1、Nutrition as indicator for poverty reduction将营养纳入脱贫指标营养纳入脱贫指标Chen Chunming 陈春明Nutrition Surveillance TeamChinese Center for Disease Control and Prevention Nutrition is essential to the first goal of MDG-eradicate poverty and hunger 营养对实现千年发展目标第一目标消除贫困与饥饥饿的意义 Income poverty and non-income poverty 收入贫
2、困与非收入贫困 Change of nutritional status of poor rural during 1990-2000 1990至2002年中国贫困地区营养状况的变化 Nutrition assessment on poverty alleviation 脱贫的营养评价Nutrition is essential to poverty reduction营养对消除贫困的意义 Malnutrition slows economic growth:1.Direct losses in productivity due to poor physical status,2.Indire
3、ct losses due to poor cognitive function 3.Losses due to increased health care cost营养不良造成经济增长减慢来自营养不良造成经济增长减慢来自:1 体格发育不足造成劳动生产率降低的直接损失体格发育不足造成劳动生产率降低的直接损失 2 2 认知功能差造成的间接损失认知功能差造成的间接损失 3 3 医疗开支增加的损失医疗开支增加的损失 Evidences 证据 1%height deficit due to early childhood stunting causes 1.4%productivity reducti
4、on in adult life 由于儿童早期生长迟缓造成得成年身高矮由于儿童早期生长迟缓造成得成年身高矮1 1，可降低劳动生，可降低劳动生产率产率1.41.4 Eradication of anemia in adults can increase productivity 5-17%消除成人贫血可增加劳动生产率消除成人贫血可增加劳动生产率5-7%5-7%Low birth weight children loss IQ 5 points 低出生体重儿童损失智商低出生体重儿童损失智商5 5分分 Stunted children loss IQ 5-11 points 生长迟缓儿童可损失智商生
5、长迟缓儿童可损失智商5-115-11分分 Iron deficiency anemia children loss IQ 8 points 缺铁性贫血儿童可损失智商缺铁性贫血儿童可损失智商8 8分分 Iodine deficiency disorder children loss 10-15 points 碘缺乏儿童可损失智商碘缺乏儿童可损失智商10-1510-15分分 Fetal under-nutrition and malnutrition under age of 2 cause increased chronic disease risk,such as hypertension,d
6、iabetes and CHD risk in adult life 胚胎至胚胎至2 2岁期间的营养不良可导致成年高血压、糖尿病和冠岁期间的营养不良可导致成年高血压、糖尿病和冠心病的危险增加心病的危险增加Impact of 10 points IQ loss丢失丢失1010分智商的影响分智商的影响高能力高能力High capacity populationImpact of 10 points IQ loss丢失丢失1010分智商的影响分智商的影响低能力低能力Low capacitypopulation Target for poverty reduction扶贫目标扶贫目标 MDG targ
7、et for poverty reduction includes income poverty and non-income poverty 千年发展目标的减贫目标包括收入贫困和非千年发展目标的减贫目标包括收入贫困和非收入贫困收入贫困 Even target of income poverty reduction may be achieved,the non-income poverty target could be far lag behind 即使降低收入贫困目标达到，非收入贫困目即使降低收入贫困目标达到，非收入贫困目 标的降低还可能远远滞后标的降低还可能远远滞后 Non-incom
8、e poverty includes nutrition,human development and human capital formulation,under nutrition is strongly linked to income poverty 非收入贫困包括营养、人才发展和人力资本，非收入贫困包括营养、人才发展和人力资本，营养不良对收入贫困有很大影响营养不良对收入贫困有很大影响Income poverty收入贫困收入贫困Low food Frequent Hard Frequent Large Intake infection physical pregnancies fami
9、lies labor 食物不足 频繁感染 重体力劳动 频繁妊娠 大家庭 Malnutrition 营养不良Direct loss in Indirect loss in Loss in resourcesProductivity from productivity from from increasedpoor physical poor cognitive health care costs status development&of ill health体格发育不足体格发育不足带来带来 schooling 疾病造成医疗开支增加疾病造成医疗开支增加劳动生产率降低劳动生产率降低 智力发育及入学
10、问题智力发育及入学问题 带来间接劳动生产率带来间接劳动生产率 下降下降(Food security achieved,dietary pattern of rural residents shifted positively 食物保障已解决，膳食结果趋于合理食物保障已解决，膳食结果趋于合理 Achieved food security食物保障食物保障:Energy intake 能量摄入 2300 Kcal/day Shift of dietary pattern膳食模式转变膳食模式转变:(Energy share of CHO and fat)Rural-getting better 谷类供
11、能比谷类供能比Cereals to 61.5%脂肪供能比脂肪供能比Fat to 27.5%动物性食物供能比动物性食物供能比Animal food 4.5%pt.%of Energyshare Year Urban Rural Fat 199228.4 18.6200235.027.5Cereals199257.471.7200248.561.5Animal food 199215.26.2200217.610.7Changes in Dietary Intake:2002 vs.1992(2)The situation of poor rural household贫困农户的膳食情况贫困农户的
12、膳食情况Year%of poor households贫困户贫困户Energy intake Kcal/day能量摄入能量摄入%RDA达到推达到推荐量荐量Energy share from cereals%谷类供能比谷类供能比19954.12003837619982.51864787920002.720348585The existing poor population is even harder in terms of dietary quality.目前仍处于贫困的农户膳食质量更差目前仍处于贫困的农户膳食质量更差(3)Comparison of poor rural(PR)w gener
13、al rural(G)贫困农村与一般农村比较贫困农村与一般农村比较5 5岁以下儿童营养不良患病率岁以下儿童营养不良患病率%(2000)%(2000)Underweight Stunting 低体重率低体重率 生长迟缓率生长迟缓率地区地区 B B男男 G G女女 Total BTotal B男男 G G女女 Total Total 农村农村R 13.2 14.7 13.8 20.0 20.7 20.3 (9.2 9.3 9.3)(17.7 16.8 17.3)一般一般G 9.1 11.4 10.1 14.3 15.3 14.8 较贫困较贫困P 20.8 20.8 20.8 30.5 30.7 3
14、0.6 (13.8 15.0 14.4)(29.4 29.3 29.3)全国全国N 10.7 11.8 11.4 15.7 16.2 16.0 (7.8 7.8 7.8)(14.8 13.8 14.3)*红 色-2002(4)Changes of Prevalence of Malnutrition during 1990-2002 1990-2002儿童营养不良率的变化儿童营养不良率的变化 Underweight%Stunting%低体重率低体重率 生长迟缓率生长迟缓率 Urban Rural National Urban Rural National 城市城市 农村农村 全国全国 城市城市
15、 农村农村 全国全国 *1990 8.0 22.6 20.0 9.4 41.4 35.0 *1995 4.6 17.8 14.4 8.9 39.1 31.6 1998 2.7 12.6 9.6 4.1 22.6 16.7 2000 3.4 13.8 11.4 2.9 20.3 16.0 2002 3.1 9.3 7.8 4.9 17.3 14.3(5)Comparison of western with Eastern Malnutrition of children under 5东西部比较东西部比较 5 5岁以下儿童营养不良患病率岁以下儿童营养不良患病率 West 西西部部 East 东部
16、东部19981998Underweight低体重低体重%19.0 9.1 P0.001Stunting生长迟缓生长迟缓%31.3 17.2 P0.001 2000 Underweight 低体重低体重%21.6 9.6 P0.001 *13.8Stunting 生长迟缓生长迟缓%30.8 14.5 P2100/person/day 能量摄入能量摄入21002100 2.Cereal energy share 75%of total energy intake 谷类食品供能比谷类食品供能比75%75%3.Prevalence of stunting of children aged 3 3 3岁
17、儿童生长迟缓率岁儿童生长迟缓率 Background information for the recommendation建议依据建议依据 1 1 Population with energy intake 1500 kcal/day or protein intake 50g/day:人均能量摄入低于1500千卡或蛋白质摄入低于50克的人群:Risk of chronic hepatitis is higher than that of population with intakes over this level,RR=1.46 and 1.45 repectively.Attributa
18、lbel Risk is 32.4%and 31.0%其慢性肝炎的患病率高于摄入水平在此值之上的人群，其相对危险度分别为1.48和1.45 归因危险度分别为32.4%和 31.0%Energy/protein intake&cereals energy share of rural households不同收入农村住户热能、蛋白质和谷类热能比不同收入农村住户热能、蛋白质和谷类热能比Income of households最低最低5%Lowest10%(6%-9%)15%(10-14%)20%(15-20%)1998年年 能量摄入能量摄入 kcal Energy18551988(2118)207
19、4(2245)2119(2256)蛋白质蛋白质 g Protein56.859.0(61.1)60.8(64.4)62.2(66.4)谷类热能比谷类热能比%Cereal energy%77.074.3(71.7)73.2(70.9)72.7(71.7)Income of households最低最低5%Lowest10%(6%-9%)15%(10-14%)20%(15-20%)2000年年 能量摄入能量摄入kcal Energy intake17501788(1825)1880(2065)1896(1943)蛋白质摄入蛋白质摄入,g Protein44.947.1(49.3)50.6(57.5
20、)51.9(55.9)谷类热能比谷类热能比%Cereal energy share%8582.1(79.4)80.5(77.0)78.9(74.3)建议依据建议依据 2 2 Dietary intake of poor households贫困户膳食能量摄入贫困户膳食能量摄入Year%poor households贫困户贫困户EnergyKcal/man*能量摄入能量摄入%RDA供给量供给量%ECereal谷类供能谷类供能比比Protein g蛋白质蛋白质 克克1995 4.120038378561998 2.518627879562000 2.72034858553*Reference man 以标准人计以标准人计月龄月龄建议依据建议依据3 3 Peak prevalence of stunting 生长迟缓率高峰年龄段生长迟缓率高峰年龄段Thank you!谢谢！
