2013年中国2岁以下儿童母亲维生素B12营养状况及其影响因素

目的 了解中国2岁以下儿童母亲维生素Bl2营养状况的现状,并分析其影响因素.方法 利用2013年中国居民营养与健康状况监测中2岁以下儿童母亲的调查数据,采用多阶段分层抽样方法抽取中国30个省(自治区、直辖市)的55个县(市/区)2岁以下儿童母亲.最终采集2岁以下儿童母亲血液样本10331份,问卷调查收集其基本情况,通过...     

边远地区儿童维生素A营养状况

【目的】了解边远地区儿童维生素A(vitamin A,VA)状况。【方法】进行眼部临床症状检查、视力情况问卷和血清VA测定。评价标准结膜干燥:任何阶段的结膜干燥性变化;夜盲:日间视力正常而低照明条件下视物困难。维生素A缺乏(VAD):血清VA值≤0.35μmol/L;亚临床维生素A缺乏(SVAD):0.35<血清VA值≤0.70μmol/L;可疑SVAD:0.70≤血清VA值≤1.05μmol/L[2]。VAD公共卫生问题:某地区VAD率>5.0%。SVAD公共卫生问题:轻度某地区夜盲率<1.0%,且2.0%≤SVAD率≤10.0%。中度1.0%≤某地区夜盲率<5.0%,且10.0%≤SVAD率<20.0%。【结果】儿童结膜干燥和夜盲率均为0.1%。以血清VA含量判断VAD、SVAD、可疑SVAD患病率分别为0.7%、11.7%、39.2%。广西、青海、内蒙、新疆、云南、贵州六省儿童SVAD患病率均>10%。SVAD患病率随所在地区海拔高度的增加而增高。儿童血清VA均值为(1.06±0.33)μmol/L,以广西最低。血清VA水平随其所在地区海拔高度的增加而降低。新疆的托克逊、青海的民和、贵州的普定和遵义、广西的贵港、内蒙的包头和依金霍格旗存在不同程度的VAD和SVAD公共卫生问题。【结论】边远贫困地区是我国VAD和SVAD公共卫生问题的重点地区,应给予干预。     

不同地区乳母膳食状况调查

本研究对我国7个地区产后1～6个月的1 013名乳母进行了膳食调查。结果表明,各地区乳母产后一个月内动物性食物的摄取量较高,平均为349g,蛋白质摄取量为97 g,但维生素C的摄入量只有32 mg。从产后第2个月开始乳母蛋白质摄取量达不到RDA值。各月组乳母的热能摄入量基本相同,平均为每天9 753 kJ。所有被调查乳母膳食中最显不足的是钙、锌和核黄素。各地区同一月组乳母营养素摄取量间有很大差别。     

Evaluation of vitamin B12 status in Egypt IV: Food consumption patterns among lactating mothers and their impact on the intake of the vitamin

The adequacy of vitamin B₁₂ intake was assessed among 62 lactating mothers in the 2–32 weeks of lactation by an interactive 24-h recall and an open-ended food frequency questionnaire. Double portions of the foods consumed were sampled and assayed microbiologically for its vitamin B₁₂ content. Based on the food item and its respective vitamin B₁₂ content, combined with the usual portion size in grams and the frequency of consumption, a rapid calculator of approximate dietary vitamin B₁₂ intake was developed. The estimated vitamin B₁₂ intake averaged 4.17±0.74?µg/d. Only 25.8% of the lactating mothers had adequate vitamin B₁₂ intake (>2.5?µg vitamin B₁₂ daily). Three quarter of the studied population were consuming vitamin B₁₂<2.5?µg/d. Out of those, 50% had estimated daily intake <2.0?µg/d. This percentage prevalence confirms the additional burden on the lactating mothers to satisfy the daily vitamin B₁₂ requirement for its breast-fed baby.     

Vitamin A Nutritional Status of Urban Lactating Chinese Women and Its Associated Factors

We aimed to investigate dietary vitamin A (DVA) intake, serum vitamin A (SVA) concentrations, and breast milk vitamin A (BMVA) concentrations of urban lactating Chinese women and explore the associated factors. We recruited 326 lactating women from ten cities in China and collected their dietary information, blood samples, and breast milk samples. SVA and BMVA were assessed with high-performance liquid chromatography. Mann–Whitney U tests, Kruskal–Wallis H tests, Chi-square tests, Spearman correlation tests, and multiple regression analyses were conducted. The median (25th, 75th) of DVA, SVA and BMVA were 372.36 (209.12, 619.78) μg RAE/day, 1.99 (1.71, 2.35) μmol/L, and 1.67 (1.13, 2.15) μmol/L, respectively. Only 3.1% of lactating women met the recommended nutrient intake of Vitamin A (VA), and 20.6% had a BMVA level below 1.05 μmol/L. Compared to underweight or normal weight women, overweight or obese lactating women had lower DVA and BMVA but higher SVA (p = 0.022; p = 0.030; p = 0.003). Multiparous women had a higher risk of inadequate BMVA (p = 0.023) than primiparous women. SVA and BMVA were positively associated with DVA, especially for lactating women not using VA supplements (β = 0.174, 95%CI = 0.025, 0.324, p = 0.022; β = 0.501, 95%CI = 0.208, 0.795, p = 0.001). There was no association between SVA and BMVA (β = 0.165, 95%CI = −0.037, 0.366, p = 0.109). In conclusion, VA nutritional status among Chinese urban lactating women needs more attention, especially for those who are obese, overweight, or higher parity. Increased DVA may contribute to increased BMVA.     

Nutritional status and dietary intake of lactating Yoruba mothers in Nigeria

A study was conducted into the nutritional status and dietary intake of 100 lactating Yoruba mothers in Nigeria. The group included 75 rural and 25 urban women, all from lower socioeconomic groups. All the mothers had given birth to singleton babies and fully breast fed their infants. Energy inadequacy ranged between 82-83% while protein inadequacy varied from 78-91%. Urban women were lower in both categories. Compared to the recommended allowance, the mean daily intake of iron, thiamin and calcium was found to be adequate and the intake of vitamin A was high. Mean energy, protein, riboflavin, and ascorbic acid intakes were inadequate. Results generally agree with those from other developing countries. The mothers were generally healthy and the weights of their infants were found to be satisfactory. Most of the mothers were maintaining a satisfactory lactation performance. The contribution of supplemental food for the infants was judged insignificant.     

2002年与2007年江苏省居民膳食维生素A摄入比较

目的比较2002年与2007年江苏省居民膳食维生素A摄入状况的变化情况。方法资料来源于2002年和2007年江苏省居民营养与健康状况调查数据,分析采用SAS8.0统计软件。结果2007年江苏省居民每标准人日视黄醇当量摄入量为766.9μg,其中男性为798.3μg,女性为743.1μg;城市为738.8μg,农村为776.0μg。相比2002年有明显的升高,RNI达标人群的比例由16.1%上升为39.0%。其中男性为798.3μg,女性为743.1μg;城市为738.8μg,农村为776.0μg。地区差异依然存在,与居民经济收入成正相关。苏北城市与农村的膳食维生素A摄入量分别低于苏南城市与农村;城市各年龄组女性膳食维生素A摄入量低于同龄组男性。与2002年相比,2007年视黄醇当量摄入的蔬菜水果来源有所增加,动物性食物来源有所下降。结论江苏省居民维生素A视黄醇当量摄入状况有了较大程度的改善,但仍需要加强对低收入人群、城市女性以及苏北地区摄入状况的改善。     

补充富含类胡萝卜素的蔬菜对儿童维生素A营养状况的影响

于１９９６年９月～１２月在山东省泰安市某幼儿园的两个班使用富含类胡萝卜素的蔬菜进行了干预试验。所选择两个班４１名儿童的平均年龄为５．３～６．５岁,其中３９％的儿童血清视黄醇低于０．３０ｍｇ／Ｌ,处于边缘缺乏状态。分为２个组：对照组,不改变日常膳食,平均每日每人摄入１９３ｇ浅色蔬菜（圆白菜、大白菜、土豆、黄瓜、菜花和白萝卜等）和５６ｇ黄绿色蔬菜（菠菜、空心菜、胡萝卜和红心红薯等）;试验组,平均每日每人摄入２３８ｇ黄绿色蔬菜和３４ｇ浅色蔬菜。结果表明膳食中黄绿色蔬菜对改善学龄前儿童的维生素Ａ营养有重要影响,且安全、廉价。     

Influence of iron on vitamin A nutritional status

Iron deficiency seems to deteriorate vitamin A metabolism leading to a reduction in serum retinol and an increase in hepatic retinol and retinyl ester. These alterations probably result from an increase in retinol sequestration to the liver and/or impairment in the activity of hepatic retinyl ester hydrolases decreasing vitamin A mobilization.     

学龄儿童维生素A营养状况及其与铁的相关性研究

为观察学龄儿童维生素A(VA)营养状况、亚临床VA缺乏患病率及VA与铁的相关性 ,对北京房山山区 1 0 1 2名 7～ 1 3岁学龄儿童进行膳食调查 ,随机抽取 30 5名儿童 ,静脉采血于避光下分离血清 ,用高效液相色谱法检测血清VA含量 ,同时测定其血清铁蛋白 (SF)、红细胞游离原卟啉 (FEP)和血红蛋白 (Hb) ,并依现行标准将其分为正常、铁缺乏 (ID)、红细胞生成缺铁期 (IDE)与缺铁性贫血 (IDA)四组 ,观察VA与铁的相关性。结果显示受检儿童膳食总能量、蛋白质和铁平均每日摄入量均达到膳食营养素的推荐摄入量 (RNI)及适宜摄入量 (AI) ,但平均每日VA摄入量为 (51 3 7± 2 86 1 ) μgRE ,仅占RNI的 59 7% ;血清VA平均含量为(1 0 1± 0 2 9) μmol L ,血清VA低于 1 0 5μmol L者占受检儿童的 59 0 % ,其中 1 2 8%的儿童血清VA低于0 70 μmol L ,正常及以上者仅占 41 0 %。并观察到血清VA含量与机体铁状况有相互随对方下降而减低的趋势。结果表明 ,该地区儿童存在明显的VA缺乏 ,应加强营养教育、改善不合理的膳食结构并通过适当的VA防治予以纠正     

维生素A缺乏对大鼠铁营养状况的影响

目的 研究维生素A(VA)缺乏对大鼠铁营养状况的影响及其可能的机制。方法 雄性Wistar大鼠40只．按体重随机分为IVA和铁缺乏组，ⅡVA完全缺乏组，ⅢVA轻度缺乏组，Ⅳ VA正常对照组。实验动物喂饲8周后处死，测定血清VA、血清铁、铁蛋白、血红蛋白、肝内总铁含量，并用逆转录一聚合酶链反应(RT-PCR)法检测各组大鼠肝脏转铁蛋白mRNA的表达情况。结果 维生素A缺乏显地降低血清铁蛋白、血红蛋白和肝内总铁含量。抑制肝脏转铁蛋白mRNA的表达。结论 维生素A缺乏可能通过降低肝脏转铁蛋白mRNA的表达水平从而抑制了铁的吸收和转运。     

儿童维生素A与铁营养状况的相关性研究

目的了解中国儿童维生素A(VA)的营养状况、VA缺乏率、VA边缘缺乏率,研究血浆VA与铁营养状况的相关性。方法由2002年“中国居民营养与健康状况调查”的大样本中随机抽取380名3~12岁儿童,检测血浆VA含量,同时测定血红蛋白(Hb)、总铁结合力(TIBC)、铁蛋白(SF)及转铁蛋白受体(sTfR)。了解儿童VA营养状况,计算VA缺乏率、VA边缘缺乏率,研究VA与铁营养状况评价指标的相关性。结果受试儿童VA平均含量为(1·03±0·24)μmol/L,其中8·4%儿童VA缺乏,44·7%儿童VA边缘缺乏。血浆VA与Hb呈正相关(r=0·16986,P<0·01),与sTfR呈负相关(r=-0·12863,P<0·05),与TIBC、SF不相关。结论铁缺乏伴随VA边缘缺乏在中国儿童中普遍存在,VA与铁营养状况存在相关性。     

沈阳地区婴幼儿维生素D营养状况的调查研究

目的 了解沈阳地区0～3岁婴幼儿维生素D(VitD)营养状况与其性别、年龄以及季节的关系,为本地区婴幼儿合理进行VitD的补充提供科学依据。方法 对沈阳市妇婴医院儿童保健门诊体检的0～3岁婴幼儿,采用化学发光法进行血清25(OH)D水平检测。结果 2 381例婴幼儿25(OH)D总体平均水平为(36.73±18.75)ng/ml,其中25(OH)D水平严重缺乏组8例(0.34%)、缺乏组174例(7.31%)、不足组149例(6.55%)、正常组2 026例(85.09%)、过量组24例(1.01%);不同性别间血清25(OH)D水平差异无统计学意义(P＞0.05);0～1岁婴儿组血清25(OH)D水平低于1～3岁幼儿组,两组差异有统计学意义(P＜0.05);不同季节婴幼儿血清25(OH)D水平冬季最高,春季最低。结论 沈阳地区0～3岁婴幼儿VitD的总体营养状况较好,但仍存在VitD缺乏及过量现象。应注重科学合理补充VitD,避免出现VitD不足、过量及中毒情况。     

住院治疗中新生儿维生素A、D、E水平单中心现况调查

目的 调查河南安阳地区住院治疗中新生儿维生素A、D、E水平及相关影响因素,为早期防治维生素A、D、E缺乏提供科学依据。方法 选取2017年5月-2019年2月在安阳市人民医院新生儿科住院治疗的329例新生儿为研究对象。采用高效液相色谱法和液相串联质谱法检测新生儿维生素A、D、E。结果 1)新生儿维生素A水平为(0.17±0.09) mg/L,维生素D水平为(14.21±12.05) ng/ml,维生素E水平为(6.50±3.80) mg/L。2) 足月儿与早产儿的维生素A水平,不同性别新生儿的维生素D水平,高危儿与非高危儿的维生素E水平差异均有统计学意义(P＜0.05)。不同体重组维生素A、D、E水平差异无统计学意义(P＞0.05)。3) 维生素A亚临床缺乏,维生素D及维生素E缺乏比例较高。4) 不同季节出生的新生儿维生素D水平差异有统计学意义(P＜0.05)。孕末期3个月补充维生素D剂量≥400 U/d与＜400 U/d的新生儿维生素D水平差异有统计学意义(P＜0.05)。结论 河南安阳地区住院治疗中新生儿大部分存在维生素A、D、E缺乏,是否足月、是否为高危儿可能分别与维生素A、E水平有关。不同性别、季节及孕末期补充维生素D的剂量与维生素D水平有关。     

A lowering effect of a pharmacological dose of vitamin E on serum vitamin a in normal adults

We have studied the effects of oral vitamin E (vE) on serum vitamin A (vA) levels and vA transport proteins, retinol binding protein (RBP) and prealbumin (PA), in normal subjects taking and not taking pharmacological doses of vA and/or vE acetate. Nineteen subjects were given 9009 ug of oral vA acetate daily for one week. Ten of these continued on 9009 ug of vA daily for two weeks (group I), while nine received 147 mg of vE acetate in addition to vA (group II). A third group (group III) consisted of 10 subjects who received only 147 mg of vE daily for 3 weeks. Group IV represented control subjects not given either vA or vE pills over the 3 week study period. Groups I and II showed significant increases in serum vA levels after 1 week of vA treatment. Group I to week 3 (p<0.01) while group II serum vA levels significantly fell from week 1 to week 3 (p<0.01). No significant differences were demonstrated in RBP or PA in groups I and II. Group III showed a significant fall in serum vA and RBP levels from initial to week 3 (p<0.005) with no significant change in PA. Control subjects (group IV) showed no significant variation of any parameter over the three week test period. The fall in serum vA and RBP seen among our subjects taking vE alone is consistent with either enhanced hepatic vA uptake or increased vA transport to and utilization by peripheral tissues.     

Nutritional status of an institutionalized aged population.

The nutritional status of 146 elderly residents in a long-term care facility was evaluated using biochemical and anthropometric measures. The level of nursing care required and meal locale had no significant effect on the overall nutritional status of the residents. The biochemical data indicated three nutritional problems requiring treatment and follow-up: anemia, low vitamin B6 status, and reduced albumin levels. The incidence of these problems in other groups of elderly deserves further study. Six percent of the study population were anemic, with 13% having low serum folate, 6% with low transferrin saturation, and 31% with low TIBC values suggesting more than one factor involved in the anemia. Low vitamin B6 status was observed in 28% of the population. Whether this is due to poor intake, poor absorption, or both is not known. The percentage of residents with decreased albumin levels was slightly higher than that observed in other studies of the elderly, and may be related to the more advanced age of this population.     

晚发型维生素K缺乏性出血患儿及其母亲维生素K营养状况的研究

【目的】以血清凝血酶原前体蛋白(PIVK-Ⅱ)来研究晚发型维生素K缺乏性出血(late vitamin K deficiencybleeding,LVKDB)患儿及其母亲维生素K营养状况,观察不同剂量维生素K对PIVKA-Ⅱ的影响。【方法】采用前瞻性研究方法,18例自2002年1月~2003年12月在沧州市中心医院住院的LVKDB患儿及其母亲组成观察组,患儿又分为5 mg和10 mg治疗组。20例同期住院的急性上呼吸道感染患儿及其母亲组成对照组。各组分别化验PIVKA-Ⅱ水平,观察组患儿在应用维生素K24 h3、d7、d三个时间检测。PIVKA-Ⅱ采用酶联免疫吸附试验方法。【结果】①应用维生素K24 h3、d、7 d观察组患儿PIVKA-Ⅱ水平高于对照组患儿(P<0.01);②观察组母亲PIVKA-Ⅱ水平与对照组母亲无差异(P>0.05);③观察组患儿维生素K 5 mg和10 mg治疗组血清PIVKA-Ⅱ水平无差异(P>0.05)。【结论】LVKDB患儿维生素K严重缺乏,而其母亲不存在维生素K不足,在LVKDB患儿治疗中没有必要应用大剂量维生素K。     

维生素A营养状况的评价方法

维生素A是人体必需的营养素之一。在世界范围内严重的维生素A缺乏已经得到有效控制的情况下,“亚临床状态”的维生素A缺乏依然是许多国家,尤其是发展中国家所面临的公共卫生问题。准确地评价高危人群的维生素A营养状况对于研究临床和亚临床维生素A缺乏对人体健康的影响以及营养干预策略的制订和实施有着极为重要的意义。目前用于评价人体维生素A水平的指标包括临床症状、组织学指标、功能指标和生化指标等。     

补充维生素A对健康成人铁营养状况的影响

目的观察健康成人补充维生素A(VA)后铁营养状况的变化。方法选择115名健康成人志愿者,按血清视黄醇浓度用区组设计方法将男女志愿者随机分入4组(男、女各半),在日常膳食的基础上,分别补充不同剂量的VA,干预剂量(以视黄醇计)分别为600μg/d(A组)、400μg/d(B组)、200μg/d(C组)和0μg/d(D组),干预期4个月。补充剂为微胶囊化的视黄酰乙酸酯,将5日剂量装入1粒胶囊,每5日口服1粒。胶囊外包装只标注剂量类型,现场实验人员和受试者均不知道每一种胶囊的补充类型。干预期内,受试者接受常规膳食,每月进行1次24h回顾性膳食调查。干预试验前后,采集空腹上臂静脉血,取血清测定血液血红蛋白(Hb)浓度,血清视黄醇、血清铁(SI)、铁蛋白(SF)和转铁蛋白受体(TfR)浓度。结果共有108名受试者完成干预试验,A、B、C和D组各为27、28、27和26名。干预期内,4组受试者膳食能量营养素、视黄醇当量(RE)和铁摄入量无显著性差异(P>0.05)。干预结束后,A组受试者血清视黄醇浓度从干预前的(1.63±0.55)μmol/L升高到了(1.93±0.52)μmol/L(P<0.05);B和C组血清视黄醇浓度分别平均升高了0.29μmol/L和0.14μmol/L(均为P<0.05);而对照组D组变化不显著(P>0.05)。干预试验前后各组Hb差异没有显著性(P>0.05);高剂量VA组受试者干预后SI浓度比干预前显著升高,而SF和TfR浓度则显著降低(均为P<0.05);中剂量组和低剂量组在干预前后SF和TfR未见显著性变化。结论铁营养状况正常的成人,在没有专门给予膳食铁干预的情况下,通过较大剂量VA补充干预,铁营养状况仍然得到进一步提高。     

Effect of traditional food supplements on nutritional status of lactating mothers and growth of their infants

ObjectivesDuring lactation, traditional food supplements (TFS) are commonly consumed in India to increase lactation performance and health of mothers. TFS are rich in fats, nuts, dry fruits, and sugars and indulging in such supplements for 3 to 6 mo postpartum may put the mother at risk for obesity. The aim of this study was to assess the nutrient quality of TFS and its effect on nutritional status of lactating mothers and infant's weight gain in first 6 mo after delivery.MethodsA random sample of 125 Indian urban lactating mothers (28.9 ± 3.2 y) was assessed within 6 mo postpartum for anthropometry, diet by 24-h recall on 3 random days, along with socioeconomic factors, lactation history, and infant's birth weight and current weight.ResultsAmong 18 different TFS, 50% TFS were rich in calcium, 33% rich in iron, 38% in zinc, and only 13% were good sources of vitamins. Mothers consuming TFS (n = 75) had significantly higher fat intakes than mothers consuming no TFS Supplements (NTS; n = 50). A higher weight gain was seen in TFS mothers (10.5%) than NTS mothers (8.8%) after adjusting for number of days after delivery, parity, mother's age, and breast-feeding practices (P < 0.05). Percent weight gain in infants of TFS mothers (120.7% ± 7.3%) was higher than in infants of NTS mothers (96.2% ± 7.8%; P = 0.024) after adjusting for infant's age and mother's breast-feeding practices.ConclusionTFS may be modified to increase its micronutrient quality and to reduce fat contents with the goal of reducing the risk for obesity in mothers, while still benefiting infant growth.