New strategies to reduce anaemia and risk of overweight and obesity through complementary feeding of infants and young children in Peru

秘鲁正在经历迅速的变化，经济逐步发展，越来越多的人移民到城市。饮食习惯和健康也在发生变化。婴儿和儿童变得越来越高，但也变得越来越重。在过去的10年里，儿童、青少年和成年人的超重和肥胖显著增加。然而，与此同时，6-23个月大的婴儿和幼儿的饮食中不含有足够的微量营养素(必要的维生素和矿物质)，特别是铁。尽管通过国家保健服务向妇女和幼儿提供了良好的膳食补充剂(包括铁在内的微量营养素补充剂)，但铁和其他微量营养素缺乏症引起的贫血(血液中红细胞或血红蛋白缺乏症)的患病率仍然很高。需要新的战略来解决贫血和超重/肥胖这两个饮食问题。这两个营养挑战的一个潜在驱动因素是食用高能量、低营养的食物。婴儿喂养是健康的关键时期，因为婴儿的营养和成长对儿童、青春期和成年期的健康有重大影响。对影响婴幼儿喂养的多种因素缺乏研究和了解不足，是改善营养和健康的障碍。该项目将采取综合办法，查明推动秘鲁婴幼儿食物消费的因素，特别是护理员和家庭、社区和当地社区(保健设施和日托设施)的作用。需要更有力的证据来说明人们所处的环境，以便为促进婴幼儿更健康喂养的战略提供信息。我们的项目将使用新的方法和采用全面的方法来检查两个城市周边中心的婴幼儿喂养情况，反映了利马和高地Huánuco的不同生态。除了了解婴儿的喂养模式和做法外，我们还将组织以社区为基础的参与式研讨会，以确定解决健康补充喂养的已确定挑战的解决方案。讲习班将产生改善婴幼儿营养的解决方案(干预措施)的原型，将在当地社区试行。根据官方发展援助，该项目涉及可持续发展目标2：减少饥饿和营养不良，确保儿童能够获得充足和有营养的食物；可持续发展目标3：确保健康的生活和福祉。最佳的婴儿和儿童喂养对于健康成长和发展以及防止终生健康差距至关重要。在秘鲁，社会经济地位较低的城郊家庭面临着营养贫乏的饮食的巨大风险，而这些饮食也是高能量的。这增加了在生命过程中超重和与饮食相关的非传染性疾病的风险。秘鲁卫生部对减少贫血和促进健康补充喂养做法的国家方案进行了投资，然而，这还没有实现贫血的大幅减少，还需要新的、更全面的战略。因此，这项研究将与利马和瓦努科的城市周边人口合作，制定有针对性的战略，以改善婴幼儿喂养。这项工作将使儿童、家庭、当地社区、卫生服务机构、地区和国家卫生当局受益，同时为地方和国家政策提供信息。

Peru is experiencing rapid change with progressive economic development and increasing migration to cities. Dietary habits and health are also changing. Infants and children are getting taller but also getting heavier. In the last 10 years there have been significant increases in overweight and obesity among children, adolescents and adults. At the same time, however, the diets of infants and young children aged 6-23 months do not contain enough micronutrients (essential vitamins and minerals), particularly iron. Despite good provision of dietary supplements (micronutrient supplements including iron) to women and young children through national health services, there is still a high prevalence of anaemia (a deficiency of red cells or haemoglobin in blood) caused by iron and other micronutrient deficiencies. New strategies are required to address these two dietary problems of anaemia and overweight/obesity. An underlying driver of these two nutritional challenges is the consumption of foods that are high in energy and low in nutrients. Infant feeding is a critical time for health because the nutrition and growth of infants has a significant effect on health in childhood, adolescence and adulthood. A lack of research and poor understanding of the multiple factors influencing infant and young child feeding is a barrier to improving nutrition and health. This project will take a holistic approach to identifying the factors that drive food consumption in infants and young children in Peru, particularly the role of caregivers and families, communities and local neighbourhoods (health facilities and daycare facilities). There is a need for stronger evidence that accounts for the environments that people live in to inform strategies to promote healthier feeding of infants and young children. Our project will use novel methods and adopt a holistic approach to examine infant and young child feeding in two peri-urban centres reflecting different ecologies of coastal Lima and highland Huánuco. As well as understanding infant feeding patterns and practices, we will organise community-based participatory workshops to identify solutions to the identified challenges of healthy complementary feeding. The workshops will lead to prototypes for solutions (interventions) to improve infant and young child nutrition which will be piloted in the local community.Compliance with Official Development Assistance This project addresses SDG2: reduce hunger and malnutrition and ensure children have access to sufficient and nutritious food; and SDG3: ensure healthy lives and wellbeing. Optimal infant and child feeding is critical for healthy growth and development and to prevent lifelong disparities in health. In Peru, peri-urban households with lower socio-economic status are at significant risk of nutrient-poor diets that are also high in energy. This increases the risk of overweight and diet-related non-communicable disease over the lifecourse. The Peruvian Ministry of Health has invested in national programmes to reduce anaemia and to promote healthy complementary feeding practices, however, this has not yet achieved substantial reductions in anaemia and novel, more holistic, strategies are needed. This study will therefore work with the peri-urban populations in Lima and Huánuco to develop tailored strategies to improve infant and young child feeding. The work will benefit children, families, local communities, health services, regional and national health authorities whilst informing local and national policies.