使用膳食质量指数评价浦东新区部分小学生膳食质量

[目的]建立并使用膳食质量指数(DQI)评价浦东新区部分小学生的膳食质量,为有针对性使用膳食指南开展营养干预提供依据。[方法]依据中国居民膳食指南,选择14个元素构成DQI,用DQI对浦东新区小学生的膳食情况进行评分,以评价浦东新区小学生的膳食质量。[结果]DQI总分与性别、地域、经济状况和营养状况相关性有统计学意义,DQI对浦东新区小学生膳食总体状况具有代表性;浦东新区小学生的膳食状况为摄入不足和摄入过量并存。城区和乡镇地区小学生膳食质量存在一定差异,乡镇地区小学生摄入不足程度大于城区小学生,部分需要限制的食物摄入过量程度也大于城区小学生,显示出乡镇地区小学生膳食不均衡问题更加严重。无论营养过剩小学生还是营养不良小学生,膳食模式都是摄入不足和摄入过量并存,营养过剩小学生摄入过量程度更大。[结论]采用DQI评价小学生的膳食质量,能够更好地评价小学生膳食是否符合中国居民膳食指南,既可用于人群间的比较,还可以用于进行个体化膳食指导。     

浦东新区某大型企业员工膳食模式的评价

目的使用膳食质量指数(DQI)评价浦东新区某大型企业员工的膳食质量,为有针对性地使用膳食指南开展营养干预提供依据。方法依据中国居民膳食指南,选择8个元素构成DQI,用DQI对企业员工的膳食情况进行评分,以评价膳食质量。结果 DQI总分与性别、年龄及受教育程度相关性有统计学意义;企业员工的DQI均值为正,即总体膳食状况为摄入过量。通过不同膳食模式人数比例分析,可知大部分的员工膳食模式都存在中等程度及以上的摄入过量,但摄入不足也不容忽视。结论采用DQI评价企业员工的膳食质量,可以很好的评价企业员工膳食是否符合中国居民膳食指南。     

应用调整的膳食平衡指数评价厦门市区成年居民膳食质量

目的利用调整的中国膳食平衡指数(DBI-07)综合评价厦门市城区18~65岁居民膳食质量,为开展营养干预提供依据。方法采用多阶段分层整群抽样方法于2010年10—12月对厦门市区6个社区居委会成年居民进行调查,采用连续3天24 h回顾法对其中的520人进行了膳食调查,采用DBI-07的评分方法评价厦门城区成年居民膳食质量水平。结果被调查的厦门市城区成年居民的膳食质量处于中度失衡状态,摄入不足和摄入过量并存;女性的摄入不足程度高于男性;各年龄段中,40~50岁人群摄入不足程度最高,摄入过量程度最低。结论被调查的厦门市城区成年居民水果、奶类及豆类摄入不足,肉类、食用油及盐类摄入过量;成年居民的主要膳食模式为A模式,且A模式反映了膳食中摄入不足与摄入过量的问题均较少,为最优模式。     

应用膳食平衡指数评价广西成年居民膳食质量

目的利用我国最新修订的膳食平衡指数(Diet Balance Index,DBI16)评价广西18岁以上成年居民的膳食质量,为今后提高居民膳食质量、开展合理膳食及营养干预提供依据。方法选用2015年中国健康与营养调查中,广西1169例18岁以上具有完整3天24小时膳食调查资料的居民,应用DBI16评分方法评价广西成年居民膳食质量。结果广西成年居民的膳食质量距DBIDQD=33.04,主要问题是低度摄入不足(DBILBS=24.66);而摄入不足、膳食失衡的程度,均为男性高于女性、农村高于城市、≥60岁年龄组高于其他年龄组(均为P<0.05)。畜禽肉类、谷类摄入过量,水果、奶类和豆类摄入不足,食物种类偏少。膳食模式主要是B模式(49.62%)和E模式(26.60%)。结论广西成年居民膳食处于低度失衡状态。应加强对中国居民膳食指南和膳食宝塔的宣传教育,并开展针对性的膳食引导和营养干预,结合广西居民膳食结构特色和主要问题,制定广西居民膳食指南。     

松江区18～59岁居民的膳食质量和膳食模式评价

目的利用膳食平衡指数(DBI-07)综合评价松江区18~59岁居民的膳食质量和膳食模式,为开展有针对性的干预措施提供科学依据。方法采用分层随机整群抽样方法,选取2007年上海市松江区居民营养与健康状况监测的18~59岁居民,采用DBI-07评分及评价方法评价松江区居民的膳食质量和膳食模式。结果松江区居民膳食质量处于低度不平衡状态,摄入不足和摄入过量同时存在,其中男性摄入不足和不均衡程度高于女性(P<0.05),城区摄入过量和不均衡程度高于农村地区,40~50岁人群膳食失衡程度高于其他年龄段人群,但均无显著性差异(P>0.05);A模式和B模式为松江区居民采用的主要膳食模式,分别为49.59%和33.06%。结论 DBI-07方法较好地评价了松江区居民膳食状况及存在的问题,今后需要针对不同人群采取有效的干预措施,以提高居民"平衡膳食"的意识。     

应用中国膳食平衡指数评价山东省成年居民膳食质量

目的 通过运用中国膳食平衡指数（DBI＿16）对山东省18～80岁居民的膳食质量进行整体评价,以指导下一步针对性膳食干预的实施。方法 选取2015年中国成人慢性病与营养监测项目中山东省具有完整膳食与基本信息数据的3 275例18～80岁居民,使用DBI＿16评分方法评价其膳食质量。结果 山东省成年居民摄入量严重不足的为蔬菜、水果、奶类、豆类、鱼虾类、蛋类,摄入过量的为食用油和调味品食盐类。居民膳食质量整体上属于中度膳食失衡（DBI＿DQD=37.9分）水平,同时处于中度膳食摄入不足（DBI＿LBS=27.0分）和低度膳食摄入过量（DBI＿HBS=10.9分）水平;农村、男性、鲁西北、60岁以上以及受教育程度较低者膳食摄入过量及膳食不均衡程度较为严重;膳食模式集中于D、E、G、H四种,主要以H模式为主。结论 山东省18～80岁成年居民的膳食摄入情况有待改善,同时存在摄入不足和摄入过量的问题,因此要继续增强平衡膳食相关营养知识的宣传力度,改善居民的营养与健康状况。     

用膳食平衡指数法评价新疆喀什地区维吾尔族成年居民膳食营养状况北大核心CSCD

目的应用修订的膳食平衡指数(DBI-07)综合评价新疆喀什地区维吾尔族成年居民的膳食质量。方法于2013年5—6月,采用多阶段分层整群随机的概率比例规模抽样方法,选取喀什地区1604名维吾尔族居民,膳食调查采用连续3天24小时回顾法。采用DBI-07评价新疆喀什地区维吾尔族居民的膳食质量和膳食模式。结果新疆喀什地区75.0%的维吾尔族居民膳食质量处于中度失衡状态(DQD=33.77),同时存在74.4%的中度的摄入不足(LBS=26.43)和48.2%的低度的摄入过量(HBS=7.34),农村膳食失衡、摄入不足、摄入过量的程度均高于城市;无论是在城市还是农村,男性的膳食失衡与膳食摄入过量的程度均高于女性(P<0.05);城市各年龄段比较差异无统计学意义,但是在农村差异明显(P<0.05),18~44岁年龄组的人群膳食摄入过量的程度最高,膳食摄入不足的程度最低。城市的文化程度越高者,其膳食摄入过量的程度越高,膳食摄入不足的程度最低。喀什地区维吾尔族居民膳食主要有A、B、D和E模式,其中B模式为主要模式,占77.0%。居民蔬菜水果、奶豆类食物及蛋类摄入不足,其中以奶类及豆类食物最严重,谷类、盐和食用油摄入过量。结论 DBI-07方法较好地评价了喀什地区维吾尔族居民膳食状况及存在的问题,今后需要针对不同人群采取有效的干预措施,以提高居民"平衡膳食"的意识。     

用膳食平衡指数法评价新疆喀什地区维吾尔族成年居民膳食营养状况北大核心CSCD

目的应用修订的膳食平衡指数(DBI-07)综合评价新疆喀什地区维吾尔族成年居民的膳食质量。方法于2013年5—6月,采用多阶段分层整群随机的概率比例规模抽样方法,选取喀什地区1604名维吾尔族居民,膳食调查采用连续3天24小时回顾法。采用DBI-07评价新疆喀什地区维吾尔族居民的膳食质量和膳食模式。结果新疆喀什地区75.0%的维吾尔族居民膳食质量处于中度失衡状态(DQD=33.77),同时存在74.4%的中度的摄入不足(LBS=26.43)和48.2%的低度的摄入过量(HBS=7.34),农村膳食失衡、摄入不足、摄入过量的程度均高于城市;无论是在城市还是农村,男性的膳食失衡与膳食摄入过量的程度均高于女性(P<0.05);城市各年龄段比较差异无统计学意义,但是在农村差异明显(P<0.05),18~44岁年龄组的人群膳食摄入过量的程度最高,膳食摄入不足的程度最低。城市的文化程度越高者,其膳食摄入过量的程度越高,膳食摄入不足的程度最低。喀什地区维吾尔族居民膳食主要有A、B、D和E模式,其中B模式为主要模式,占77.0%。居民蔬菜水果、奶豆类食物及蛋类摄入不足,其中以奶类及豆类食物最严重,谷类、盐和食用油摄入过量。结论 DBI-07方法较好地评价了喀什地区维吾尔族居民膳食状况及存在的问题,今后需要针对不同人群采取有效的干预措施,以提高居民"平衡膳食"的意识。     

浙江省居民膳食结构与质量评价

目的评价浙江省18－79岁居民的膳食结构及膳食质量,为干预措施提供依据。方法选取2010—2012年＂中国居民营养状况监测项目＂中浙江省6个市18－79岁居民的膳食调查资料,利用中国膳食平衡指数评价居民的膳食结构及膳食质量。结果浙江省居民的膳食质量多处于轻度（41.08%）到中度（50.79%）的膳食失衡,摄入不足与摄入过量并存,其中轻度和中度摄入不足分别占66.17%和27.88%,轻度膳食过量占35.55%;膳食平衡指数DBI-LBS、DBI-HBS和DBI-DQD分别为46.00、26.00和57.00;摄入过量及膳食失衡在人群中的分布特点为：男性高于女性,农村高于城市,40－49岁者最高,摄入不足与膳食失衡随着文化程度的增高而降低（P〈0.05）;浙江省居民的主要膳食模式为模式B,为62.41%;其次为模式A,为26.44%。结论浙江省居民的膳食中,摄入不足与摄入过量并存,呈现一定程度的膳食失衡,男性、40－49岁、农村地区及文化程度低的居民为重点干预人群。     

基于膳食平衡指数的中山市成年居民膳食质量研究

目的用修订的膳食平衡指数(DBI-07)评价中山市成年居民膳食质量,为其营养指导提供依据。方法用多阶段分层整群随机抽样法,2015年对984名18~65岁居民进行食物频率问卷调查,计算食物的人均每日摄入量,用DBI-07评分法和A、B、D、E模式评价居民膳食质量。结果居民膳食质量整体处于低度失衡状态(DQD=20.5±6.4),主要问题是低度摄入不足(LBS=16.4±7.3);膳食质量男性、≥硕士学历、月收入≥6 000元者较好,≥50岁组膳食质量较差。在A、B、D、E 4种膳食模式中,以较优模式A(64.7%)为主,B模式(31.2%)次之。结论中山市成年居民膳食低度失衡。总体上蔬菜、水果和奶类摄入不足,畜禽肉类摄入过量。应加强宣传中国居民膳食指南和膳食宝塔,针对性地开展营养干预。     

Diet Quality and Academic Performance

BACKGROUND: Although the effects of nutrition on health and school performance are often cited, few research studies have examined the effect of diet quality on the academic performance of children. This study examines the association between overall diet quality and academic performance. METHODS: In 2003, 5200 grade 5 students in Nova Scotia, Canada, and their parents were surveyed as part of the Children's Lifestyle and School-performance Study. Information on dietary intake, height, and weight and sociodemographic variables were linked to results of a provincial standardized literacy assessment. Diet Quality Index-International was used to summarize overall diet quality. Multilevel regression methods were used to examine the association between indicators of diet quality and academic performance while adjusting for gender and socioeconomic characteristics of parents and residential neighborhoods. RESULTS: Across various indicators of diet quality, an association with academic performance was observed. Students with decreased overall diet quality were significantly more likely to perform poorly on the assessment. Girls performed better than boys as did children from socioeconomically advantaged families. Children attending better schools and living in wealthy neighborhoods also performed better. CONCLUSIONS: These findings demonstrate an association between diet quality and academic performance and identify specific dietary factors that contribute to this association. Additionally, this research supports the broader implementation and investment in effective school nutrition programs that have the potential to improve student access to healthy food choices, diet quality, academic performance, and, over the long term, health.     

Diet Quality of Elite Australian Athletes Evaluated Using the Athlete Diet Index

While athletes’ nutrient intakes have been widely reported, few studies have assessed the diet quality of athletes. This is the first study to evaluate the diet quality of athletes using the purpose-built Athlete Diet Index (ADI). A convenience sample of 165 elite athletes from Australian sporting institutions completed the ADI online, with subsequent automated results provided to their respective accredited sports dietitians (ASDs). At the completion of athlete participation, ASDs (n = 12) responded to a range of survey items using a Likert scale (i.e., 1 = strongly agree to 5 = strongly disagree) to determine the suitability of the ADI in practice. Differences in ADI scores for demographics and sport-specific variables were investigated using independent t-tests, analysis of variance (ANOVA) and Bonferroni multiple comparisons. Spearman’s rank correlation was used to assess the association between total scores and demographics. The mean total ADI score was 91.4 ± 12.2 (range 53–117, out of a possible 125). While there was no difference in total scores based on demographics or sport-specific variables; team sport athletes scored higher than individual sport athletes (92.7 vs. 88.5, p < 0.05). Athletes training fewer hours (i.e., 0–11 h/week) scored higher on Dietary Habits sub-scores compared with athletes training more hours (≥12 h/week; p < 0.05), suggesting that athletes who train longer may be at risk of a compromised dietary pattern or less than optimal nutrition practices that support training. Most (75%) ASDs surveyed strongly agreed with the perceived utility of the ADI for screening athletes and identifying areas for nutrition support, confirming its suitability for use in practice.     

Longitudinal Diet Quality Trajectories Suggest Targets for Diet Improvement in Early Childhood

BackgroundThere is little information about how diet quality evolves in early childhood, whether children exhibit varying diet quality trajectories, or which components of diet quality should be targeted for intervention.ObjectiveThe goal of this study was to identify and evaluate trajectories of dietary quality in young children.DesignThis was a secondary analysis of an observational, longitudinal cohort study of non-Hispanic African American or White children and their parents from racially concordant households with 4 years of follow-up (up to 13 study visits). Data on mother, infant feeding, and body mass index were assessed at baseline. Diet was evaluated using 3-day diaries at each visit.Participants/settingOf 372 children enrolled, 349 children had at least 3 study visits with dietary data for this analysis. Participants were enrolled at age 3 years between March 2001 and August 2002 in Cincinnati, OH. Final study visits were conducted between February 2005 and June 2006.Main outcome measureThe main outcome measure was the total Healthy Eating Index 2005 (HEI-2005) score and HEI-2005 component scores.Statistical analysesDiet quality trajectories were modeled using group-based modeling techniques.ResultsThe total HEI-2005 score was low at age 3 years (mean ± standard error = 55.1 ± 0.4 of maximum 100 points) and remained stable to age 7 years (mean ± standard error = 54.0 ± 0.6; P = 0.08 for trend). Five HEI-2005 trajectory groups were identified, of which 1 declined and 1 improved over time. HEI-2005 component scores, except milk intake and meat/beans scores, differed significantly (all, P ≤ 0.02) among trajectory groups at age 3 years, and most differences were maintained at age 7 years. Total vegetables, dark green and orange vegetables and legumes, and whole grains component scores were low for all trajectory groups. Whole fruit; total fruit; saturated fat; and calories from solid fats, alcoholic beverages, and added sugars (SoFAAS) were highly variable among trajectory groups. Children in the lowest diet quality trajectory group were less likely to be breastfed and more likely to have been regular consumers of soft drinks (e.g., powdered drink mixes, sport drinks, or soda pop) before age 3 years.ConclusionsYoung childhood diet quality was low at age 3 years and remained stable to age 7 years. Improving intake of vegetables and whole grains is needed for all children. Focused attention regarding increasing fruit intake and reducing SoFAAS may be needed for families at increased risk for low overall diet quality.     

Prenatal Depression and Diet Quality During Pregnancy

BackgroundMaternal nutrition during pregnancy has a significant effect on the health of the offspring and mother, highlighting the need for identifying factors that may affect diet during pregnancy. Research in nonpregnant and pregnant populations suggest depression may play a role.ObjectiveTo investigate the relationship between prenatal depression and diet quality during pregnancy overall and by race/ethnicity and to explore the relationships between prenatal depression and the 12 Healthy Eating Index 2010 dietary components.DesignA cross-sectional secondary analysis of a cohort study of Kaiser Permanente Northern California women entering prenatal care between October 2011 and April 2013.Participants/settingParticipants included 1,160 adult pregnant women.Main outcome measuresPoor diet quality was defined as a Healthy Eating Index 2010 score in the lowest quartile.Statistical analyses performedLogistic regression was used to assess the relationship between prenatal depression (defined as a depression diagnosis, Patient Health Questionnaire score of 10 or greater or antidepressant medication dispensing between the last menstrual period and completion of the food frequency questionnaire) and poor diet quality overall and by race/ethnicity. Relationships between prenatal depression and each of the 12 Healthy Eating Index 2010 dietary components were assessed using t-tests and linear regression analyses.ResultsOne hundred fifty-nine (14%) participants had prenatal depression. Women with prenatal depression had nearly two times the odds of poor diet quality (odds ratio 1.80, 95% CI 1.23 to 2.60) compared with women without prenatal depression, after adjusting for potential confounders. Differences emerged by race/ethnicity; after adjusting for potential confounders the adjusted odds of poor diet quality were significant only among Hispanic women. Hispanic women with prenatal depression had an increased odds of poor diet quality compared with Hispanic women without prenatal depression (odds ratio 2.66, 95% CI 1.15 to 6.06). Women with prenatal depression had a higher consumption of empty calories (from solid fats, alcohol, and added sugars; threshold for counting alcohol >13 g/1,000 kcal) (P=0.01) and lower consumption of greens and beans (P<0.05), total fruit (P<0.01), and whole fruit (P<0.01), compared with women without prenatal depression. Except for empty calories, these findings remained after adjusting for potential confounders.ConclusionsStudy findings suggest that women with prenatal depression are at a higher risk of poor diet quality compared with women without prenatal depression, and the relationship is stronger among Hispanic women. Nutrition counseling interventions for women with depression should consider the use of culturally sensitive materials and target limiting empty calories from solid fats, alcohol, and added sugars and encourage eating more greens, beans, and fruit.     

Socioeconomic Status and Diet Quality in College Students

ObjectiveTo investigate the existence and trajectory of diet disparities among college students from different socioeconomic statuses (SESs).MethodsA random sample of freshman and sophomore students was invited to participate in an online survey on eating behaviors. Ordinary least squares regressions were fit to 148 complete responses to examine the association between family income ≤200% of the federal poverty level and overall, healthy, and unhealthy food consumption.ResultsLow-SES students reported eating significantly more unhealthy food during their freshman year than their non–low-SES peers. This difference is not statistically significant for second-year students and robust to on-campus spending power.Conclusions and ImplicationsDisparities in diets for students from different socioeconomic backgrounds that were observed in the freshman year of college were absent in the sophomore year. Awareness of these disparities and trend is important to broadly promote healthy eating.     

Caregiver Status and Diet Quality in Community-Dwelling Adults

Objective: We investigated cross-sectional and longitudinal associations of diet quality with middle-aged caregiver status. Methods: Caregiving in the Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS) study (57.7% women, 62% African American (AA)) was measured at waves 3 (2009–2013) and 4 (2013–2017) (mean follow-up time 4.1 years). Diet quality was assessed by the Healthy Eating Index 2010 (HEI-2010) derived from two separate 24 h diet recalls. Multivariable ordinary least square regression was performed for cross-sectional analyses of the association of wave 4 caregiving with wave 4 HEI-2010. Wave 3 caregiving was examined both cross-sectionally and with annual rate of change in HEI using mixed-effects linear regression Models. Multivariable models were adjusted for age, sex, and poverty status. Results: Cross-sectional analyses at wave 4 demonstrate an inverse association of frequent caregiving (“Daily or Weekly” vs. “Never”) for grandchildren with HEI-2010 total score (i.e., lower diet quality) among Whites (β = −2.83 ± 1.19, p = 0.03, Model 2) and AAs (β = −1.84 ± 0.79, p = 0.02,). The “cross-sectional” analysis pertaining to grandchildren caregiving frequency suggested that frequent caregiving (i.e., “Daily or Weekly” vs. “Never” (β = −2.90 ± 1.17, p = 0.04)) only among Whites was inversely related to HEI-2010 total score. Total HEI-2010 score was also related to caring (Model 1), for the elderly over “5 years vs. Never” among Whites (−7.31 ± 3.54, p = 0.04, Model 2). Longitudinally, we found slight potential improvement in diet quality over time (“Daily or Weekly” vs. Never by TIME interaction: +0.88 ± 0.38, p = 0.02) with frequent caregiving among Whites, but not so among AAs. Conclusions: Frequent caring for grandchildren had an inverse relationship with the diet quality of White and AA urban middle-aged caregivers, while caring for elderly was inversely linked to diet quality among Whites only. Longitudinal studies should address the paucity of research on caregivers’ nutritional quality.     

Correlates of Prenatal Diet Quality in Low-Income Hispanic Women

BackgroundLow-income Hispanic women are at-risk of poor prenatal diet quality. Correlates associated with prenatal diet quality in this group of women are understudied.ObjectiveThe objective of this study was to examine the associations between financial, cultural, psychosocial, and lifestyle correlates and prenatal diet quality in low-income Hispanic women.DesignThis cross-sectional analysis used data from pregnant women enrolled in the Starting Early Trial, a randomized-controlled trial of a primary-care based child obesity prevention program beginning in pregnancy. The trial enrolled women from clinics affiliated with a large urban medical center in New York City from 2012 to 2014. Financial, cultural, psychosocial, and lifestyle variables were collected using a comprehensive baseline questionnaire. Usual dietary intakes over the past year were assessed using the Block Food Frequency Questionnaire 2005 bilingual version.ParticipantsThe study enrolled low-income Hispanic women between 28 and 32 gestational weeks (N=519).Main outcome measuresPrenatal diet quality was measured by the Healthy Eating Index 2015.Statistical analyses performedUnadjusted and adjusted multivariable linear regression analyses were performed to determine independent associations between financial, cultural, psychosocial, and lifestyle correlates and Healthy Eating Index 2015 total score.ResultsOverall prenatal diet quality was poor (mean Healthy Eating Index 2015 total score=69.0±9.4). Most women did not meet the maximum score for total vegetables (65.3%), whole grains (97.1%), dairy (74.8%), fatty acids (84.4%), refined grains (79.8%), sodium (97.5%), saturated fats (92.9%), and added sugars (66.5%). Women who reported screen time ≤2 hours/day, physical activity before and/or during pregnancy, and being born outside the United States had higher mean Healthy Eating Index 2015 total score than women with screen time >2 hours/day, no physical activity, and those born in the United States.ConclusionsPrenatal diet quality of low-income pregnant Hispanic women was suboptimal. This cross-sectional study revealed associations between cultural and lifestyle factors and prenatal diet quality in low-income Hispanic women. Longitudinal studies are needed to determine long-term influences and specific behaviors to target for effective intervention studies.