200個國家和地區學齡兒童和青少年的身高體重指數變化參差不齊
作者：
小柯機器人發布時間：2020/11/8 22:25:12
非傳染性疾病風險因素協作組匯總研究了200個國家和地區學齡兒童和青少年的身高體重指數變化趨勢。2020年11月7日，該研究發表在《柳葉刀》雜誌上。
關於學齡兒童和青少年的健康和營養的全球可比數據很少。研究組的目的是估計學齡兒童和青少年的平均身高和平均身體質量指數（BMI）的年齡軌跡和時間趨勢，該指數衡量的是體重增加超出了身高增加的預期。
研究組使用了由非傳染性疾病危險因素協作組組織整理的心臟代謝危險因素資料庫，應用貝葉斯分層模型來估算1985-2019年間5-19歲年齡段的兒童每年平均身高和平均BMI的趨勢。
研究組匯總了來自2181個基於人口研究的數據，並對200個國家和地區的6500萬參與者的身高和體重進行了測量。2019年，研究組估計19歲青少年人口身高最高的國家（荷蘭、黑山、愛沙尼亞和波赫的男孩，荷蘭、黑山、丹麥和冰島的女孩）與最矮的國家（東帝汶、寮國、索羅門群島和巴布亞紐幾內亞的男孩，瓜地馬拉、孟加拉國、尼泊爾和東帝汶的女孩）身高差距超過20釐米及以上。
在同一年，青少年BMI最高的國家（太平洋島國、科威特、巴林、巴哈馬、智利、美國和紐西蘭的男孩和女孩，南非的女孩）和BMI最低的國家（印度、孟加拉、東帝汶、衣索比亞、查德的男孩和女孩，日本和羅馬尼亞的女孩）差距約為9–10 kg/m2。
在某些國家/地區，5歲兒童的身高或BMI值一開始超過全球中位值，在某些情況下其健康狀況與表現最好的國家一樣。但隨著年齡的增長，與同齡人相比，他們的健康狀況逐漸惡化，身高增長變慢（例如奧地利和巴貝多的男孩，比利時和波多黎各的女孩），或相對於身高體重增加過快（例如科威特、巴林、斐濟、牙買加和墨西哥的女孩和男孩；以及南非和紐西蘭的女孩）。
在另一些國家，5歲兒童在兒童後期和青春期身高超過了其他同齡人（例如拉脫維亞、捷克共和國、摩洛哥和伊朗），或體重增加變緩（例如義大利、法國和克羅埃西亞）。
考慮到身高體重指數的變化，韓國、越南、沙烏地阿拉伯、土耳其和一些中亞國家（如亞美尼亞和亞塞拜然）的女孩，中歐和西歐（如葡萄牙、丹麥、波蘭和黑山）的男孩，在過去3.5年中，身體狀態變化最為健康，因為與其他國家的兒童和青少年相比，他們相對於BMI身高增加更快。
撒哈拉以南非洲的大多數國家、紐西蘭和美國的男孩和女孩，馬來西亞和一些太平洋島嶼國家的男孩，以及墨西哥的女孩，其身體狀態變化最不健康，與其他國家的兒童相比，身高增長過矮，體重相對身高增長過多，或者兩者兼之。
總之，在各個國家，學齡兒童和青少年隨年齡和時間變化的身高和BMI軌跡變化很大，這表明營養質量參差不齊。
附：英文原文
Title: Height and body-mass index trajectories of school-aged children and adolescents from 1985 to 2019 in 200 countries and territories: a pooled analysis of 2181 population-based studies with 65 million participants
Author: Andrea Rodriguez-Martinez, Bin Zhou, Marisa K Sophiea, James Bentham, Christopher J Paciorek, Maria LC Iurilli, Rodrigo M Carrillo-Larco, James E Bennett, Mariachiara Di Cesare, Cristina Taddei, Honor Bixby, Gretchen A Stevens, Leanne M Riley, Melanie J Cowan, Stefan Savin, Goodarz Danaei, Adela Chirita-Emandi, Andre P Kengne, Young-Ho Khang, Avula Laxmaiah, Reza Malekzadeh, J Jaime Miranda, Jin Soo Moon, Stevo R Popovic, Thorkild IA Srensen, Maroje Soric, Gregor Starc, Ahmad A Zainuddin, Edward W Gregg, Zulfiqar A Bhutta, Robert Black, Leandra Abarca-Gómez, Ziad A Abdeen, Shynar Abdrakhmanova, Suhaila Abdul Ghaffar, Hanan F Abdul Rahim, Niveen M Abu-Rmeileh, Jamila Abubakar Garba, Benjamin Acosta-Cazares, Robert J Adams, Wichai Aekplakorn, Kaosar Afsana, Shoaib Afzal, Imelda A Agdeppa, Javad Aghazadeh-Attari, Carlos A Aguilar-Salinas, Charles Agyemang, Mohamad Hasnan Ahmad, Noor Ani Ahmad, Ali Ahmadi, Naser Ahmadi, Soheir H Ahmed, Wolfgang Ahrens, Gulmira Aitmurzaeva, Kamel Ajlouni, Hazzaa M Al-Hazzaa, Amani Rashed Al-Othman, Rajaa Al-Raddadi, Monira Alarouj, Fadia AlBuhairan, Shahla AlDhukair, Mohamed M Ali, Abdullah Alkandari, Alaa Alkerwi, Kristine Allin, Mar Alvarez-Pedrerol, Eman Aly, Deepak N Amarapurkar, Parisa Amiri, Norbert Amougou, Philippe Amouyel, Lars Bo Andersen, Sigmund A Anderssen, Lars ngquist, Ranjit Mohan Anjana, Alireza Ansari-Moghaddam, Hajer Aounallah-Skhiri, Joana Araújo, Inger Ariansen, Tahir Aris, Raphael E Arku, Nimmathota Arlappa, Krishna K Aryal, Thor Aspelund, Felix K Assah, Maria Cecília F Assuno, May Soe Aung, Juha Auvinen, Mária Avdicová, Ana Azevedo, Mohsen Azimi-Nezhad, Fereidoun Azizi, Mehrdad Azmin, Bontha V Babu, Maja Bksgaard Jrgensen, Azli Baharudin, Suhad Bahijri, Jennifer L Baker, Nagalla Balakrishna, Mohamed Bamoshmoosh, Maciej Banach, Piotr Bandosz, José R Banegas, Joanna Baran, Carlo M Barbagallo, Alberto Barceló, Amina Barkat, Aluisio JD Barros, Mauro Virgílio Gomes Barros, Abdul Basit, Joao Luiz D Bastos, Iqbal Bata, Anwar M Batieha, Rosangela L Batista, Zhamilya Battakova, Assembekov Batyrbek, Louise A Baur, Robert Beaglehole, Silvia Bel-Serrat, Antonisamy Belavendra, Habiba Ben Romdhane, Judith Benedics, Mikhail Benet, James E Bennett, Salim Berkinbayev, Antonio Bernabe-Ortiz, Gailute Bernotiene, Heloísa Bettiol, Jorge Bezerra, Aroor Bhagyalaxmi, Sumit Bharadwaj, Santosh K Bhargava, Zulfiqar A Bhutta, Hongsheng Bi, Yufang Bi, Daniel Bia, Elysée Claude Bika Lele, Mukharram M Bikbov, Bihungum Bista, Dusko J Bjelica, Peter Bjerregaard, Espen Bjertness, Marius B Bjertness, Cecilia Bjrkelund, Katia V Bloch, Anneke Blokstra, Simona Bo, Martin Bobak, Lynne M Boddy, Bernhard O Boehm
Issue&Volume: 2020/11/07
Abstract:
Background
Comparable global data on health and nutrition of school-aged children and adolescents are scarce. We aimed to estimate age trajectories and time trends in mean height and mean body-mass index (BMI), which measures weight gain beyond what is expected from height gain, for school-aged children and adolescents.
Methods
For this pooled analysis, we used a database of cardiometabolic risk factors collated by the Non-Communicable Disease Risk Factor Collaboration. We applied a Bayesian hierarchical model to estimate trends from 1985 to 2019 in mean height and mean BMI in 1-year age groups for ages 5–19 years. The model allowed for non-linear changes over time in mean height and mean BMI and for non-linear changes with age of children and adolescents, including periods of rapid growth during adolescence.
Findings
We pooled data from 2181 population-based studies, with measurements of height and weight in 65 million participants in 200 countries and territories. In 2019, we estimated a difference of 20 cm or higher in mean height of 19-year-old adolescents between countries with the tallest populations (the Netherlands, Montenegro, Estonia, and Bosnia and Herzegovina for boys; and the Netherlands, Montenegro, Denmark, and Iceland for girls) and those with the shortest populations (Timor-Leste, Laos, Solomon Islands, and Papua New Guinea for boys; and Guatemala, Bangladesh, Nepal, and Timor-Leste for girls). In the same year, the difference between the highest mean BMI (in Pacific island countries, Kuwait, Bahrain, The Bahamas, Chile, the USA, and New Zealand for both boys and girls and in South Africa for girls) and lowest mean BMI (in India, Bangladesh, Timor-Leste, Ethiopia, and Chad for boys and girls; and in Japan and Romania for girls) was approximately 9–10 kg/m2. In some countries, children aged 5 years started with healthier height or BMI than the global median and, in some cases, as healthy as the best performing countries, but they became progressively less healthy compared with their comparators as they grew older by not growing as tall (eg, boys in Austria and Barbados, and girls in Belgium and Puerto Rico) or gaining too much weight for their height (eg, girls and boys in Kuwait, Bahrain, Fiji, Jamaica, and Mexico; and girls in South Africa and New Zealand). In other countries, growing children overtook the height of their comparators (eg, Latvia, Czech Republic, Morocco, and Iran) or curbed their weight gain (eg, Italy, France, and Croatia) in late childhood and adolescence. When changes in both height and BMI were considered, girls in South Korea, Vietnam, Saudi Arabia, Turkey, and some central Asian countries (eg, Armenia and Azerbaijan), and boys in central and western Europe (eg, Portugal, Denmark, Poland, and Montenegro) had the healthiest changes in anthropometric status over the past 3·5 decades because, compared with children and adolescents in other countries, they had a much larger gain in height than they did in BMI. The unhealthiest changes—gaining too little height, too much weight for their height compared with children in other countries, or both—occurred in many countries in sub-Saharan Africa, New Zealand, and the USA for boys and girls; in Malaysia and some Pacific island nations for boys; and in Mexico for girls.
Interpretation
The height and BMI trajectories over age and time of school-aged children and adolescents are highly variable across countries, which indicates heterogeneous nutritional quality and lifelong health advantages and risks.
DOI: 10.1016/S0140-6736(20)31859-6
Source: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31859-6/fulltext