Subclinical nutritional deficiency in treated coeliac disease and nutritional content of the gluten free diet

Patients with coeliac disease are started on a gluten free diet at the time of diagnosis, but after a varying period of follow-up are often discharged from outpatient and dietary follow-up. We have studied the nutritional status and dietary intake of 54 patients with treated coeliac disease diagnosed in adult life.
Each patient was paired with a healthy age and sex matched control. There was no difference in height in patients compared to controls, but a greater proportion of patients (15%) than controls (4%) had weight below the UK population lower 5th percentile ( x ² test P <0.05). Triceps skinfold thickness was 102% of age and sex matched mean reference values, but mid-arm circumference and arm muscle circumference were below reference mean values (93.1% and 91.5% of reference values, respectively). Haemoglobin, mean corpuscular volume, red cell folate and 25 hydroxyvitamin D were all in the normal range.
A strict gluten free diet was followed by 78% of patients; 22% had occasional gluten intake. Seventy-four per cent considered that they had reduced their intake of bread since commencing a gluten free diet. In 48% of patients, average daily intake of energy was less than the estimated average requirement, and in more than one-third of patients the intake of iron, copper, magnesium, retinol and folic acid was less than the relevant reference nutrient intake (RNI). In more than 10% of patients, average daily intake of calcium, zinc or vitamin B6 was less than the RNI. Vitamin D intake was lower than the RNI in four of five patients older than 65 years.     

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。     

高职高专学生膳食营养与脑力工作能力、学习疲劳的相关性分析

目的 调查高职高专学生膳食营养状况及其与脑力工作能力、学习疲劳的关系。方法 采用连续3 d 24 h膳食回顾法对高职高专学生膳食营养状况进行调查,统计其膳食营养素摄入量达到推荐摄入量（RNI）的情况,并对比营养素摄入不同学生的脑力工作能力指数及学习疲劳发生率。结果 高职高专学生烟酸、维生素C平均摄入量<80% RNI,能量、脂肪、蛋白质、维生素B₁、维生素B₂、钙、铁、锌、硒平均摄入量在80%~120% RNI,维生素E、磷、钠平均摄入量>120% RNI。蛋白质、烟酸、维生素B₁、维生素B₂、维生素C、钙摄入充足学生的第8节课后脑力工作能力指数均大于摄入不足者（均P<0.01）,学习疲劳发生率均低于摄入不足者（均P<0.01）;磷、钠摄入充足学生的第8节课后脑力工作能力指数均大于摄入过多者（均P<0.01）,学习疲劳发生率均低于摄入过多者（均P<0.01）。结论 高职高专学生膳食营养素烟酸、维生素C摄入量偏低,而维生素E、磷、钠摄入量偏高,学生营养素摄入不均衡与脑力工作能力降低、学习疲劳发生率增加有关。     

Food and nutrient intakes of a population sample of 7-year-old children in the south-west of England in 1999/2000 – what difference does gender make?

Objectives To describe the diet of schoolchildren aged 7 years, and identify gender differences in food and nutrient intakes. Subjects A cohort of children resident in the south-west of England in 1999/2000. Methods Diet was assessed using three 1-day unweighed food diaries. Nutrient intakes were compared with dietary reference values for this age group, and with children aged 7–10 years in the British National Diet and Nutrition Survey. Food and nutrient intakes were contrasted between boys and girls. Results Median nutrient intakes exceeded the reference nutrient intake (RNI) for most nutrients. Median intakes of iron and zinc were below the RNI. Median sodium intake was greater than the maximum set by the Scientific Advisory Committee on Nutrition. The mean energy intake for boys and girls, respectively, were 7.3 and 6.8 MJ, this is below the estimated average requirement. The percentage of energy from fat was 35.3% for boys and 36.1% for girls. Boys had higher iron intakes than girls, even after adjustment for energy intake. There were differences in the types of foods eaten between boys and girls; girls ate more fruit and vegetables (P = 0.001) and boys ate more breakfast cereals (P = 0.016). Conclusions The dietary intakes of these 7-year-old children were adequate for most nutrients. However, a reduction in the sodium content of the diet would be advantageous. Fruit and vegetable consumption should be encouraged particularly among boys.     

Food and nutrient intakes of a population sample of 7-year-old children in the south-west of England in 1999/2000 - what difference does gender make?

OBJECTIVES: To describe the diet of schoolchildren aged 7 years, and identify gender differences in food and nutrient intakes. SUBJECTS: A cohort of children resident in the south-west of England in 1999/2000. METHODS: Diet was assessed using three 1-day unweighed food diaries. Nutrient intakes were compared with dietary reference values for this age group, and with children aged 7-10 years in the British National Diet and Nutrition Survey. Food and nutrient intakes were contrasted between boys and girls. RESULTS: Median nutrient intakes exceeded the reference nutrient intake (RNI) for most nutrients. Median intakes of iron and zinc were below the RNI. Median sodium intake was greater than the maximum set by the Scientific Advisory Committee on Nutrition. The mean energy intake for boys and girls, respectively, were 7.3 and 6.8 MJ, this is below the estimated average requirement. The percentage of energy from fat was 35.3% for boys and 36.1% for girls. Boys had higher iron intakes than girls, even after adjustment for energy intake. There were differences in the types of foods eaten between boys and girls; girls ate more fruit and vegetables (P = 0.001) and boys ate more breakfast cereals (P = 0.016). CONCLUSIONS: The dietary intakes of these 7-year-old children were adequate for most nutrients. However, a reduction in the sodium content of the diet would be advantageous. Fruit and vegetable consumption should be encouraged particularly among boys.     

Nutrient intake and food consumption among pregnant women from an agricultural region of Morocco

This study aimed to assess dietary intake and nutrient adequacy in pregnant women selected from an agricultural region of Morocco. On a sample of 172 pregnant women from rural and urban area, data on socio-demographic characteristics and dietary habits by a quantified food frequency were collected using questionnaires. Mean daily intakes of energy and nutrients were estimated and compared to reference nutrient intakes (RNI). The results show that the mean daily intakes of energy (3110.9 kcal in urban; 2707.5 kcal in rural) and some nutrients were adequate. However, iron, folate, zinc and calcium intakes were inadequate for the majority of women and more markedly in rural area. Education level appeared to affect nutrient intakes while no differences were registered across pregnancy stages or according to household size. The study suggests that an education program should be conducted to improve dietary intakes in order to prevent risks for pregnancy outcome in this population.     

北京市房山区164名中小学生膳食营养摄入状况分析

目的调查北京市房山区中小学生膳食营养摄入状况,为房山区学生改善营养提供科学依据。方法对北京市房山区中小学生进行膳食调查,采用3 d 24 h膳食回顾结合家庭调味品称重法,依据中国食物成分表计算每日食物消费及营养素摄入状况。结果共调查北京市房山区中小学生164名,男生91名,女生73名,平均年龄(8.93±2.21)岁。中小学生水产品类、奶及奶制品、大豆类及其制品、蔬菜水果类摄入不足,畜禽肉类、盐摄入过多。能量平均摄入量为1710.30 kcal,蛋白质、脂肪和碳水化合物平均摄入量分别为61.57、72.21、211.48 g,供能比分别占14.38%、37.95%和47.68%。中小学生维生素A、维生素B1、维生素B2、维生素C、硒平均摄入量达到推荐摄入量(RNI)的比例分别为34.8%、27.4%、33.5%、24.4%和47.0%。仅2.4%的学生钙摄入量达到了RNI,超过一半的学生铁、锌、铜平均摄入量达到RNI。其中,女生铁摄入量达到RNI的比例低于男生(P<0.05)。结论北京市房山区中小学生膳食结构不合理、微量营养素摄入不足,需加强学生、家长、学校食堂营养宣教,有针对性地改善学生营养状况。     

Maternal Diet Influences Fetal Growth but Not Fetal Kidney Volume in an Australian Indigenous Pregnancy Cohort

Suboptimal nutrition during pregnancy is recognised as a significant modifiable determinant in the development of chronic disease in offspring in later life. The current study aimed: (i) to assess the dietary intakes of pregnant Indigenous Australian women against national recommendations and (ii) to investigate the associations between maternal nutrition during pregnancy and the growth of the offspring, including kidney development in late gestation in the Gomeroi gaaynggal cohort (n = 103). Maternal dietary intake in the third trimester was assessed using the Australian Eating Survey Food Frequency Questionnaire. Estimated fetal weight (EFW) and kidney size were obtained by ultrasound. Birth weight was retrieved from hospital birth records. Of the five key nutrients for optimal reproductive health (folate, iron, calcium, zinc and fibre), the nutrients with the highest percentage of pregnant women achieving the nutrient reference values (NRVs) were zinc (75.7%) and folate (57.3%), whereas iron was the lowest. Only four people achieved all NRVs (folate, iron, calcium, zinc and fibre) important in pregnancy. Sodium and saturated fat intake exceeded recommended levels and diet quality was low, with a median score of 28 out of 73 points. After adjusting for smoking and pre-pregnancy body mass index, only maternal intake of retinol equivalents and the proportion of energy from nutrient-dense or energy-dense, nutrient-poor (EDNP) foods were associated with fetal growth. EFW decreased by 0.13 g and birth weight decreased by 0.24 g for every µg increase in maternal dietary retinol intake. Interestingly, EFW, but not actual birth weight, was positively associated with percentage energy from nutrient dense foods and negatively associated with percentage energy from EDNP foods. Dietary supplement usage was associated with increased birthweight, most significantly iron and folate supplementation. Current dietary intakes of pregnant Australian women from this cohort do not align with national guidelines. Furthermore, current findings show that maternal retinol intake and diet composition during pregnancy can influence fetal growth, but not fetal kidney growth in late gestation. Strategies that aim to support and optimise nutrient intakes of Indigenous pregnant women are urgently needed. Future studies with long-term follow-up of the children in the current cohort to assess renal damage and blood pressure are imperative.     

Non-starch polysaccharide intake in vegans and the relationship with energy distribution and mineral intakes

Background There is little information available about non-starch polysaccharide (NSP) intake in vegans. This study aimed to estimate the intake of NSP in the habitual vegan diet and to assess the relationship between NSP intake and energy distribution, and intakes of selected minerals.
Method NSP intake, energy distribution and intakes of calcium, magnesium, iron and zinc were estimated, using a 4-day weighed record, in 26 adult vegans (male n  = 11, female n  = 15) consuming their habitual diet.
Results Mean BMI values in males (22.0) and females (21.1) were significantly lower than the average for the UK population. Mean daily NSP intakes in males (27 g) and females (23 g) were higher than the dietary reference value (DRV) population average of 18 g day^–1, although six subjects had intakes below this and two male subjects had intakes below the DRV individual minimum of 12 g day^–1. Cereals were the major contributor to total NSP intakes. Mean contributions to total energy intake in males and females were in-line with the DRV. Mean calcium intakes were below the reference nutrient intake (RNI) while mean intakes of magnesium, iron and zinc were above the RNIs. There were significant positive correlations between NSP intake and calcium, magnesium, iron and zinc.
Conclusion Occasional low NSP intakes and, conversely, high intakes of NSP combined with marginal calcium intakes in some vegans are of concern. Further work is needed to assess food sources and NSP intakes in the current vegan diet.     

Do diets high in sugars compromise micronutrient intakes? Micronutrient intakes in the Dietary and Nutritional Survey of British Adults according to dietary concentration of ‘added’, ‘non-milk extrinsic’ or ‘total’ sugars

Objective : It has been claimed that dietary sugars, particularly added and non-milk extrinsic sugars, are 'empty calories', displacing micronutrients from the diet. Evidence for this hypothesis was examined using data from the Dietary and Nutritional Survey of British Adults (Gregory et al ., 1990). Method : Men and women aged 16–64 years were classified into quintiles (fifths) of the distribution of food energy from added sugars, non-milk extrinsic sugars (NMES) and total sugars. Micronutrient intakes were compared across quintiles for each type of sugars energy. Results : Many nutrients showed a non-linear relationship with sugars energy (whether added, NME or total), with the highest nutrient intakes among average consumers. The most marginal nutrient (in comparison to dietary reference values) was iron among women; no group achieved the RNI for iron, regardless of sugar level or type. Calcium intakes were below the RNI among women in the first quintile (all types of sugars), although under-reporting may have led to underestimations of intake in this group. Intakes of several nutrients fell in the 4th and 5th quintiles (all types), but remained adequate in comparison to the RNI (except for iron and folate in women). There were positive relationships between extrinsic and total sugars, and vitamin C, which reflected fruit juice consumption. Diets high in added and NME sugars tended to be of lower nutrient density, but any deficit in nutrient intake was contingent on a low energy intake, which was untypical. Conclusions : These data suggest that NME sugar intakes providing up to about 17% of food energy did not compromise micronutrient intakes in these British adults. Specific advice may be needed to counteract low nutrient intakes (e.g. iron intake in women), particularly where energy intake is restricted.     

深圳市某单位集体用餐人群膳食营养素的调查分析

目的了解深圳市轻体力劳动集体用餐者膳食营养摄入状况。方法选择某单位从事轻体力活动的健康成年男女45人,通过称重记录,监测观察对象2个月内能量摄入的情况,结合《中国居民膳食指南》及中国居民膳食营养素推荐摄入量(RNI)标准进行评价。结果该集体人群的膳食不够合理,膳食结构简单,膳食纤维、维生素A、B1和微量元素钙、镁、铁、锌、铜、硒等与RNI/AI比较,其摄入值都过低,而烟酸,维生素C、E,锰,磷则都高于其RNI、AI值;膳食中三大营养素比例不适宜,摄入蛋白质比、脂肪比显著低于参考值,而碳水化合物比显著高于参考值。结论该人群能量、营养素缺乏和过剩并存,整体营养健康状况不容乐观。     

Zinc and vitamin A intake and status in a national sample of British young people aged 4-18 y

OBJECTIVE: To examine zinc and vitamin A intake and status and associated dietary, socio-demographic, lifestyle and physiological factors in British young people. DESIGN: National Diet and Nutrition Survey of young people aged 4-18 y. SETTING: Great Britain, 1997. SUBJECTS: Complete 7-day weighed dietary records were provided by 1520 participants, while 1193 provided blood samples. RESULTS: A total of 13 and 11% of participants respectively reported low dietary intakes of zinc and vitamin A (retinol equivalents), relative to the UK lower reference nutrient intake. These percentages were not altered significantly by including contributions to intake from supplements, mainly containing vitamin A (as retinol). Likelihood of low zinc and/or vitamin A intake was more often associated with age, sex and likely under-reporting of food consumption than with other socio-demographic and lifestyle factors. Low zinc and vitamin A intakes were generally less likely in those with higher consumption of dairy foods (mainly milk). Zinc and vitamin A status (assessed by plasma zinc and retinol concentrations) were adequate in almost all participants. Plasma zinc concentration was not significantly associated with zinc intake. Plasma retinol concentration was correlated with vitamin A intake (overall r=0.17, P<0.001; adjusted for age and plasma alpha(1)-antichymotrypsin concentration) and increased significantly with age (P<0.001) in both sexes. A significant association was found between plasma zinc and retinol concentrations in boys only (r=0.17, P=0.001). CONCLUSION: Zinc and vitamin A intakes and status were generally adequate in this national sample of British young people.     

1982年与2012年中国6~17岁学龄儿童膳食维生素A的摄入比较

  目的  了解中国6~17岁学龄儿童(以下简称学龄儿童)膳食维生素A、视黄醇和胡萝卜素摄入水平,为促进儿童营养改善和健康成长提供基础数据。  方法  通过分析1982年全国营养调查和2012年中国居民营养与健康状况监测中的膳食调查数据,计算学龄儿童每人每天各种食物及调味品摄入量。根据1982年与2012年的食物成分表,分别计算动物性食物来源的视黄醇和植物性食物来源的胡萝卜素摄入量,并将二者折合计算维生素A总量,与维生素A的推荐摄入量(recommended nutrient intake, RNI)进行比较。  结果  中国学龄儿童膳食维生素A摄入总量(μg RAE)从1982年的(333.3±15.9)μg RAE下降到2012年的(215.3±9.5)μg RAE(F=61.95, P < 0.001);其中,视黄醇摄入量从(28.4 ±2.0)μg增加到(107.6±4.8) μg(F=225.36, P < 0.001),胡萝卜素摄入量从(3 673.9±217.3)μg下降到(1 297.4±82.0)μg(F=214.98, P < 0.001)。1982年儿童膳食维生素A摄入总量为农村高于城市(F=5.28, P=0.022),2012年则为城市高于农村(F=14.85, P < 0.001)。2012年仅有四分之一的儿童膳食维生素A摄入量达到80%RNI以上。  结论  1982—2012年中国学龄儿童膳食维生素A摄入水平整体有所下降,动物性食物贡献率有所增加,植物性食物贡献率大幅度降低。建议加强膳食指导,丰富农村儿童食物供应的种类,改善儿童的维生素A营养状况。     

Nutrient intake and food consumption among pregnant women from an agricultural region of Morocco

This study aimed to assess dietary intake and nutrient adequacy in pregnant women selected from an agricultural region of Morocco. On a sample of 172 pregnant women from rural and urban area, data on socio-demographic characteristics and dietary habits by a quantified food frequency were collected using questionnaires. Mean daily intakes of energy and nutrients were estimated and compared to reference nutrient intakes (RNI).

The results show that the mean daily intakes of energy (3110.9?kcal in urban; 2707.5?kcal in rural) and some nutrients were adequate. However, iron, folate, zinc and calcium intakes were inadequate for the majority of women and more markedly in rural area. Education level appeared to affect nutrient intakes while no differences were registered across pregnancy stages or according to household size. The study suggests that an education program should be conducted to improve dietary intakes in order to prevent risks for pregnancy outcome in this population.     

中国居民膳食维生素A的摄入状况调查

目的分析中国居民膳食维生素A的摄入状况及1982~2002年摄入量的变化趋势。方法利用2002年中国居民营养与健康状况调查数据进行分析。膳食调查包括23470户,共68965人。结果全国平均每标准人日视黄醇当量摄入量为469.2μg,摄入量达到RNI的居民占14.5%,达到60%RNI的占33.1%,不足20%RNI的居民占23.2%。6类地区中3类农村仅有9.7%的居民摄入量达到RNI。随着收入水平从低到高,视黄醇当量的摄入量总体呈上升趋势。从1982~2002年,居民视黄醇当量的平均摄入水平没有太大改善。结论中国居民膳食维生素A的总体摄入水平仍较低。     

惠州学院164名在校女生膳食营养状况调查

目的了解女大学生膳食营养状况,为开展高校膳食营养教育提供参考。方法采用24h膳食记录法和查帐法对惠州学院164名随机抽样的女大学生进行连续3d的膳食调查,通过实验室检查进行营养状况评价。结果惠州学院在校女生能量摄入量只占RNI的73%,钙摄入量只占RNI的42%;碳水化合物、维生素B1、维生素B2、铁、锌摄入量不足;动物性食品偏少;血液钙、镁、铁、铜、锌浓度偏低。结论惠州学院女生膳食结构不合理,应调整膳食结构,增加动物性食物的摄入,提高膳食能量、钙、维生素B1、维生素B2、微量元素的摄入量。     

包头市343例孕妇孕中、晚期膳食营养状况调查

目的 了解包头市孕妇孕中、晚期饮食习惯及营养素的摄入情况,为有针对性的指导孕妇合理膳食及进一步研究孕妇营养与健康问题提供科学依据.方法 采用半定量食物频率法,对调查对象进行膳食调查.结果 调查对象的膳食构成以谷薯类食物为主,蔬菜、奶类和鱼、禽、蛋、肉类摄入不足;孕妇膳食总能量达推荐摄入量标准(RNI)的111％,三大产热营养素的热能供给比例基本适宜,其中蛋白质摄入量达到RNI的113％,钙、铁、锌摄入缺乏,维生素B2摄入不足,维生素A、B1、C的摄入量均达到RNI的80％;孕妇在怀孕期补充过钙制剂和叶酸的比例分别为55.3％和65.2％,但对锌、铁制剂补充的人数较少.结论 包头市孕妇孕中、晚期膳食中营养素摄入尚不均衡,存在一定程度的营养缺乏现象,应加强有针对性的营养指导,尤其应适当降低动物性食物的摄入量.     

山东省农村育龄妇女代表性膳食下铁、锌、钙吸收率分析

目的:研究山东省农村育龄妇女代表性膳食下铁、锌、钙的吸收率,以及膳食因素对它们吸收利用的影响。方法:用代谢平衡法,使用原子吸收分光光度计(AAS)测定膳食与粪便的铁、锌、钙,计算铁、锌、钙的吸收率。同时测定影响铁、锌、钙吸收的因子:膳食脂肪、蛋白、植酸、纤维素和VitC的含量,计算日平均摄入量,将其结果与我国育龄妇女每日推荐膳食营养素摄入量(RNI)进行比较。结果:铁、锌、钙的吸收率分别为8·26%、21·48%、47·94%,铁的平均日摄入量为13·77mg,占RNI的68·85%,远低于推荐量,锌的平均日摄入量为15·43mg,占RNI的102·87%,高于推荐量,钙的平均日摄入量为409·38mg,占RNI的51·17%,远低于推荐量。蛋白质和VitC的日摄入量分别为65·70g与34·20mg,占RNI的82·12%~109·50%和34·20%,低于推荐量。脂肪、植酸和膳食纤维的摄入量较高。结论:在蛋白质和抗坏血酸的日摄入量较低,脂肪、植酸和膳食纤维的摄入量较高的条件下,铁吸收率较低,铁营养缺乏,锌营养尚可,钙摄入量显著低于RNI,显示钙摄入严重不足。     

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.