成都郊区学龄前儿童钙营养及骨矿状况的调查

目的：了解郊区学龄前儿童的膳食钙营养及骨矿发育状况。方法：随机选取成都郊区两所幼儿园，对161名3～6岁儿童进行膳食调查，检测血钙、尿钙，并用DEXA法、超声骨量分别测腰椎骨矿及跟骨骨量。结果：郊区学龄前儿童膳食钙营养状况仍较差。只达推荐量的32％左右；低血钙、低尿钙百分率分别为42．24％、63．34％；骨量、骨密度、骨面积与体重、身高呈正相关，学龄前儿童已表现出骨密度差异，男孩较女孩高，郊区学龄前儿童骨矿状况较城市同龄儿童为低。结论：郊区学龄前儿童由于膳食结构不合理。钙营养不足，低尿钙、血钙发生率较高，骨量发育较城市明显落后。必须加强人们对钙营养重要性的认识，调整膳食结构，多食人奶制品、豆制品等含钙丰富的食物，改普钙营养状况。促进达到最佳骨量。     

不同方式补充铁对学龄前儿童生长发育和铁营养状况的影响

目的　观察每日补充铁与间歇性补充铁对学龄前儿童生长发育和铁营养状况的影响。方法　选择日托幼儿园 3～ 6岁儿童 35 3名 ,按整群随机的原则按班分为 3组 ,分别为每日补充组 ( 1周 5次 ,周一至周五 ) ,每周补充一次组 ,安慰剂对照组。补充期为 14周。结果　每日补充组和每周补充一次组儿童的血红蛋白和血清铁蛋白含量均显著升高 (P <0 0 5 ) ,其中每周补充一次组儿童血红蛋白显著高于对照组 (P <0 0 5 ) ,红细胞游离原卟啉含量显著低于对照组 (P <0 0 5 )。干预结束后 ,两个补充组儿童的铁缺乏率显著低于对照组 ;每日补充组儿童的体重增长 ( 0 74± 0 5 5 )kg ,显著高于对照组的 ( 0 5 6± 0 5 7)kg。结论　补充多种微量营养素可以改善儿童的生长发育状况。对于铁缺乏较轻的儿童 ,可采用间歇性补充铁替代每日补充铁来改善铁营养状况     

孕期不同钙摄入量对孕产妇钙代谢的影响

目的　研究孕期不同钙摄入量对孕产妇钙代谢的影响。方法　 36名孕妇通过膳食指导和监测按钙摄入量水平随机分为传统膳食组、膳食钙干预组和膳食加钙剂联合干预组 ,对孕产期有关钙代谢指标、骨钙素及产后 45天骨密度监测。结果　血清钙磷各期各组间无差异 ( P>0 .0 5) ,随孕期进展钙吸收率、钙贮留量、血清碱性磷酸酶和尿羟脯氨酸增加 ,孕末期达高峰 ,产后下降 ;骨钙素也增加 ,产后仍增加 ;粪钙和尿钙降低 ,产后粪钙略增加而尿钙明显降低。母体腰椎骨密度组间差异显蓍 ( P<0 .0 1 )。钙摄入量与尿钙、钙贮留量和骨钙素呈正相关 ( r>0 .53,P<0 .0 1 ) ,与钙吸收率呈负相关 ( r=- 0 .51 ,P<0 .0 1 )。结论　我国传统膳食导致孕期低钙摄入情况下 ,母体虽可通过降低尿钙和粪钙的排泄 ,增加肠道钙吸收率和骨钙动员等调节 ,维持胎儿钙需要和自身血钙稳定 ,产生对摄入低钙的适应 ,但这种适应是有限的 ,不能达到较高钙贮留来满足妊娠期钙需要 ,对自身骨健康和代谢有一定影响 ,因此孕期应强调富钙食物、钙剂和 VD的补充     

补充钙剂对青春期骨矿含量的影响

为研究补充钙剂对青少年骨矿含量以及体格发育的影响 ,选取 1 61例 9～ 2 0岁健康青少年 ,按性别和性发育程度分为补钙组和对照组。实验前后评价两组膳食钙摄入量、运动量水平、性发育程度 ,并测定两组青少年身高、体重和桡骨远端 1 3处骨矿含量、骨宽和血清总碱性磷酸酶水平。结果表明本组青少年膳食钙摄入量低于每日膳食钙参考摄入量的适宜摄入量水平 ,补充钙剂对青少年身高、体重无明显影响 ;骨矿含量增长除女性青春期后期有显著性差异外 ,其余各组增长与对照组比较无显著性。结果提示 ,青春期存在体格快速发育和骨量迅速积累的特点 ,补充钙剂对骨矿含量的增长作用有限 ,对体格发育也无明显影响 ;在女性骨量增长较少阶段补充钙剂则可能有助于骨矿含量的增加 ,且这种作用可能通过降低骨代谢率实现     

几种钙制剂补钙效果及儿童补钙方式的探讨

目的调查几种钙剂补钙效果及探讨儿童补钙方式。方法通过2004-2005年对城区部分3-6岁892名儿童分别服用4种补钙剂和儿童不同时间服用1种钙剂，测定补钙前后发钙值进行比较。结果 儿童用葡萄酸钙（甲组）、中性钙（乙组）、乳酸钙（丙组）、碳酸钙（丁组）补钙，服用前后发钙分别上升22．9％、4．0％、3．3％、6．0％，甲组效果优于其他3组（P〈0.01），采用20d间歇补钙效果比间歇10、30d和连续补钙效果好（P〈0．01）。结论根据城区目前饮食状况，建议每日补钙500mg左右，每半年补钙2个月，采用间歇补钙法进行补充。     

补充维生素A对集体学龄前儿童血红蛋白的影响

【目的】　为探讨血清维生素 (VA)浓度对儿童血红蛋白的影响。　【方法】　对集体学龄前贫血儿童投维生素A每日 2 0 0 0IU ,观察治疗前后血红蛋白、血清铁、血清VA浓度的变化。　【结果】　亚临床状态VA缺乏占 31.6 % ,可疑缺乏占 5 8% ,仅 10 .4 %的儿童血清VA浓度正常 ;贫血组儿童血清VA量明显低于非贫血组 (P <0 .0 1)。给贫血组儿童投VA 2 0 0 0U/d ,3个月后 ,血红蛋白、血清铁、血清VA浓度明显提高 (P <0 .0 1) ,对照组无明显改变。　【结论】　亚临床状态VA缺乏在儿童中已是很重要的营养问题 ,并与贫血有一定关系 ,补充维生素A对儿童血红蛋白、血清铁、血清VA浓度有一定的影响     

间隔补铁防治儿童缺铁性贫血效果的评价

为克服每日口服铁剂防治铁缺乏症或缺铁性贫血时吸收率低，副作用明的显的缺点，我们对２３８名学龄前儿童随机分为３组；分别每日，每３日及每７日口服补充等量铁剂，经３个月补铁试验，观察正常与贫血儿童对３种不同方案的防治效果与副作用发生率。结果显示，每３日或每７日间隔补铁方案在纠正贫血，提高血清铁蛋白浓度方面与每日补铁方案具有相同效果，同时减少了每日补铁造成机体内暂时铁过量的可能性以及由此而加重的胃肠道副作     

维生素K与钙对去卵巢大鼠骨代谢的影响

切除雌鼠双侧卵巢造成快速骨丢失,复制女性绝经后骨质疏松症的动物模型。以饲料添加方式补充维生素Ｋ（９０ｍｇ／ｋｇ） 和钙（５ｇ／ｋｇ） 。实验期６ 个月,通过测定尿钙、尿羟脯氨酸、血清钙、碱性磷酸酶、骨钙素等生化指标观察单纯补充维生素Ｋ、钙及两者联合作用对骨代谢的影响。结果发现：补充Ｖｋ 可减少尿钙、尿羟脯氨酸排泄,降低血清碱性磷酸酶水平,提高血清骨钙素及其羧化水平,表明维生素Ｋ 能抑制骨分解代谢,促进骨形成代谢,并且与钙的联合作用效果优于单纯补充维生素Ｋ 或钙。本实验结果提示：绝经后妇女作为骨质疏松危险人群,应注意膳食维生素Ｋ 与钙的摄入。大剂量的维生素Ｋ 有可能被用于骨质疏松症的药物防治     

老年骨质疏松患者服用钙加维生素D后骨密度及生化指标的改变

目的了解补充钙和维生素D对骨丢失和骨转换的影响。方法对31例门诊原发性骨质疏松症和骨量减少患每日服用1片碳酸钙和维生素D复合剂(每片含元素钙600mg和维生素D125IU),连服6个月。治疗前后检测腰椎骨密度(BMD)、骨矿含量(BMC)及骨转换生化指标。结果碳酸钙和维生素D复合剂每日1片能明显改善骨质疏松引起的腰背疼和腿痛性痉挛,有明显疗效。可以维持腰椎骨密度,明显增加男性腰椎骨矿含量( 2．7％),与治疗前比较,明显提高血清250HD( 13．8％)和BGP(％29．5％),减少尿HOP／Cr比值(-17．5％)。结论老年人每天1片碳酸钙和维生素D复合剂对防止骨丢失,改善维生素D的营养状态,促进骨形成和抑制骨吸收有一定作用。     

不同钙负荷剂量对大鼠生长及钙铁锌水平影响

目的以不同负荷剂量的钙饲料喂养正常生长发育期的大鼠，研究过量钙补充对机体生长发育、钙吸收代谢及对机体铁锌元素水平的影响。方法将初断乳的Wistar雄性大鼠按体重随机分成4组．其中本底组于喂养开始时全部处死，作为钙代谢实验的本底值。其余3组分别饲以不同钙负荷剂量的饲料．进行为期28d的生长实验．随后分别进行3d的钙代谢实验。结果饲料中不同钙负荷剂量对大鼠的生长发育有影响，其中体重增长缓慢，股骨重量增加．但股骨长度并未增加，提示在生长发育期长骨过早发生钙化不利于身高的增长。过量钙喂养使大鼠脏器、器官的脏体系数发生改变，对睾丸、肾脏等器官有一定危害；机体对钙的吸收、利用率下降．造成补钙剂的浪费．增加机体代谢负担，同时使血清铁、锌浓度降低，血清钙浓度增高，尿钙增加，是肾结石的潜在危险因素。结论给正常生长发育期的大鼠补充过量钙剂，不仅对其生长发育有影响，同时对某些脏器有危害。过量钙剂干扰了机体对钙、铁、锌等营养元素的吸收利用。     

口服碳酸钙制剂对孕产妇骨密度的影响

目的探讨孕产妇补充碳酸钙制剂对其骨密度的影响。方法36例孕第一胎妇女从孕20周开始通过膳食、膳食干预及碳酸钙补充摄入不同剂量的钙至产后45天。监测并比较孕中、孕末及产后期的血钙、碱性磷酸酶、尿羟脯氨酸、骨钙素及产后骨密度的差异。结果(1)传统膳食加40g／d奶粉补充的孕产妇产后骨密度虽优于传统膳食组,但明显低于奶粉加碳酸钙组;(2)奶粉加碳酸钙补充组的产妇腰椎骨密度明显高于奶粉组和传统膳食组,并维持至正常非常非孕同龄妇女的水平;(3)奶粉加碳酸钙补充组在孕末期、产后期的碱性磷酸酶活性、尿羟脯氨酸水均明显低于传统膳食组而骨钙素含量明显高于传统膳食组。结论(1)我国传统膳食钙摄入量约450mg／d,孕期的低钙摄入可导致产后骨密度下降;(2)孕期在传统膳食基础上补充40g奶粉／d,可使其产后骨密度优于传统膳食组,但不能维持骨密度至正常的水平;(3)奶粉加碳酸钙的联合补充,可使孕产妇产后骨密度明显高于传统膳食组和奶粉补充组,并维持其骨密度至正常水平。     

孕晚期妇女服用钙及维生素D初步观察

目的观察孕晚期妇女服用钙及维生素D对孕期妇女低钙和维生素D缺乏的效果.方法对24例孕28周后的晚期妊娠妇女,每日服用碳酸钙加维生素D1片.并与同期11例不服任何钙剂及维生素D3的晚期妊娠妇女(对照组)进行比较.结果(1)用药组产前血清钙(Ca)、磷(P)、骨钙素(BGP)及25羟基D3(25OHD3)明显高于用药前的孕28周(P＜0.001);而对照组产前与孕28周比较无明显变化.(2)给药组产前尿羟脯氨酸与肌酐比值(HOP/cr)、尿钙(Ca)与肌酐比值(Ca/cr)比孕28周明显减少.(3)尿中Ⅰ型胶原交联C末端肽与肌酐比值(crosslaps/cr)给药组,和对照组在产前明显高于孕28周(P＜0.001),但产后42天,给药组明显低于对照组(P＜0.001).(4)两组血清碱性磷酸酶(AKP)产前明显均高于孕28周时水平(P＜0.001),表明胎盘产生大量AKP.结论孕期服用碳酸钙加维生素D3有明显促进骨形成,抑制骨吸收的作用和提高血清钙、磷的作用.给药8～10周后,虽然25OHD3比治疗前有明显升高,但仍低于同年龄健康妇女的水平,提示对孕产妇应适当增加维生素D3的用量.     

Calcium intake in preschool children--a study of dietary patterns in a low socioeconomic community.

BACKGROUND: There is a lack of published data on sources and quantity of calcium intake in preschool children. STUDY OBJECTIVES: To assess calcium intake compared with the Dietary Reference Intake (DRI), to identify major food sources of calcium, and to compare dietary patterns of healthy preschool children who do and do not meet the calcium DRI. DESIGN: Cross-sectional study. SETTING: Primary care pediatrics practice at a large urban medical center. SUBJECTS: A group of 228 children aged 44 to 60 months in a low socioeconomic community. METHODS: Diet was assessed using three or four 24-hour recalls administered approximately three months apart to the parents. Nutrient values were computed using a dietary analysis program based on USDA values. RESULTS: Mean daily calcium intake was 852 mg/day (S.D., 271) and 44% reported mean calcium intake less than the DRI of 800 mg/day. Milk consumption accounted for 64.3% and cheese for 6.7% of the daily calcium intake. Multiple linear regression analysis adjusting for age, sex, race, body mass index, and total caloric intake confirmed the main contribution of mainly milk and, to a much lesser extent, cheese consumption, as determinants of calcium intake. All of the children who consumed less than 1.2 servings of milk (288 ml) milk per day reported mean daily calcium intake below the DRI. CONCLUSIONS: Calcium intake below the DRI may be common in preschool children in low socioeconomic communities, and is associated primarily with lower milk intake. These findings indicate the need to promote the consumption of low-fat milk in preschool children.     

补钙对低钙膳儿童骨矿物质含量的影响

江门市１６２名７周岁（男童８７人，女童７５人）低钙膳食习惯的儿童，随机双盲分为两组。实验组以碳酸钙形式补给，每天供给钙３００ｍｇ，对照组给予同外形的安慰剂，持续１８个月。每６个月测定上臂的骨矿物质含量（ＢＭＣ）、骨矿物质含量与骨宽的比值（ＢＭＣ／ＢＷ）一次。了解膳食的基础摄入情况和测定２５－羟维生素Ｄ３的生理活性等。结果：１８个月后，实验组与对照组比有明显差异，ＢＭＣ（１６．５％：１３，９７％，Ｐ＝０．０２），ＢＭＣ／ＢＷ（９．４５％：６．３１％，Ｐ＝０．０００８）。表明增加钙的摄入对骨的获得有一定作用，但对身高的增长不明显。     

补钙16个月对青春期男女生骨量的影响

目的探讨不同钙摄入量对我国青少年骨量的影响。方法对北京郊区337人(平均年龄为13.6岁)开展为期16个月的双盲对照干预研究,每天给予3次不同剂量碳酸钙片,每片含60IU维生素D,用双能X线吸收仪(DXA)测定全身、腰椎和前臂骨量。结果女生全身骨矿物密度的年增长率由低钙摄入组到高钙摄入组逐渐升高,调整混杂因素后差异消失。女生前臂远端1/3处和男生前臂远端1/10处的骨矿物含量年增长率和骨面积年增长率均以每天钙摄入900～1100mg/d的人群(平均钙摄入量984mg/d)最高,其中调整混杂因素后男生差异消失。结论青春期钙摄入量达到1000mg/d以上可促进青少年骨量增长,此结果有性别差异。     

The effects of a high calcium dairy food on bone health in pre-pubertal children in New Zealand

Childhood and adolescence is the period of most rapid skeletal growth in an individual's lifetime. A greater peak bone mass achieved in the first 2-3 decades of life, may protect against the risk of osteoporotic fracture in later life. The aim of this randomized, controlled study was to assess in pre-pubertal boys and girls (aged 8-10 years) the effect of 18 months of a calcium enriched, cocoa flavoured product on bone density, bone growth and bone size in New Zealand children. One hundred and fifty four pre-pubertal boys and girls (aged 8-10 years) were randomized to receive a high calcium dairy drink or a control drink reconstituted with water for 18 months. They were assessed at baseline and then every 6 months for the first 18 months, while they were having the supplement; they were then followed up 12 months after supplementation had finished. Bone mineral density and bone mineral content were assessed at the total body, hip and spine. Indicators of bone size (vertebral width and height) were also measured at the spine. Anthropometric data was collected, medical history questionnaires were administered (including the Tanner or pubertal stage questionnaire), dietary calcium intake was assessed with a calcium food frequency questionnaire and calcium supplement compliance was determined. There was no significant difference between the 2 groups for bone mineral density or bone mineral content at any time point. There was no difference in vertebral height or width at any stage of the study, indicating no additional influence on bone size at the lumbar vertebrae. There were no significant differences between height, weight, lean mass or fat mass at any time point. Both groups had higher habitual calcium intakes than recommended for this age group going into the study and throughout the study. In this 2(1/2) year study (18 months supplementation, 1 year follow-up) we did not observe a difference in bone mineral density in pre-pubertal children. This was probably due to their high habitual dietary calcium intake whereby minimal addition of calcium to the diet reached the threshold level where no further benefit was seen. There were no significant differences between the two groups in body composition. Growth and the mean height and weight remained between the 50th and 75th percentile for their age. We have shown calcium supplementation in children with high habitual dietary calcium intake appears not to have additional effects on bone mass. Calcium supplementation needs to be targeted in those children with low habitual dietary calcium intake.     

补充酸奶对北京郊区学前儿童体格生长的影响

目的: 观察补充酸奶对3~5岁学前儿童体格发育和营养状况的影响。 方法: 选择北京郊区7所幼儿园的402名学龄前儿童(男217人,女185人),其身高和/或体重低于WHO推荐标准的均值。随机分为对照组和酸奶组,酸奶组每天补充1杯酸奶(125 g),每周补充5 d;对照组不补充;两组均保持正常饮食,持续9个月。每月测量儿童的身高、体重和上臂围,并记录儿童补充和出勤的情况;每3个月进行膳食调查和血生化指标检测。 结果: 酸奶组儿童膳食中钙、锌和维生素A的摄入水平较对照组明显提高,且补充9个月时血红蛋白(Hb)明显高于对照组。酸奶组儿童的身高在3 、6 和9个月内的增长值(1.90、3.83、5.43 cm)比对照组显著提高(1.77、3.64、5.24 cm),也高于WHO推荐的50 个月龄儿童参考标准。酸奶组儿童的体重在3、6和9个月内的增长值(0.70、0.98、1.42 kg)比对照组显著提高(0.49、0.80、1.20 kg),并与WHO推荐的50 个月龄儿童参考标准持平。结论: 3~5岁学龄前儿童补充9个月酸奶后,可以明显改善机体营养状况,增加体格生长速率。     

济宁市区儿童补钙效果的实验研究

目的：了解我市儿童缺钙现状及补钙效果。方法：于1996～1997年对市区2108名3～6岁儿童发钙进行了调查，同时采用配对实验的方法对四种补钙剂、钙强化饮食及不同的补钙方法等进行了实验研究。结果：我市儿童缺钙现象严重，补钙状况令人担忧；不同的钙制剂补钙效果差异显著；单纯钙强化饮食不可取，满足不了儿童生长的钙需求，补钙方法不同效果不一。结论：综合我市目前饮食结构状况，建议儿童每日补钙400mg左右，采用15日连续服用，停服7日的间歇补钙法；每半年补钙两个月。有关部门应着力整顿钙制剂市场，为儿童补钙提供真正合格的钙制剂。     

Annual feedback is an effective tool for a sustained increase in calcium intake among older women

We aimed to optimize calcium intake among the 2,000+ older women taking part in the Vital D study. Calcium supplementation was not included in the study protocol. Our hypothesis was that annual feedback of calcium intake and informing women of strategies to improve calcium intake can lead to a sustained increase in the proportion of women who consume adequate levels of the mineral. Calcium intake was assessed on an annual basis using a validated short food frequency questionnaire (FFQ). Supplemental calcium intake was added to the dietary estimate. Participants and their nominated doctor were sent a letter that the participant's estimated daily calcium intake was adequate or inadequate based on a cutoff threshold of 800 mg/day. General brief statements outlining the importance of an adequate calcium intake and bone health were included in all letters. At baseline, the median daily consumption of calcium was 980 mg/day and 67 percent of 1,951 participants had calcium intake of at least 800 mg per day. Of the 644 older women advised of an inadequate calcium intake at baseline (<800 mg/day), 386 (60%) had increased their intake by at least 100 mg/day when re-assessed twelve months later. This desirable change was sustained at 24 months after baseline with almost half of these women (303/644) consuming over 800 mg calcium per day. This study devised an efficient method to provide feedback on calcium intake to over 2,000 older women. The improvements were modest but significant and most apparent in those with a low intake at baseline. The decreased proportion of these women with an inadequate intake of calcium 12- and 24-months later, suggests this might be a practical, low cost strategy to maintain an adequate calcium intake among older women.