TCNCYH Phu truxyng 79 (2) -2012
DINH DUaNG VA K H A U P H A N THLKC T t CUA TRE 24 - 59 T H A N G T U 6 | T A I XA X U A N Q U A N G - CHIEM HOA -
TUYEN QUANG N A M 2011
L6 Thi Hwong\ Le H6ng Phwgng\ Nguyen Thuy Linh' Doan Thj Thu Huyen\Vu Hong Cuong ' Tru-dng Dgi hoc Y Ha NC ' Truing Cao ding Y te Thanh H6i Nghidn cCm md tS dt ngang tr6n 196 tr6 tu- 24 - 59 thang tudi bao gdm do ludng s6 do nhan trie che tr6. thu th0p thdng tm v^ khiu phin cua tr6 thdng qua phdng vin 90 bd mg va thdo lu$n nhdm nhim tta th$p thdng tin vi nhtrng thgc phim sin cd & dia phwong. Kit qua cho thiy (j? 16 suy dmh dudng thi thip cdi 29.1% (CC/T). thi thiiu cdn Id 24.5% (CN/T) vi thi gdy cdm Id 14.3% (CN/CC) Khiu phin Sn tmng binh cua trd 24 - 35 thdng ddp Ovg duvc Iheo nhu ciu khuyin nghi (NCKN) vi muc protein vd nSng tuong Khiu phin Sn cOa trd 36 - 59 thdng khdng ddp Ceng dCi nhu ciu vi ndng lutyng theo NCKN, sit trong khiu phin dn cOa trd 36 - 47 thdng chi dgt 6.9mg/ngdy thip han NCKN. Hdm luxyng canxi trong khiu phin dn cua trd dgt 67 - 86% NCKN. Luxyng lipid tmng khiu phin khdng dat NCKN Cdc thuc phim sin cd df dia phuong diu cd thi cung cip du 4 nhdm thuc phim: Glucid, Protid, Lipid, vitamin vd chit khodng.
TO khoa: Suy dinh du-org, kh4u ph^n, thu-c phSm s i n co, tre em, Chiem Hoa I. DAT V A N D ^
Suy dinh du'O'ng tre em a Viet Nam, dac bi?t suy dinh du'O'ng nang va the thiiu can da giam nhanh va giam b i n vOng, xu6ng con du-ai 20% (nam 2008) [2]. Tuy nhien, suy dinh du'O'ng a tre em Viet Nam v l n con &
mtpc cao so VOT cac nu'dc trong khu vu'c va tren the giai; ty le suy dinh du'dng 6" khu vu-c mien nui luon cao han so vdi khu vu'c d6ng bang, nong thon cao han thanh thj, nhO'ng vung bi han han, lu Igt co ty le suy dinh du'dng cao han cac vung khac. Trong khi mot so tfnh thupc khu vi/c dong bang c6 ty
\g SDD giam xu6ng mdc thap nhu* thanh pho Ho Chi Minh (7,8%). Ha Ngi (9,7%) thi nhieu khu vyc m i i n nui ty le SDD v l n d mdc rat cao nhu' O i c Nong (31,9%), Kon Tum (31,5%), Quang Binh (30,6%), Lai Chau (30,0%) [5]. Suy dinh du'dng anh hu'dng nghiem trpng den s y phat trien the
chat, tinh than cua tre, dac biet la suy dinh du'dng thap coi - anh hu'dng den chieu cao, tam voc cua Ngu-di Viet Nam [3]. Cac nghien cdu v i tlnh trang dinh du'dng cua tre da du'p'c de cgp nhiiu, nhu'ng con it nghien cdu v i khau p h i n an cua tre va thirc phim san CO d dja phyang thu'dng du'p'c diing cho tre, dgc bi0t nghien cdu tren doi tu'cmg tre em d cac tfnh mien nui. Vi vgy, chiing toi t i i n hanh nghien cdu de tai: "Tinh trang dinh du'dng va khau p h i n thyc t i cua tre 24-59 thang tu6i tai xa Xuan Quang - Chiem Hoa - Tuyen Quang nam 2011' nham cac muc tieu:
Danh gia tinh trang dinh du-o-ng tre 24 - 59 thang tuoi tgi x§ Xuan Quang - huyen Chiem Hda - tinh Tuyen Quang nam 2011.
Md ta khau phin thuc te cua tre 24 - 59 thang va cac fhyc phim san cd tai % phuxyng thuang duuc dung cho tre.
TCNCYH Phu truung 79 (2) - 2012 II. B 6 1 TU'O'NG V A PHU-OhJG PHAP
1. Dja diem nghign ciru; XS XuSn Qgang - Hgy^n Chiem Hda - Tinh TgySn Qgang
2. Doi tu'O'ng nghien ciru: Tre tO' 24 - 59 thSng tu6i
3. Thd'i gian nghien cipu: TO' thdng 5/2011 den thSng 12/2011
4. Thiet ke nghien cii'u: Nghi§n cu'u mO ta cat ngang.
5. Cd' mau va chpn m l u va Phu'O'ng phap thu th$p so li^u:
5.1. Dieu tra nhan trac: Tien hdnh can do toan bo s6 tre tir 24 - 59 thdng tu6i tsi xS theo ky thu$t edn do chuSn.
2.5.2. Sieu (ra khau phan: ChQn mau 30 trd eho mOi nhom tuoi 24 - 35 thdng, 36 - 47 thdng, 48 - 59 thdng. Dung phu'ang phdp hoi ghi khau phdn 24 gidr qua cdc bd m? hode nhOng nguCT tnfc tiep cham soc tre; ky thudt dieu tra tan xuSt tieu thu thg'c phim vd bg cau hoi thiet ke sdn i i dieu tra khau phan vd tim hilu cdc thLre pham s i n c6 ir d|a Phu'O'ng [9].
2.5.3. Thio lupn nhom: 01 cu0c thao ludn nhOm viri cdn bp hpi phg nO', hOI nSng ddn, cdn bO h-^m y t l xd; 01 cg?c thao Igdn
2. Tinh tr^ng dinh d y & n g cua tre
nhdm vd'i bd mp c6 eon tir 24 - 59 thdng tuoi theo bdng hu'dng d§n thdo ludn nhdm.
6. Phan tich s6 li$u
Cdc s6 li$u nhdn trie du'pc tlnh todn dg'a theo quin t h i tham khdo WHO. Trd dtrpe coi Id g l y cdm, cdi cpe bode thilu edn nlu cdn n$ng theo chllg cao, chieg cao theo tuli vd cdn ndng theo tgoi l l n lu'pt nho hon -2SD [1OJ.
S6 li^u khiu phln 24h du'pc nhdp blng phln mem Access cOa Vien Dinh du'png vd phdn tieh bang phln mem STATA 10.
S6 li$u djnh tinh, su' dung bang ma trdn d l ting hpp va phdn tieh.
III. K£T QUA
1. Thong tin chung ve doi tyo'ng nghien ciru: Trong s6 trd du'pc nghidn cu'u, trd nam chiem 48,5%, trd nO- chilm 51,5%;
phdn bo tre theo nhdm tuli kha dong dig: 24 -35 thdng (37,2%); 36 - 47 thdng (35,7%); 48 -59 thdng (27,1%). Nghi nghidp chinh cga me tre Id Idm rupng vd Idm r l y (84,7%). ChT c6 15,3% cdc ba mp Id ddn tpc Kinh, ehu yeu Id ddn tic Tdy (69,4%) vd cdc ddn tgc khde.
Trinh i i vdn hda cOa mp d p 3 chiem t^ ii eao nhlt (48,5%) tilp d i n Id elp 2 (30,6%), t^ ii bi mp mO chO Id 2,5%.
80 60 40 -
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B i l u a l 1. Tinh trang dinh du'ang theo cac chi s6 CN/T, CC/T va CN/CC ir trd 24 - 59 thdng t u l i
TCNCYH Phu tnmng 79 (2) - 2012
Ty Id trd SDD chung mO'C d* ndng (Z - score < 3 SD) 6 thi nhp cdn, thip cdi vd gdy cdm ll lupt Id 3,1%; 8,2% vd 3,6%. S6 trd b| SDD mO'C dO trung binh cua ba thi trdn ehilm t^ Id ll liipt Id 21,4%, 20,9% vd 10,7%, trong d6 s l trd bj SDD mO'C d* trung btnh cQa thi nh? cdn ca nhlt trong s6 ba thi sgy dinh du'dng.
1
2.U - "
Bieu do 2. Phan bo cac the suy dinh du'O'ng theo nhom tuoi
Bilu d l 2 cho thay tre tu' 24 - 35 thang tuoi CO ty le suy dinh duang cac the nhe cdn, thap cdi vd gdy com cao hon so vcri cac nhom tuoi con lai (31,5% nh^ can, 38% thap col va 18,3%
gdy com). Tuy nhien, chung toi khong tim thay su khac biet ve ty le suy dinh duong giOa cdc nhom tuli d ea 3 the nhe can, thdp col va gay com (p > 0,05).
I l l ' " " ; ' " T l i , i | i i i , l C . i y r o i n
Biiu ad 3. Phan b6 cic thi suy dinh ch/6ng theo glal tlnh
Ty Id suy dinh dg'dng thi thilu cdn d trd nO' cao gin gip 2 lln so vdi tre nam (31,7% v4 17%) m<it cdch r5 rdt vd mang y nghTa thing kd vdi p < 0,05. Tu'png t\f, trd ni> cOng c6 ty Id suy dinh du'dng thi thip cdi vd gdy cdm cao hpn so vdi trd nam.
Khau phln dn trung binh cua trd 24 - 35 thdng tuli dd ddp i>ng du'pc NCKN v l mO'C nang lu'png, protein. Tuy nhidn ir nhlm trd tO' 36 - 59 thdng tuli, khiu phln dn trung binh thi,rctS chu'a ddp O'ng dCi nhu olu ndng lu'png, trong dd nhdm trd 36 - 47 thdng khig phan dn trunj:
binh cdn khdng ddp O'ng NCKN v l sit. Khiu phln dn cOa cd 3 nhdm a?t 67 - 85% NCKN | lu'png canxi vd khlng d?t nhu clu khuyin nghj v l lypng lipid tilg thg hdng ngdy. 06 Sir l < H biet CO y nghTa thing ke v l hdm lypng sit trong khiu phln dn giOa cdc nhdm tuli vdi p < 0 J (bang 1).
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TCNCYH Phu tnmng 79 (2) - 2012 Bang 1. K h i u p h l n an thirc t§ eiia tre theo nhdm tudi
Trung binh Nang tu'O'ng (Kcal) Protein
(9) Lipid
(g) Glucid
(g)
Vit A (mg)
Canxi Sat (mg) (mg) 24 - 35thang
NCKN 36 - 47 thdng
1194,2 1180 1247,3
48,2 3 6 - 4 4
51,5 28,1
32 29,5
187,3 1 4 7 - 1 7 7
192,9 843,8
400 780,3
433,4 500 491,8
10,8 7,7 6,9
NCKN 40
48 - 59 thdng NCKN
30,6 40
>0.05 206,9 186-220
403.7 10,7
>0,05 s0,01 3. Thyc p h i m s i n co tai dja phyo'ng
3.1. Nhim ngO cic
Ngu coc Id nhom thirc phdm san co tai xa Xudn Qgang va chu yeu la gao.
"Gia dinh thi khong thieu gao, gia dinh tu CO, thi truung cung ban diy. Ngu eic co ban la khing phii mua"
(TLN can bi xi Xuan Quang, Chiem Hoa, Tuyen Quang)
3.2. Nhom chat dam
Doi vdi nhom thu-c pham gidu chit dam, kit qga thdo Igdn nhom cho thdy thg'c phim sin CO nhlt tai dja phg'png chu y l u la la thit Ipn, thjtgd, tning, ddu phg, ca, cga, 6c, bin:
"Bd thi rat it, khing co, con cic thit khac ga, ipn, vit co; ci thi san co, torn thi it, 6c hen thi cung ci. Cua ci nhiiu nhung ma khing dung"
(TLN cin bi xa Xuan Quang, Chiim Hoa, Tuyin Quang)
Tgy nhien chg yeg tre hay dg'pc an thjt, cd vd tning, dag phu vi day la nhu'ng thu'c phdm d l chl biln, thong dung va san cd tai gia dinh. Tai ffla phypng, eua r l t san o6 dac biet la mua he, tuy nhien cae bd me khong cho tre an do hp khdng bilt che biln hoac io sp tre bj roi loan tieu hda khi an.
3 3 Nhom rau cu qua
Cac loai rau Id Id khd san co tai dia phyong nhy rau ngot, muong, mdng tPi, rau day, rau rdn nhyng chg yeu la tap trgng vao mua he, mua thu. MiJa dong chu y l u Id rau cai vd rau bi. Neu nha khong co san thi cac ba me co t h i d i dang mua va cho tre an:
"Rau muing, rau ngot, rau day, mong loi la khong phai mua, rau rin cung tring duuc, rau bao cung tring duac"
(TLN ba me co con 3-5 tuii, Xuan Quang, Chiem Hoa, Tuyen Quang)
Cac ba me tai day cung d l cap d i n rau ngot rirng va rau bao Id 2 loai rau khd san c6 vdo mga he va mua thu, ba me eung thydng eho tre an:
'Cho an li rau ngot rirng, ngpt han, ngon han rau ngot cua minh. Rau bao, no giing nhu bi cong anh"
(TLN ba me co con 3 - 5 ludi, Xuin Quang, Chiem Hia, Tuyin Quang)
Bd me thydng cho tre an cac loai qua chin va rdt san co nhy du du, chuoi, nhan Dira, mit, ol, xoai thi it san co hon, do do tre cung it dypc an hon.
"Du du, chuoi thuung la lu co, cin co them nhan. Dua thi It, chi mil si nhi tring"
197
TCNCYH Phu truung 79 (2) - 2012 (TLN ba mp ci con 3 - 5 tuii, Xuin Quang, Chiim Hia, Tuyin Quang)
3.4. Nhim cung cip chit bio Thyc phim cung e l p chit bdo s i n cd d dja phypng vdo miia dong chij y l u Id lac vO'hg. Tuy nhien cd r l t it bd m? eho trd dn vi do ban thdn hg khdng hilu dypc gid trj dinh dydng eua nhu'ng thyc phim ndy hode lo sp tre khdng dn dypc:
"Cd nhi ipc thi eOng khing ci, mi bio mua vi cho tre diing li khi ning khing ci.
Gia dinh nio sin ci thi van di li ci quan lim cho tri in hay khing. 0 thirl diim niy thi gan nhu nhi nio cung ci".
(Tnrdng TYTxa Xuin Quang, Chiem Hoa, Tuyin Quang).
IV. BAN LUAN
K i t qua nghien ciru cho thay ty Id suy dinh dydng t h i nhe can la 24,5% (CN/T), t h i thip coi Id 29,1% (CC/T), vd the gay cdm Id 14,3%
(CN/CC). So vdi ty ip suy dinh dydng ehung tren todn q u i c cua tre dydi 5 tuoi. ty Ig suy dinh dypng the nhg cdn d Chiem Hda eao hpn, ty Ig suy dinh dydng t h i t h i p cdi d mire typng dypng (29,3%), cdn ty Ig suy dinh dypng t h i g l y cdm eao hpn g i p 2 l l n (7,1%) [6]. Ty Ig suy dinh dypng tgi day cung typng dypng vdi ty Id suy dinh dydng cua tre dydi 5 tuli p cdc tinh thupc khu vyc trung du va miln nui phia Bic. Theo phdn mCre cua Vign Dinh dydng thi ddy Id viing ed ty Ig suy dinh dypng cao, ddc bigt ty Ig suy dinh dydng t h i gdy com Id r l t cao. Tuy nhidn, ty Ig suy dinh dydng tai dja phypng trong nghien cu'g t h i p hon r l t nhilu so vdi huydn Hydng Hda trong nghien cu'u oOa tdc gia Le Thj Hypng: ty Ig tre suy dinh dydng t h i nhg can Id 49,7%, thap cdi Id 51,9% va g l y com la 15,3% [4], Ty Ig nay eung t h i p hpn k i t qua dilu tra cua UNICEF (2005) [8]. Mac du vgy,
198
ty Id suy dinh dydng ngng cua cdc t h i vl cdn d mire cao: t h i thilu edn Id 3,1%, ti t h i p cdi Id 8,2% vd t h i gdy cdm la 3,6%. 1 Id suy dinh dydng p nhdm t u l i 24 - 35 thdr eao hpn so vdi cdc nhdm t u l i khdc vd ca hpn so vdi k i t qua dilu tra cua vidn Din dypng trdn nhdm t u l i tir 24 - 35 thang. C t h i gial thich k i t qud ndy do sau khi tre dug cai su'a, c h l dp dn chya phu hpp, khdn ddm bao dinh dydng trong khiu phln dli d i n ty Id suy dinh dydng cao hpn tj 1$ su;
dinh dydng d cdc nhdm t u l i tilp theo Nghidn ciiu ciia chOng tdi cho t h i y tre nO a ty Id suy dinh dydng t h i nhg cdn eao hon s(
vdi tre nam (p < 0,05). Tuy nhidn k i t qua cu, mdt s6 nghidn ciru khdc Igi cho thiy ty Id su) dinh dydng d tre nam eao hpn tre nu' [4, 8].
K i t qua dieu tra khiu p h l n dn ciia tre ctic thiy khiu phan an cua tre tir 36 - 59 thang tuli thyc t l chya dap u'ng du nhu elu nang lypng so vdi NCKN. Nhdm tre 36 - 47 thdng tuli, hdm lypng sdt trong khiu phln dn clii dgt 6,9 mg/ngay trong khi do NCKN cho tre lu'a tuli ndy la 8,4 mg/ngay Khiu phln In ciia ca 3 nhdm t u l i chi dgt 67 - 86% lug'ng canxi so vdi khuyin nghj (NCKN Id 600mg/
ngdy) [1]. Lu'a t u l i tu' 3 - 5 t u l i Id giai dogn tre phdt then mgnh v l tdm vdn dpng vd tieu hao nhilu nang lypng eho ede hogt d|ng hang ngdy do dd mpt c h l dd an khdng dam baose Id nguydn nhan quan trpng gay suy dinh dypng, anh hypng d i n sy phdt triln thi chit vd tinh t h i n cua tre sau nay Chiing toi clw ring sy thilu kiln thu'c v l chdm sde \ri de cdc ba mg vdi n g h i nghidp chinh Id lam n6ng nghigp (84,7%) anh hypng tdi vide chdm s&
dinh dydng eho tre hang ngdy Id nguySn nhdn d i n d i n hdm lypng dinh dydng trong khiu p h l n hdng ngdy ciia tre khong M NCKN.
Cac thyc p h i m san cd d dja phypng, tlift nhy k i t qua nghidn cu'u, d l y du 4 nhom t l f l
TCNCYH Phu truung 79 (2) - 2012
phim deu san ed va dypc sir dgng hang ngdy cho tre. Tuy nhien, co mot s l thyc phim san cd nhy cua, hen nhyng ba me khdng cho tre an vi khdng bilt c h l biln hoac eho rang tre se bj roi loan tieg hda khi an.
NggIn thyc pham la san cd nhyng ty le suy dinh dypng cao cd the do nguyen nhdn cdc bd mg thilu kiln thirc cham sdc tre nhy da ndi p tren.
V. K^T LUAN
Tinh trang suy dinh dydng cua tre em ty 24-59 thang tuoi tai q u i n the nghien ciru typng doi cao vdi ty Id suy dinh dydng the thilu can la 24,5%. t h i t h i p coi Id 29,1% va 14,3% the gdy cdm. Nang lypng k h i u phan an eiia tre 36-59 thang chya dat so vdi nhg cag khgyin nghj. Ham lypng sat trong khiu phln an cua tre 36-47 thang chi dat 6,9mg/
ngdy thap hpn NCKN. Ham lypng canxi trong khiu phln an eua tre chi dgt 67-86% so vdi NCKN. Lypng lipid trong khiu phdn khdng dat nhu c l u khuyin nghi. Cdc thyc pham san cd d dja phypng dam bao dii 4 nhom thyc phdm: Protid, Glucid, Lipid, Vita- min va mudi khoang.
TAI LIEU THAM K H A O 1. Bo Y t l (2007). "Nhu c l u dinh dydng khuyin nghi cho ngydi Viet Nam", Nhd xuat ban Y hoc, Hd Noi, 27 - 45.
2. Bo Y t l , Vien Dinh d y d n g (2009).
•Chypng trinh mgc tieu phdng chong suy dinh dypng tre em d Viet Nam (1998 - 2008)", Nhd x u l t ban Y hpc, Ha Npl.
3. Le Thj Hp'p, Ha Huy Khoi (2010). "Xu I hydng tang trydng t h i tgc cua ngydi Viet
Nam va djnh hydng cua Chiln lypc Quic gia v l Dinh dypng trong gial doan 2011- 2020", Tap ehi Dinh dydng va Thyc phim - 6 (3+4).
4. Le Thj Hyo'ng, Vu Phyo'ng Ha (2011),
"Kiln thire, thyc hdnh ngoi con ciia cac ba mg va tinh trang dinh dydng ciia tre em dydi 2 tuoi vung dan tpc thilu s l tai huydn Hydng Hda, tinh Qgang trj nam 2010". Tap ehi Nghidn cyg Y hoc, 70 (5): 1 6 - 2 1 .
5. Vien Dinh Dyo'ng - Tdng cue thing ke (2008). "Kit qua dieu tra theo doi ty Ig SDD tre em cac tinh nam 2007", Tdi lieu hgi nghj Dmh dypng todn quoc, 12-19.
6. Vien Dinh Dydng - Unicef (2010).
"Tinh hinh dinh dydng Viet nam nam 2009- 2010", Nhd xult ban y hoc, 9 - 24.
7. Institute of Medicine (2002). "Dietary Reference Intakes. Energy carbohydrate, fiber, fat, fatty acids, cholesterol, protein, and amino acids"- Washington (DC): National Academies Press
8. USAID/West A f r i c a (2008),
"Understanding Child Malnutrition in the Ba- bel: A Case Study from Goundam Cercle, Timbuktu Region, Mall", Sahelian West Africa Malnutrition Situation Report, 1 -14.
9. Rosalind S Gibson (2005). Principles of Nutritional assessment. Second edition, Oxford University express
10. WHO (2006). Child grovrth standards:
length/helghtifor-age, welght-for-age, weight- for-iength, vi/e'ght-for-height and body mass index-for-age: methods and development, Geneva.
TCNCYH Phu tnmng 79 (2) - 2012
Summary
NUTRITIONAL STATUS AND DIET OF CHILDREN 24 - 59 MONTHS IN XUAN QUANG COMMUNE, CHIEM HOA DISTRICT, TUYEN QUANG PROVINCE 2011 A Cross-sectional study among 196 children aged 24 - 59 months including anthropomel measurement, 24 hours recall of child's food intake from 90 mothers and group discussions gather information on nutrition, diet and food availability in the local. The results showed tt The rate of stunting malnutrition was 29.1% (H/A), undera/elght (W/A) was 24.5% and wasti (W/H) was 14.3%. The average diet of children 24 - 35 months has met the needs recomme dations on protein and energy levels Diets of children 36 - 59 months were less than the d mand for energy as recommendations, iron in the diet of children 36 - 47 months only 6.9m day was lower than recommendations. Calcium in the diet of children was only 67 - 86% coi pared to recommendations. Lipid In the diet was less than the demand as recommendatior The food availability in the local can provide fully 4 food groups: glucid, proteins, lipids, vitamii and minerals.
Keywords: Malnutrition, diet, food availability, children, Chiem Hoa
HIEU QUA TRUYiN THONG GIAO DUG DINH DU^aNG PHONG CHIDNG THIEU MAU THiEU SAT a NU" HOC SINH 16 - U
TUpl TAI BiNH LUC - HA NAM
Nguyen Thuy Linh, Le TM Huong, Pham Vin Pha, Pham Duy Turn Truung Dpi hpc Y Ha At Nghiin eiru can thiip so sinh IruOe sau cd ddi chimg lpi cpng ding trin 418 nir hoe sinh tir (6-(
tudi d 2 b-uirng phi IhOng trung hpe Binh Lue B vi Binh Lpc C tpi huyin Binh Lpc, tlnh Hi Nam tnmg thing cho thiy tpi thai diim Irudc can thiip ty 1$ thiiu miu li 14.6%. tf ii thiiu sit li 32%. Tmng sS S Iri bl thiiu miu, eP 43,1% thiiu miu do thiiu sii Cd mSi liin quan giira nghi nghiip eua me vii til thiiu miu thiiu sit Sau 6 thing can thipp bing truyin thing giio dpc dinh duOng, kiin IhUc, thpc tiin cua hoc sinh vi phdng ching thiiu miu thiiu sit di duac cii thiin ri rit Thpc hinh Ihuimg xuyin 3 cie thue phim giiu sit trong cie bita in ling iin dpt gin 100%. Tf ii thiiu miu d tnjOng can thiip giii tu 13,3% xuing cin 6,9%, tf li thiiu sit giim IU41,5% xuing cdn 3f ,9%.
Tir khoa: Thiiu mau thilu sit, truyin thdng, nO' hoc sinh. Ha Nam
I BAT V A N D t ' " ^ ' '^^" ' " ' S'^"" ^^^ " * " ^ ^^ '^P ° " * ^ [5]. NO' vj thdnh nien 16 - 18 la dp tuli dan|
Thilu mdu thilu sdt la mdt benh thilu vi day thi, chuan bj cho giai doan k i t hon vi ehlt dinh dypng cd y nghTa sire khoe cpng Idm me, tre phdt triln t h i chat r l t nhanh.|
ddng quan trpng hign nay thilu mdu thilu nhu cdu dinh dydng tang Idn dpt biln. fi*
sat anh hypng d i n sy phat t n i n t h i lyc va tri bidt, tre mat mau kdm theo mdt l y p n g | |
