长江社区居民营养现状调查及干预对策

[目的 ]　了解社区居民营养现状 ,以便今后在社区开展针对性的综合营养干预。　 [方法 ]　随机抽取该社区3 3 0名 18岁 (含 18岁 )以上居民 ,采用 2 4h膳食回顾法 (连续 3天 )调查食物摄入情况 ,同时测量身高、体重与血压。　 [结果 ]　蛋白质、碳水化合物、脂肪供热比为 16.97%、5 1.3 3 %、3 1.71%。钙、锌、硒、视黄醇当量、维生素B2 、维生素C摄入明显不足。高血压患病率、肥胖患病率达到 14 .8%和 2 2 .2 %。　 [结论 ]　居民膳食结构不尽合理 ,迫切需要在社区开展针对性营养干预 ,促进居民营养水平提高 ,预防各类营养相关疾病     

糖尿病社区综合防治效果评价

[目的 ]　通过社区糖尿病综合防治 ,使糖尿病病人病情稳定 ,并发症减少 ,病人生活质量提高 ,医药费用降低。以此观察社区卫生服务在糖尿病综合防治中的实际效果。　 [方法 ]　对糖尿病人进行防治糖尿病健康教育 ,并饮食和运动的量化干预 ,建立科学的生活方式 ,纠正不良的生活习惯 ,控制可能导致糖尿病并发症发生的危险因素 ,配合必要的药物治疗。　 [结果 ]　综合管理 3个月 ,83例病人综合防治前后自身对照糖尿病防治知识及自我保健能力方面平均提高 89.16% (P <0 .0 1) ,纠正不良生活方式和不良生活习惯 79.3 2 % (P <0 .0 1) ,糖尿病自测率提高 71.0 8% (P <0 .0 1) ,体重平均下降 1.80kg(P <0 .0 1) ,腰围平均下降 1.77cm(P <0 .0 1) ,臀围平均下降 1.0 4cm(P <0 .0 1) ,体重指数 (BMI)平均下降 0 .68(P <0 .0 1) ,收缩压平均下降 11.19mmHg(P <0 .0 1) ,舒张压平均下降 5 .61mmHg(P <0 .0 1) ,空腹血糖平均下降 3 .3 3mmol/L(P <0 .0 1) ,餐后 2h血糖平均下降 3 .5 4mmol /L(P <0 .0 1) ,患者医药费用平均每人减少 97.0 5元。　 [结论 ]　社区卫生服务综合防治糖尿病 ,能提高疗效 ,提高患者的生活质量和降低医药费用     

海淀区成人肥胖干预措施研究

目的研究成人肥胖特点,探索有效干预措施。方法对北京市海淀区三个社区体重指数(BMI)≥28的肥胖成人,采取整群抽样法进行问卷式调查,随机抽取其中280名肥胖病人并按所在社区随机分为干预组和对照组,进行干预前后的对比分析。结果干预后干预组的肥胖相关知识认知程度提高,运动行为改变显著;认为应该制定减肥方案率明显提高(P<0·01);运动频率显著提高,运动行为改变以干预组的完全不运动最为显著,由干预前的53·38%下降至干预后的18·01%(P<0·05);干预组肥胖病人的体重下降率为35·44%,对照组的体重下降率为9·01%。结论锻炼率过低、肥胖相关知识的缺乏是当前成人肥胖的特点,也是控制的关键点。在社区更多的组织干预活动,改善居民的行为习惯、增加体育锻炼等干预措施是可行有效的。     

曹家渡社区脑卒中知信行干预效果评价

[目的 ]　分析曹家渡社区 3 5岁以上居民经 2年综合干预后 ,脑卒中有关知识、信念、行为 (KAP)的改变。[方法 ]　 1998年随机调查 481人 ,作为基线调查人群 ,其中对照组 2 41人 ,干预组 2 40人。经过 2年社区干预后 ,于 2 0 0 0年随机抽查了 45 4人 ,对照组和干预组各调查了 2 2 6和 2 2 8人。 [结果 ]　干预组总体信念、高血压患者相关行为、高血脂患者相关行为等得分均显著高于对照组 (P <0 .0 5 ) ,且其及格率也显著高于对照组 (P <0 .0 5 )。 [结论 ]　社区综合干预措施具有一定效果 ,有助于改善居民对防制脑卒中的认识和相关行为     

医学生舒张压测量过程中变音与消失观察

[目的 ]　探讨用Korotkoff分期法的第 4期表示舒张压和第 5期表示之间的差别。 [方法 ]　对 2 6 1例医学生采用汞柱式血压计间接测量法 ,测量两上肢的变音与消失的汞柱值。 [结果 ]　两上肢舒张压变音和消失的均值男性均显著高于女性 (P <0 .0 0 1) ,而变音和消失均值与运动与否无关 (P >0 .0 5 )。舒张压变音发生率在左上肢为39 .8% ,右上肢为 39.5 % ,运动者变音发生率较不运动者显著增多 (P <0 .0 5 )。变音发生率与男、女性别无关 (P <0 .0 5 )。变音和消失之间的差值约为 15mmHg。[结论 ]　舒张压的表示方法以第 5期消失的汞柱值较为合理。若以此值表示舒张压 ,则舒张压的标准可能相应下降。     

上海市徐汇区结核病防治模式效果评价

[目的 ]　评价新旧两种结核病防治模式运转效果。　 [方法 ]　收集 2 0 0 1年 9月前后的新旧结核病防治模式下的结核病有关资料 ,进行对比分析。　 [结果 ]　新模式运转后 ,登记新发病人中痰阳率较旧模式提高 (P <0 .0 5 ) ;两所定点治疗医院对确诊结核病全程管理率保持 10 0 % ,治愈率提高 2 .70 % ,但与旧模式无差异 (P >0 .0 5 ) ;各医院疑似结核病人转诊率由 38.69%上升到 99.2 0 % (P <0 .0 0 1) ;转诊到位率由 69.2 7%上升到 86.5 6% (P <0 .0 0 1)。社区对结核病人全管覆盖率 99.5 8% ,较旧模式提高 1.5 1% ,但无统计学差异 (P >0 .0 5 ) ;外来人口通过预防性体检 ,结核病的检出率与2 0 0 1年同期相比差异有显著性 (P <0 .0 0 1) ;外来人口结核病建卡和管理率上升了 2 3.76%。　 [结论 ]　徐汇区现行结核病防治模式优于旧模式 ,可进一步完善和推广     

共轭亚油酸减肥作用的人体试食试验研究

[目的 ]　研究共轭亚油酸对人体的减肥作用。　 [方法 ]　 3 0名单纯性肥胖的志愿者连续食用共轭亚油酸胶囊 3 5d ,于试验开始及结束时均测试各项安全性指标及功效性指标。　 [结果 ]　受试者连续食用共轭亚油酸胶囊 3 5d后 ,体重平均下降 1.9kg ,体脂总量平均下降 1.2kg ,体脂百分率平均下降 0 .7% ,三角肌处脂肪厚度减少 2 .1mm ,肩胛下脂肪厚度减少 4.1mm ,脐旁脂肪厚度减少 3 .5mm ,髂棘处脂肪厚度减少 3 .6mm ,腰围减少 4.3cm ,臀围减少 1.5cm。试验前、后受试者各项临床指标均未见异常 ,并且试验后运动耐力未下降。　 [结论 ]　共轭亚油酸对人体具有明显的减肥作用 ,且对机体健康无明显损害。     

社区健康教育干预对大肠癌早发现的价值

[目的 ]　对卢湾区社区健康教育干预对大肠癌早发现的价值进行评估。 [方法 ]　采用多种形式宣传大肠癌高危人群 ,早期症状和三早 (早发现、早诊断、早治疗 )工作的重要性 ,促使有肛肠症状的病人及时就医。 [结果 ]　建网后组大肠癌病人初发肛肠症状至确诊的持续时间缩短 ,居民大肠癌防治知识知晓率明显提高 (P <0 .0 1)。另外 ,卢湾区早期大肠癌病人中近 1/ 4系受健康教育启示就医而被及时发现。实施大肠癌因症就诊早诊断技术后 ,卢湾区组 (n =2 2 7)大肠癌早期率达 2 6 .9%。而对照组南市区组 (n =136 )仅为 7.3% ,两组的期别构成有显著差别 (P <0 .0 1)。 [结论 ]　社区健康教育干预对大肠癌早发现有积极的促进作用。     

扬州市农村社区人群肥胖超重现况及影响因素

[目的 ]　了解扬州市农村社区人群肥胖超重的流行特点及其影响因素。 [方法 ]　采取整群抽样方法 ,对扬州市 3县 (市 ) 7个农村社区 30 0 78名对象进行流行病学调查。 [结果 ]　 1 5～ 74岁居民体重指数 (BMI)均值为 2 2 .89;肥胖超重患病率为 2 9.95% ,标化率为 2 4.6 0 % ;肥胖超重的患病率与年龄呈正相关 ,患病率最高峰值在 45～ 54年龄段 ;不同职业中干部患病率最高 ,为 44.35% ;肥胖超重非条件Logistic多因素分析结果 ,肥胖家族史、生活满意度、年龄、高血压家族史、家庭收入等 1 4个因素为危险因素 ,体育锻炼是保护因子。 [结论 ]　肥胖超重由多因素引起 ,应当采取综合预防和干预措施控制肥胖超重的发生。     

支气管哮喘社区管理的经济和疗效分析

[目的 ]　观察支气管哮喘患者经社区管理后医疗费用和病情严重度变化情况。 [方法 ]　推行《全球哮喘防治战略创议》实行哮喘病社区管理并进行回顾性分析。患者分为正规防治组和非正规防治组 ,比较随访一年前后医疗费用和其他经济损失及哮喘临床症状变化情况。 [结果 ]　哮喘病社区管理后患者医疗费用明显下降 ,正规防治组的医疗费用显著低于非正规防治组 (P <0 .0 1) ,症状明显好转率显著高于非正规防治组 (P <0 .0 1)。 [结论 ]　支气管哮喘患者经管理和规范防治 ,可减少医疗费用支出 ,改善临床症状 ,提高患者生活质量     

高脂饲料诱导肥胖大鼠模型的方法研究

[目的]研究高脂饲料建立肥胖大鼠模型的方法以及肥胖诱导对肥胖大鼠的瘦素、胰岛素水平的影响。[方法]将50只雄性Wistar大鼠随机分为肥胖诱导组和正常对照组,分别喂以高脂饲料和基础饲料8周,观察摄食量和体脂含量的变化,第8周末测定血脂四项、瘦素和胰岛素水平进行比较。[结果]本次研究高脂饲料配方喂养肥胖大鼠的体重、血清总胆固醇、低密度脂蛋白胆固醇、瘦素和胰岛素水平均显著高于正常对照组(P﹤0.05)。[结论]本高脂饲料配方致肥效果良好,喂养肥胖大鼠产生瘦素抵抗和胰岛素抵抗,并伴有一定程度的血脂代谢紊乱。     

天津市居民超重（肥胖）控制中膳食关键因素分析

目的了解天津市居民超重（肥胖）患者的膳食结构和营养状况,分析天津居民超重（肥胖）与膳食因素的关系。方法采用多阶段分层整群随机抽样的方法,在已经建立的天津市慢性非传染病综合示范社区中随机抽取1542户,共2886人,分别测量身高、体重,计算体重指数（BMI）,并采用称重法和24h回顾法对调查对象进行膳食调查。结果能量、蛋白质、脂肪摄入越高,人群超重（肥胖）的患病风险越高。随着膳食碳水化合物供能比的增加,人群患超重（肥胖）风险降低。膳食纤维是超重（肥胖）的保护因素。膳食纤维日摄入量不低于20g,可以降低患超重（肥胖）的风险。每天摄入蔬菜、水果≥500g可以预防超重（肥胖）。热能和16种营养素摄人量中,热能、蛋白质、脂肪、碳水化合物、钙、锌、铁、膳食纤维、维生素A、维生素E、维生素B1、维生素B2、维生素C与每人每天营养素标准供给量（RDA）比较,差异均有统计学意义（P〈0．01）。与膳食宝塔相比,超重肥胖患者膳食中蔬菜水果、奶类、豆类摄入不足,鱼虾类、畜肉类摄人过多,食盐和油脂的摄入量严重超标。结论天津市居民膳食结构与肥胖率升高有内在联系,所以要针对性地改进膳食结构。     

Mediating effects of home-related factors on fat intake from snacks in a school-based nutrition intervention among adolescents

The purpose of the present study was to investigate if the effects of the parental component of a school-based intervention on dietary fat intake from snacking were mediated by changes in home-related factors. A random sample of 10 schools with 2232 pupils aged 11-15 years was randomly assigned to one of two intervention groups [one with (n = 1226) and one without a parental component (n = 1006)]. Fat intake, home availability of low-fat foods and parental encouragement and support to eat a low-fat diet were assessed with validated self-administered questionnaires. Mediation was assessed with the product-of-coefficient test. Changes in home-related determinants were significantly related to changes in fat intake from snacks; therefore, school-based obesity programmes on adolescents should try to address these determinants. In the present study, one of the three investigated home-related factors, namely parental support, was affected by the parental component intervention. Decreases in parental support were prevented. These changes in parental support were found to mediate the parental intervention effects on changes in fat intake from snacks. Home-related factors appear to be related to changes in adolescents' snacking behaviours, therefore, school-based obesity programmes should target them. Nevertheless, more research is needed concerning effectively addressing the other determinants.     

High dietary saturated fat intake accentuates obesity risk associated with the fat mass and obesity-associated gene in adults

Fat mass and obesity-associated (FTO) is the strongest genetic determinant of obesity identified to date. Dietary fat is a key environmental factor that may interact with genotype to affect risk of obesity and metabolic syndrome (MetS). This study investigated associations among FTO rs9939609, obesity measures, and MetS phenotypes in adults and determined potential modulation by dietary fat intake at baseline and after a 7.5-y follow-up when MetS cases and controls were selected. FTO rs9939609 genotype, biochemical, dietary, and lifestyle measurements were determined in the LIPGENE-SU.VI.MAX study (n = 1754). FTO rs9939609 A allele carriers had a higher risk of being overweight or obese [OR = 1.66 (95% CI: 1.07, 2.57); P = 0.02] and of having a larger abdominal circumference [OR = 1.42 (95% CI: 1.01, 1.99); P = 0.04] compared with the TT homozygotes. These associations were independent of physical activity and energy intake and were maintained over the follow-up period, particularly in the MetS individuals. High dietary SFA intake (≥ 15.5% energy) and a low dietary PUFA:SFA intake ratio (<0.38) further accentuated the risk of having a BMI ≥ 25 kg/m(2) and being abdominally obese. Non-risk allele carriers appeared to be unresponsive to dietary SFA intake or to the dietary PUFA:SFA intake ratio with respect to obesity measures. In conclusion, FTO rs9939609 was associated with obesity measures, especially in those with the MetS, which was further exacerbated by high dietary SFA intake at baseline and 7.5 y later. These data indicate important novel modulation of genetic risk by dietary fat exposure in individuals with increased cardiometabolic risk.     

2005年唐河县城区部分肥胖人群营养知识与态度调查

[目的]为进一步开展肥胖人群营养知识宣传教育提供科学依据。[方法]2005年8~11月,在唐河县人民医院对接受健康体检的226名城区肥胖者进行调查。[结果]调查226人,知道或听说过中国居民膳食指南、中国居民膳食宝塔、肥胖人膳食指导原则的分别占17.26%、10.18%、25.66%;60.62%的认识到需要增加膳食纤维的摄入量,减少饱和脂肪酸的摄入量,1/3左右认识到需要补充维生素及微量元素。营养知识掌握好的占11.50%,掌握较差的占88.50%。营养知识得分与文化程度呈正相关(P<0.01)。[结论]城区肥胖人群营养知识比较缺乏,应对肥胖人群开展营养知识的宣传教育。     

成都市学龄前儿童肥胖影响因素的病例对照研究

[目的]了解成都市学龄前儿童肥胖的影响因素,为儿童肥胖的预防和控制提供基础资料。[方法]在成都市幼儿园随机选取50名年龄3￣6岁肥胖儿童,按1︰2的比例与100名同性别、同身高、同年龄的正常儿童配对,通过问卷调查方法进行儿童肥胖影响因素的病例对照研究。[结果]本次病例对照研究结果表明,遗传因素和环境因素对学龄前儿童肥胖均有影响。学龄前儿童肥胖危险因素主要是食量、出生巨大儿、父母BMI、进餐速度及运动时间。[结论]学龄前儿童肥胖的危险因素多与生活行为方式密切相关,因此应加强对家长和幼教人员的营养教育,增强其健康意识,培养儿童良好的饮食和运动习惯,从而达到有效地预防和控制儿童肥胖的目的。     

Differences in impact between a family- versus an individual-based tailored intervention to reduce fat intake

The present study investigates the impact of a tailored nutrition intervention on the reduction of fat intake and on psychosocial determinants of fat intake. Furthermore, differences in impact between a family-based intervention (tailoring two family members, one adult and one child, simultaneously) and an individual-based intervention (tailoring one family member, one adult or one child) were studied. Analyses were conducted among 180 respondents, comparing 44 adolescents in the family condition with 50 adolescents in the individual condition and 44 parents in the family condition with 40 parents in the individual condition. Respondents in both conditions reported positive reactions towards the tailored fat feedback letters. Tailored fat feedback resulted in significantly more positive psychosocial determinants of fat intake and, among respondents with high fat intake at baseline, in a significant decrease in percent energy from fat. Parents in the family-based intervention group reported higher social support scores at post-test. No differences in post-test fat intake were found between the two study conditions. It is concluded that the results further illustrate the potential of tailored fat feedback, but the results do not provide evidence for superiority of family-based tailoring above individual-based tailored interventions for fat. Further research may be aimed at investigating the impact of comprehensive tailored family interventions, in which more than two family members participate.     

How women''s adopted low-fat diets affect their husbands.

OBJECTIVES. One way of promoting a reduction in dietary fat intake is by changing the diet of family members. This study investigated the long-term effects of a low-fat dietary intervention on husbands of women who participated in the Women's Health Trial (WHT). METHODS. An average of 12 months after the end of the WHT, a randomly selected sample of participants' husbands was sent dietary and health questionnaires as part of a follow-up study of the maintenance of the low-fat diet among WHT participants. RESULTS. We found an absolute difference in fat intake between groups of 4 percentage points (32.9% energy from fat among intervention husbands [n = 188] vs 36.9% among control husbands [n = 180]). The wife's attitude and fat intake were among the most important predictors of her husband's fat intake, indicating that the effect of the WHT intervention on the husbands of participants was more likely due to their acceptance of lower-fat foods being served at home than to overt actions by the men. CONCLUSIONS. Our results suggest that a dietary intervention aimed at women can have an effect on their husbands and may be a cost-effective approach to healthy dietary change for both women and men.