1989-2009年中国九省区居民膳食营养素摄入状况及变化趋势(二)18-49岁成年居民膳食能量摄入状况及变化趋势

目的分析九省区18-49岁居民能量摄入状况及其变化趋势,为中国居民能量参考摄入量修订和相应的膳食指导提供依据。方法以"中国健康与营养调查"项目1989-2009年间8次调查中有膳食调查资料的18-49岁调查对象作为研究对象。使用SAS9.2软件对数据库资料进行统计分析。结果 2009年九省区18-49岁男女性成年居民的能量摄入[kJ/d(kcal/d)]分别为10277.6(2456.4)和8539.1(2040.9)。其中城市、郊区、县城和农村男性成年居民的能量摄入[kJ/d(kcal/d)]分别为9707.3(2320.1),10022.8(2395.5),9876.3(2360.5)和10632.8(2541.3);女性分别为7923.7(1893.8),8120.7(1940.9),8340.0(1993.3)和8909.0(2129.3)。能量的食物来源以谷类食物为主,尤其是农村成年居民,约占总能量的57.7%。蛋白质、脂肪和碳水化合物供能比分别为15.1%、31.4%和53.5%。其中,城市、郊区、县城和农村成年居民的脂肪供能比分别为36.0%、33.7%、32.19%和29.2%,1989-2009年我国成年居民能量摄入呈现出总体下降的趋势,能量摄入从高到低依次为农村、郊区、县城、城市,以郊区降低最明显,20年间减少1966.1 kJ/d(469.9 kcal/d)。结论 2009年我国九省区18-49岁成年居民能量摄入较前有较大幅度减少,脂肪供能比显著增加,使肥胖及膳食相关慢性病的高危人群增加。其原因可能在于动物性食物和食用油摄入的增加,值得重点关注。在修订能量参考摄入量和制订膳食指导原则时,应充分考虑我国的经济发展水平及不同地区的人群膳食消费特点。     

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。     

1991-2009年中国九省区膳食营养素摄入状况及变化趋势(四) 50-79岁居民蛋白质摄入状况及变化趋势

目的分析九省区50-79岁居民蛋白质摄入状况及其变化趋势。为营养政策制定和中国居民蛋白质参考摄入量修订提供依据。方法以1991-2009年"中国健康与营养调查"项目中有膳食调查资料的50-79岁调查对象作为研究对象。使用SAS9.2软件对数据库资料进行统计分析。结果 1991-2009年50-79岁居民平均每天蛋白质的摄入量呈现出下降的趋势,男性和女性平均每天蛋白质摄入量分别共下降了4.3g和5.5g。2009年男性和女性平均每天蛋白质的摄入量分别达到70.4g/d和60.9g/d。平均每天动物性食物提供蛋白质的量在男性和女性中分别增加了6.5g和4.8g,动物性食物提供蛋白质的比例相应提高了约10%,2009年动物性食物提供蛋白质的比例接近30%。豆类以外的植物性食物提供蛋白质的量在男性和女性中分别减少了9.8g和9.6g,其所提供蛋白质的比例相应下降了10个百分点。豆类食物提供的蛋白质的量相对稳定。由于平均每日蛋白质摄入总量的减少,男性和女性蛋白质摄入量低于蛋白质平均需要量(EAR)的比例呈现逐年增加的趋势,男性和女性分别增加了12.2和15.9个百分点,2009年有37.9%的男性和40.1%的女性蛋白质的摄入量低于EAR。结论 1991-2009年中国九省区50-79岁居民平均每日蛋白质摄入量呈下降趋势,但是随着膳食结构的改变,优质蛋白质摄入量增加,蛋白质质量提高。在修订50岁以上人群蛋白质参考摄入量时,应充分考虑在经济发展过程中居民膳食结构的改变。     

1991—2015年中国九省(自治区)老年居民膳食能量及宏量营养素摄入状况

目的分析中国九省(自治区) 60岁及以上老年人能量及宏量营养素摄入的变化趋势。方法利用"中国健康与营养调查"1991—2015年九轮随访调查中的膳食数据,采用多阶段分层整群随机抽样方法抽取60岁及以上的老年人作为研究对象。采用连续3天24小时膳食回顾法和家庭称重记账法(食用油和调味品)收集膳食资料,借助食物成分表将食物消费量转换成能量及各类营养素摄入量。结果2015年中国九省(自治区)老年人能量摄入量为1706. 8 kcal/d,蛋白质、脂肪和碳水化合物的平均摄入量分别为52. 2、61. 4和219. 3 g/d,其供能比分别为12. 3%、33. 3%和53. 0%。与1991年相比,能量、蛋白质、碳水化合物摄入量分别下降了352. 3 kcal/d、11. 5 g/d和89. 8 g/d。脂肪供能比上升了9. 0%,碳水化合物的供能比下降了8. 7%,蛋白质供能比无明显变化趋势。2015年,老年人蛋白质、碳水化合物摄入量均存在城乡差异,高收入老年人的蛋白质和脂肪摄入量较高,碳水化合物摄入量则较低。谷类食物、其他食物、食用油分别为能量、蛋白质、脂肪的主要来源。结论中国九省(自治区)老年人需要适当增加能量摄入,降低脂肪摄入。通过食物替代的方法,指导农村及低收入的老年人选择更加经济和可及性更好的食物,满足自身营养需求,并应关注城市和高收入老年人动物性食物摄入过多可能导致的血脂变化。     

1991-2009年中国九省区膳食营养素摄入状况及变化趋势(十) 7～17岁儿童青少年膳食锌的摄入状况及变化趋势

目的了解1991-2009年中国九省区儿童青少年膳食锌的摄入状况、食物来源以及变化趋势。方法利用"中国健康与营养调查"的资料,选取1991、1993、1997、2000、2004、2006和2009年7轮调查中的7～17岁儿童青少年为对象,采用连续3 d 24 h膳食回顾询问法收集膳食资料。结果中国九省区儿童青少年平均每日锌摄入量从1991年的10.4mg下降到2009年的9.1mg。1991年和2009年中国九省区儿童青少年膳食锌摄入量低于平均需要量(EAR)的比例分别为66.6%和79.6%。膳食锌主要来源于谷类食物、动物性食物、坚果和蔬菜水果。结论我国儿童青少年人群中普遍存在锌摄入不足的问题,需要进行适当干预以增加膳食锌摄入量。[营养学报,2013,35(2):131-133]     

邯郸市居民膳食摄入及膳食结构状况分析

目的了解邯郸市居民膳食摄入及膳食结构状况,为指导当地居民合理膳食,提高营养水平和促进健康提供科学依据。方法采用多阶段分层与人口成比例的整群随机抽样方法,以家庭为单位进行入户调查,利用3d24h膳食回顾和3d全家称重数据,用Excel建立数据库,用SPSS17.0统计软件进行数据分析。结果邯郸市居民膳食摄入以谷类为主,平均标准人日谷类食物摄入量440.9g,水果摄入量34.9g,奶及其制品摄入量52.6g,食用油、盐平均摄入量分别为43.2和11.7g。每标准人日摄入能量为8369.2kJ,蛋白质标准人日摄入量为60.9g;脂肪为85.5g,膳食纤维为11.4g。谷类食物提供的能量占总能量的47.8%,来源于脂肪提供的能量比例为37.9%。结论邯郸市居民膳食摄入以谷类为主,蔬菜和水果摄入明显不足,油、盐摄入相对较高,脂肪摄入高于全国水平,脂肪供能比超出建议范围,膳食结构不合理。相关部门应加强宣传与干预,倡导正确的平衡膳食理念。     

1991～2009年中国九省区中老年居民膳食脂肪与胆固醇摄入状况及变化趋势

目的研究中国九省区中老年居民1991～2009年膳食脂肪和胆固醇的摄入状况及变化趋势。方法从"中国健康与营养调查"资料中选取1991、1993、1997、2000、2004、2006和2009年7轮调查50岁及以上的健康调查对象作为研究对象,计算人群平均每日的脂肪摄入量、胆固醇摄入量和脂肪供能比,并与中国居民膳食脂肪适宜摄入量进行比较。结果 1991～2009年,九省区中老年居民脂肪摄入量和胆固醇摄入量增加,脂肪供能比不断提高,至2009年男性中老年居民已达到81.9g/d、270.8mg/d和31.8%,女性中老年居民已达到70.4g/d、238.5mg/d和32.2%;脂肪供能比超过30%以及胆固醇平均摄入水平超过300mg/d的人群比例显著增加,至2009年男性中老年居民已达到54.7%和35.8%,女性中老年居民已达到56.9%和29.8%。结论 1991年以来中国九省区城乡中老年居民膳食结构发生了显著的变化,居民脂肪供能比以及胆固醇摄入量已超过或接近中国居民膳食脂肪参考摄入量的要求,应控制含脂肪和胆固醇高的食物的摄入量。     

1989-2009年中国九省区膳食营养素摄入状况及变化趋势(五)18-49岁成年居民膳食脂肪与胆固醇摄入状况及变化趋势

目的研究我国九省城乡居民1989~2009年膳食脂肪和胆固醇的摄入状况及变化趋势,为进行合理的膳食指导提供基础性资料。方法利用"中国居民健康与营养调查"的资料,选取1989、1991、1993、1997、2000、2004、2006、2009年八轮调查中18~49岁的健康成年居民作为研究对象,计算人群平均每日的脂肪摄入量、胆固醇摄入量、脂肪供能比和脂肪食物来源,并与中国居民膳食脂肪适宜摄入量进行比较。结果 1989~2009年,我国九省居民脂肪摄入量和胆固醇摄入量增加,脂肪供能比不断提高,至2009年成年男性已达到85.9g/d、291.1mg/d和31.1%,成年女性已达到72.4g/d、263.7mg/d和31.7%;脂肪供能比超过30%以及胆固醇平均摄入水平超过300mg/d的人群比例显著增加,至2009年成年男性已达到54.3%和40.5%,成年女性已达到55.6%和34.1%。结论我国九省城乡居民膳食结构发生了显著的变化,居民脂肪供能比以及胆固醇摄入量已超过或接近中国居民膳食脂肪参考摄入量的要求,应控制含脂肪和胆固醇高的食物的摄入量。     

1991—2009年中国9省（自治区）中老年人膳食锌的摄入状况及变化趋势

目的描述1991—2009年中国9省（自治区）50～79岁中老年人膳食锌的摄入状况、食物来源以及变化趋势。方法利用＂中国健康与营养调查＂的资料,选取1991、1993、1997、2000、2004、2006和2009年调查中50～79岁中老年人作为研究对象,采用连续3天24小时膳食回顾询问法收集膳食资料。结果中国9省（自治区）中老年人平均每日锌摄入量从1991年的11.0 mg下降到2009年的10.6 mg。在4类地区中,郊区人群减少得最多（0.7 mg）。1991年和2009年中国9省（自治区）中老年人膳食锌摄入量达到推荐摄入量（RNI）的比例分别为40.5%和35.8%。1991—2009年,男性中老年人膳食锌摄入量低于60%RNI的比例增长了56.9%,女性中老年人增长了89.2%。膳食锌主要来源于谷类食物、动物性食物、坚果和蔬菜水果。结论我国中老年人群中存在锌摄入不足的问题,应该引导中老年人增加摄入富含锌的食物,以维持锌营养需求与健康状况。     

中国居民膳食能量、蛋白质、脂肪的来源构成及变化

目的:分析中国居民膳食能量、蛋白质、脂肪结构现状及变化趋势。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。膳食调查采用连续3d24h回顾法,调味品消费量采用“称重法”。样本:全国31个省132个县23470户,其中城市7687户,农村15783户,调查人数为68962人。结果:我国居民每标准人日能量摄入9.42MJ(2250.5kcal)。20年来呈下降趋势。蛋白质与脂肪提供能量比例分别为11.8%与29.6%,大城市的脂肪供能比达到了38.4%。从能量的食物来源看,谷类占总能量的57.9%,动物性食物占12.6%,纯热能食物为17.3%。蛋白质摄入量为65.9g,粮谷类占52%,豆及豆制品占7.5%,动物性食物占25.1%,其它食物占15.3%。膳食脂肪摄入为76.3g,39.2%来源于动物性食物。结论:由于我国处于经济转型期,居民的膳食特点是能量摄入量下降;谷类供能比下降;蛋白质摄入量下降;脂肪摄入量,特别是动物性食物提供的脂肪上升。脂肪提供的能量增加。     

The relationship of eating frequency and caloric density to energy intake among rural Mexican preschool children

The energy intake of children in a population characterized by chronic malnutrition was measured in order to examine the effects of eating frequency and caloric density. Forty-five children aged 33-60 months were each observed continuously throughout one day. Food intake was determined by weighing and all aspects of food-related behavior were recorded. The children ate on average 13.5 +/- 4 times each day. Children who ate more frequently had significantly higher energy intake than children who ate fewer than 13 times [1655 vs. 1395 kcal (6928 vs. 5839 kJ)], and the excess was consumed during snacks. The caloric density of all foods consumed averaged 121 kcal (507 kJ) per 100 g. While children served meals of low caloric density [less than 100 kcal (419 kJ) per 100 g] consumed less energy at meals than did other children [709 vs. 900 kcal (2968 vs. 3767 kJ)], they consumed more energy from snacks [917 vs. 617 kcal (3839 vs. 2583 kJ]. Thus, total energy intake did not differ significantly between children served meals of lower vs. higher caloric density.     

Child-care environment and dietary intake of 2- and 3-year-old children

Background:  Previous research has shown that children in child-care do not comply with dietary intake recommendations (i.e. either exceeding or not meeting recommendations), which may be attributable to specific features of the child-care environment. The present study explored the relationship between the social and physical child-care (day-care) environment and dietary intake of 2- and 3-year-olds in Dutch child-care centres.
Methods:  The dietary intake of 135 children, aged 2 and 3 years, who were in child-care was assessed by observing randomly selected children at three meals (morning snack, lunch and afternoon snack) to determine dietary intake (i.e. saturated fat, dietary fibre and energy intake). The environment was observed using the Environment and Policy Assessment and Observation checklist, a structured instrument assessing the physical and social environment.
Results:  Children consumed a mean of 486 kJ (116 kcal) during the morning snack, 2043 kJ (488 kcal) during lunch and 708 kJ (169 kcal) during the afternoon snack. There were some gender and age differences in dietary intake. Several environmental factors (e.g. serving style and staff's model dietary behaviour) were significantly associated with the children's dietary intake.
Conclusions:  Overall, energy intake was in the upper range of recommended intake for children in child-care. The associations of several environmental factors with dietary intake stress the importance of the child-care environment for children's dietary behaviour. Intervening in this setting could possibly contribute to the comprehensive prevention of childhood obesity.     

Effects of long-term intervention with low- and high-glycaemic-index breakfasts on food intake in children aged 8-11 years

The aim of the present study was to investigate the effects of long-term intervention of low-glycaemic-index (GI) v. high-GI breakfasts on energy and macronutrient intakes in children aged 8-11 years. Preadolescent children were assigned to one of two groups in a random cross-over design. Each group was given low-GI and high-GI breakfasts on two non-consecutive days per week for 10 weeks per breakfast type. Each breakfast provided approximately 1273 kJ (300 kcal) and was closely matched for macronutrient and dietary fibre content. Subsequent food intake at an ad libitum buffet lunch was recorded and daily energy and macronutrient intakes were measured by 24 h recall and 3 d food diaries. There was a tendency towards a reduced energy intake at lunch following the low-GI breakfast compared with the high-GI breakfast, although the mean difference of 75 kJ (18 kcal) was not significant (P = 0.406). In particular, there was a trend towards a reduced energy intake in the low-GI arm compared with the high-GI arm among boys. In addition, data from the 3 d food diaries showed that there was a tendency towards a reduced energy intake during the low-GI compared with the high-GI study period. In conclusion, although the difference in energy intake following the low-GI and high-GI breakfasts was not statistically significant, the reduced energy intake following the low-GI breakfast is encouraging. Both dietary fibre and carbohydrate type may affect GI, thus their potential and relative modulating effect on appetite requires further investigation.     

Metabolizable energy of diets low or high in dietary fiber from cereals when eaten by humans

The metabolizable energy (ME) of two diets that differed in their content of dietary fiber (DF) from cereal products was measured in balance experiments in six human subjects. DF intake was 19.7 g/d with the low fiber diet and 48.3 g/d with the high fiber diet. Daily gross energy intakes were 2114 kcal (8845 kJ) and 2341 kcal (9795 kJ)/d with the low and the high fiber diets, respectively. DF contributed 83 kcal (347 kJ) and 203 kcal (849 kJ) to daily gross energy intake with the low and the high fiber diets, respectively, when heat of combustion of DF of 4.2 kcal (17.6 kJ)/g was assumed. Increasing the intake of DF resulted in an increase in stool weight and a greater fecal energy loss. Total energy losses were 253 kcal (1056 kJ) and 409 kcal (1711 kJ)/d with the low and the high fiber diets, respectively. ME provided by the low and the high fiber diet were 1861 kcal (7786 kJ) and 1932 kcal (8083 kJ)/d. The total increase in energy losses due to the increase in DF consumption exceeded the gross energy provided by additional DF. Compared with the low fiber diet, ME provided by protein and fat was decreased during the high fiber diet. Calculation of the apparent digestibility of DF indicated that fiber may have provided ME in the form of short-chain fatty acids during the low as well as during the high fiber intake. However, estimation of the amount of fecal gross energy indicated that available components of the diet, such as starch, must have been utilized incompletely during both experimental periods.     

Does a new steam meal catering system meet patient requirements in hospital?

BACKGROUND: It has been consistently observed that a significant proportion of hospital inpatients are malnourished and many actually develop malnutrition in hospital. The NHS provides over 300 million meals each year at a cost of pound 500 million, yet there is relatively little research evaluating how well different catering systems provide for the needs of hospital inpatients. AIM: The aim of the study was to: (i) evaluate whether a new steam meal catering system (Steamplicity) enables patients in theory to meet their energy requirements in hospital and (ii) compare energy and protein intake using Steamplicity with a traditional bulk cook-chill system. METHODS: Patients not at nutritional risk had their food intake at one lunchtime assessed. Energy intake was compared with the patients' energy requirements and energy and protein intake were compared with previous data from a bulk system. RESULTS: Fifty-seven patients had a median daily energy requirement of 7648 kJ (1821 kcal) [inter-quartile range (IQR): 6854-9164 kJ]. Assuming 30% [2293 kJ (546 kcal)] should be supplied by the lunch meal the average intake of 1369 kJ (326 kcal) fell short by 40%. Patients served meals from Steamplicity ate less energy [1369 kJ versus 1562 kJ (326 kcal versus 372 kcal) P = 0.04] but similar protein (18 g versus 19 g P = 0.34) to the bulk system. The largest difference was the energy provided by the dessert since the bulk system served more hot high-calorie desserts. CONCLUSIONS: Patient intakes did not meet their estimated requirements. The patients in this study were eating well and not at nutritional risk, thus patients with a poor appetite will be even less likely to meet their nutritional requirements. Steamplicity meals result in a lower energy intake than meals from a bulk cook-chill system, but similar protein intakes.     

Dietary intake in the diabetes prevention program cohort: baseline and 1-year post randomization

PURPOSE: To describe usual dietary intake assessment at baseline and 1-year post-randomization in the ethnically diverse Diabetes Prevention Program cohort. METHODS: Participants were randomized to Lifestyle Modification, Metformin, or Placebo. Usual diet was assessed by a modified, previously validated food frequency interview. RESULTS: Complete data were available for 2934 subjects (90.7% of those randomized). Baseline median estimated energy intake was 7676 kJ/d (1828 kcal/d) and 8585 kJ/d (2044 kcal/d) for women and men, respectively. The median percent of energy from fat ranged from 30.6% for Asian American men to 37.5% for American Indian men and women. After 1 year among the Lifestyle group, the median change in total energy and percent energy from fat was -1897 kJ/d (-452 kcal/d) and -6.6%, respectively. For the Metformin and Placebo groups, change in median total energy was -1235 kJ/d (-294 kcal/d) and-1051 kJ/d (-250 kcal/d), respectively, and change in median percent energy from fat was -0.8% and-0.8%, respectively (p < 0.001 for differences between groups, adjusted for gender and ethnicity). CONCLUSIONS: One-year post-randomization, significant differences in dietary intake were observed in the Lifestyle compared with the Metformin or Placebo group, and these were consistent with the general intent of the DPP lifestyle modification intervention.     

Validation of food diary method for assessment of dietary energy and macronutrient intake in infants and children aged 6-24 months

OBJECTIVES: To compare the estimated food diary record (ED) method against weighed intake record method (WI) for assessing dietary intake in infants and children aged 6-24 months; additionally, to compare WI with metabolisable energy intake (ME) measured by doubly labelled water (DLW) in infants aged 6 12 months. DESIGN: Cross-over study of 5 day WI vs 5 day ED. SUBJECTS: Seventy-two children aged 6-24 months. METHODS: Subjects were randomly assigned to one method during week 1 crossing over to the alternative method in week 2. Data were coded and translated into daily nutrient intakes using COMP-EAT version 5 nutritional analysis software. The analysis compared energy, protein, fat and carbohydrate. Twenty-one infants were dosed with DLW for measurement of total energy expenditure (TEE) and ME. RESULTS: Mean energy intake calculated from WI and ED was 3,782 and 3,920 kJ/day, respectively. There was no significant difference between these values. Using WI as a reference, ED showed a mean bias of 138 kJ/day, equivalent to 3.6% of mean energy intake. Limits of agreement (+/- 2 s.d. of the bias) were wide at +/- 1,385 kJ/day. There were no significant differences between methods for any of the nutrient sub-classes. Using DLW as a reference, WI showed a mean bias of 243 kJ/day, equivalent to 7.3% of mean energy intake, limits of agreement were wide at +/- 1686 kJ/day. CONCLUSION: There is no evidence from the present analysis that ED is less accurate than WI for assessing energy and nutrient sub-class intakes in groups of this age but this good agreement between methods in groups does not extend to individuals.