老年知识分子营养状况调查

作者调查了170名60岁以上(含60岁)老年知识分子的营养状况。结果表明:(1)每人每日热量和蛋白质平均摄入量均达供给量标准的100％以上;蛋白质、脂肪和碳水化物的热量构成比分别为11.6％、34.2％和54.2％,动物性蛋白质占总蛋白质的44.3％。(2)体格检查贫血率约55％;高脂血症54.7％;一个以上(含1个)重要器官器质性疾病的患病率力72.9％。常见病为高血压病、冠心病、肺气肿和脑动脉硬化症。(3)本组老人高胆固醇血症和冠心病的患病率明显高于广州市老人院老人和广西巴马县老年农民,这可能与摄入高热量、高蛋白和高动物性脂肪膳食有关。     

南方防化兵营养调查

1985年4、9月对某防化团一、二、五三个连队进行了营养调查。膳食调查用称量法,连续3天;用生活观察法结合作息时间表测定战士一日热能消耗量;体格检查和抽查暗适应时间,同时对伙房卫生及烹调方法进行调查。一、膳食调查膳食构成以谷类为主,辅以肉、豆、菜,肝蛋类为零,鱼亦少。二、热能营养素的摄取量每人每日摄取:热能3721(3079～4736)kcal,而消耗为3167kcal,热量充裕;糖供给总热能的60.7％,脂肪占28.2％,蛋白质占9.7％,蛋白质摄入量为101.9(78.0～127.3)g,春季豆类及动物蛋白质不足1/3;脂肪摄入量为16.9(79.6～     

单纯性肥胖儿童合理饮食模式的探讨

目的探索单纯性肥胖儿童饮食模式的合理性。方法以总热能为1200～1600kcal／d，三餐热能中总热能的百分比为25％、40％、35％，高蛋白、适量脂肪和碳水化合物为饮食模式。总热能逐渐降低，用1个月时间过渡到制订的正规方案。治疗和随访46例肥胖儿。结果46例肥胖儿随访22例6个月(平均每人5．9个月)，肥胖度由51％降至29％。平均身高增加3．1cm。治疗后平均总热能为1413kcal／d，三大营养素占总热能的百分比为蛋白质21％，脂肪为44％，碳水化合物为35％，平均三餐热能分配362kcal(26％)、577kcal(41％)、47kcal(33％)。结论治疗单纯性肥胖儿不应过分降低总热能的摄入，应提高早中餐的质和量，降低晚餐的热能摄入。以高蛋白、适量脂肪、碳水化合物为合理饮食模式。     

老年鼻饲患者营养状况的评价

目的评价老年鼻饲患者营养状况.方法采用膳食调查、人体测量、实验室检查方法,对31例78～99岁的老年鼻饲患者进行营养状况评价.结果调查的患者普遍存在营养不良.产生原因①热能摄入不足,平均每日1339±283kcal;②营养素摄入不均衡,蛋白质摄入基本符合要求,平均每日59.1±13.3g,碳水化物摄入偏低,占总热能的52.5%±8.90%,脂肪摄入偏高,占总热能的30.0%±8.96%;③老年人消化、吸收功能减退,自身合成代谢减少,分解代谢增加;④老年人往往同时患有多种慢性疾病,使鼻饲内容及用量受到限制.结论临床医生和营养人员应根据患者的具体情况进行科学计算,确定每日热能和营养素供给量以及各类食物的合理搭配,并在治疗过程中予以调整.     

某高级中学住宿生膳食与营养状况调查

[目的 ]　为创建我区学生膳食示范点 ,为今后发展中学学生膳食探索经验。 [方法 ]　用记帐法和称量法调查2 71名住宿学生的膳食情况 ,并结合人体测量指标评估其营养状况。 [结果 ]　平均每日男女生能量和各种营养素摄入量分别为 :能量 (32 5 0± 16 4)kcal,(2 5 80± 172 )kcal;蛋白质 (112 .1± 10 .3) g ,(97.0± 9.7)g ;脂肪 (137.6± 11.5 ) g ,(136 .0± 10 .9) g ;碳水化物 (390 .6± 17.9)g ,(2 37.8± 18.0 ) g。蛋白质 /脂肪 /碳水化物供能比为 13 .8∶38.1∶48.1;15 .0∶47.4∶36 .9。脂肪供能占总热量比例超过 30 %。碳水化物供能比低于 5 0 %。来自动物及豆类的蛋白质占总蛋白质的 5 0 %以上。早中晚三餐热能分配为 2 1∶38∶41和 2 7∶35∶38。常量及微量元素中铁、钠、钾、磷、碘、铜、硒、锰均达中国居民膳食营养素参考摄入量(DRIs)要求 ;钙、锌男女生摄入量分别为DRIs 的 5 8.90 %和 5 6 .6 0 %、79.47%和 78.71%。维生素E、C和尼克酸均达DRIs要求 ;VitA摄入量男女分别为DRIs 的 6 3 .9%和 73 .1%。VitB2 摄入量男女分别为DRIs 的 83 .33 %和 90 .83 %。 [结论 ]　膳食结构基本合理 ,但应减少脂肪摄入 ,增加主食和菜果的供给量。     

学龄儿童脂肪摄入量调查分析

以北京某小学9～11岁学龄儿童202名为研究对象进行3日膳食调查。结果表明．平均每人每日摄入总热量6538．8KJ，占供给量标准的76．23％。热量来源：蛋白质占13．3％，脂肪占39．2％，碳水化合物占47.4％。脂肪摄入量68．2g，其中动物性脂肪35.9g．占脂肪总量的53％，摄入不饱和脂肪酸14．3g，饱和脂肪酸18.5g，P／S比值为0.77，胆固醇摄入量为430.3mg。上述结果表明该人群热能摄入量不足，而脂肪供热比偏高．摄入胆固醇量偏高。文中建议改善学龄儿童的膳食．增加主食量，减少动物性脂肪和含胆固醇多的食物摄入量，以利于学龄儿童身体健康。     

湖南两所中学寄宿生营养调查(摘要)

<正> 于1982年10月对两个县级中学,桃江一中和宜章一中的1084名奇宿生进行了营养调查。膳调采用称重法记录各种食物的消耗量,用询问法登记零食,调查三天。两校的食物构成相似,主食以大米为主,占食物摄入量的48％和51％。红薯占4～4.5％,动物性食品占5.5％,蔬菜占32～38％。平均每人每日的热能摄入量为2459千卡,占平均供给量的96％。蛋白质摄入53.2克,达到标准的64％。钙和核黄素缺乏较明显,仅达到标准的40％。胡萝卜素、硫胺素和抗坏血酸供给均算充足。从热能来源看,74％来自碳水化物,18％来自脂肪,而来自蛋白质者仅占8％。对257人进行了体格检查,发现舌乳头肥大者106人,口角湿白者56人,分别占受俭人     

西北某卫校学员营养调查

１９９５年分别于冬、夏两季对某卫校学员进行了膳食营养调查。结果表明，食物结构以谷类和蔬莱为主，动物和豆类食品很少。优质蛋白冬季占总蛋白摄入的２８．０％，夏季占１９．３％，未达到规定的３０％～５０％。每人每日热能摄入冬季为１１．６ＭＪ，夏季为１１．０ＭＪ，每人每日热能消耗冬季为１０．０ＭＪ，夏季为９．２ＭＪ，摄入大于消耗。说明热能能满足需要；但视黄醇、核黄素、钙和磷摄入量不足。     

我军步兵与通信兵部队营养健康现状调查——1．步兵部队膳食调查

目的 了解南、北方步兵部队战士的膳食营养状况,为制定我军步兵部队新的食物定量标准提供科学依据.方法 采用称量法,连续5 d对南方某部甲、乙连及北方某部丙、丁连共245人进行膳食调查;同时进行24 h生活观察.结果 (1) 平均每人每日的能量消耗为15.56 kJ,属于重度～极重度体力劳动强度;(2)平均每人每日消耗的食物种类,南方步兵为27～34种;北方步兵为30～41种;(3)谷类、蔬菜、鱼虾的摄入量普遍不足;多数连队蛋类、豆类及制品的摄入量偏低,但油脂的摄入量偏高,平均超标18.6%;(4)热能81.5%来源于植物性食物,而摄入动物性蛋白质和大豆蛋白质之和占摄入蛋白质总量的46.8%,符合军标要求;(5)平均每人每日的能量摄入量达标;但南步乙连和北步丁连的蛋白质摄入偏低;(6)平均每人每日钙、维生素A、维生素B1、维生素B2和尼克酸的摄入量明显低于军标.结论 步兵部队目前能量和多数营养素的摄入量能达到军标要求,但钙、维生素A、维生素B1、维生素B2和尼克酸等营养素摄入普遍不足,油脂的摄入量偏高,部分连队蛋白质摄入不足.建议增加动物内脏、蔬菜、水果及奶类的供给,适当限制脂肪摄入.     

新疆克孜勒苏自治州柯、维、汉族中学生膳食调查

1990年4～6月我们对克州的柯、维、汉族中小学生进行了营养性贫血调查，同时为了解膳食结构和营养状况对贫血的影响，对柯族三中、维族一中和汉族二中集体食堂进行了连续三天称量法的膳食调查。其结果为：学生每人每日摄入粮谷类（634．649（柯）、641．14g（维）和530.74g（汉）。热量的摄入占平均供给量86．63％（柯）、102．79％（维）和91．09％（汉）；热能中77－21～88．sl％来自谷物，10．02～12．00％来自蛋白质11．11～19．26％来自脂肪。热能来源分布谷物占比重过大，蛋白质和脂肪偏低。蛋白质占供给量标准的71．64％（柯）、86．…     

The nutritional status of elderly bed-ridden patients receiving tube feeding

Long-term enteral feeding by tube has become a frequently used procedure in elderly patients. However, only a few studies dealing with the nutritional assessment of such patients are currently available. This study was designed to clarify this issue. Anthropometric and biochemical variables, energy expenditure and dietary intake were investigated in 44 hospitalized bed-ridden patients with and without tube feeding over 65 years of age and 41 age-matched free-eating elders in a nursing home. All patients with tube feeding received enteral nutrition by nasogastric tube. The body weight, body mass index, mid-upper-arm circumference, arm muscle circumference and serum level of albumin were significantly lower in the patients with and without tube feeding, compared with free-eating elders of both genders (p<0.05). Energy intakes of the patients with tube feeding were 1,171+/-286 kcal/d (about 26 kcal/kg/d), which is comparable to the predicted total energy expenditure (1.2 x basal energy expenditure). Protein intake was 44.9+/-13.1 g/d (about 1.0 g/kg/d) and the percentage of protein per total energy was 15%. These intakes are generally considered to be optimal for bed-ridden patients receiving tube feeding. However, the incidence of protein-malnutrition, as evidenced by decreased arm muscle circumference (<80% of normal) and hypoalbuminemia (<35 g/L), in the patients with tube feeding was significantly higher than that in the healthy elders. In addition, the orally fed bed-ridden patients were also malnourished, suggesting that the bed-ridden patients easily became malnourished even if they were fed energy and protein which approximated calculated predicted values. These findings raise a problem concerning nutritional management of bed-ridden patients.     

The effectiveness of targeted feeding assistance to improve the nutritional intake of elderly dysphagic patients in hospital

Background Dysphagic older patients are prescribed texture modified food or fluids as treatment. The present study aimed to determine whether targeted feeding assistance using trained volunteers increased oral intake in elderly dysphagic patients. Method Individualized feeding assistance was given to patients who were diagnosed with dysphagia by a speech and language therapist. Data were collected between 08.00 h and 16.00 h and compared with previously collected data from dysphagic patients who received no targeted feeding assistance. Results The group with targeted assistance (n = 16) had higher intakes of energy and protein from both meals and supplements combined compared to the controls (n = 30); mean difference = 2327 kJ (554 kcal) (95% CI = 1294–3360 kJ; P < 0.001) and 28 g protein (95% CI = 13–41 g; P = 0.01). The assisted group ate more from meals only; mean difference = 1336 kJ (318 kcal) (95% Cl = 517–2155 kJ; P = 0.002) and 6 g of protein (95% Cl = 2–26 g; P = 0.02); and from nutritional supplements only, median difference = 1205 kJ (287 kcal) (95% CI = 613–1273 kJ; P = 0.0002) and 15 g protein (95% CI 6.9–15 g; P < 0.0001). Conclusion Nutritional intake can be improved by targeted feeding assistance in hospitalized elderly dysphagic patients on texture modified diets.     

Malnutrition in tubefed nursing home patients with pressure sores.

This study compares the nutritional status and dietary intake of 14 tubefed nursing home patients with pressure sores (age: 70 +/- 5 years, mean +/- SEM) to 12 tubefed patient-controls without sores (age: 60 +/- 7 years). Patients tended to have higher calorie intake (32 +/- 3 kcal/kg) than patient-controls (26 +/- 2 kcal/kg, p = 0.11). Protein intake was significantly higher in patients (1.4 +/- 0.2 g/kg) than patient-controls (0.9 +/- 0.1 g of protein per kg, p less than 0.05). Despite increased calorie and protein intake, biochemical measures of nutritional status were worse in the patients. Serum albumin was lower in patients (33 +/- 1 g/L) than in patient-controls (37 +/- 1 g/L, p less than 0.05) as was level of hemoglobin (patients: 117 +/- 5; patient-controls: 132 +/- 5 g/L, p less than 0.05). Patients with stage IV (severe) sores had lower serum cholesterol levels (3.46 +/- 0.31 mmol/L, n = 5) than patients with stage II/III (milder) sores (4.58 +/- 0.23 mmol/L, n = 9, p less than 0.05). Plasma zinc was low in both patients (11.2 +/- 0.6 mumol/L) and patient-controls (11.5 +/- 0.7 mumol/L, p = NS). Pressure sore surface area was positively correlated with calorie intake per kilogram of body weight (r = +0.59, p less than 0.04) and negatively correlated with body mass index (r = -0.70, p less than 0.03), hemoglobin (r = -0.55, p less than 0.07) and serum cholesterol (r = -0.57, p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)     

Assessment of intragastric pH value changes after early nasogastric feeding

Studies have suggested that early feeding after injury decreases morbidity and mortality. Few reports, however, have focused on the change in pH inside the stomach after early tube feeding. The aim of the present study was the assessment of 1) the change in intragastric pH after surgery, and 2) the effect of early nasogastric tube feeding on intragastric pH value. From April 1997 to February 1998, 80 patients who underwent colon resection for colorectal cancer by a single surgeon entered the study and were randomized into four groups. Twenty patients (group I) were kept on NPO for 1 wk, and 20 patients per group (groups II, III, and IV) were fed through a nasogastric tube from the second to the seventh postoperative day with low-residual (Osmolite HN), high-fat (Pulmocare), and glutamine-containing (AlitraQ) enteral formulas. Feeding started at 500 kcal/500 cc/d. If the patient tolerated the formula well, feeding increased to 1500 kcal/1500 cc(-1)/d(-1) the following day. Intragastric pH was measured preoperatively and then twice daily until the sixth postoperative day. The pH value of intragastric juice increased significantly once feeding started (3. 67 +/- 1.33 on the third postoperative day; 4.28 +/- 1.26 on the six postoperative day). The pH value seemed only mildly affected by the patient's tolerance for tube feeding (poorly tolerated group, pH 3. 52 +/- 1.75 versus 3.75 +/- 1.21 in the well-tolerated group on the third postoperative day; poorly tolerated group, pH 3.67 +/- 1.02 versus 4.45 +/- 1.27 in the well-tolerated group on the sixth postoperative day). The pH value of intragastric juice was higher in group II than in groups III and IV (4.51 +/- 1.57, 3.90 +/- 1.20, 4. 42 +/- 0.89 respectively, on the sixth postoperative day). This series suggests that early nasogastric feeding can significantly elevate the intragastric pH value in patients after resection of colorectal cancer. Nasogastric feeding may decrease the incidence of stress ulceration by elevating the pH value of intragastric juice.     

Response to a diet low in total fat in women with postmenopausal breast cancer: a pilot study

A feasibility study was instituted to determine if women with postmenopausal breast cancer would follow a low-fat diet (20% of kcal) for at least four months. Nineteen women, whose baseline food intake was 1,504 +/- 420 kcal with 56 +/- 16 g of fat, reported a decrease in fat intake to 21 +/- 6 g after two months of dietary intervention. Serum concentrations of cholesterol, HDL cholesterol, and estradiol were significantly reduced by the fifth month on the diet. We conclude that self-selected patients can adhere to a low-fat diet, and that serum cholesterol may serve as an indicator of dietary compliance.     

Does a new steam meal catering system meet patient requirements in hospital?

BACKGROUND: It has been consistently observed that a significant proportion of hospital inpatients are malnourished and many actually develop malnutrition in hospital. The NHS provides over 300 million meals each year at a cost of pound 500 million, yet there is relatively little research evaluating how well different catering systems provide for the needs of hospital inpatients. AIM: The aim of the study was to: (i) evaluate whether a new steam meal catering system (Steamplicity) enables patients in theory to meet their energy requirements in hospital and (ii) compare energy and protein intake using Steamplicity with a traditional bulk cook-chill system. METHODS: Patients not at nutritional risk had their food intake at one lunchtime assessed. Energy intake was compared with the patients' energy requirements and energy and protein intake were compared with previous data from a bulk system. RESULTS: Fifty-seven patients had a median daily energy requirement of 7648 kJ (1821 kcal) [inter-quartile range (IQR): 6854-9164 kJ]. Assuming 30% [2293 kJ (546 kcal)] should be supplied by the lunch meal the average intake of 1369 kJ (326 kcal) fell short by 40%. Patients served meals from Steamplicity ate less energy [1369 kJ versus 1562 kJ (326 kcal versus 372 kcal) P = 0.04] but similar protein (18 g versus 19 g P = 0.34) to the bulk system. The largest difference was the energy provided by the dessert since the bulk system served more hot high-calorie desserts. CONCLUSIONS: Patient intakes did not meet their estimated requirements. The patients in this study were eating well and not at nutritional risk, thus patients with a poor appetite will be even less likely to meet their nutritional requirements. Steamplicity meals result in a lower energy intake than meals from a bulk cook-chill system, but similar protein intakes.     

低蛋白饮食对3/4期慢性肾脏病患者肾功能及营养状况的影响

目的 评估低蛋白饮食对3/4期慢性肾脏病(CKD)患者肾功能水平及营养状况的影响.方法 将34例3/4期CKD患者随机分为A组(n=14)和B组(n=20),分别给予0.6 g·kg~(-1)·d~(-1) 和0.8 g·kg~(-1)·d~(-1)蛋白质摄入量,对两组患者个体化跟踪指导6个月,测定治疗前后人体测量指标及血生化指标,进行人体营养状况整体评价和24 h膳食回顾调查.结果 A组治疗后血肌酐值水平明显下降(P=0.010),白蛋白水平明显升高(P=0.042),热能(P=0.018)和碳水化合物(P<0.001)的摄入均较治疗前明显提高.通过营养干预,整体、A组和B组患者营养不良发生率比治疗前分别下降了14.7%、7.2%和21.1%.结论 0.6 g·kg~(-1)·d~(-1)蛋白质摄入量及用小麦淀粉代替部分主食的饮食方案可明显提高3/4期CKD患者碳水化合物和热能的摄入量,改善其营养状况和肾功能.     

Energy and nutrient intake of Swiss women aged 75–87 years

OBJECTIVE: Reliable data about the nutrient intake of elderly noninstitutionalized women in Switzerland is lacking. The aim of this study was to assess the energy and nutrient intake in this specific population. SUBJECTS: The 401 subjects were randomly selected women of mean age of 80.4 years (range 75-87) recruited from the Swiss SEMOF (Swiss Evaluation of the Methods of Measurement of Osteoporotic Fracture Risk) cohort study. A validated food frequency questionnaire (FFQ) was submitted to the 401 subjects to assess dietary intake. RESULTS: The FFQ showed a mean daily energy intake of 1544 kcal (+/-447.7). Protein intake was 65.2 g (+/-19.9), that is 1.03 g kg(-1) body weight per day. The mean daily intake for energy, fat, carbohydrate, calcium, magnesium, vitamin C, D and E were below the RNI. However, protein, phosphorus, potassium, iron and vitamin B6 were above the RNI. CONCLUSION: The mean nutrient intake of these free living Swiss elderly women was low compared with standards. Energy dense foods rich in carbohydrate, magnesium, calcium, vitamin D and E as well as regular sunshine exposure is recommended in order to optimise dietary intake.     

Effect of dietary fat and cholesterol on plasma lipids and lipoprotein fractions in normolipidemic men

In a controlled feeding situation, male subjects were assigned to one of four treatment groups: low fat (31% of total kcal)/low cholesterol (193 mg/d) (LFLC), low fat/usual cholesterol (504 mg/d) (LFUC), usual fat (46% of total kcal)/low cholesterol (UFLC) and usual fat/usual cholesterol (UFUC) intake. For the first 2 wk of the 10-wk study all subjects consumed the UFUC diet. Subjects consumed experimental diets during wk 3-7 and resumed their customary intake during wk 8-10. Plasma total, high-density-lipoprotein (HDL), low-density-lipoprotein and very-low-density-lipoprotein cholesterol and triglycerides were determined weekly. A significant effect (P less than 0.05) of dietary fat on plasma total and HDL cholesterol was observed between the end of wk 2 and 7. Low fat intake resulted in 17 +/- 2 mg/dL lower total cholesterol and 10 +/- 1 mg/dL lower HDL cholesterol than the usual fat intake. Plasma lipids were not affected either by dietary cholesterol or by any interaction of dietary fat with cholesterol.     

Management of diabetic patients requiring nutritional support.

A retrospective analysis was performed on 70 patients with diabetes mellitus who required nutritional support over the 10-yr period 1979-1989. Information was available for 65 patients, of whom 55 had non-insulin-dependent diabetes mellitus (NIDDM). Enteral nutrition (EN, 750-2200 kcal/day) was given to 40 NIDDM patients (group A) and 6 insulin-dependent diabetic (IDDM) patients (group B), and parenteral nutrition (PN, 1600-2400 kcal/day) was given to 18 NIDDM patients (group C) and 4 IDDM patients (group D). Three NIDDM patients required both types of feeding. Preadmission diabetes treatment remained the same during feeding for 31% of the total group (38% of group A, 33% of group B, 23% of group C, and 0% of group D). The NIDDM patients in group C who received insulin during PN required a high daily dose of approximately 100 U. The IDDM patients on PN required an increase of 225% from their preadmission daily dose. The likelihood of a patient requiring a major change from preadmission diabetes therapy depended mainly on the severity of the underlying illness and on the type of feeding (greater with PN) but not on preadmission therapy, age of patient, or type of EN (cyclic vs. continuous). Hypoglycemic episodes were uncommon in all groups. There were no significant differences between the prefeeding and feeding blood glucose levels and HbA1c results.