世界衛生組織重新製定兒童生長程度新標準

　　生物穀報道 世界衛生組織(WHO)正在重新製定孩子身高和體重生長程度的標準。新的健康生長指導計劃於明年正式發布，它將有助於對付營養**症和肥胖症。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。

　　目前，世界各地的保健員都根據20世紀70年代製定的身高和體重標準曲線來判斷嬰兒和兒童的生長狀況，但是製定標準曲線的數據是取自於美國兒童，這些孩子主要是靠嬰兒配方奶喂養。

　　到20世紀90年代，這一標準曲線的缺點變得日益清楚。主要的問題是母乳喂養的孩子一般比配方奶喂養的孩子的體重要輕一些。因此，部分母親會過早地被建議轉用固體食品喂養嬰兒，即使母乳喂養因有助於抵抗傳染性**而被認為是*健康的選擇。現在還不清楚美國孩子的統計數據是否也適合於其它國家的孩子。

　　現在，一個為期14年的項目即將代替這個過時的標準。在多中心生長參考指數的研究項目中，醫生們對來自巴西、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行了跟蹤調查。他們記錄了孩子生長期間的頭圍、身高、體重發展狀況，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，本次國際性項目的參加者是專門選擇健康處於*佳狀況的孩子，也就是其母親不抽煙並用母乳喂養孩子。研究的目的是創建一個顯示孩子理想生長的參考指數。而以前的研究考慮了各種健康狀況孩子的生長情況。

　　WHO項目的共同協調人Merecde de Onis說目前研究顯示，以良好方式喂養的嬰兒的生長速度是一樣的，與他們的種族特性無關。這有助於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於遺傳性質的不同或其它原因如營養和**等引起的。

　　WHO還在分析這些數據，並計劃在明年的某個時候隆重地推出新的生長標準。WHO還將花巨大的努力培訓分布在100多個國家的保健人員，讓他們學會用*新的生長標準指數。

　　新標準對公眾的健康來說意義重大。Onis說：“它將是基本指數。”這些指數將有助於盡早鑒別哪些孩子處於營養**狀況，應該補充食物或提供其它幫助，目的是孩子開始出現營養**而不是情況嚴重時就被鑒別出來。

　　另一方麵，新標準也將篩選出體重超標、有可能發展成糖尿病的孩子。Onis說，因為母乳喂養的孩子的生長速度比配方奶喂養的孩子慢，因此新標準也許會讓更多的孩子成為超標兒童。

　　美國約翰·霍普金斯·布隆博格公眾健康學校的Keith West是研究國際性健康和營養學的專家，他認為應該為更大的孩子和成年人創立更好的體重參數指標，他說，因為孩子的健康會影響到其今後一生，因此為孩子建立健康規範尤為重要

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Now a vast, 14-year project to replace the outdated standards is coming to fruition.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