home 8, 45 and 180 d after the initial consultation. Maternal knowledge, practices and adherence to nutritional recommendations were assessed, and anthropometric measurements were taken. Day-long dietary intake was evaluated on a subsample of children. Doctors in the intervention group had better knowledge of child nutrition and improved Assessment and counseling practices. Maternal recall of recommendations was higher in the intervention than in the control group, as was satisfaction with the consultation. Reported use of recommended foods was also increased. Daily fat intake was higher in the intervention than in the control group; mean daily intakes of energy and zinc also tended to improve. Children 12 mo of age or older had improved weight gain and a positive but nonsignificant improvement in length. Nutrition-counseling training improved doctors' performances, maternal practices and the diets and weight gain of children. The randomized design with blind outcome evaluation strongly supports a causal link. These results should be replicated in other settings.