单纯性肥胖儿童营养调查

对南京某小学31名单纯性肥胖儿童和327名正常体重儿童进行了营养调查。结果表明：肥胖儿每日食物摄入量比对照组多174．5克，各种营养素和热能摄入量也高于对照组，热能超标659千卡／（人·日），且晚餐热能比重过大。过多的营养素和热能显然促进了肥胖的发生和发展。建议肥胖儿调整膳食结构，减少膳食中动物性食物，特别是高热能食物的摄入，同时适当补充含钙食物。     

托幼儿童身长体重及营养素摄入水平的研究:四年系统观察

1979～1983连续四年观察了两个全托托儿所和一个全托幼儿园儿童的身长、体重及膳食营养状况。结果表明,到1982年时,儿童身长、体重在标准均值以上的人数均超过50％,托儿所儿童能量及蛋白质的摄入量加上零食中的含量能达到供给量标准。各类食物摄入量也能达到或超过北京市推荐的托儿所儿童参考食物量标准。幼儿园儿童营养素的摄入量与供给量比较都偏低,但其生长发育良好,故对该年龄组儿童的营养素供给量应再进行研究。     

大学生膳食营养状况的调查研究

目的：了解大学生膳食营养状况，为指导大学生合理膳食提供理论依据。方法：采用分层整群抽样，分年级随机抽取班级，对所抽取班级学生全部进行调查。结果：大学生营养素及热能摄入量除铁以外均低于供给量标准。热能的食物来源分布合理，营养素来源以及碳水化合物所占比例偏多；蛋白质来源以运动性食品与豆类食品摄入量偏低；早餐的营养素和热能摄入量均明显不足。大学生营养不良率为18.62％，肥胖率为23.97％。结论：大学生营养状况较差，膳食结构不合理。应全面增加各种营养摄入量，合理搭配食物，以提高营养水平。     

农村学龄儿童营养状况调查

本文采用分层整群抽样的方法,调查了陕西省眉县农村10～11岁儿童的营养状况。结果显示:眉县农村85％左右的10～11岁儿童生长发育落后于WHO建议的标准。24小时膳食调查发现,每日膳食摄入量以粮谷类为主,能量摄入量未达到我国标准供给量的60％,未达到WHO建议标准50％。蛋白质摄入量更低,未达到供给量的45％,除铁和维生素C的摄入量较高外,其余营养素的摄入量均未达到供给量的70％。每日三餐热能分配也不合理,表现为早餐热能偏高或偏低,午餐热能不足,晚餐热能偏高的现象。     

北京市儿童青少年食物频率问卷的信度和效度研究

目的 对研制的北京市儿童青少年食物频率问卷的信度和效度进行评价,为儿童青少年营养状况评估和健康干预以及饮食习惯与慢性疾病关联性的研究提供一个简便、可信的研究工具。方法 对北京市130名10~17岁儿童青少年进行4次24 h饮食回顾调查和2次食物频率问卷调查,24- h饮食回顾作为“标准”方法与食物频率问卷比较来评价其效度, 2次间隔6个月的食物频率问卷调查结果相比较来评价其信度。结果 两次食物频率问卷调查结果间能量及营养素摄入量估计差异较小,除蛋白质、磷和锌的摄入量第二次低于第一次外(P<0.05),其他营养素摄入量间差异无统计学意义(P>0.05)。两次食物频率问卷调查结果间所有能量及营养素摄入量均呈正相关(P<0.01),Pearson相关系数从0.315(钙)至0.521(锌),平均为0.431,女性高于男性(0.49 vs 0.32)。食物频率问卷调查的能量及营养素摄入量均高于24 h饮食回顾(P<0.01),食物频率问卷高估明显。调整总能量摄入和个体内变异等影响后,食物频率问卷与24 h饮食回顾调查结果的能量和所有营养素摄入量均呈正相关(P<0.05),Pearson相关系数从0.27(维生素A)至0.53(锌),平均0.38。四分位分组显示:研究对象被良好区分(相同组或相邻组),比例从66.2%(维生素E、钙)至79.2%(铁),平均73.0%,研究对象被严重错分(相隔2组),比例平均为6.2%。结论 此食物频率问卷有较好的信度和效度,可作为今后儿童青少年膳食营养摄入状况调查和评价的适用工具。     

平衡膳食对改善山区学龄儿童营养状况的初步观察

目的研究平衡膳食对山区学龄儿童营养状况的影响。方法2004年11月份在某山区选取二年级小学生60名,分为2组,每周5天在学校进食3餐,干预组根据营养素推荐摄入量配餐,对照组则保持日常膳食模式,实验期为30天,观察实验前后两组儿童营养状况的变化。结果干预组膳食结构合理,营养素供给充足,儿童的体格发育和营养状况得到明显改善,对照组由于膳食结构不合理,营养素摄入量普遍低下,影响了儿童的正常生长发育。结论在贫困地区以食物为基础的营养干预可改善儿童生长发育和营养状况。     

影响学龄儿童热能摄入量各种因素的分析

<正> 热能虽然不是营养素,但它是蛋白质、脂肪和碳水化合物三大产热物质的综合表现,其摄入量不足或过多对儿童生长发育及健康都会造成不良影响。因此,探讨影响儿童热能摄入量的有关因素,对于饮食性营养不良及肥胖症的仿治均有着十分重要的意     

基于价格和营养质量指数的配餐法在南宁市幼儿园膳食管理中的应用

目的 提供一种结合食物价格及营养质量指数的实用方法,以改善幼儿园不合理的膳食。方法 结合当地食物价格,计算INQ指数/食物可食部分价格比值,构建基于价格和INQ指数的食物数据库并指导南宁市3所幼儿园的膳食配餐,干预期为2个月,干预前后分别进行1次膳食调查,计算并分析干预前后幼儿园膳食结构、营养素摄入量和营养素-价格比的差异。结果 干预前,3所幼儿园的膳食结构不合理,儿童的大部分营养素摄入量低于5岁男孩的RNI标准。干预后膳食能量来源结构较干预前有所改善,儿童的营养素量摄入量较干预前均有不同程度增加,除硒和钙外,其余营养素的摄入量均超过了RNI标准,其中干预前后能量、蛋白质、脂肪、核黄素、钙等多种营养素平均摄入量存在统计学差异（P＜0.05）;除幼儿园A的硒元素、B幼儿园的能量、脂肪、碳水化合物和尼克酸及幼儿园C的脂肪外,其余营养素摄入量与食物价格的比值均较干预期有所提高,干预前后视黄醇、核黄素、维生素E、钙等多种营养素的营养素-价格比差异具有统计学意义（P＜0.05）。结论 基于价格及营养质量指数的配餐法科学准确、简单实用,可在不显著增加经费支出情况下明显改善幼儿园膳食质量。     

南京市学龄前儿童营养调查

为了解与改进学龄前儿童的营养状况,对南京市五所幼儿园1000名2～5岁的儿童进行营养调查。结果表明,各年龄组儿童热能、蛋白质和大部分营养素的摄入量均接近或超过了全天RDA的50％,但也存在某些营养素摄入量明显不足。如钙的摄入量四个年龄组分别为RDA的15.8％、11.7％、12.2％和13.1％;锌的摄入量为RDA的35.1％、36.4％、37.5％和38.0％;VC、VB_1和VB_2的摄入量略显不足。儿童中Caup指数在10～13的占2.0％,在13～15的占29.3％,血红蛋白在110g/L以下者占34.6％。     

无锡市崇安区某幼儿园儿童生长发育及膳食营养状况

目的了解无锡市崇安区某幼儿园儿童生长发育及膳食营养状况。方法采用记账法和称重法对崇安区某幼儿园3~6岁711名儿童进行5天膳食调查,分析其食物和营养素摄入情况。同时根据儿童身高、体重测量结果评价其生长发育状况。结果 711名幼儿园儿童中,消瘦占11.25%,超重占13.50%,肥胖占7.59%;奶类及制品摄入严重不足,禽畜肉类摄入量过高。平均能量摄入量超过中国居民膳食能量需要量(EER),钙摄入不足,蛋白质、碳水化合物及其他营养素均过剩。结论该园儿童营养摄入不均衡,营养问题以超重和肥胖为主,需要调整和优化膳食结构,促进儿童健康成长。     

Evaluation of nutritional adequacy of the food intake in an Integrated Center of Public Education (CIEP)

The paper's general objective is to evaluate the nutritional adequacy of the food consumed in an Integrated Center of Public Education in the city of Americana, state of Sao Paulo. The data on food consumption in the city of seven to 15 years old was obtained through a recordatory inquiry. To transform the food consumption in energy and nutrients intake a food composition table was used. The establishment of nutritional recommendations was based in the defined standard for the Brazilian population. It was verified that the food consumption is insufficient to attend the energy requirements of children of eight years old or older. It was shown that the protein intake is much higher than the requirements. For all ages, the iron intake is adequated. It is also shown that school meals contribute with 72% of vitamin C requirement. The paper stress that the school meals program should be based on previous diagnoses of the nutritional status of the target population and the food consumption at home.     

Fortified Foods Are Major Contributors to Nutrient Intakes in Diets of US Children and Adolescents

BackgroundEven in an era of obesity and dietary excess, numerous shortfall micronutrients have been identified in the diets of US children and adolescents. To help tailor strategies for meeting recommendations, it is important to know what foods contribute greatly to micronutrient intakes. Data are lacking on specific contributions made by added nutrients.ObjectiveOur aims were to examine the impact of fortification on nutrient adequacy and excess among US children and adolescents and to rank food sources of added nutrient intake and compare rankings with those based on total nutrient intake from foods.Design and statistical analysesData were from 7,250 respondents 2 to 18 years old in the National Health and Nutrition Examination Survey 2003-2006. Datasets were developed that distinguished nutrient sources: intrinsic nutrients in foods; added nutrients in foods; foods (intrinsic plus added nutrients); and total diet (foods plus supplements). The National Cancer Institute method was used to determine usual intakes of micronutrients by source. The impact of fortification on the percentages of children having intakes less than the Estimated Average Requirement and more than the Upper Tolerable Intake Level was assessed by comparing intakes from intrinsic nutrients to intakes from intrinsic plus added nutrients. Specific food sources of micronutrients were determined as sample-weighted mean intakes of total and added nutrients contributed from 56 food groupings. The percentage of intake from each grouping was determined separately for total and added nutrients.ResultsWithout added nutrients, a high percentage of all children/adolescents had inadequate intakes of numerous micronutrients, with the greatest inadequacy among older girls. Fortification reduced the percentage less than the Estimated Average Requirement for many, although not all, micronutrients without resulting in excessive intakes. Data demonstrated the powerful influence of fortification on food-source rankings.ConclusionsKnowledge about nutrient intakes and sources can help put dietary advice into a practical context. Continued monitoring of top food sources of nutrients and nutrient contributions from fortification will be important.     

Fortification masks nutrient dilution due to added sugars in the diet of children and adolescents

High intakes of added sugars have often been suspected of lowering nutrient density, especially in the diet of children and adolescents. Because fortified foods, which currently contribute considerably to the intake of vitamins and minerals, are often also sweetened with added sugars, they could counteract this nutrient dilution. Data from the DOrtmund Nutritional and Anthropometric Longitudinally Designed (DONALD)-Study were used to assess the effects of added sugars, fortified food and energy intakes, time and age on nutrient densities. A total of 4993 3-d weighed dietary records from 849 children and adolescents 2-18 y old, collected between 1985 and 2001 were analyzed using a mixed linear model, in which the means of the data and the covariance structure specific to the DONALD-Study was modeled. In general, nutrient densities in the diets of children and adolescents were above recommended nutrient densities. Added sugars intake [in percentage of energy intake (E%)] was positively associated with energy intake (MJ/d; P < 0.05) and intake of fortified food (E%; P < 0.0001). Positive effects of fortification on nutrient densities (usually P < 0.0001) exceeded the negative effects of added sugars intake (usually P < 0.01) for most nutrients, in some cases even twofold. Associations between energy intake and nutrient densities were negative and, with the exception of thiamin in 2- to 3-y-olds, statistically significant. Time and age trends were heterogeneous. Our data did not show significant nutrient dilution because of added sugars. The positive effect of fortification on nutrient densities was greater than the negative effect of added sugars. Therefore, fortification should more often be considered in dietary analyses.     

Growth of preschool children was improved when fed an iron-fortified fermented milk beverage supplemented with Lactobacillus acidophilus

Food fortification is an efficient strategy applied to overcome iron deficiency anemia. This study investigated the effect of iron fortification with probiotic bacteria in a milk beverage on growth and iron status of preschool children with a usually low–bioavailable-iron diet intake. The fermented milk beverage was fortified with iron amino acid chelate (3 mg iron per 80 mL) and supplemented with Lactobacillus acidophilus (test) or not (control). The beverage was fed to 190 children aged 2 to 5 years for a duration of 101 days. Anthropometric, hematologic, and nutritional assessments were carried out before and after the intervention. The levels of red blood cells, hemoglobin, and hematocrit decreased (P < .001) in both groups (test and control) but remained within the reference range. The children fed the probiotic milk beverage exhibited higher red blood cell status and a positive correlation between iron intake and hemoglobin. An increased serum ferritin level was observed in the control group (P < .001). Nutritional status was improved after intervention in both groups by comparing the indices of weight for age and height for age. However, no difference was observed in the weight for height index in these groups. Energy and nutrient intake increased (P < .001) with intervention, and the prevalence of inadequacy was reduced. The fortified beverage contributed to improved nutrient intake and nutritional status of the preschool children. The higher demand and mobilization of nutrients to offset growth may have contributed to maintain blood parameters at borderline levels.     

Iron Nutrition in Schoolchildren of Western Mexico: The Effect of Iron Fortification

In Mexico, food fortification is used as a strategy to combat micronutrient deficiencies. However, little is known about the effects of food fortification in vulnerable populations. This study was carried out in a population of school children believed to be at risk of various micronutrient deficiencies, including iron. The study aimed at determining iron status of children, and identifying and quantifying the sources of iron intake and the presence of relevant enhancers and inhibitors of iron absorption in the diet. The iron status and dietary iron intake was assessed of schoolchildren aged 3–14 years in western Mexico. Hemoglobin, serum ferritin, and transferrin saturation percentages were used to evaluate the iron status in a school-based sample of 762 children. Dietary data were collected from 607 children using semi-quantitative food frequency questionnaires. The overall prevalence of anemia and iron deficiency was 3.7% and 4%, respectively. Iron intake ranged from 1.9 to 3.3 times the recommended daily allowance, with fortified iron accounting for 72% of the total iron intake. Although iron fortification of staples such as maize flour in Mexico for more than a decade most likely contributed to reducing the prevalence of anemia and iron deficiency, the relatively large amounts of iron consumed could eventually lead to problems related to excessive iron intake in some children. Nutritional guidelines for iron fortification in Mexico should be defined and put into practice.     

Iron Nutrition in Schoolchildren of Western Mexico: The Effect of Iron Fortification

In Mexico, food fortification is used as a strategy to combat micronutrient deficiencies. However, little is known about the effects of food fortification in vulnerable populations. This study was carried out in a population of school children believed to be at risk of various micronutrient deficiencies, including iron. The study aimed at determining iron status of children, and identifying and quantifying the sources of iron intake and the presence of relevant enhancers and inhibitors of iron absorption in the diet. The iron status and dietary iron intake was assessed of schoolchildren aged 3-14 years in western Mexico. Hemoglobin, serum ferritin, and transferrin saturation percentages were used to evaluate the iron status in a school-based sample of 762 children. Dietary data were collected from 607 children using semi-quantitative food frequency questionnaires. The overall prevalence of anemia and iron deficiency was 3.7% and 4%, respectively. Iron intake ranged from 1.9 to 3.3 times the recommended daily allowance, with fortified iron accounting for 72% of the total iron intake. Although iron fortification of staples such as maize flour in Mexico for more than a decade most likely contributed to reducing the prevalence of anemia and iron deficiency, the relatively large amounts of iron consumed could eventually lead to problems related to excessive iron intake in some children. Nutritional guidelines for iron fortification in Mexico should be defined and put into practice.     

风险分析在食品强化管理中的应用

目的为完善我国食品强化政策法规,修订食品营养强化剂标准提供参考和依据。方法研究风险分析在国际及国外一些国家食品强化管理中的应用状况,按照风险分析的3个组成部分分别阐述食品强化管理中风险评估、风险管理和风险交流的特征及关键因素。结果营养素风险评估需同时考虑改善营养不足及防止营养过量,应根据营养素安全范围间距划分风险等级,进行分类管理。制定食品强化法规标准时,不应局限于针对单一营养素的评价,还要评估食品强化对膳食及疾病模式的影响。结论鉴于我国居民营养状况、膳食结构十分复杂,建议根据国情按照风险分析方法调整和完善食品强化政策和标准,指导食品工业界的研发,提高消费者的营养认知水平。     

江苏省居民食物结构与营养水平调查研究

通过食物消费量计算和抽样膳食调查进行了江苏省居民膳食结构与营养水平的研究。结果表明:80年代中期是本省在总体上解决温饱问题的转折点;但动物性食物的消费量尚处于较低水平。食物消费量计算较膳食调查结果人均日粮食摄取量高约70g,动物性食物低近18g,因而能量与营养素摄取量也不尽相同,而能量与蛋白质的动物性来源则膳食调查高于食物消费量计算约4％。认为调查结果更符合实际,表现了膳食结构处于调整阶段的倾向,但营养素摄取仍不够平衡。食物摄取与营养水平城乡间差别明显,县际间也有较大差别。健康水平有提高,体格测量结果与营养水平的关系尚难确定。建议适当提高动物性食物和豆类的摄取,但动物性脂肪不宜过高。据此提出了江苏省居民2000年的食物结构设想,并应根据各地不同情况区别要求。另外对膳食结构的DDP评分方法也进行了初步讨论。     

Nutritional Adequacy and Diet Quality Are Associated with Standardized Height-for-Age among U.S. Children

Nutritional status affects linear growth and development. However, studies on the associations between nutritional status, diet quality, and age-standardized height in children are limited. The aim of this study was to assess the relationship between macro- and micronutrient intake and food consumption and height-for-age Z score (HAZ) among US children in the National Health and Nutrition Examination Survey (NHANES). This cross-sectional population-based study included 6116 US children aged 2–18 years. The usual dietary intake of nutrients and food groups was estimated by the multiple source method (MSM) using two-day food consumption data from NHANES 2007–2014. After adjusting for covariates, HAZ was positively associated with intakes of energy, protein, carbohydrate, fat, vitamins A, D, E, B6, and B12, thiamin, riboflavin, niacin, calcium, and iron. Children in the highest tertile of HAZ were less likely to consume lower than the EAR for vitamin E and calcium. Major foods consumed by children with lower HAZ were soft drinks, high-fat milk products, cakes, cookies, pastries, and pies, whereas children with higher HAZ tended to consume low-fat milk products, tea, and low-calorie fruit juice. These findings suggest that adequate nutritional intake, diet quality, and nutrient-dense food are important factors for height in children.     

Childhood Nutrition in Rural China: What Impact Does Public Health Insurance Have?

ObjectivesTo investigate the impact of public health insurance coverage, specifically the New Cooperative Medical Scheme (NCMS), on childhood nutrition in poor rural households in China, and to identify the mechanisms through which health insurance coverage affects nutritional intake.MethodsLongitudinal data on 3291 children were taken from four time periods (2004, 2006, 2009, and 2011) from the China Health and Nutrition Survey (CHNS). Panel data analysis was performed with the fixed-effect model and the propensity score matching with difference-in-differences (PSM-DID) approach.ResultsThe introduction of the NCMS was associated with a decline in calories, fat, and protein intake, and an increase in the intake of carbohydrates. The NCMS had the greatest negative effect on children aged 0 to 5 years, particularly girls. Out-of-pocket medical expenses were identified as the main channel through which the NCMS affected the nutritional intake of children.ConclusionsThe study showed that the NCMS neither significantly improved the nutritional status of children nor enhanced intake of high-quality nutrients among rural poor households. These findings were attributed to the way in which health-seeking behavior was modified in the light of NCMS coverage. Specifically, NCMS coverage tended to increase healthcare utilization, which in turn increased out-of-pocket medical expenditures. This encouraged savings to aid financial risk protection and resulted in less disposable income for food consumption.