三峡水库消落区城镇、农村人口食物消费与膳食营养状况及儿童营养状况的调查

背景：目前对三峡水库消落区居民食物营养状况进行监测的相关调查较少。目的：了解三峡水库消落区形成前人群营养状况和膳食结构，为连续动态进行食物与营养监测提供基础数据。设计：横断面调查。单位：重庆医科大学公共卫生学院营养与食品卫生学教研室。对象：调查于2004—02／03完成，调查地点主要选取三峡水库人口较集中、面积较大、影响可能较大的消落区，如开县、云阳等县。其中对消落区居民食物营养状况的首次监测选择在开县进行。对开县52户城区居民和50户农村居民进行调查，每户选择1名主要担任买菜、购粮任务的成员为调查对象，均自愿参加观察。本次调查共调查了102人，男42人，女60人。同时对开县1999—05／2003-11儿童体格测量以及血色素检测等资料进行分析。方法：采用人户问卷调查。对家庭基本情况、住户食物消费与膳食营养等方面进行调查分析。膳食调查采用24h膳食回顾结合食物消费频数调查，对农村及城镇居民进行家庭消费水平的重要指标Engel指数测定，Engel指数=用于食品的开支／家庭总收入&;#215;100％。主要观察指标：①消落区居民食物消费量、能量及营养素摄入量。②消落区儿童低体质量患病率及儿童生长迟缓率。结果：纳入消落区居民102人，全部进入结果分析，无脱落。①消落区居民食物消费量状况：开县城区居民粮食消费量为人均243g／a，其中蔬菜、水果、鱼类食品消费低于全国平均水平，而食用油脂消费却呈较高态势；开县农村居民粮食消费量为人均268g／d，其中粮食消费明显下降，而肉类、食用油脂消费出现增高趋势。②消落区居民能量摄入量状况：开县城区居民能量摄入量为人均6909kJ／d，较1998年重庆市城市居民和全国城市平均水平明显降低；开县农村居民能量摄入量人均7577kJ／d，较19年重庆市农村居民低48．4％，比全国农村平均水,98平低37％。③消落区儿童营养状况：5岁以下儿童1999年低体质量发生率与全国平均水平9．6％接近，自2000年后明显下降，波动在1．0％～4．8％之间。从1999年开始，开县5岁以下儿童生长迟缓发生率有逐步降低趋势，但贫血等常见病仍保持较高发病率，1999年贫血检出率为33．5％，2003年降至20.8％。结论：重庆市开县居民某些营养素摄入量和膳食结构有待进一步改善，有必要进行连续动态食物与营养监测。     

脑卒中患者膳食结构与营养状况调查分析

目的:调查并分析脑卒中住院患者膳食结构和营养状况。方法:根据中国营养学会推荐的《中国居民平衡膳食宝塔》,调查神经内科50例脑卒中住院患者的资料。在患者入院时对其营养状况进行评估和记录,实时登记患者住院期间每日进食的食物含量及种类,7 d统计1次。分析脑卒中患者营养状况与膳食结构特点,并与膳食金字塔营养标准进行比较。结果:住院脑卒中患者膳食结构的主要特点是:其膳食比例上存在着明显差异,主食以谷类为主,蔬菜水果、鱼禽肉类及水的平均摄入量均低于推荐水平(P<0.05),尤以豆制品摄入严重不足,仅8%脑卒中患者食用,且平均摄入量(14.90±11.72)g/d,显著低于最低推荐摄入量30 g/d水平(P<0.05)。油脂摄入过量,平均摄入(34.24±24.41)g/d,高于25 g/d推荐摄入量(P<0.05)。蛋类较符合膳食金字塔的推荐摄入量,差异无统计学意义(P>0.05)。结论:住院脑卒中患者有不良饮食习惯,其膳食结构不合理,膳食状况以谷类、蔬菜水果、鱼禽肉类、奶类、水及豆类摄入不足为主要问题,应加强住院期间的健康教育和饮食指导,以调整不平衡膳食结构、提高患者营养知识水平及纠正不良的膳食习惯,最终达到提高患者的生活与生命质量的目的。     

106例慢性心力衰竭患者营养及膳食结构调查

目的了解经口进食的慢性心力衰竭患者的营养状态、膳食结构及部分微量营养素摄入状况,为指导其合理膳食及制订相关营养干预措施提供依据。方法调查在某三级甲等医院心力衰竭中心住院的106例经口进食的慢性心力衰竭患者,通过心力衰竭特异性微型营养评价量表评估患者的营养状况,并采用24 h膳食回顾法记录患者3 d的早、中、晚3餐及加餐情况。计算膳食中的各类营养素含量,与《中国居民膳食指南(2016)》《中国居民膳食营养素参考摄入量(2013)》及2010年—2012年江苏省膳食调查数据进行比较。结果 106例经口进食的慢性心力衰竭患者存在营养风险,营养不良的发生率约61.32%。心力衰竭患者蔬菜类、大豆类及坚果类食物的每日人均摄入量符合中国居民膳食指南推荐要求;谷类薯类及杂豆、水果类、奶类及奶制品尚未达到推荐要求;畜禽肉类、水产类、蛋类、油脂类、盐类均超过推荐要求。每日人均摄入能量为(5 316.66±659.15) kJ,每日人均摄入蛋白质、脂肪、碳水化合物分别为(62.27±23.24) g、(51.27±37.81) g、(140.28±47.46) g,供能比分别为20.34%、33.42%、...     

老年患者营养状况调查与护理干预研究

目的：调查老年患的营养状况，研究如何对老年患进行平衡膳食、合理营养的指导和干预。方法：采用膳食询问法，记录3d的饮食情况，调查126名老年患的营养状况。结果：热能、动物脂肪、钠摄入量偏高，蛋白质摄入量偏低，钙、铁、维生素B1、B2摄入量明显偏低。结论：膳食要满足老年人营养需求，特别是蛋白质、钙、铁、维生素和膳食纤维。应减少动物性食品，增加豆类、乳类、蔬菜、水果等，少吃油腻、过咸、烟熏食物，同时老年人合理膳食需结合健康生活方式才能发挥营养作用，从而达到营养平衡。对老年患膳食营养进行合理有效的护理干预，有助于提高患生存质量，使患早日恢复健康。     

军队疗养员膳食脂肪酸摄入17年变化分析

目的探讨膳食结构和脂肪酸摄入的变迁对军队老干部健康的影响。方法对1992年、2002年和2008年来我院疗养的军队老干部进行询问调查、膳食调查和医学检验。结果军队老干部谷类食物消费量下降,动物性食物的消费量显著提高。能量和脂肪的摄入已超过推荐摄入量。脂肪供能比增长较快,2008年已达37％,远远超过推荐摄入量20％～30％。每日总脂肪酸的摄入量也显著增高,比我国居民平均摄入量高20％以上,饱和脂肪酸（SFA）、单不饱和脂肪酸（MuFA）、多不饱和脂肪酸（PuFA）的摄入量也逐年上升。军队老干部的总体健康状况有了很大改善,但心脑血管疾病的患病率却呈明显上升趋势。结论军队老干部平均膳食质量改善明显,但存在膳食脂肪酸摄入量明显偏高,超重、肥胖及心血管疾病患病率上升的问题,应加强营养知识宣传和营养干预。     

贫困地区高一学生食物摄入频率观察

目的:调查甘肃省会宁县高一学生的膳食摄入状况和膳食模式,为进一步改善和提高其膳食营养状况提供基础资料。方法:采用膳食频率法结合称重法,收集被调查对象连续一年的食物消费资料。结果:调查对象膳食频率评分平均及格率仅为21.3%,性别差异不显著;城镇生源在谷类及其制品、鱼虾类、奶类及其制品、腌制蔬菜、软饮料及糕点摄入频率评分存在显著性差异,除腌制蔬菜评分是农村高于城镇外,其余各种食物均为城镇高于农村。35.7%的调查对象每日摄入五大类食物,性别和生源间的差异不显著。结论:有必要针对性的开展营养教育,增加蔬菜水果、动物瘦肉、奶类、豆类等食物的摄入量,改善该人群的营养状况。     

南昌市部分人群的维生素A营养状况调查

目的 为了全面了解维生素A的营养状况,对老年人和大学生的维生素A的摄入量和血清水平做了调查.方法 调查了某福利院60名60岁以上的老人,其中男性35人,女性25人;调查124名年龄18～20岁的大学生,男生61人,女生63人.用称重法对老年人做4天膳食调查;以回顾性问卷调查做了大学生的膳食调查.以改进微量荧光法测定调查对象的血清维生素A含量.结果 维生素A(视黄醇当量)摄人量为414～485μg/day,占RNI的51.75%～64.3%.老年人血清维生素A含量的平均水平为1.26±0.47 μmol/L;大学生血清维生素A平均水平为1.27±0.23 μmol/L;没有发现临床维生素A缺乏者.维生素A正常者占82.39%,老年人中有46.15%,大学生97.58%,差异有统计学显著意义.结论 本次调查未发现临床维生素A缺乏者,但是17.61%有程度不同的缺乏,视黄醇当量摄入量不足是导致缺乏的原因,必须加强营养,普及营养知识.     

福安市城乡学龄前儿童膳食与营养状况调查

目的了解福安城乡不同地域学龄前儿童的膳食与营养状况,为改善儿童健康状况提供科学膳食。方法采用《中国居民膳食营养素参考摄入量》(DRIs)评价标准和世界卫生组织(WHO)推荐的Z评分法,对福安市城乡不同地域5所幼儿园2985名幼儿膳食中的主要营养素摄入进行分析。结果福安城、乡儿童中,女童低体质量营养不良、生长迟缓略高于男童。乡镇儿童营养不良发生率较城区儿童营养不良发生率偏高。而城区儿童的肥胖发生率也高于乡镇儿童(尤其是中度肥胖)。两组男女性之间,经统计学U检验,无显著性差异,P>0.05。乡镇儿童的膳食存在营养素结构不合理,早餐简单喝一些牛奶或一些饼干、面包,缺乏维生素、铁、锌、钙、蛋白质等多种元素;部分儿童没有吃餐就送到托儿所,严重引起三大营养缺乏。结论开展营养健康教育,将食物和营养知识纳入婚龄妇女"优生优育"教育内容,开展儿童生长发育和营养监测,加强儿童膳食营养的健康指导。     

护士早餐膳食营养调查分析

目的了解护士的膳食营养状况，分析存在的问题，以便更好地进行膳食指导。方法采用食物频率问卷方法，调查110名护士日常生活中选择早餐食物时经常考虑的因素、食物种类的搭配、摄入量、开支情况以及进餐所需用的时问等进行膳食调查分析。结果本组护士从早餐的膳食结构、能量和营养素摄入量、能量来源分布、蛋白质的来源分布、能量餐次比评价等均需要改善。结论护士对营养知识掌握不足，护士早餐存在不科学的膳食结构，必须要加强膳食指导，以保证各种营养素的均衡摄入，从而促进护士身体健康。     

胃肠癌辅助化疗患者营养状况及膳食营养素摄入情况调查分析

目的:调查胃肠癌辅助化疗患者营养状况及膳食营养素摄入情况,为护理人员对患者进行饮食营养护理提供依据。方法:对62例患者采用综合性营养评价法(SGA)调查其总体营养状况;采用询问和称重法相结合的方法,对患者化疗前任意3 d、化疗用药后1~3 d、停药后8~10 d的膳食营养素摄入情况进行调查[7]。对SGA标准下营养良好与营养不良患者传统营养评价指标(BW、BMI、Hb、TLC及ALB)、膳食营养素(能量、蛋白质、脂肪、碳水化合物、膳食纤维、维生素A、维生素C、维生素E、钙、磷、铁、锌、硒)摄入情况进行比较。结果:营养良好14例(22.6%),营养不良48例(77.4%)。营养良好者与营养不良者除BW外,BMI、Hb、TLC及ALB比较差异均有统计学意义(P<0.01),且能量、蛋白质、脂肪、碳水化合物、钙、铁的摄入量比较差异均有统计学意义(P<0.01,P<0.05)。结论:胃肠癌辅助化疗患者普遍存在营养不良状况,分析认为膳食营养的摄入情况在改善患者营养状况中起着重要的作用。肿瘤专科护士应加强营养相关知识的学习,对患者进行专业的饮食营养护理。     

Factors associated with food intake,nutritional status,and function among nursing home residents with dementia

Declined food intake is prevalent among long-term care (LTC) residents with dementia and associated with deleterious health outcomes. This study explores food intake, nutritional status, and function and its associated factors in LTC residents with dementia. Data from 82 LTC residents with dementia were used in this secondary analysis. The majority of residents were either malnourished or at risk of being malnourished and demonstrated a worse appetite than previously described in the literature. Comorbid illness, depressed mood, and appetite were associated with 37.1% of the variance in food intake over 30 days. Dementia level and appetite were associated with 22.2% of the variance in nutritional status. Food intake and nutritional status were associated with 29.1% of the variance in function. This study also highlights a new demographic that may require extra assistance in combating declined food intake: LTC residents with dementia who reside in a facility that follows restrictive food practices such as a kosher diet. The potential reversibility of factors associated with food intake and nutritional status provides opportunities for intervention.     

三峡工程对开县人群健康可能发生的潜在影响的预测评估

背景三峡库区历史上曾为传染病、自然疫源性疾病和地方病的高发地区,其淹没面积大、人口密集,水库形成后的污染可能会造成对人群健康的危害.目的通过分析开县地区人群的主要健康指标以及影响因素,对三峡水库形成后可能产生的对人群健康造成的影响因素进行预测性评估.设计横断面调查.单位重庆医科大学公共卫生学院及重庆市开县疾病控制中心.对象调查于2004-02/05在重庆市开县完成,调查对象为该县所有人口的疾病监测资料,选择三峡库区重庆段其他库区县及非库区县人群的疾病监测资料作为对照.方法收集有关社会发展、人群健康和与公共卫生体系的有关指标,深入有代表性的重点乡镇现场调查.对相关资料数据进行比较分析,并利用定量与定性相结合的方法对三峡工程对人群健康的潜在影响做出全面预测评估.主要观察指标①开县、重庆市和全国1999～2001年一般人群的健康状况比较.②开县、重庆市和全国1999～2003年传染病发病率比较.③水库形成后对人群健康产生的潜在影响.结果①开县、重庆市和全国1999～2001年一般人群的健康状况比较开县孕产妇病死率、婴儿以及5岁以下儿童病死率高于全国和重庆市的平均水平,多项指标显示出开县的一般人群健康状况较差.②开县、重庆市和全国1999～2003年传染病发病率比较重庆市的传染病发病率维持在250/10万左右,高于全国水平(190/10万左右).开县的传染病发病率逐年升高,近两年的发病率达国内的1.5倍以上.③水库形成后可能发生的对人群健康产生的潜在影响介水传染病尤其是病毒性肝炎的发病;自然疫源疾病及虫媒传染病性疾病的发生;肝癌等恶性肿瘤性疾病.结论应加强对现有公共卫生体系相对薄弱环节和潜在各种疾病流行和突发公共卫生事件发生的认识.随着三峡工程的进度加快,必须加强防治对策,预防和减轻水库形成后可能对人群产生的健康危害.     

In utero dietary exposures and risk of islet autoimmunity in children

OBJECTIVE: The goal of this study was to examine whether maternal dietary intake of vitamin D, omega-3 fatty acids, and omega-6 fatty acids during pregnancy is associated with the appearance of islet autoimmunity (IA) in offspring. RESEARCH DESIGN AND METHODS: The Diabetes Autoimmunity Study in the Young (DAISY) is recruiting at birth and following children at increased risk for type 1 diabetes, as determined by HLA-DR genotype or by family history of type 1 diabetes. A total of 233 mothers of newly recruited DAISY subjects were asked to recall their intake of food and nutritional supplements during the third trimester of pregnancy using the Willett food frequency questionnaire. Children were followed for an average of 4 years (range 0.8-7.3 years) for the appearance of insulin, GAD(65), and IA-2 autoantibodies. Sixteen children developed at least one autoantibody during this period. Unadjusted and adjusted hazard ratios (HRs) for the development of IA were estimated with survival analysis using a Weibull distribution. RESULTS: Maternal intake of vitamin D via food was significantly associated with a decreased risk of IA appearance in offspring, independent of HLA genotype, family history of type 1 diabetes, presence of gestational diabetes mellitus, and ethnicity (adjusted HR = 0.37; 95% CI 0.17-0.78). Vitamin D intake via supplements, omega-3 fatty acids, and omega-6 fatty acids intake during pregnancy were not associated with appearance of IA in offspring. CONCLUSIONS: Our findings suggest that maternal intake of vitamin D through food during pregnancy may have a protective effect on the appearance of IA in offspring.     

Resident coping strategies in the nursing home: an indicator of the need for dietary services change.

Inadequate food intake leading to malnutrition impacts up to 85% of nursing home residents. Malnutrition can result in compromised quality of life and lead to chronic disability, functional decline, increased health care utilization and costs, and death. This article examines organizational structure (Perrow, 1979) and person-environment fit (Lawton, 1982) as factors in nutritional care of nursing home residents. The strategies used by residents to cope with organizational food and food service issues, competence, and environmental press in the nursing home can alert nurses to the need for changes in dietary services to increase food intake and quality of life.     

2010年长江三峡库区消落带小型兽类监测

目的 了解2010年长江三峡水库消落区内不同季节、不同海拔高度小型兽类种类和密度变化,为制定科学防控措施提供依据。 方法 2010年在三峡库区上、中、下游选择4个典型消落区作为监测点,分别于退水后的6月和蓄水前的9月进行监测。在消落区中按10 m高程差设置3个监测条带,每个监测条带中用100个鼠夹进行鼠形动物密度监测。 结果 6－7月,在4个监测点共布放鼠夹1394个,捕获小型兽类31只,密度为2.22%;主要种类及构成为黑线姬鼠(80.65%)、黄胸鼠(6.45%)、四川短尾鼩(9.68%)、褐家鼠(3.22%)。9-10月,共布放鼠夹891个,捕获小型兽类11只,密度为1.23%;主要种类及构成为黑线姬鼠(9.09%)、黄胸鼠(45.45%)、四川短尾鼩(18.18%)、褐家鼠(18.18%)和长尾巨鼠(9.09%)。退水后(6月)的密度要高于蓄水前(9月),黑线姬鼠为优势种。 结论 在消落区范围内,存在多种鼠类,种群结构与迁移有季节性的变化。有必要在合适的季节开展小型兽类,尤其是鼠类的监测工作,并采取长期的控制措施。     

Do California Counties With Lower Socioeconomic Levels Have Less Access to Emergency Department Care?

Objectives: The study objective was to examine the relationship between number of emergency departments (EDs) per capita in California counties and measures of socioeconomic status, to determine whether individuals living in areas with lower socioeconomic levels have decreased access to emergency care. Methods: The authors linked 2005 data from the American Hospital Association (AHA) Annual Survey of Hospitals with the Area Resource Files from the United States Department of Health and Human Services and performed Poisson regression analyses of the association between EDs per capita in individual California counties using the Federal Information Processing Standard (FIPS) county codes and three measures of socioeconomic status: median household income, percentage uninsured, and years of education for individuals over 25 years of age. Multivariate analyses using Poisson regression were also performed to determine if any of these measures of socioeconomic status were independently associated with access to EDs. Results: Median household income is inversely related to the number of EDs per capita (rate ratio = 0.83; 95% confidence interval [CI] = 0.71 to 0.96). Controlling for income in the multivariate analysis demonstrates that there are more EDs per 100,000 population in FIPS codes with more insured residents when compared with areas having less insured residents with the same levels of household income. Similarly, FIPS codes whose residents have more education have more EDs per 100,000 compared with areas with the same income level whose residents have less education. Conclusions: Counties whose residents are poorer have more EDs per 100,000 residents than those with higher median household incomes. However, for the same income level, counties with more insured and more highly educated residents have a greater number of EDs per capita than those with less insured and less educated residents. These findings warrant in‐depth studies on disparities in access to care as they relate to socioeconomic status. ACADEMIC EMERGENCY MEDICINE 2010; 17:508–513 © 2010 by the Society for Academic Emergency Medicine     

Does a liquid supplement improve energy and protein consumption in nursing home residents?

One popular strategy to improve the acceptance and efficacy of oral liquid supplements in long-term care is dispensing them during the medication pass, although few studies support its effectiveness. This study evaluated the impact of a supplement medication pass program on energy and nutrient consumption and weight in nursing home residents. Findings indicate that residents maintained their prestudy weight and had a 29% decrease in supplement energy intake, a 19% increase in food energy intake, and a 17% decrease in net energy intake (supplement plus food). Supplement and food protein intake remained stable. Over longer periods, this reduced energy consumption could lead to weight loss, so routine monitoring and periodic evaluations of resident intake (both food and supplement) are recommended to ensure residents are receiving and consuming adequate amounts of daily energy and nutrients.     

Food intake and nutritional status of hospitalised older people

de oliveira m.r.m. & leandro‐merhi v.a. (2011) Food intake and nutritional status of hospitalised older people. International Journal of Older People Nursing 6 , 196–200 doi: 10.1111/j.1748‐3743.2010.00227.x Background and aims. Disease is influenced by the nutritional status of the individual. We have assessed the relationship between nutritional status and food intake among recently hospitalised older people. Methods. A cross‐sectional study was undertaken with 240 older people in a hospital that provides care for the public and private healthcare systems. Nutritional status was classified by the MNA (Mini Nutritional Assessment) into: malnourished, risk of malnutrition and without malnutrition. Food intake was estimated by the reported food intake during a typical day. The Kruskal–Wallis test was used to compare the medians and the correlation coefficient of Spearman to verify the relationship between the consumption of energy, protein and vitamin C and MNA scores. Results. 33.8% were classified as adequate regarding nutritional status; 37.1% were classified as being at risk of malnutrition and 29.1% were classified as malnourished. The malnourished individuals reported significantly less energy and nutrient intake than those at risk of malnutrition or those without malnutrition (P = 0.001). Not all nutrient intake, just some (iron, cholesterol and fibre), were lower in malnourished people. Conclusions and implications for practice. Deterioration of the nutritional status of older people is accompanied by a reduction in energy and some nutrient intake. The investigation of food intake in older people could provide important information about nutritional risk.