丰良镇温泉水污染食物型氟中毒的调查研究

为了确证丰良镇病区是一类温泉水污染食物型病区,对其地氟病流行情况,环境介质含氟量、生活习惯进行了详细的调查。结果病区与对照区之间饮水氟、土壤氟、空气氟、天然食物氟无明显差异。但病区人日均摄氟总量(3.64mg)高于对照区(1.59mg)。病区居民有用温泉水处理食物的习惯,其中经温泉水处理的蔬菜、菜干、豆腐三种常用食物的日均摄氟量之和为对照区相同食物(未经温泉水处理)的9倍(2.07mg/0.23mg);比较实验亦显示用温泉水处理的蔬菜含氟量远高于对照;病区居民点和温泉的距离与其氟斑牙患病率、指数及尿氟呈负相关。因此认为该病区是一类温泉水污染食物型氟中毒病区。     

饮水型氟病区和非病区儿童总摄氟量调查

目的:探讨地方性氟中毒病区和非病区儿童中总摄氟量水平,为评价氟对人体健康效应及地方性氟中毒综合防治措施的制定提供依据.方法:选择地方性氟中毒重病区瓦庙村,以及非病区新淮村为调查点,两村所有8～13岁在校学生为调查对象.采用询问法和称量法相结合计算儿童每人每天的总摄氟量.结果:两村的饮水氟含量、米饭和馒头中的氟含量差异有统计学意义,蔬菜中氟含量差异无统计学意义.病区村儿童日平均总摄氟量(3.05±0.99 mg/人日)显著高于非病区村(0.78±0.13 mg/人日),病区村儿童日平均总摄氟量远超过国家标准.结论:病区村儿童的高氟摄入情况仍比较严重.     

西藏昌都县卡若村饮茶型氟铝联合中毒调查

目的对西藏自治区开展饮茶型氟铝联合中毒病情调查。方法在无工业污染的西藏昌都县卡若镇卡若村进行流行病学调查、临床检查;采集砖茶、饮水、茶水(酥油茶)、尿、主食、副食、检测含氟量、含铝量,计算人均总摄氟量、总摄铝量和经砖茶摄氟量、摄铝量。结果8~12岁儿童12人,氟斑牙检出率为12.67%。临床检查成人34人,检出氟骨症19人(55.88%),重度2人(5.88%),为地方性氟中毒重病区。砖茶、饮水、砖茶饮料、主食、副食含氟量检测结果分别为(1 139.0±138.7)mg/kg、(0.09土O.02)mg/L、(3.68土1.44)mg/L、(2.66±1.39)mg/L,人均总摄氟量9.97 mg/d,其中经砖茶摄入9.30 mg/d,占总摄入量93.28%;含铝量分别为(3 888.5±474.1)mg/kg、(0.04±0.01)mg/L、(9.31士4.11)mg/L、(4.55±3.74)mg/L、人均总摄铝量41.50 mg/d。其中经砖茶摄入29.25 mg/d,占总摄入量70.48%。结论西藏昌都县卡若镇卡若村可能是饮茶型氟铝联合中毒。     

四川省饮茶型氟中毒病区环境氟值分析

目的分析四川省饮茶型氟中毒病区环境氟值与饮茶型氟中毒的关系。方法在每个病区县选择10个乡镇,调查包括砖茶、粮食、茶水及水的含氟量。结果砖茶氟平均含氟905mg/L;饮砖茶区绝大多数环境低氟,砖茶为主要氟源,占病区总摄氟80%以上;个别病区存在饮水和饮茶混合型病区。结论减少砖茶氟含量是目前控制饮茶型氟中毒的有效措施     

饮茶型氟中毒与饮水型氟中毒成人生化测定分析

目的探讨饮茶型氟中毒病区牧民与饮水型氟中毒病区居民血液生化有无差异。方法随机选择16~55岁饮茶型氟中毒病区牧民79人,饮水型氟中毒病区居民92人,男女均衡。测定饮水、奶茶、尿氟铝含量,同时检查氟斑牙,拍摄右前臂及骨盆正位X线片,检测血清电解质及生化指标。氟采用离子选择电极法,铝、钙、磷采用ICP-AES法检测,血清酶类、BUN、CREA、UA、CO2结合率用日本奥林巴斯AU-400全自动生化分析仪检测。结果血铝、钙、BUN、CREA、CO2结合率饮茶型氟中毒病区牧民明显高于饮水型氟中毒病区居民。TBIL、DBIL、IDBIL饮水型氟中毒病区居民高于饮茶型氟中毒病区牧民。结论饮茶型氟中毒病区牧民与饮水型氟中毒病区居民生化改变有明显不同,其发病机理较为复杂,可能与所饮用砖茶氟、铝含量较高有关。     

营养因素对贵州省燃煤型地方性氟中毒重病区形成的影响

目的:探讨营养因素对贵州省燃煤型地方性氟中毒重病区形成的影响。方法:采用随机抽样方法,对2个重病区村寨和1个对照病区村寨作了营养因素相关流行病学现况调查。根据《中国居民膳食营养素推荐摄入量-Chinese DRIs》及《食物营养计算器V1.6》进行相关营养素计算,比较分析儿童和成人膳食营养水平。结果:2个重病区成人和儿童能量、蛋白质摄入低于国家标准和对照病区村;重病区村人群B族维生素和钙、锌、硒等元素摄入不足,尤以钙缺乏最为明显,摄入量显著低于对照病区村。结论:能量、蛋白质、维生素及钙、锌、硒等元素缺乏对地氟病重病区形成有显著影响。     

低氟砖茶对饮茶型氟中毒的预防作用

目的观察不含添加剂低氟砖茶预防饮茶型氟中毒效果。方法采集预防试点居民饮用不含添加剂低氟砖茶前后奶茶、尿样检测含氟量。结果改用不含添加剂低氟砖茶后,55户居民奶茶含氟量均值由4.18 mg/L降至0.97mg/L、1.13 mg/L(P0.01);居民尿氟含量由3.39 mg/L降至2.22 mg/L、1.86 mg/L(P0.01);居民经奶茶摄氟量由10.26 mg/d降至2.52 mg/d。结论不含添加剂低氟砖茶可有效降低奶茶含氟量,使居民日摄氟量降低,尿氟下降。长期饮用不含添加剂低氟砖茶可能是预防饮茶型氟中毒的有效方法。     

重庆市燃煤型氟中毒病区人体氟摄入和尿氟的调查

[目的]掌握重庆市燃煤型氰中毒病区人群不同途径摄氟量与尿氟的相关关系,为防治氟中毒提供科学依据. [方法]抽样检测病区和非病区饮水、饮食、空气中的氟水平,调查病区和非病区生活习惯,估算出通过不同途径摄入人体的氟水平,与成人和儿童尿氟水平进行相关性分析. [结果]病区成人和儿童的尿氟含量水平高于非病区,经呼吸道摄入的氟水平,病区远高于非病区,经消化道摄入人体的氟水平病区与非病区无差异. [结论]呼吸道的摄氟量可能是影响重庆市燃煤型氟中毒病区氟中毒病情的主要因素.     

中年人群膳食钙的摄人状况及变化趋势--中国心血管流行病学多中心协作研究

目的 探讨中年人群膳食钙的摄人状况及变化趋势。方法 l992一l994年和l998年先后两次随机抽取中年人进行膳食调查。结果 l998年的结果显示，各组人群膳食钙日平均摄人量存在较大差异，男性最高为643mg，最低为27lmg，女性最高为559mg，最低为l92mg；各组人群膳食钙日平均摄人量达到居民膳食钙参考摄人量(DRIs)的人数所占的比例均较低，最高者仅为l7．3％。钙的食物来源中，从谷类及薯类、蔬菜和水果、豆类以及奶类中摄人的钙分别占膳食总的钙摄人量的22．0％、39．5％、l0．1％及5．3％。12组人群总的钙日平均摄人量由第一次调查时的4l6mg增加到第二次调查时的470mg(P＜0．001)，达到的DRIs人数由第一次调查时的4．4％增加到第二次调查时的7．9％(P＜0．001)。结论 近年来我国中年人群膳食钙的摄人量有所增加，然而总体上仍较低，绝大多数中年人的膳食钙摄人量未达到中国营养学会推荐的标准，并且钙的来源仍以难以吸收的植物性食物为主。     

2011年若尔盖县饮茶型氟中毒监测

目的 为及时掌握若尔盖县饮茶型氟中毒病区居民户合格砖茶普及情况,动态评价病区人群饮茶型地氟病流行趋势,为采取针对性干预措施提供依据.方法 2011年对5个监测村50个居民户采集砖茶并测定茶氟含量,检测8 ～ 12岁儿童氟斑牙患病情况及成人氟骨症X线患病情况.结果 检测村民砖茶氟含量最小值为502.05 mg/kg,最大值为1 513.4 mg/kg;平均值为990.28 mg/kg,无合格份数,日人均摄氟量达5.23 mg;检查137名8～12岁儿童,共检出极轻度及以上氟斑牙病例15例,检出率为10.95％;共X线拍摄成人氟骨症111名,检出49例氟骨症患者,检出率为44.14％.结论 若尔盖县属于饮茶型氟中毒高流行区,农牧民群众处于高摄氟状态;成人氟骨症病情重,呈现慢性氟中毒蓄积.     

燃煤污染氟中毒病区居民室内空气氟污染

中国14个省、市、自治区的部分地区盛产高氟、高硫煤,居民以落后的烧煤方式——室内堆煤做饭、取暖,由于没有炉灶及烟囱,燃烧不完全,排出大量含氟煤烟,污染室内空气及粮食、蔬菜、饮水,造成严重的氟中毒。室内空气中氟化物及二氧化硫浓度分别为10.5～304μg/m~3及0.2～122.7mg/m~3,其日平均浓度均超过国家大气卫生标准的几倍到几十倍。在一些病区居民总氟摄入量为2.43～11.3mg/d·人,超过规定水平。摄氟途径为消化道、呼吸道。所有病区居民从呼吸道摄氟量均超过国家标准,而从消化道摄氟量仅重病区超过规定。由此看出,从呼吸道摄入氟对氟斑牙的患病率起着重要作用。     

Prevalence of Brick Tea-Type Fluorosis in the Tibet Autonomous Region

Background

The prevalence of brick tea-type fluorosis is high in Tibet because of the habit of drinking brick tea in this region. Brick tea-type fluorosis has become an urgent public health problem in China.

Methods

A cross-sectional survey was conducted to investigate prevalence of brick tea-type fluorosis in all districts of Tibet using a stratified cluster sampling method. Dental fluorosis in children aged 8–12 years and clinical skeletal fluorosis in adults were diagnosed according to the national criteria. A total of 423 children and 1320 adults participated in the study. Samples of drinking water, brick tea, brick tea infusion (or buttered tea), and urine were collected and measured for fluoride concentrations by the fluoride ion selective electrode method.

Results

The fluoride level in all but one of the brick tea samples was above the national standard. The average daily fluoride intake from drinking brick tea in all seven districts in Tibet was much higher than the national standard. The prevalence of dental fluorosis was 33.57%, and the prevalence of clinical skeletal fluorosis was 46.06%. The average daily fluoride intake from drinking brick tea (r = 0.292, P < 0.05), urine fluoride concentrations in children (r = 0.134, P < 0.05), urine fluoride concentrations in adults (r = 0.162, P < 0.05), and altitude (r = 0.276, P < 0.05) were positively correlated with the prevalence of brick tea-type fluorosis. Herdsmen had the highest fluoride exposure and the most severe skeletal fluorosis.

Conclusions

Brick tea-type fluorosis in Tibet is more serious than in other parts of China. The altitude and occupational factors are important risk factors for brick tea-type fluorosis.Key words: brick tea-type fluorosis, skeletal fluorosis, dental fluorosis, altitude, Tibet     

Phytate intake and molar ratios of phytate to zinc, iron and calcium in the diets of people in China

OBJECTIVE: To assess the phytate intake and molar ratios of phytate to calcium, iron and zinc in the diets of people in China. DESIGN: 2002 China Nationwide Nutrition and Health Survey is a cross-sectional nationwide representative survey on nutrition and health. The information on dietary intakes was collected using consecutive 3 days 24 h recall by trained interviewers. SUBJECTS: The data of 68 962 residents aged 2-101 years old from 132 counties were analyzed. RESULTS: The median daily dietary intake of phytate, calcium, iron and zinc were 1186, 338.1, 21.2 and 10.6 mg, respectively. Urban residents consumed less phytate (781 vs 1342 mg/day), more calcium (374.5 vs 324.1 mg/day) and comparable amounts of iron (21.1 vs 21.2 mg/day) and zinc (10.6 vs 10.6 mg/day) than their rural counterparts. A wide variation in phytate intake among residents from six areas was found, ranging from 648 to 1433 mg/day. The median molar ratios of phytate to calcium, iron, zinc and phytate x calcium/zinc were 0.22, 4.88, 11.1 and 89.0, respectively, with a large variation between urban and rural areas. The phytate:zinc molar ratios ranged from 6.2 to 14.2, whereas the phytate x calcium/zinc molar ratios were from 63.7 to 107.2. The proportion of subjects with ratios above the critical values of phytate to iron, phytate to calcium, phytate to zinc and phytate x calcium/zinc were 95.4, 43.7, 23.1 and 8.7%, respectively. All the phytate/mineral ratios of rural residents were higher than that of their urban counterparts. CONCLUSIONS: The dietary phytate intake of people in China was higher than those in Western developed countries and lower than those in developing countries. Phytate may impair the bioavailability of iron, calcium and zinc in the diets of people in China.     

河北省成年居民膳食钠摄入状况及食物来源分析

目的 了解并分析河北省成年居民膳食钠摄入状况。方法 研究数据来自2015年河北省居民营养与健康状况监测项目,采用分层多阶段与人口成比例整群随机抽样的方法,共有1 465户3 212名18岁及以上居民纳入本研究。将连续 3 d 24 h 膳食回顾数据和调味品称重数据相结合,以《中国食物成分表2004》为依据,计算膳食钠。结果 调查对象平均每标准人日摄入膳食钠4 279.9(2 962.4～6 186.9)mg,其中城市为4 095.6(2 724.9～5 754.9)mg,农村为4 426.9(3 078.3～6 454.4)mg,农村高于城市(χ²=20.977,P<0.05)。不同经济状况居民中,家庭人均年收入<20 000元的居民膳食钠摄入量为4 751.3(3 312.5～6 820.3)mg,与其他收入组差异有统计学意义(H=39.766,P<0.001); 不同文化程度的居民中,大专及以上的居民每标准人日摄入膳食钠3 692.5(2 572.4～5 130.6)mg,与其他文化程度组差异有统计学意义(H=21.275,P<0.001)。调查对象膳食钠主要来源于食盐(73.1%)、高盐调味品(酱油占12.6%,酱类占7.4%,腐乳咸菜类占5.9%,味精、鸡精占3.4%)和零食、小吃、速食类(7.6%)。结论 河北省成年居民膳食钠的摄入量较高,食盐、高盐调味品和零食、小吃、速食类是膳食钠的主要来源,农村居民、低收入和教育程度相对较低的居民膳食钠摄入量较高,建议应加强减盐限钠政策的战略性和针对性。     

1989-2009年中国九省区膳食营养素摄入状况及变化趋势(七)18～49岁成年居民膳食锌的摄入状况及变化趋势

目的描述1989-2009年中国九省区18～49成年岁居民膳食锌的摄入状况、食物来源以及二十年间的变化趋势。方法利用"中国健康与营养调查"的资料,选取1989、1991、1993、1997、2000、2004、2006和2009年调查中18～49岁成年人作为研究对象,采用连续3 d 24 h膳食回顾询问法收集膳食资料。结果中国九省区居民平均每日锌摄入量从1989年的12.3mg下降到2009年的11.2mg。1989年和2009年中国九省区成年居民膳食锌摄入量不足的概率分别为32.7%和45.8%。膳食锌主要来源于谷类食物、动物性食物、坚果和蔬菜水果。结论我国成年居民中普遍存在着锌摄入不足的问题,应该从调整膳食结构入手,引导居民增加富含锌的食物摄入,以维持锌营养需求与健康状况。     

Calcium Intake among Myanmar Residing in Bago, Kayin, and Yangon Areas

A cross-sectional survey combined with 24-hour dietary recall and food diary was undertaken to assess the calcium intake of the Myanmar population. The study was conducted from November 2003 to October 2005. A total of 886 subjects of both sexes aged above 2 years from three States and Divisions (Bago, Kayin, and Yangon) of Myanmar were included in the study. The major measures were mean daily calcium intake (mg/day) and major sources of calcium in the diet. Overall mean calcium intake was 197+13mg/day (2-9 years), 421+2mg/day (10-19 years), 399+21 mg/day (20-49 years), and 383+25mg/day (>50 years) for males, while the corresponding values for females were 207+17 mg/day, 366+19 mg/day, 387+16 mg/day, and 327 +19 mg/day. Calcium intake was less than 80% of the recommended dietary allowances (RDA) for Myanmar for ages 2-9 years and 10-29 years in all the study areas, and for the 50 years and above age group in Yangon. Fish paste was found to be the major source of calcium. Milk and milk products contributed very little to total calcium intake, contributing 2.1% for residents in Yangon, 5.1% in Pa-an and none in Bago. Consumption of calcium rich foods, particularly milk and milk products, should be encouraged among the Myanmar people. Towards this end, appropriate nutrition education materials should be developed for promotional purposes.     

辽宁省≥50岁居民营养素摄入水平分析

目的了解辽宁省≥50岁居民营养素摄入水平,为政府制定相应社会发展政策提供依据。方法在2009年辽宁省居民膳食营养与健康调查数据中选取536名≥50岁居民资料进行分析。结果辽宁省≥50岁居民每人每天摄入的能量平均为8 510.05 kJ(2 040.78 kCal),占推荐摄入量(RNI)的92.76%,从食物中获得的能量基本得到满足,蛋白质摄入量平均为66.83 g,占推荐摄入量的95.47%,脂肪、碳水化合物、膳食纤维的摄入量分别为68.35、274.60、13.01 g;≥50岁居民维生素A、B1、B2平均摄入水平严重不足,分别为557.94μg视黄醇当量、0.95 mg、0.83 mg,仅占RNI的74.39%、73.08%、59.29%,钠、铁、磷、锰的摄入量分别为4 808.03、21.27、984.14、4.14 mg,远高于适宜摄入量(AI),分别是AI的2.19、1.42、1.41、1.72倍;钙的摄入量为454.89 mg,远低于AI,仅占AI的45.49%。结论辽宁省≥50岁居民营养素摄入不平衡,应加强营养知识的宣传教育,引导居民合理膳食,以有效预防与营养有关慢性病的发生。     

Older black women differ in calcium intake source compared to age- and socioeconomic status-matched white women

Racial disparity in osteoporosis between older black and white women is well established; however, less is known regarding daily dietary and supplemental calcium intake in these populations. Moreover, racial differences in calcium intake are confounded by differences in socioeconomic status (SES). The objective of this study was to assess calcium intake and source in older black women (n=33) and white women (n=33), matched in age and SES. Calcium intake and source were evaluated by interview using a 46-item calcium food frequency questionnaire including all food groups and supplements. Black and white women were identical in SES and matched on age (black women 66.9+/-6.2 years vs white women 67.1+/-5.5 years [mean+/-standard deviation], P=0.85). No significant difference existed for dietary calcium intake between black and white women (974+/-524 vs 1,070+/-600 mg/day; P=0.65) or total calcium intake between black and white women (1,485+/-979 vs 1,791+/-887 mg/day; P=0.15). Dairy foods contributed most to dietary calcium intake in black and white women and differed by race (black women 402+/-269 mg/day, white women, 603+/-376 mg/day; P=0.02). Calcium intake from grains differed by race (black women 205+/-201 mg/day vs white women 130+/-234 mg/day; P=0.010) and fortified cereals were a major source of calcium for black women. Calcium supplementation contributed substantially to total calcium intake in both groups, with more white women (n=23, 70%) using supplements than black women did (n=19, 58%). However, no racial difference existed in supplemented calcium intake (black women, n=19; 889+/-605 vs white women, n=23; 1,034+/-460 mg/day; P=0.20). Our data suggest that total daily dietary and supplemental calcium intakes do not differ, but calcium intake from dairy foods and from grains differ in older black and white women matched in age and SES.     

总摄氟量卫生标准的研究

在全国选轻、中、重和极重４个燃煤型氟病区和１个对照区及高（饮水型氟病区）、适宜和低饮水氟地区各２个，共１１个调查点，代表了中国不同地区人群的不同摄入氟水平。调查研究的内容包括空气、饮水和食物氟含量，８～１５岁和＞１５岁２个人群组的日总摄氟量、氟斑牙和氟骨症患病率以及尿氟水平。研究结果表明：在燃煤型氟病区８～１５岁和＞１５岁人群的日总摄氟量分别小于或等于２．２８ｍｇ与３．１０ｍｇ，在饮水型氟病区８～１５岁和＞１５岁人群的日总摄氟量分别小于或等于２．３４ｍｇ和３．５４ｍｇ时，无重度氟斑牙和氟骨症发生，尿氟属正常范围。根据这些结果，并参考国内外有关人群总摄氟量的资料，提出了人群总摄氟量卫生标准的建议值，８～１５岁在燃煤型氟病区为每日２ｍｇ，饮水型氟病区为每日２．４ｍｇ；＞１５岁在燃煤型氟病区为每日３ｍｇ，饮水型氟病区为每日３．５ｍｇ，为预防地方性氟中毒提供了综合评价指标     

深圳居民膳食结构与膳食营养素摄入状况研究

目的了解深圳居民的膳食结构、营养素摄入现状,为制定卫生政策和指导居民合理饮食提供科学依据。方法 2009年6—7月,运用多阶段整群随机抽样法,抽取深圳市8个行政区中73个社区,每个社区抽取120户居民中15岁以上常住居民（每户随机抽1人,共8 782人）,再从中抽取50%对象进行膳食调查。采用食物频率法获取调查对象过去1年各种食物食用频率和食用量。结果共调查3 500人。深圳居民平均每标准人日摄入豆类、水果、奶类分别为15.4、154.3、95.4 g,低于推荐食物摄入量;畜禽肉类、食用油、食盐分别为169.3、41.1、6.6 g,高于推荐食物摄入量。深圳居民每标准人日摄入能量2 537.8 kcal,占RNIs的112.8%;蛋白质、脂肪、碳水化合物的摄入量分别为86.01、10.7、293.2 g,提供能量的比例分别为13.6%、39.2%、47.2%;核黄素和硫胺素摄入量分别为1.2、1.0 mg,分别占RNIs的92.3%和76.9%;钙和钠的摄入量分别为689.74、129.9mg,分别占RNIs的86.2%和187.7%。动物性食物提供的蛋白质占48.8%,脂肪中动物性脂肪占54.7%。结论深圳居民能量、蛋白质、脂肪及大多数营养素的摄入量基本充足,但钙、核黄素和硫胺素的摄入仍然不足,且脂肪的摄入量过多,而碳水化合物的摄入量不足。仍需加强合理营养、平衡膳食的宣传教育,防止营养相关慢性病发病率持续上升。