Implications of diet and nutrition for growth and prevalence of anaemia in rural preschool-aged children in Shandong Province, China.

A nutrition surveillance and nutritional improvement programme through nutrition field worker training, nutrition education and encouraging the utilization of home gardens was undertaken among rural preschoolaged children in the four counties of Linshu, Caoxin, Zoucheng and Yucheng in Shandong Province in China from 1990 to 1995. A baseline survey was conducted in 1990. This included physical and biochemical measurements being taken on 3474 children aged 0-5 years and dietary household surveys being taken on a random subsample of 312 children. The baseline survey showed that the average height and weight of the subjects was lower than the World Health Organization (WHO) standard with the prevalence of stunting, underweight and wasting being 24.2, 12.5 and 2.1%, respectively (using the Z scores <= -2 as the cut-off point). The prevalence of anaemia was 61.9% (using haemoglobin (HB) <= 110 g/L as the cut-off point). The range of mean intakes of protein and energy was, respectively, 54.0-67.2% and 56.4-68.4% of the Chinese recommended dietary allowance (RDA) depending on the age group. Mean calcium intake was less than 30% of the RDA for all age groups and the mean intakes of ascorbic acid, niacin, retinol and riboflavin were between 30.6 and 96.1% of the RDA. Nutrition education and nutrition field worker training were the key components of the intervention phase that followed the baseline survey. Over 5 years, 531 nutrition field workers were trained, 1200 parents joined in nutrition classes and approximately 8000 villagers received basic nutrition information. The latter included promotion of breast-feeding, identification of sources of appropriate foods for weaning, and also for the prevention and treatment of common nutritional deficiencies. Home gardens for fruit, vegetable and livestock were also encouraged. The evaluation survey of the project was conducted in 1995 among 2728 0-5- year-old children. The results indicated that the nutritional status of preschool-aged children had improved greatly. The prevalence of stunting and underweight was reduced by 37.8 and 21.3%, respectively, while there was no significant change in the prevalence of wasting. The average rate of anaemia decreased by 79.6% in 1995.