基于潜在类别分析的养老机构老年人营养知识及态度与膳食指南符合率的关联性研究

目的 了解养老机构老年人营养知识和态度的潜在类别及其与膳食指南符合率之间关系,为养老机构老年人的营养分类管理提供研究基础。方法 采用便利取样法,对宁夏3所养老机构350名老年人进行营养知识、态度和膳食摄入情况问卷调查。采用潜在类别分析法对研究对象的营养知识及态度进行分类,比较不同营养知识及态度类别间膳食指南符合率的差异。结果 养老机构老年人营养知识可分为营养知识一般（38.98%）和营养知识缺乏（61.02%）两个潜在类别;营养态度可分为营养态度积极（45.86%）、营养态度一般（27.28%）和营养态度消极（26.86%）三个潜在类别。养老机构老年人谷类、薯类、蔬菜类、蛋类及奶类食物的膳食指南符合率在不同营养知识类别中存在差异（x2=44.49,20.80,10.51,8.35,15.66,均P<0.05）;谷类、粗杂粮、水产类、蛋类及奶类食物膳食指南符合率在不营养态度类别中存在差异（x2=30.95,14.23,24.07,14.40,18.33,均P<0.05）。结论 养老机构老年人营养知识及态度欠佳,膳食指南符合率较低,应对不同营养知识及态度类别的老年人提供有针对性的精细化指导。     

Energy under-reporting in Swedish and Irish dietary surveys: implications for food-based dietary guidelines

An analysis of dietary survey data from Sweden and Ireland revealed that with a declining ratio of energy intake to estimated basal metabolic rate (EI:BMR), %energy from fat, saturated fat and carbohydrate fell while that of protein increased. However, where the definition of under-reporting is less strict, as in the Irish database (EI:BMR) < 1.27), the quantitative effect on macronutrient balance, while statistically significant, is not of such magnitude as to be of nutritional significance. However, with respect to foods, under-reporting was found to be of considerable significance in using such data to formulate food-based dietary guidelines. The Swedish data show that under-reporting of foods is associated with a decreasing percentage of consumers, decreasing intake per eating occasion and decreasing frequency of eating. The development of food-based dietary guidelines will involve comparisons of patterns of food intake among people with contrasting high or low intakes of target nutrients. The Swedish data compared food intakes for those with low or high intakes of saturated fatty acids (SFA) among under-reporters and acceptable reporters of energy intake. Whereas absolute values were always lower with the lower EI:BMR group (< 1.1) compared to the higher EI:BMR group (> 1.35) the ratio of intakes for the low vs. high SFA groups were broadly significant at either EI:BMR ratio. This paper highlights the difficulties that under-reporting will pose for food-based dietary guidelines.     

Consommation d’huiles et matières grasses en France : relations avec le niveau d’étude et la région de résidence dans la cohorte SU.VI.MAX

The relationships between intake of added oils and fats with region of residence and educational level were also assessed. Our objective was to describe the relative contribution of ten created food groups to total fat intake in middle-aged subjects.Subjects were participants of the SU.VI.MAX study who completed at least six 24-h dietary records after inclusion into the study (n=6572).Added oils and fats were the main source of total fat intake. Animal fat (AF) and margarine intakes showed a significant inverse association with educational level, whereas oils with mono-unsaturated fatty acids (MUFA) were positively associated with education level. AF intake was significantly higher in the Western and Northern parts of France (54.2 and 50.4%) and lower in the Mediterranean Coast (39.0%). A significant inverse gradient was found with oils with poly-unsaturated fatty acids (PUFA) or MUFA in the Southwest and the Mediterranean Coast compared to the Northern part of France.We showed a north to south gradient for animal fat intake and the opposite for oils with MUFA and PUFA in France This gradient parallels the known disparities for cardiovascular mortality in this country. This should contribute to adapt dietary guidelines for dietary change in a public-health perspective.     

Intake of added oils and fats among middle-aged French adults: relationships with educational level and region of residence

OBJECTIVE: To describe the relative contribution of 10 created food groups to total fat intake in middle-aged subjects. The relationship of added oil and fat intake with region of residence and educational level was also assessed. DESIGN: Cross-sectional study. SUBJECTS/SETTING: Participants of the French Supplémentation en Vitamines et Minéraux Antioxydants study who completed at least six 24-hour dietary records after inclusion into the study (N=6,572). RESULTS: Added oils and fats were the main source of total fat intake. Animal fat and margarine intakes showed a significant inverse association with educational level, whereas oils with monounsaturated fatty acids (MUFA) were positively associated with education level. Animal fat intake was significantly higher in the western and northern parts of France (54.2% and 50.4%) and lower in the Mediterranean Coast (39.0%). A significant inverse gradient was found with oils with polyunsaturated fatty acids or MUFA in the southwest and the Mediterranean Coast compared with the northern part of France. CONCLUSIONS: We showed a north to south gradient for animal fat intake and the opposite for oils with MUFA and polyunsaturated fatty acid in France. This gradient parallels the known disparities for cardiovascular mortality in this country. This should contribute to adapting dietary guidelines for dietary change in a public health perspective.     

Food-based dietary guidelines--the Austrian perspective

Presently, no national dietary guidelines--neither food- nor nutrient-based--exist for Austria. Usually, the recommendations of the German Society of Nutrition are used instead. The determination of national characteristics of nutritional behaviour and food consumption can reveal starting-points for the improvement of nutritional status in Austria. Seven-day weighed records (children and adolescents, n = 2.173) and 24-h-recalls (adults, n = 2.488) were used for the evaluation of nutrient intake and food consumption. For a sub-sample of children and adolescents, results from laboratory assessment of biomarkers were also available (n = 1.400). Based on fat intake, the age groups were divided into low fat intake (less than 25th percentile = 28-34% fat energy) and high-fat eaters (greater than 75th percentile = 38-45% fat energy). Approximately 75% of the Austrian population have fat intakes above 30% of energy intake, older age groups having a higher prevalence of high fat intakes. Intakes of saturated fatty acids reach 40-46% of total fat. The usual intake of dietary fibre in the Austrian population is between 17-21 g/d; some individuals are able to achieve the recommended intakes for dietary fibre, but do not represent a significant majority of the population. The mean intakes of fruits are clearly higher in children and adolescents (10% of total food intake) than in adults (2-6%). Differences in the intake of selected nutrients in foods between low and high fat consumers, unexpectedly, did not result in different plasma concentrations of cholesterol, nor did it result in differences in fat soluble vitamins. Therefore, one of the primary dietary guidelines for Austria should be the reduction of fat consumption, which is also associated with increasing intakes of fruits and vegetables, increasing intakes of dietary fibre and decreasing intakes of cholesterol.     

Recommended dietary reference intakes, nutritional goals and dietary guidelines for fat and fatty acids: a systematic review

Dietary fat and its effects on health and disease has attracted interest for research and Public Health. Since the 1980s many bodies and organizations have published recommendations regarding fat intake. In this paper different sets of recommendations are analyzed following a systematic review process to examine dietary reference intakes, nutritional goals and dietary guidelines for fat and fatty acids. A literature search was conducted in relevant literature databases along a search for suitable grey literature reports. Documents were included if they reported information on either recommended intake levels or dietary reference values or nutritional objectives or dietary guidelines regarding fat and/or fatty acids and/or cholesterol intake or if reported background information on the process followed to produce the recommendations. There is no standard approach for deriving nutrient recommendations. Recommendations vary between countries regarding the levels of intake advised, the process followed to set the recommendations. Recommendations on fat intake share similar figures regarding total fat intake, saturated fats and trans fats. Many sets do not include a recommendation about cholesterol intake. Most recent documents provide advice regarding specific n-3 fatty acids. Despite efforts to develop evidence based nutrient recommendations and dietary guidelines that may contribute to enhance health, there are still many gaps in research. It would be desirable that all bodies concerned remain transparent about the development of dietary recommendations. In order to achieve this, the type of evidence selected to base the recommendations should be specified and ranked. Regular updates of such recommendations should be planned.     

Strategies for altering population intakes of fats and fatty acids.

Quantitative dietary guidelines for fats were first issued in 1977 in the USA and these guidelines have changed little since then. In the UK only 14% of the population achieve the dietary goal for fat (33% energy) and only 3% achieve the target (10% energy) from saturated fatty acids. Analysis of the Dietary and Nutritional Survey of British Adults reveals that across quartiles of decreasing total fat intake, the actual fatty acid composition of this fat does not alter; i.e. when total fat is lowered, all fatty acid categories are equally lowered. This arises because 85% of total fat and of each of the categories of fatty acids are provided by just five foods (milk, meat, cereals, spreads and vegetables). When total fat in the UK is lowered, the intake of polyunsaturated fatty acids is lowered. The problem is that if the intake of polyunsaturated fatty acids falls below a threshold of about 5% energy, the cholesterol-raising properties of certain saturated fatty acids, e.g. myristic acid, are greatly augmented. In order to alter the balance of dietary fatty acids, more data are needed on food choices of those in the population achieving particular targets. These targets cannot be based on existing dietary goals, since so few people attain them. A new set of 'interim attainable dietary guidelines', based on prevailing dietary intakes, must be the basis for establishing sensible food-based dietary guidelines.     

某高校学生的膳食及营养状况调查

目的了解高校学生的膳食及营养状况,寻找主要存在的营养问题,以便制定干预措施。方法采用随机整群抽样的方法,抽取某高校20～23岁的165名学生;利用调查表对其膳食情况进行为期5d的记录。结果该人群异常体质的人占33.3%,且以体质偏轻为主。男、女大学生体质状况偏轻者分别占12.5%、33.1%。男、女大学生能量摄入均不足,分别达到RNI的66.8%和89.6%。男生膳食摄入蛋白质、脂肪略低于参考摄入量,碳水化合物摄入合理。女生脂肪、碳水化合物略低于参考摄入量,但蛋白质略高于RNI标准。结论大学生营养状况较差,膳食结构不合理。在高校开展有针对性的膳食营养健康教育十分必要。建议大学生适当调整膳食结构、提高营养水平、增强自身身体素质。     

Dietary guidelines and patterns of intake in Denmark

Food-based dietary guidelines in Denmark have usually been expressed in simple terms only and need to be elaborated. Quantitative recommendations on fruit and vegetable intake were issued in 1998, recommending 600 g/d (potatoes not included). This paper is based on a national dietary survey in 1995 (n = 3098, age range 1-80 years) supplemented with data from a simple frequency survey in 1995 (n = 1007, age range 15-80 years) and from the first national survey in 1985 (n = 2242, age range 15-80 years). Only data on adults are included in this paper. Fat intake, saturated fat in particular, is too high (median intake 37 %energy and 16 %energy, respectively). Main fat sources are separated fats (butter, margarine, oil, etc.: 40%), meat (18%), and dairy products (21%). Total fat intake decreased from 1985 to 1995 but fatty acid composition did not improve. Dietary fibre intake is from 18 to 22 g/d (women and men, respectively) with 62% from cereals, 24% from vegetables and 12% from fruit. Mean intake of vegetables and potatoes was from 200 to 250 g/d (women and men, respectively). Mean intake of fruit and vegetables (potatoes not included) was 277 g/d, or less than half of the new recommendation (600 g/d). Only 15% of participants in the frequency survey reported consuming both fruit and vegetables every day, and only 28% reported to do so almost every day. In conclusion, dietary intake in Denmark is characterized by a high intake of saturated fat and total fat, and by a relatively low intake of fruit and vegetables.     

Are dietary recommendations for dietary fat reduction achievable?

Despite several sets of dietary guidelines aimed at reducing fat intakes in the UK populations the actual fat intake in the UK has remained remarkably constant over the last decade. It is therefore of utmost importance to understand why the advice of the 1980s was not taken on board by the nation, to enable the achievement of current nutritional targets for dietary fat set for 2005. The nature of the diets of those individuals in the UK who have low fat intakes in line with the dietary goals are considered here, with the aim to increase our understanding of how the goals can be achieved in the free-living population. This paper postulates that a low fat diet will be easier to achieve, more palatable and hence more acceptable to the consumer if the dietary fat is replaced with a mixture of energy from sugar and starch. Further research is required to gain a greater understanding of what type of dietary composition will enable the free-living population to achieve a reduction in their dietary fat intake. This in turn will allow the dissemination of appropriate nutritional advice in the future and inform product development initiatives in the food industry.     

绍兴市小学生膳食及营养健康状况

目的了解绍兴市小学生的膳食结构及营养状况,为调整学生膳食结构、改善学生营养状况提供科学依据。方法通过膳食调查、体格检查和血红蛋白测定,评价绍兴市3所小学学生的营养素摄入情况和一般营养状况。结果平均每人每日能量、蛋白质、核黄素、尼克酸、维生素E、铁、铜、磷、硒、碘摄入量基本达到RNI,但膳食纤维、维生素A、维生素C及钙摄入量不足,碳水化合物偏低,脂肪摄入量偏高。学生营养不良率为15.29%,肥胖率为11.61%,贫血率为4.48%。结论绍兴市小学生膳食结构不尽合理,动物性食物摄入过高,粮谷类、果蔬类及乳类食品摄入过低,存在肥胖和营养不良同时高发的“双峰”现象。     

上海市黄浦区部分社区糖调节受损人群营养状况调查

[目的]了解社区糖调节受损人群的营养状况。[方法]用24 h膳食回顾法对174名糖调节受损者的营养膳食状况进行调查。[结果]糖调节受损人群能量摄入高于参考摄入量,达114.71%。在三大营养素中脂肪供能占40.36%,碳水化合物供能占44.27%,蛋白质供能占15.32%。膳食纤维、钙、锌、铜,以及A、B族维生素和维生素C的摄入量均低于参考摄入量。[结论]糖调节受损人群的营养摄入不合理,需加强营养教育。     

Difficulties in changing the diet in relation to dietary fat intake among patients with coronary heart disease

OBJECTIVE: To study barriers in following nutritional advice among coronary heart disease patients in relation to dietary fat intake. DESIGN: A cross-sectional study using 4-day food records and a questionnaire with regard to barriers to or difficulties in following dietary advice. SUBJECTS: Altogether, 362 male subjects with coronary heart disease from two separate patient populations (91 + 271) were included in the study, with the mean age of 50 years and 60 years, respectively. The patients were classified into low (< or = 30 E%) or high (> 30 E%) fat intake groups. The patients with low dietary fat intake obtained on an average 10 E% less energy from fat as compared to the high dietary fat intake group. RESULTS: Overall, most patients with coronary heart disease reported difficulties in following nutritional advice when eating in social situations. Patients with high dietary fat intake reported more frequently than patients with low fat intake that they eat like other people without thinking about what they eat. On the other hand, there were no differences between the high and low fat intake groups in the barriers: eating at work, food price, shopping, taste or knowledge of nutrition. CONCLUSIONS: Our results suggest that the sensitivity to social influence is an important factor explaining noncompliance with dietary advice among patients with high dietary fat intake.     

Deficiencies in nutritional intake in patients admitted with diabetes-related foot complications

Aim: Adequate nutritional intake is an essential component for timely wound healing. The present research aimed to identify the frequency of inadequate dietary intake, including the specific nutritional elements most frequently lacking, in a group of patients admitted with diabetes‐related foot complications. Methods: Consecutive patients admitted to a diabetic foot unit underwent a dietary assessment, which included the retrospective collection of a seven‐day food history for the period just prior to admission. The collected data were entered into FoodWorks, and comparisons were made with recommendations made by national guidelines. Results: Thirty‐five patients underwent nutritional assessment, 74% male and 26% having impaired renal function. Protein consumption was in excess of daily recommended intake, and although the overall fat intake as a percentage of total calories consumed was in keeping with national guidelines, the intake of saturated fat was inappropriately high. Of the 12 micronutrients assessed, niacin and vitamin C were appropriately consumed by all; average intake of potassium, phosphorus and thiamine approached recommended levels, while the intake of magnesium, calcium, zinc, riboflavin, folate and vitamin A all fell short of recommended daily requirements. No dietary differences were identified between individuals with normal and abnormal renal function, but deficiencies in calcium and iron were identified only in women. Conclusion: Dietary deficiencies of macronutrients were not identified in individuals admitted with diabetes‐related foot complications, but many patients were found to be consuming well below the daily recommended daily intake of one or more of the micronutrients deemed necessary for normal wound healing.     

湖南某民航空勤人员营养状况调查研究

目的了解湖南某民航空勤人员的营养摄入状况、膳食结构,为引导其合理膳食、建立科学的食物消费观提供依据。方法对湖南某民航的全部空勤人员（369人）进行食物频率调查;膳食调查采用多阶段整群抽样抽取95人,以24 h回顾法连续3 d进行膳食营养素摄入情况的调查。结果膳食调查结果显示,民航空勤人员膳食结构为谷类22.26%、蔬菜水果类40.43%,摄入比例偏低;鱼禽肉蛋类20.24%、油脂类4.90%,摄入比例偏高。膳食纤维摄入量过低,只达到推荐摄入量的50.10%。钙、维生素B2摄入量不足,分别占推荐摄入量的79.29%和75.71%。结论湖南某民航空勤人员营养状况总体良好,食物结构基本合理,营养素摄入存在蛋白质、脂肪摄入过高,碳水化合物、钙、维生素B2和膳食纤维摄入偏低的问题。因此,需对湖南某民航空勤人员加强营养教育,树立正确营养观念,平衡膳食,合理营养。     

Dietary fat intake and insulin resistance in black and white children

OBJECTIVE: The purpose of this study was to determine whether dietary fat intake above current Acceptable Macronutrient Distribution Range (AMDR) guidelines was associated with greater insulin resistance in black and white children. RESEARCH METHODS AND PROCEDURES: We studied 142 healthy children (n = 81 whites, n = 61 blacks), 6.5 to 14 years old. Dietary composition was determined by repeated 24-hour dietary recall, body composition by DXA, visceral fat by computed tomography, and insulin sensitivity (SI) and acute insulin response to glucose (AIRg) by frequently sampled intravenous glucose tolerance test. Subjects were categorized by ethnicity (white/black) and dietary fat intake (above-AMDR/within-AMDR guidelines), and differences were analyzed by 2 x 2 analysis of covariance, adjusting for covariates. RESULTS: After adjusting for total body fat, gender, and Tanner stage, subjects consuming dietary fat above AMDR intake guidelines had lower SI and higher AIRg. This effect was specific to black children (32% lower SI and 62% higher AIRg in above-AMDR compared with within-AMDR blacks) and was not seen in whites. DISCUSSION: In black, but not white, children, those with dietary fat intake above current AMDR guidelines had lower SI and higher AIRg than those who met AMDR guidelines. These findings support current AMDR guidelines for dietary fat in black children and adolescents. The mechanism(s) underlying the ethnic differences in the relationship between dietary fat intake and SI in children require further investigation.     

Self-Reported Dietary Intake of Youth with Recent Onset of Type 2 Diabetes: Results from the TODAY Study

Despite the widely recognized importance of diet in managing diabetes, few studies have documented usual dietary intake in young people with type 2 diabetes. The objectives of our study were to assess dietary intake among a large, ethnically diverse cohort of young people with type 2 diabetes and compare intake to current recommendations. The Treatment Options for Type 2 Diabetes in Adolescents and Youth (TODAY) study is a multicenter randomized clinical trial of 699 youth aged 10 to 17 years. At baseline, following a run-in period that included standard diabetes education, diet was assessed using a food frequency questionnaire between 2004 and 2009. Analysis of variance and nonparametric tests were used to compare mean and median nutrient intakes; logistic regression was used to compare the odds of meeting predefined dietary intake recommendation cutpoints between subgroups of age, sex, and race–ethnicity. Percent of energy from saturated fat was consistently 13% to 14% across all subgroups—substantially exceeding national recommendations. Overall, only 12% of youth met Healthy People 2010 guidelines for intake of <10% of energy from saturated fat and only 1% of youth met American Diabetes Association recommendations for intake of <7% of energy from saturated fat. Dietary intake fell substantially below other Healthy People 2010 targets; only 3% met calcium intake goals, 11% met fruit consumption goals, 5% met vegetable consumption goals, and 67% met grain intake goals. Overall, dietary intake in this large cohort of young people with type 2 diabetes fell substantially short of recommendations, in ways that were consistent by sex, age, and race–ethnicity. The data suggest a critical need for better approaches to improve dietary intake of these young people.     

老年知识分子营养状况调查

作者调查了170名60岁以上(含60岁)老年知识分子的营养状况。结果表明:(1)每人每日热量和蛋白质平均摄入量均达供给量标准的100％以上;蛋白质、脂肪和碳水化物的热量构成比分别为11.6％、34.2％和54.2％,动物性蛋白质占总蛋白质的44.3％。(2)体格检查贫血率约55％;高脂血症54.7％;一个以上(含1个)重要器官器质性疾病的患病率力72.9％。常见病为高血压病、冠心病、肺气肿和脑动脉硬化症。(3)本组老人高胆固醇血症和冠心病的患病率明显高于广州市老人院老人和广西巴马县老年农民,这可能与摄入高热量、高蛋白和高动物性脂肪膳食有关。     

Creatinine, diet, micronutrients, and arsenic methylation in West Bengal, India

Background: Ingested inorganic arsenic (InAs) is methylated to monomethylated (MMA) and dimethylated metabolites (DMA). Methylation may have an important role in arsenic toxicity, because the monomethylated trivalent metabolite [MMA(III)] is highly toxic.Objectives: We assessed the relationship of creatinine and nutrition—using dietary intake and blood concentrations of micronutrients—with arsenic metabolism, as reflected in the proportions of InAS, MMA, and DMA in urine, in the first study that incorporated both dietary and micronutrient data.Methods: We studied methylation patterns and nutritional factors in 405 persons who were selected from a cross-sectional survey of 7,638 people in an arsenic-exposed population in West Bengal, India. We assessed associations of urine creatinine and nutritional factors (19 dietary intake variables and 16 blood micronutrients) with arsenic metabolites in urine.Results: Urinary creatinine had the strongest relationship with overall arsenic methylation to DMA. Those with the highest urinary creatinine concentrations had 7.2% more arsenic as DMA compared with those with low creatinine (p < 0.001). Animal fat intake had the strongest relationship with MMA% (highest tertile animal fat intake had 2.3% more arsenic as MMA, p < 0.001). Low serum selenium and low folate were also associated with increased MMA%.Conclusions: Urine creatinine concentration was the strongest biological marker of arsenic methylation efficiency, and therefore should not be used to adjust for urine concentration in arsenic studies. The new finding that animal fat intake has a positive relationship with MMA% warrants further assessment in other studies. Increased MMA% was also associated, to a lesser extent, with low serum selenium and folate.     

中国人群膳食营养素及营养状况分析──1989年8省实例研究

为了解我国１０年经济体制改革后人群膳食结构的改变及身体的营养状况，于１９８９年对８省的１６市２４县居民的调查结果进行分析。结果表明，城市和县城居民热能摄入低于郊区和农村。来源于动物性食物的热能，城市和县城占１１％～１３％，郊区和农村只占５％～９％左右，各类地区来源于动物性食物的蛋白质和动物性脂肪随经济收入的上升而增加。调查人群成人（２０～４５岁）超重（ＢＭＩ≥２５．０）的检出率在７％～１２％之间，消瘦（ＢＭＩ＜１８．５）在７％～１０％之间。城市和县城居民超重检出率显著高于郊区和农村居民（Ｐ＜０．００１）。低收入组的超重检出率低于中高收入组（Ｐ＜０．００１）。体质指数（ＢＭＩ）随热能、蛋白质、脂肪等营养素摄入量的增加而升高。