膳食平衡指数评价广东省成年居民膳食质量

目的 利用膳食平衡指数（DBI_16）综合评价广东省成年居民的膳食质量,为开展营养干预提供依据。方法 采用 DBI_16 评分方法评价2015年广东省营养调查中成年人居民膳食质量水平。结果 本研究共对3 424名广东省居民膳食情况进行分析,年龄18~92岁,珠三角地区（广州、深圳、佛山、惠州、江门）1 254人（占36.6%）、男性1 570人（占45.8%）,女性1 854人（占54.2%）,41~60岁1 538人（占44.9%）,小学及以下文化程度1 636人（占47.8%）。广东省居民总体膳食存在中度摄入不足（29相似文献   

陕西省汉中地区农村居民膳食质量及其影响因素研究

目的 采用中国膳食平衡指数(DBI)评价陕西省汉中地区农村居民膳食质量状况及其影响因素.方法 2010年对汉中地区18 ～ 80岁农村居民膳食采用半定量食物频率问卷进行横断面调查,采用DBI相关指标评价其膳食质量,应用多因素线性回归方法分析影响摄入不足和摄入过量可能的影响因素.结果 调查的2748人中谷薯类、豆类、腌菜、植物油和食盐每标准人日平均摄人量均高于全国农村居民平均水平(P＜0.01),其中80％以上村民的谷薯类、食用油和盐摄入量平均水平超过推荐量;动物性食物、蛋奶类和蔬菜水果则低于全国平均水平(P＜0.01),存在明显摄入不足.人群平均负端分(DBI LBS)和正端分(DBI HBS)分别为22.8和9.8,中度摄入不足(20＜DBI LBS≤40)和摄入过量(10＜DBI HBS≤20)的比例分别为62.6％和48.0％.影响摄入不足的主要因素有文化程度、财富指数、高血压史、体育锻炼和看电视时间;影响摄入过量的主要因素有性别、年龄、家庭人口数、劳动强度、睡眠时间、吸烟和饮酒情况.结论 汉中地区农村居民膳食结构不均衡,并以摄入不足为主,同时存在部分食物摄入过量;有必要在不同人群中开展有针对性的干预措施,改善当地居民营养状况.     

2013年中国成年人吸烟状况与多种慢性病的关联研究

目的 研究我国成年人吸烟现状及不同吸烟人群与多种慢性病的关联。方法 基于2013年全国慢性病及其危险因素监测,覆盖31个省份的298个监测县（区）,按多阶段分层整群抽样方法抽取全国≥ 18岁居民176 534人。利用询问调查收集对象前12个月的吸烟行为（吸烟状态、现在吸烟者日均吸烟量、现在每日吸烟者吸烟年限等）、慢性病（高血压、糖尿病、高TC血症和高TG血症）相关信息,测量血压,检测血糖和血脂。采用基于复杂抽样设计的权重对指标进行分析。结果 共收集有效样本175 386人。其中男性占42.7%,女性占57.3%。成年人男性吸烟者高血压、高TC血症和高TG血症患病率分别为30.4%、7.2%和18.0%,高于非吸烟者;女性吸烟者高血压、糖尿病、高TC血症和高TG血症患病率分别为35.6%、14.0%、10.3%和15.9%,均高于非吸烟者,差异均有统计学意义（均P<0.05）。多因素分析结果显示,我国成年人男性吸烟者比非吸烟者高血压患病风险有所降低,患高TG血症风险比非吸烟者高19%（OR=1.19,95% CI：1.10~1.30）。其中,现在日均吸烟≥ 20支男性高TG血症患病风险比非吸烟者高41%（OR=1.41,95% CI：1.28~1.55）。我国成年人女性吸烟者比非吸烟者高TG血症患病风险高40%（OR=1.40,95% CI：1.15~1.70）;每日吸烟年限≥ 20年者高TG血症比<20年者高60%（OR=1.60,95% CI：1.31~1.95）。结论 吸烟者比非吸烟者总体慢性病患病率高,且吸烟年限长或现在每日吸烟量大的人群患病风险大幅增加。     

北京市2014年成年人吸烟及危害认知现况调查

目的 了解2014年北京市成年人现在吸烟状况及危害认知情况。方法 2014年9-11月采用多阶段分层随机整群抽样方法在北京市16个区（县）共抽取36个街道/乡镇180个社区,共计19 815名18～79岁常住居民进行问卷调查。结果 有效样本量为19 738人。现在吸烟率为26.6%（5 253/19 738）,男性为52.2%（4 875/9 340）,女性为3.6%（378/10 398）,男性高于女性;50～59岁年龄组现在吸烟率最高,达32.7%（1 473/4 499）;郊区现在吸烟率为28.9%（2 320/8 023）高于城区的25.0%（2 933/11 715）。现在每日吸烟率为23.7%（4 677/19 738）。开始每天吸烟的平均年龄为19.2岁,日均吸烟量为15.2支。知识得分平均为5.8分;现在吸烟者5.5分,明显低于现在不吸烟者6.0分（t=-9.854,P=0.000）。5.7%（298/5 213）的现在吸烟者打算1个月内戒烟,就医时医生建议戒烟的比例为66.0%（1 638/2 481）。慢性病患者的现在吸烟率为31.8%（3 703/11 628）,5.5%（202/3 686）打算1个月内戒烟。结论 北京市男性吸烟水平仍处于高平台期;开始每日吸烟年龄低龄化;吸烟和被动吸烟危害知识缺乏;戒烟意愿低;医生建议戒烟率低。     

天津市2016年35~79岁居民吸烟归因死亡及戒烟效果分析

目的 分析吸烟对天津市35~79岁居民死亡的影响以及戒烟效果。方法 收集2016年天津市35~79岁居民死亡病例39 499例,调整5岁年龄组、受教育程度、婚姻状况后,分析吸烟导致不同疾病死亡的风险和超额死亡,以及不同年份戒烟的效果。结果 35~79岁男性死亡者中,有13.56%（1 589例）的死亡是由于吸烟所引起,其中吸烟引起肺癌的超额死亡百分比最高（47.60%）;吸烟者肺癌的死亡风险是不吸烟者的2.75（95% CI：2.47~3.06）倍;女性死亡中,有7.29%（183例）的死亡是由于吸烟所引起,其中吸烟引起肺癌的超额死亡百分比最高（28.90%）;吸烟者肺癌的死亡风险是不吸烟者的4.04（95% CI：3.49~4.68）倍。男性死亡中,戒烟者患病的危险为吸烟者的0.80（95% CI：0.72~0.90）倍,男性戒烟≥ 10年者其OR值（0.74,95% CI：0.63~0.86）小于戒烟年限为1~9年者（OR=0.85,95% CI：0.74~0.98）,差异无统计学意义。结论 吸烟是导致天津市居民死亡的重要危险因素之一。戒烟可以明显起到保护作用。     

天津市男性居民吸烟归因死亡的研究

目的 分析吸烟对天津市男性居民死亡的影响。方法 收集2010－2012年天津市38 312例18~69岁的男性死亡者信息。调整年龄和受教育程度后,分析吸烟导致不同疾病死亡的风险和超额死亡。结果 天津市18~69岁死亡男性中22.57%是由吸烟引起的,吸烟者平均损失5年的寿命。吸烟者肺癌的死亡风险是不吸烟者的3.10倍(95%CI:2.80~3.44),心脏病死亡的风险是不吸烟者的1.47倍(95%CI:1.36~1.59),脑卒中死亡风险是不吸烟者的1.41倍(95%CI:1.30~1.53)。城市男性吸烟导致疾病死亡的风险高于农村男性,开始吸烟年龄早、每天吸烟支数多其死亡风险高。结论 吸烟是导致天津市男性居民死亡的主要危险因素。     

应用膳食平衡指数DBI_16评价云南省18岁以上德昂族居民的膳食质量

目的应用膳食平衡指数DBI_16评价云南省18岁以上德昂族居民的膳食质量,为改善德昂族居民营养状况,制定健康促进策略提供数据支持。方法采用膳食频率法对德昂族居民进行膳食调查,应用中国膳食平衡指数DBI_16评价其膳食质量。结果云南省18岁以上德昂族居民的膳食处于中度失衡状态(DQD=42),膳食摄入不足为主要问题(LBS=26),男性、65～79岁年龄段和低收入人群的膳食失衡状况较严重。被调查者奶类、蔬菜、水果和水产类摄入不足最为严重,摄入达到或接近推荐量的分别占1.96%、34.70%、31.75%和36.01%;同时也存在膳食过量问题,谷类食物、畜禽肉类、食用油超过推荐量的分别占76.92%、60.39%、63.50%。结论云南省18岁以上德昂族居民的膳食结构不合理,摄入不足和摄入过量问题同时存在,应继续加强平衡膳食的宣传教育,改善居民的营养与健康状况。     

运用中国膳食平衡指数评价医院职工膳食质量△

目的：运用中国膳食平衡指数DBI_16对南京市儿童医院职工的膳食营养状况进行评价，探讨改善职工膳食质量的方法。方法：采用问卷调查法，对医院职工进行膳食状况调查（FFQ法）和膳食营养知识调查，应用中国膳食平衡指数DBI_16对职工膳食营养状况进行评价并分析其与营养知识知晓情况的关系。结果：儿童医院职工LBS得分为14（10，19），56.3%的职工存在轻度摄入不足，5.1%的职工存在中、重度摄入不足；HBS得分为3（1，6），17.5%的职工存在轻度摄入过量，5.1%的职工存在中、重度摄入过量；DQD得分为18（15，22），75.7%的职工存在轻度膳食失衡，2.6%的职工存在中、重度膳食失衡；职工奶类和鱼虾摄入不足、禽畜肉摄入过量、食物种类少。DBI得分性别上存在统计学差异，女性膳食营养状况优于男性。职工营养知识知晓得分为2（1，3），营养知识得分越高膳食质量越高，差异有统计学意义。结论：该院职工膳食营养状况不佳，存在轻度膳食失衡；应加强医院职工膳食营养相关知识教育，改善职工的膳食营养状况。     

孕期膳食与小于胎龄儿的关系

目的 研究孕妇不同孕期膳食摄入对小于胎龄儿（SGA）发生风险的影响。方法 收集2012年3月至2016年9月在山西医科大学第一医院产科住院分娩孕妇的一般人口学特征、孕早、中、晚期膳食摄入能量、蛋白质、脂肪、碳水化合物以及新生儿基本信息。纳入研究对象8 102例，SGA组961例，适于胎龄儿（AGA）组7 141例。按照中国食物成分表将摄入食物转化为每日膳食营养素摄入量，以AGA组膳食营养素摄入量的三分位数划分为高摄入量组、中等摄入量组及低摄入量组。通过非条件logistic回归分析孕早、中、晚期膳食摄入营养素对SGA的影响。结果 相对于中等摄入量组，孕早期（<51.60 g/d）、孕中期（<52.69 g/d）及孕晚期蛋白质摄入量低（<52.65 g/d）是SGA的危险因素（OR=1.534，95% CI：1.217～1.934；OR=1.268，95% CI：1.005～1.599；OR=1.310，95% CI：1.036～1.655）。按孕前BMI分层后，孕前BMI<18.5 kg/m²的孕妇早期蛋白质摄入量低（<51.60 g/d）及总能量摄入低（<1 146.22 kcal/d）是SGA的危险因素（OR=1.872，95% CI：1.033～3.395；OR=1.754，95% CI：1.125～2.734）；孕前18.5≤BMI<24.0 kg/m²的孕妇，孕早期膳食蛋白质摄入量低（<51.60 g/d）是SGA的危险因素（OR=1.465，95% CI：1.089～1.972）；在孕前BMI≥24.0 kg/m²的孕妇中未发现膳食摄入与SGA有关联。结论 孕期膳食摄入影响SGA的发生风险，且不同孕前BMI人群膳食摄入对SGA的影响有差异，孕早期是膳食摄入对SGA作用的关键期。     

应用中国膳食平衡指数评价山东省成年居民膳食质量

目的 通过运用中国膳食平衡指数（DBI＿16）对山东省18～80岁居民的膳食质量进行整体评价,以指导下一步针对性膳食干预的实施。方法 选取2015年中国成人慢性病与营养监测项目中山东省具有完整膳食与基本信息数据的3 275例18～80岁居民,使用DBI＿16评分方法评价其膳食质量。结果 山东省成年居民摄入量严重不足的为蔬菜、水果、奶类、豆类、鱼虾类、蛋类,摄入过量的为食用油和调味品食盐类。居民膳食质量整体上属于中度膳食失衡（DBI＿DQD=37.9分）水平,同时处于中度膳食摄入不足（DBI＿LBS=27.0分）和低度膳食摄入过量（DBI＿HBS=10.9分）水平;农村、男性、鲁西北、60岁以上以及受教育程度较低者膳食摄入过量及膳食不均衡程度较为严重;膳食模式集中于D、E、G、H四种,主要以H模式为主。结论 山东省18～80岁成年居民的膳食摄入情况有待改善,同时存在摄入不足和摄入过量的问题,因此要继续增强平衡膳食相关营养知识的宣传力度,改善居民的营养与健康状况。     

安徽省学龄前留守儿童膳食平衡指数评价研究

  目的  运用调整的膳食平衡指数(DBI_16)评价安徽省部分3~6岁留守儿童的膳食质量,为快速、准确地评估学龄前留守儿童的营养健康状况提供一定的参考和借鉴。  方法  2018年9—12月,选择安徽省怀远县和舒城县有完整膳食调查资料的3~6岁留守儿童306名和非留守儿童598名作为研究对象,利用DBI_16的总分(TS)、负端分(LBS)、正端分(HBS)和膳食质量距(DQD)等指标评价膳食质量,比较留守儿童组与非留守儿童组之间的差异。  结果  留守儿童的TS(-18.2,-16.1)分值低于非留守儿童,LBS(24.8,23.1)、HBS(7.9,6.4)和DQD(35.9,34.4)的分值均高于非留守儿童,差异均有统计学意义(Z值分别为-46.02,12.45,4.14,4.78,P值均 < 0.05);在食物摄入量及评分上,学龄前儿童的蔬菜水果、动物性食物、奶类豆类和饮水摄入存在明显不足,留守儿童与非留守儿童在奶类(-4.1,-2.7)、动物性食物(-2.2,-0.8)和食物种类(-7.4,-6.2)的膳食摄入得分方面差异均有统计学意义(Z值分别为-26.42,-13.51,-6.59,P值均 < 0.01);学龄前留守儿童中高度的摄入不足比例为44.1%,66.0%的留守儿童存在中高度的膳食不平衡,留守儿童组和非留守儿童组在摄入过量和膳食不平衡的膳食质量分布上,差异均有统计学意义(χ2值分别为15.79,11.51,P值均 < 0.05)。  结论  安徽省学龄前儿童的膳食质量亟待改善,膳食摄入不足是存在的主要问题;留守儿童组与非留守儿童组间的DBI_16存在差异。应适量增加学龄前儿童奶类、蛋类、水果的摄入,开展有针对性的干预措施。     

Tobacco smoking, an independent determinant for unhealthy diet?: A cross-sectional study of Norwegian workers on platforms in the North Sea

The objective of the study was to examine whether male tobaccosmokers had a more unhealthy diet than non-smokers. Data onsmoking and other variables were collected by questionnaireinterviews and food intake by one 24 h recall. The setting was2 oll platforms. The participants were 310 healthy men workingon 2 platforms in the Norwegian sector of the North Sea. Themean ages were 37 and 39 years for non-smokers and smokers.The prevalence of smoking was 50.3%. Smoking decreased withincreasing level of education, but increased with degree ofurbanization. Smokers consumed less vegetables, fruit and fish,but more meat, soft drinks containing sugar and more coffeethan non-smokers. Smokers had a higher intake of fat and a lowerintake of carbohydrate, vitamins A, D and C and dietary fibre.Smoking was an independent predictor for increasing the consumptionof coffee and high intake of energy, energy from fat and cholesteroland a decreasing consumption of vegetables, fruit, energy fromcarbohydrates, dietary fibre and vitamins A and C. It is concludedthat smokers had a more unhealthy diet than non-smokers.     

Antioxidant vitamin intakes assessed using a food-frequency questionnaire: correlation with biochemical status in smokers and non-smokers

The increasing interest in the possible role of antioxidant vitamins in many disease states means that methods of assessing vitamin intakes which are suitable for large-scale investigations are now required. The suitability of the food-frequency questionnaire, which was developed by the Medical Research Council - Cardiff Group, for determining dietary intake of antioxidant vitamins in epidemiological studies was investigated in 196 Scottish men. The validity of the dietary data was assessed by comparison with serum vitamin concentrations, and separate analyses were performed for current smokers and non-smokers. The results showed that total energy intake and the percentage of energy derived from sugar were higher in smokers, and that both dietary and serum values of vitamin C, beta-carotene and vitamin E were lower in smokers than non-smokers. After adjustment for serum lipids, energy intake and body mass index, correlation coefficients between dietary and serum vitamins C and E were similar for smokers (r 0.555 and 0.25 respectively) and non-smokers (r 0.58 and 0.32 respectively). Correlation between dietary and serum carotenes was reduced from 0.28 in non-smokers to 0.09 in smokers and correlations for retinol and total vitamin A were weakly significant only for non-smokers. The food-frequency questionnaire assigned greater than 70% of subjects correctly into the upper or lower plus adjacent tertiles of serum vitamin values, with the exception of beta-carotene and total vitamin A for smokers. Thus, the food-frequency questionnaire appeared to be an adequate tool for assigning individuals into tertiles of serum antioxidant vitamins with the main exception of beta-carotene for smokers. Marked differences do occur between the vitamins and between the smoking groups which may reflect reduced accuracy of reporting on the food-frequency questionnaire or differential absorption and metabolism of the vitamins.     

Lifestyle and dietary differences in smokers and non-smokers from an Italian employee population

In a sample of 200 subjects, representative of a population of 1936 civil servants, we tested differences in life style, dietary habits and distribution of risk factors for CHD between smokers and nonsmokers. The two groups (79 smokers) and (121 non-smokers) did not differ significantly by age or sex. The percentage of sedentary subjects, of hypercholesterolaemics and of hypertensives was found to be particularly high among smokers: 67%, 33% and 30% respectively (vs 59%, 27% and 19% in non-smokers).More smokers were obese (11% vs 5%) but mean BMI was the same in smokers/non-smokers but showed a higher fat mass; the association of CHD risk factors indicates only one significant correlation (P < 0.05) between obesity and hypertension. In male smokers, higher values of LDL and triglycerides and lower intake of energy, vitamins C and A are observed and these values are significantly different than those for non- smokers. In women HDL values are higher in non-smokers whereas, in female smokers, the food cholesterol intake is particularly high 271±295 mg. There are also correlations both for the anthropometric and clinical parameters and for energy and nutrients, indicating that the lifestyle of smokers is less healthy than that of non-smokers. Smokers eat vegetables and fruits less frequently and consume more alcohol than non-smokers, who prefer sweet foods.     

Differences and trends in antioxidant dietary intake in smokers and non-smokers, 1980-1992: the Minnesota Heart Survey

PURPOSE: Differences and secular trends in dietary antioxidant vitamin intake (vitamins E, C, and beta-carotene) in current non-smokers, light smokers, and heavy smokers were examined as part of the Minnesota Heart Survey. METHODS: Three cross-sectional surveys were conducted in adults ages 25-74 years in 1980-82 (N = 1682), 1985-87 (N = 2326), and 1990-92 (N = 2487). Dietary information was obtained from a 24-hour dietary recall. Smoking was assessed through self-report. Intakes were adjusted for age, energy intake, body mass index, education level, and exercise level (vitamins E, C and beta-carotene). RESULTS: Antioxidant vitamin intakes were significantly higher in non-smokers than in light (1-20 cig/day) and heavy smokers (>20 cig/day) when all three survey periods were combined. In men, mean vitamin E intake was 9.2 mg, 8.6 mg, and 7.8 mg for non-smokers, light smokers, and heavy smokers, respectively. Results were similar in men for beta-carotene (non-smokers 1408 microg, light smokers 1287 microg, and heavy smokers 1064 microg), and vitamin C (non-smokers 81 mg, light smokers 67 mg, and heavy smokers 56 mg). Women had results of similar magnitude and direction. From 1980-92, secular trends in men showed non-significant increases from 1980-82 to 1990-92 in beta-carotene (+6.1%), while decreases were observed in vitamins E (-1.1%) and C (-2.6%). In contrast, women had large decreases in all antioxidant vitamin intakes: vitamin E (-13%), vitamin C (-18.6%), and beta-carotene (-16.2%). CONCLUSIONS: Light and heavy smokers had a significantly lower overall mean dietary antioxidant vitamin intake than non-smokers. Over the decade, antioxidant dietary intake remained relatively stable in men and decreased in women in Minneapolis-St. Paul, despite improvements in access to antioxidant rich fruits and vegetables.     

吸烟对甲状腺影响的流行病学研究

目的研究不同碘摄入量地区吸烟对甲状腺体积、功能以及甲状腺自身抗体的影响。方法对辽宁省盘山、彰武、河北省黄骅三个农村社区(分别为碘缺乏地区、碘充足地区、碘过量地区) 1999年初访的3761人进行随访,随访率达80.2%。进行问卷调查、甲状腺B超检查、血液及尿液化验。通过logistic回归进行多因素分析。结果吸烟者甲状腺肿的发生率较不吸烟者增高(15.1% us.11.5%,P<0.05),吸烟者甲状腺的平均体积较不吸烟者大(14.92 ml us.13.18 ml,P<0.05)。通过logistic回归可见吸烟是增加甲状腺肿发生率的主要危险因素。吸烟者平均血清促甲状腺激素(TSH)水平和甲状腺球蛋白(Tg)水平与不吸烟者比没有差别。吸烟者甲状腺过氧化物酶抗体(TPOAb)≥100 IU/ml的为10.8%,不吸烟者为9.0%,差异有统计学意义。多元logistic回归发现吸烟是增加TPOAb强阳性的主要危险因素。对三社区人群进行前瞻性研究,发现由不吸烟到吸烟者TPOAb变为≥100 IU/ml的发生率为7.4%,远大于吸烟情况没有变化者的2.9%(P<0.05)。多元logistic回归发现由不吸烟到吸烟是增加TPOAb≥100 IU/ml发生率的主要危险因素。结论吸烟是增加甲状腺肿发生率和增加TPOAb阳性率的主要危险因素;由不吸烟到吸烟是TPOAb变为阳性的主要危险因素。     

天津市成年人吸烟状况与吸烟人群的体质特征

目的了解天津市成年人吸烟对人体体质的影响。方法依据2005年天津市国民体质监测资料，选择天津市20～59岁年龄阶段的15012名男女市民进行问卷调查和体质指标的测试，综合分析成年人吸烟现状及吸烟人群的体质特征。结果男性在吸烟人数、吸烟量方面明显高于女性；男女不同年龄段的吸烟人群绝大多数呈逐渐增加趋势；不同职业吸烟人群的吸烟状况存在一定的差异，各职业的吸烟人群比例均较高（〉43％）；体力劳动者吸烟人群比例高于非体力劳动者。结论天津市吸烟人群和不吸烟人群的多项体质指标存在差异。建议在后续的相关研究中，将吸烟与影响体质的其他因素一并调查和研究，以利于分析各因素的影响程度；同时加强吸烟行为与经济收入相关性的调查与研究。     

Tea drinking, passive smoking, smoking deception and serum cotinine in the Scottish heart health study

Following a recent claim that the use of cotinine in body fluids, to assess passive smoking and smoking “deception”, was confounded by metabolic individuality, and by non-tobacco sources of dietary nicotine, particularly tea, data were examined from a large cross-sectional survey in a tea-drinking population. In 3383 men and women aged 44–59 years from the Scottish Heart Health Study, defined as non-smokers, both by self-report and by low thiocyanate and expired air carbon monoxide levels, serum cotinine showed minimal association with self-reported daily average tea consumption. However, there was a strong correlation between degree of self-reported passive tobacco smoke exposure and median serum cotinine level. In the same survey, serum cotinine in 4144 self-reported non-smokers and in 3326 smokers showed entirely different distributions, but the same range, suggesting heavy nicotine intake in some “non-smokers”. These analyses confirm that cotinine levels in true non-smokers reflect far more the nicotine in inhaled ambient tobacco smoke than they do nicotine in tea. Some smoking “deceivers” have the same degree of exposure to nicotine as heavy smokers. Despite individual variability, the claim of confounding is poorly supported, and cotinine is confirmed as an indicator both of passive smoking and of smoking deception.