何が効くのか? 母親と子供の栄養失調と生存率に対する介入
Zulfiqar A Bhutta1, Tahmeed Ahmed, Robert E Black
1Aga Khan University, Karachi, Pakistan. zulfiqar.bhutta@aku.edup
Lancet (London, England)
|January 22, 2008
まとめ
効果的な母子栄養介入は,発育阻害と死亡率を大幅に減らすことができます. 貧困のような根本的な原因に対処し,教育を改善することは,栄養不良の長期的排除に不可欠です.
科学分野:
- 公衆衛生と栄養について
- グローバル・ヘルス グローバル・ヘルス
- 母親と子供の健康について
背景:
- 母親と子供の栄養不良は,生存,成長,開発に影響を及ぼし,世界的な健康上の重要な課題であり続けています.
- 既存の介入は,栄養,疾病予防,支援戦略のさまざまな側面を対象としています.
研究 の 目的:
- 母親と子供の栄養不良と栄養関連のアウトカムに影響を与える介入の見直しを行う.
- 発育不全,死亡率,および障害調整寿命に対する現在の介入の潜在的な影響を評価する.
主な方法:
- 母乳育児の促進,補足栄養,微量栄養素の補給,疾病軽減戦略を含む介入の体系的なレビュー.
- 36の高負担国における介入の効果を予測するためにコホートモデルを使用した.
主要な成果:
- 授乳の促進は生存に影響するが,発育阻害にはわずかな効果がある.
- 補足的な栄養教育とサプリメントは,Zスコアに対するポジティブな効果を示しています.
- 使用済みの治療用食品を含む重度の急性栄養失調の管理は,症例死亡率を大幅に削減します.
- 妊婦 (葉酸鉄,一般的な微量栄養素) と子供 (ビタミンA,亜鉛,鉄,ヨウ素塩) のための微量栄養素の介入は,利点を示しています.
- モデル予測によると,介入により,発育不全を36%,死亡率を25%削減できるという.
結論:
- 現在の栄養と疾病予防の介入は,子供の育児阻害と死亡率を減らすための大きな可能性を秘めています.
- 発育阻害の長期的排除には,貧困,教育,女性のエンパワーメントなどの根本的な決定要因に対処する必要があります.
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