生物谷報(bào)道 世界衛(wèi)生組織(WHO)正在重新制定孩子身高和體重生長程度的標(biāo)準(zhǔn)。新的健康生長指導(dǎo)計(jì)劃于明年正式發(fā)布，它將有助于對付營養(yǎng)**癥和肥胖癥。WHO為此組織的國際性研究也表明，健康的孩子都是按相同的速度生長，與他們的種族特性無關(guān)。

　　目前，世界各地的保健員都根據(jù)20世紀(jì)70年代制定的身高和體重標(biāo)準(zhǔn)曲線來判斷嬰兒和兒童的生長狀況，但是制定標(biāo)準(zhǔn)曲線的數(shù)據(jù)是取自于美國兒童，這些孩子主要是靠嬰兒配方奶喂養(yǎng)。

　　到20世紀(jì)90年代，這一標(biāo)準(zhǔn)曲線的缺點(diǎn)變得日益清楚。主要的問題是母乳喂養(yǎng)的孩子一般比配方奶喂養(yǎng)的孩子的體重要輕一些。因此，部分母親會過早地被建議轉(zhuǎn)用固體食品喂養(yǎng)嬰兒，即使母乳喂養(yǎng)因有助于抵抗傳染性**而被認(rèn)為是*健康的選擇。現(xiàn)在還不清楚美國孩子的統(tǒng)計(jì)數(shù)據(jù)是否也適合于其它國家的孩子。

　　現(xiàn)在，一個為期14年的項(xiàng)目即將代替這個過時的標(biāo)準(zhǔn)。在多中心生長參考指數(shù)的研究項(xiàng)目中，醫(yī)生們對來自巴西、加納、印度、挪威、阿曼和美國的8500多名孩子從出生到5歲期間的生長狀況進(jìn)行了跟蹤調(diào)查。他們記錄了孩子生長期間的頭圍、身高、體重發(fā)展?fàn)顩r，以及孩子**次爬行和走路的年齡。

　　與以前測量生長的研究不同，本次國際性項(xiàng)目的參加者是專門選擇健康處于*佳狀況的孩子，也就是其母親不抽煙并用母乳喂養(yǎng)孩子。研究的目的是創(chuàng)建一個顯示孩子理想生長的參考指數(shù)。而以前的研究考慮了各種健康狀況孩子的生長情況。

　　WHO項(xiàng)目的共同協(xié)調(diào)人Merecde de Onis說目前研究顯示，以良好方式喂養(yǎng)的嬰兒的生長速度是一樣的，與他們的種族特性無關(guān)。這有助于解決一個長期以來的爭論，即不同國家孩子的生長速率是否是由于遺傳性質(zhì)的不同或其它原因如營養(yǎng)和**等引起的。

　　WHO還在分析這些數(shù)據(jù)，并計(jì)劃在明年的某個時候隆重地推出新的生長標(biāo)準(zhǔn)。WHO還將花巨大的努力培訓(xùn)分布在100多個國家的保健人員，讓他們學(xué)會用*新的生長標(biāo)準(zhǔn)指數(shù)。

　　新標(biāo)準(zhǔn)對公眾的健康來說意義重大。Onis說：“它將是基本指數(shù)?！边@些指數(shù)將有助于盡早鑒別哪些孩子處于營養(yǎng)**狀況，應(yīng)該補(bǔ)充食物或提供其它幫助，目的是孩子開始出現(xiàn)營養(yǎng)**而不是情況嚴(yán)重時就被鑒別出來。

　　另一方面，新標(biāo)準(zhǔn)也將篩選出體重超標(biāo)、有可能發(fā)展成糖尿病的孩子。Onis說，因?yàn)槟溉槲桂B(yǎng)的孩子的生長速度比配方奶喂養(yǎng)的孩子慢，因此新標(biāo)準(zhǔn)也許會讓更多的孩子成為超標(biāo)兒童。

　　美國約翰·霍普金斯·布隆博格公眾健康學(xué)校的Keith West是研究國際性健康和營養(yǎng)學(xué)的專家，他認(rèn)為應(yīng)該為更大的孩子和成年人創(chuàng)立更好的體重參數(shù)指標(biāo)，他說，因?yàn)楹⒆拥慕】禃绊懙狡浣窈笠簧?，因此為孩子建立健康?guī)范尤為重要

WHO to define ideal for child growth

healthy children grow at the same rate, no matter what their ethnic group.

The World Health Organization (WHO) is rewriting the rulebook on how fast and fat children should grow. Their new healthy growth guidelines, due to be released next year, should help fight malnutrition and obesity.

At present, health workers worldwide judge whether babies and children are growing fast enough based on standard curves of height and weight drawn up in the 1970s. The figures were calculated by collecting data on US children, who were mainly fed infant formula.

By the 1990s, shortcomings with the benchmarks were becoming clear. The main problem is that breastfed children tend to be lighter than those fed formula. So mothers are sometimes advised to switch to solid food prematurely, even though breastfeeding is considered the healthier option because it can help fight infectious diseases. It also was not clear whether the statistics for US children would hold for those in other countries.

Now a vast, 14-year project to replace the outdated standards is coming to fruition. In the Multicentre Growth Reference Study, doctors followed around 8,500 children from Brazil, Ghana, India, Norway, Oman and the United States from birth to five years old. Researchers tracked the kids' height, weight, head circumference and the age at which babies first crawled and walked.

Picture of health

Unlike previous studies to gauge growth, the participants were specifically selected to be in the best of health, so mothers did not smoke and children were breastfed. The idea is to create a reference that shows how children should grow ideally; previous records logged the growth of children of varying health.

The project has already shown that well-fed babies tend to grow at the same rate regardless of their ethnic group, says WHO project coordinator Mercedes de Onis, based in Geneva, Switzerland. This helps resolve a long-standing debate over whether the varying growth rates of children in different countries are due to genetic differences or other causes, such as nutrition or disease.

The WHO is still analysing the data and plans to launch the growth standards with some fanfare next year. It will then embark on a huge effort to train healthcare workers in 100 countries to switch to the latest figures.

The new set of standards will have far reaching implications for public well-being. "It's the basic indicator of health," says de Onis. The figures should help identify which children are malnourished and should be given food or other help. The hope is to spot kids as soon as they start to show signs of poor nutrition, before the condition becomes severe.

At the other end of the scale, the new yardstick should pick out children who weigh above the norm and are heading towards obesity. Because breastfed children grow more slowly than their formula-fed peers, the new standards will push more children into the overweight category, de Onis says.

There is a need for better reference weights for older children and *****s too, says Keith West who studies international health and nutrition at Johns Hopkins Bloomberg School of Public Health in Baltimore, Maryland. But because kids' health can influence well-being for the rest of their life, establishing healthy norms "is more critical for children," he says.

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