世界卫生组织重新制定儿童生长程度新标准

　　生物谷报道 世界卫生组织(WHO)正在重新制定孩子身高和体重生长程度的标准。新的健康生长指导计划于明年正式发布，它将有助于对付营养**症和肥胖症。WHO为此组织的国际性研究也表明，健康的孩子都是按相同的速度生长，与他们的种族特性无关。

　　目前，世界各地的保健员都根据20世纪70年代制定的身高和体重标准曲线来判断婴儿和儿童的生长状况，但是制定标准曲线的数据是取自于美国儿童，这些孩子主要是靠婴儿配方奶喂养。

　　到20世纪90年代，这一标准曲线的缺点变得日益清楚。主要的问题是母乳喂养的孩子一般比配方奶喂养的孩子的体重要轻一些。因此，部分母亲会过早地被建议转用固体食品喂养婴儿，即使母乳喂养因有助于抵抗传染性**而被认为是*健康的选择。现在还不清楚美国孩子的统计数据是否也适合于其它国家的孩子。

　　现在，一个为期14年的项目即将代替这个过时的标准。在多中心生长参考指数的研究项目中，医生们对来自巴西、加纳、印度、挪威、阿曼和美国的8500多名孩子从出生到5岁期间的生长状况进行了跟踪调查。他们记录了孩子生长期间的头围、身高、体重发展状况，以及孩子**次爬行和走路的年龄。

　　与以前测量生长的研究不同，本次国际性项目的参加者是专门选择健康处于*佳状况的孩子，也就是其母亲不抽烟并用母乳喂养孩子。研究的目的是创建一个显示孩子理想生长的参考指数。而以前的研究考虑了各种健康状况孩子的生长情况。

　　WHO项目的共同协调人Merecde de Onis说目前研究显示，以良好方式喂养的婴儿的生长速度是一样的，与他们的种族特性无关。这有助于解决一个长期以来的争论，即不同国家孩子的生长速率是否是由于遗传性质的不同或其它原因如营养和**等引起的。

　　WHO还在分析这些数据，并计划在明年的某个时候隆重地推出新的生长标准。WHO还将花巨大的努力培训分布在100多个国家的保健人员，让他们学会用*新的生长标准指数。

　　新标准对公众的健康来说意义重大。Onis说：“它将是基本指数。”这些指数将有助于尽早鉴别哪些孩子处于营养**状况，应该补充食物或提供其它帮助，目的是孩子开始出现营养**而不是情况严重时就被鉴别出来。

　　另一方面，新标准也将筛选出体重超标、有可能发展成糖尿病的孩子。Onis说，因为母乳喂养的孩子的生长速度比配方奶喂养的孩子慢，因此新标准也许会让更多的孩子成为超标儿童。

　　美国约翰·霍普金斯·布隆博格公众健康学校的Keith West是研究国际性健康和营养学的专家，他认为应该为更大的孩子和成年人创立更好的体重参数指标，他说，因为孩子的健康会影响到其今后一生，因此为孩子建立健康规范尤为重要

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Now a vast, 14-year project to replace the outdated standards is coming to fruition.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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