Avaliação da efetividade de programa governamental de distribuição de leite fortificado no crescimento de crianças de 6 a 24 meses de famílias de baixa renda, residentes no interior do Estado de São Paulo / Evaluation the effectiveness of a state-run food supplementation program for child growth according to childrens nutritional status at enrollment

AUTOR(ES)
DATA DE PUBLICAÇÃO

2009

RESUMO

OBJECTIVE: To assess the effectiveness of a state-run food supplementation program for child growth according to childrens nutritional status at enrollment. METHODS: Cohort study including secondary data of 25,433 low-income children aged between 6 and 24 months enrolled in a fortified milk program "Projeto Vivaleite" in 311 cities in the State of São Paulo, Brazil, between 2003 and 2008. Childrens growth was assessed based on weight-for-age (WA) z-scores, estimated following WHO criteria (2006). Data was routinely collected at the program enrollment and every 4 months. Inclusion criteria were: being 6 to 24 months of age at enrollment; having at least two weight measures including the first measure at enrollment; and not having any ill health conditions. At enrollment, children were categorized into three groups based on their z-scores: no compromised weight gain (z>1); at risk of low weight (-2 ≤z<-1), and low weight (z<-2). Multilevel linear regression analysis (mixed model) was performed for comparison, considering age, of adjusted average z-scores between new children enrolled and those in the program for at least four months, adjusted for correlation between repeat measures. RESULTS: The program had a positive effect on childrens weight gain. Based on their nutritional status at enrollment, adjusted average weight gain z-score was 0,1827 in children with compromised weight gain, 0,5659 in those at risk of low weight, and 1,0049 in those with low weight. CONCLUSIONS: The milk program is effective for child growth, as measured by WA z-scores. The most pronounced effect was seen among children who showed less favorable levels of weight at enrollment.

ASSUNTO(S)

nutrition rehabilitation anthropometry antropometria avaliação de programas regressão linear multinível (modelo misto) effectiveness suplementação alimentar recuperação nutricional efetividade food supplementation program evaluation multi-level linear regression (mixed model)

ACESSO AO ARTIGO

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