Nutrition and Health for Development Unit, Department of Noncommunicable Diseases, WHO Regional Office for South-East Asia, New Delhi, India,
Nutrition Unit, Division of Noncommunicable Diseases and Health through the Life-Course, WHO Regional office for Western Pacific, Manila, Philippines.
Ann Nutr Metab. 2019;75(2):131-134. doi: 10.1159/000503672. Epub 2019 Nov 19.
The double burden of malnutrition in Asia and the Pacific is driving a renewed focus on maternal malnutrition.
Though adverse consequences of maternal malnutrition have been long recognized, there is slow progress in addressing nutritional problems of women/adolescent girls. Coverage and quality of current maternal nutrition interventions, mostly delivered through antenatal care programmes vary across countries, and are often sub-optimum. Further, despite a marked increase in overweight and obesity in women of reproductive age, at present, most programmes are focused on under-nutrition and micronutrient deficiencies. Key Messages: The recent antenatal care recommendations released by World Health Organization provide a benchmark for countries to evaluate their programmes and identify gaps and challenges to improving maternal nutrition. Asian and Pacific countries need to address all forms of maternal malnutrition. For countries that historically focused on maternal under-nutrition, expanding their programmes to incorporate interventions to address overweight and obesity will be challenging. Innovative methods for nutrition counselling, both in terms of content and using novel channels of communication, are needed. Protocols and guidance on managing excessive weight gain as well as determining appropriate pregnancy weight gains are needed, while managing micronutrient deficiencies, particularly in settings where inherited disorders of red blood cells exist.
亚太地区营养不良的双重负担促使人们重新关注孕产妇营养不良问题。
尽管孕产妇营养不良的不良后果早已被认识到,但在解决妇女/少女营养问题方面进展缓慢。目前,大多数孕产妇营养干预措施主要通过产前保健计划提供,但这些措施在各国的覆盖范围和质量存在差异,往往不尽如人意。此外,尽管生育年龄妇女的超重和肥胖现象明显增加,但目前大多数方案仍侧重于营养不足和微量营养素缺乏问题。
世界卫生组织最近发布的产前保健建议为各国评估其方案以及确定改善孕产妇营养的差距和挑战提供了基准。亚洲和太平洋国家需要解决所有形式的孕产妇营养不良问题。对于那些历史上专注于孕产妇营养不足的国家来说,将方案扩大到纳入解决超重和肥胖问题的干预措施将具有挑战性。需要创新的营养咨询方法,包括内容和新颖的沟通渠道。需要制定关于管理体重过度增加以及确定适当的妊娠体重增加的协议和指导,同时管理微量营养素缺乏症,特别是在存在红细胞遗传性疾病的情况下。