天津城乡居民膳食微量营养素摄入及与高血压关系的研究

目的 分析天津城乡居民膳食微量营养素摄入状况及与高血压的关系,为提出人群营养改善预防高血压策略提供信息及依据。方法 利用2010-2012年中国居民营养与健康状况监测数据,采用连续3d 24 h回顾及调味品称重的膳食调查方法。结果 天津居民每标准人日维生素A、C、E、B₁、B₂、尼克酸、钙、钠、钾、碘、铁、锌摄入分别为313.79 μg、85.05 mg、27.91 mg、0.81 mg、0.86 mg、13.24 mg、410.85 mg、6 613.17 mg、1 735.10 mg、282.83 μg、22.21 mg、10.37 mg;膳食维生素A、B₁、B₂、钙低于推荐值,钠明显超标;除了钠、总碘农村偏高,其他微量营养素农村均最低;高血压患者膳食钾、钙、镁、铜、硒、维生素A、C、硫胺素、核黄素与血压呈负相关（均有P< 0.05）,钠、碘与血压呈正相关（均有P< 0.05）;高血压组钠、碘明显高于正常血压组和推荐值;其他微量营养素低于正常血压组（均有P<0.05）。结论 天津居民维生素A、B₁、B₂、钙摄入不足是膳食中的主要问题;钠摄入明显过多;农村居民微量营养素缺乏更严重;多种微量营养素摄入与高血压相关,急需膳食干预高血压的营养改善措施。     

海南省城乡居民膳食营养状况分析

对１９９２年海南省城乡人群的膳食结构和营养状况调查结果进行了分析。结果表明，热能摄入量偏低，食物搭配不合理，三大主要营养素摄入量，城市高于农村，各类营养素的摄入量随着经济收入的增加而上升。城市钙、锌、视黄醇，硫胺素、核黄素摄入不足，农村钙、硫胺素、核黄素摄入仅占供给量（ＲＤＡ）５０％。来源于动物性食物的热能，城市为２１．１％，农村为１１．６％。学龄前儿童热量、钙、锌摄入不足，维生素缺乏。     

中国居民微量营养素摄入的地区分布

本文依据１９９２年全国营养调查各省不同年龄居民的膳食情况,详细分析了各省、市、自治区居民微量营养素的摄入情况。分析结果显示烟酸、抗坏血酸和维生素Ｅ的摄入比较充足,大部分省份居民摄入硫胺素、锌和硒较好,而钙、视黄醇当量和核黄素摄入量普遍不足。东北、西北和西南内陆地区是营养素缺乏比较集中的地区。本文分析的结果可以为分区或分省进行微量营养素膳食干预或食物强化提供参考。     

江西省城乡居民膳食结构与营养状况研究报告

报告了１９９２年城乡人群膳食结构和营养状况，讨论了近１０年来的发展变化及存在的营养问题。调查结果表明，江西省城市钙、硒、核黄素和视黄醇摄入不足，脂肪、动物性食物和食盐摄入均偏高；江西省农村豆类和动物蛋白摄入明显少于城市，钙、硒、核黄素和视黄醇摄入仅占供给量（ＲＤＩ）一半。与１９８２年比，城市人群营养状况有明显改善，但同时存在营养过剩问题，农村改变不明显。     

小学生营养午餐微量营养素摄入情况评价

目的评价小学生在校营养午餐微量营养素的摄入情况及全天膳食比例。方法采用方便抽样的方法,选择丰台区4所提供营养午餐的小学1~6年级共770名学生作为研究对象。采用膳食分析软件分析学校连续3天的午餐食谱并考虑剩余情况,计算午餐微量营养素,包括钙、铁、锌、维生素A、维生素B_1、维生素B_2、维生素C的实际摄入量;采用3 d膳食回顾法获得校外膳食微量营养素的摄入量。结果营养午餐钙、铁、锌、维生素A、维生素B1、维生素B_2、维生素C摄入不足比例分别为100%、14.5%、19.6%、78.7%、98.2%、74.2%和92.7%,全天膳食7种微量营养素摄入不足比例分别为94.2%、14.0%、12.6%、61.7%、79.2%、51.7%和63.9%,且营养午餐和全天膳食7种微量营养素的摄入不足比例均有随年龄增加而增长的趋势(P0.001);营养午餐和全天膳食中各年龄组钙和4种维生素的实际摄入量占RNI的比例均低于相应标准,铁、锌则基本达到相应标准;营养午餐中铁锌摄入占全天摄入的百分比的平均水平达到推荐值(40%),而其他微量营养素的占比基本在30%左右。结论小学生营养午餐及全天膳食中各微量营养素的摄入不足情况均较严重,且营养午餐对全天微量营养素摄入的贡献较小。     

改善我国儿童微量营养素营养状况的干预对策研究

目的:探讨我国儿童微量营养素营养状况的干预对策,为儿童身体健康生长发育保驾护航。方法:选择2017年9月-2018年9月期间前来我院儿保科就诊的800名儿童,利用相关标准评估儿童的膳食与营养状况。结果:城市儿童钙、锌等摄入水平分别是RNI的38.40%、65.50%,三大营养素与他类微量营养素摄入量均达到RNI或AI水平;而农村维生素B12和钙、钾、铁等微量营养素的摄入显著不足,钙仅是RNI的28.1-39.6%。结论:我市城乡儿童膳食结构欠缺合理性,特别是农村地区儿童营养问题较为显著,存在多种营养素缺乏的情况,应得到政府机关的重视,贯彻落实食物强化的行动规划。     

12000名农村中老年人食物消费模式调查分析

目的通过对河南省南阳市和安徽省安庆市农村中老年居民的膳食调查 ,比较两地食物消费模式的异同。方法用简化的食物频率询问法 ,对两地 12 0 0 0多名 40岁及以上农村老年人进行调查。结果南阳的中老年人在能量和蛋白质摄入上已达到适量及充足水平 ,安庆则只达 RDA的 70 %～ 80 %。微量营养素方面 ,两地对尼克酸、抗坏血酸和铁的摄入 ,都达到或超过了 RDA水平 ;而视黄醇当量、核黄素和钙的摄入两地都明显不足。结论两地农村中老年居民在大多数食物摄入频率、营养素摄入量及膳食模式上均有差别     

孕妇不同孕期膳食营养状况及其与孕期增重的关系研究

目的分析深圳市孕妇的膳食营养状况及其与孕期增重的关系。方法以孕12 w以内健康初产妇为研究对象,前瞻性追踪调查孕期膳食情况、体质量变化等资料,获得421份有效问卷进行分析。结果本调查孕妇孕早、晚期的能量和蛋白质未达到推荐摄入量,孕期平均脂肪供能比超过推荐范围上限,孕早、中、晚期的硫胺素、核黄素、钙、铁、硒、镁、膳食纤维均未达到推荐摄入量。孕期增重与能量、产能营养素、B族维生素、钙等摄入有关,孕早期每增加1g/d的蛋白质摄入,发生孕期增重不足的风险降低2.5%,孕早期能量摄入不足的孕妇发生孕期增重不足的风险是摄入充足孕妇的2.5倍。结论本调查孕妇膳食能量和产能营养素摄入不合理,硫胺素、核黄素等微量营养素未达到推荐摄入水平,孕早期的蛋白质摄入水平降低或能量摄入不足可显著增加孕期增重不足的发生风险,应加强孕妇孕期的营养健康教育,改善不合理的饮食习惯。     

经济水平对成人营养素摄入和营养状况影响的研究

目的 动态研究经济水平对成人营养素摄入和营养状况的影响。方法 对2000年湖南省城市和农村成人的经济水平、营养素摄入和体质状况调查并与1991年的调查结果比较分析。结果 蛋白质、钙、铁、视黄醇当量、核黄素等营养素均随经济水平的提高而摄入增加（P〈0.05），钙、视黄醇当量、核黄素的缺乏在中、低经济水平人群中仍相当严重；随经济水平的提高，超重和肥胖（体质指数BMI≥25）人群增多，尤见于城市，同时农村低收入人群体重不足（BMI〈18.5）增加。结论 在经济水平增长较快的同时，城乡居民膳食结构正处于转型过程中，并存在营养素摄入不平衡现象，应及时采取有效措施，改善居民营养和健康状况。     

1200O名农村中老年人食物消费模式调查分析

目的通过对河南省南阳市和安徽省安庆市农村中老年居民的膳食调查,比较两地食物消费模式的异同.方法用简化的食物频率询问法,对两地12000多名40岁及以上农村老年人进行调查.结果南阳的中老年人在能量和蛋白质摄人上已达到适量及充足水平,安庆则只达RDA的70%～80%.微量营养素方面,两地对尼克酸、抗坏血酸和铁的摄入,都达到或超过了RDA水平;而视黄醇当量、核黄素和钙的摄入两地都明显不足.结论两地农村中老年居民在大多数食物摄人频率、营养素摄入量及膳食模式上均有差别.     

Association between mortality from suicide in England and antidepressant prescribing: an ecological study

Background

There are multiple studies in different countries regarding the prevalence of vitamin D deficiency. These studies showed high prevalence of vitamin D deficiency in Asian countries. This study tries to elucidate the prevalence of vitamin D deficiency and its influencing factors in population of Tehran.

Methods

1210 subjects 20–64 years old were randomly selected. 25 (OH) D serum levels were measured. Duration of exposure to sunlight, the type of clothing and level of calcium intake and BMI were quantified based on a questionnaire.

Results

A high percentage of vitamin D deficiency was defined in the study population. Prevalence of severe, moderate and mild Vitamin D deficiency was 9.5%, 57.6% and 14.2% respectively. Vitamin D serum levels had no significant statistical relation with the duration of exposure to sunlight, kind of clothing and BMI. Calcium intake in the normal vitamin D group was significantly higher than the other groups (714.67 ± 330.8 mg/day vs 503.39 ± 303.1, 577.93 ± 304.9,595.84 ± 313.6). Vitamin D serum levels in young and middle aged females were significantly lower than the older group.

Conclusions

Vitamin D deficiency has a high prevalence in Tehran. In order to avoid complications of vitamin D deficiency, supplemental dietary intake seems essential.     

Nutrient Intake Adequacy from Food and Beverage Intake of US Children Aged 1–6 Years from NHANES 2001–2016

The early years, between the ages of one and six, are a period of rapid physical, social and cognitive growth and a nutritionally adequate diet is an important factor for optimum development. We investigated the micronutrient adequacy and status of young US children aged 1–6 years (n = 9848) using 24-h dietary recall interviews completed by parents and caregivers participating in the National Health and Nutrition Examination Survey (NHANES) 2001–2016. data. The proportion of the sample not meeting the Dietary Reference Intakes (DRI) increased with increasing age and was most pronounced for calcium. Despite adequate iron intake, 7.4% and 2.5% had signs of iron deficiency and anemia based on serum ferritin and hemoglobin levels, with younger children and WIC participants at most risk and Non-Hispanic Black children the least. Vitamin B6 intake was adequate, but 6.4% had serum pyridoxal-5-phosphate deficiency. For vitamin E, 69% had intakes below the estimated average requirement (EAR), yet serum deficiency was only detected in 0.9%. Vitamin D intake was inadequate for 87%, but true deficiency may be overestimated. Mean DHA intake was 24 mg/d, well below expert recommendations of 70–100 mg/day. Iron and vitamin B6 deficiency and inadequate calcium, fiber, choline, potassium and DHA intakes are a concern for a significant percentage of young children. The discrepancy between nutrient intakes and serum deficiency levels needs to be further investigated.     

The impact of folic acid fortification of enriched grains on an elderly population: the New Mexico Aging Process Study

Fortification of enriched grains with synthetic folic acid is a potential concern for the elderly population who is at higher risk for Vitamin B12 deficiency. Consuming excess amounts of naturally occurring folate or synthetic folic acid can precipitate a deficiency of Vitamin B12, resulting in neurological damage. The purpose of this study was to determine the increase in folate intake in an elderly population due to the fortification of enriched grains. Three-day diet records of 320 participants (average age 76.8 years) were evaluated for total folate intake from food and supplements before and after the fortification of enriched grains. There was a significant mean daily folate intake increase of 63.8 microg due to fortification (p < 0.0001), raising the intake of total folate to 359 microg (89.8% of RDA). Supplements containing folic acid were consumed by 66% of the participants, raising the average total folate intake of supplement users to 793 microg per day. Only 5 participants exceeded the UL of 1,000 microg folic acid per day, with all 5 of these individuals consuming more than 1,000 microg folic acid per day from supplements alone. Folic acid fortification of grains does not appear to have increased the risk of excess folic acid in this population.     

3～12岁儿童营养素补充剂摄入量研究

目的通过横断面调查,描述营养素补充剂的使用率和日均使用量。方法采用多阶段随机整群抽样抽取中国7城市2农村岁3~12岁儿童1 823名,通过6个月内营养素补充剂调查问卷获得其营养素补充剂摄入情况。结果3~6岁儿童各营养素补充率均高于7~12岁儿童(P均0.05)。3~12岁儿童最常使用的营养素依次为钙(27.46%),维生素D(16.61%),锌(13.73%),维生素B2(12.35%),维生素B12(12.30%),维生素B1(12.24%),维生素C(12.18%),维生素A(11.35%),维生素B6(10.47%),叶酸(8.68%),烟酸(7.03%),泛酸(6.70%),维生素E(6.17%),铁(4.87%)。来自于补充剂的日均营养素摄入量分布范围跨度较大,且有部分极值超过可耐受最高量。大多数补充剂摄入量低于推荐量,3~6岁儿童维生素A补充剂摄入量均值和中位数高于推荐量。结论维生素A补充剂摄入量存在一定程度的超量风险。要更准确地评估儿童的营养状态和潜在的健康风险,应建立营养素补充剂摄入量的推荐标准和安全范围。     

Lack of Association between Inadequate Micronutrient Intake and Prognosis in Outpatients with Heart Failure

Inadequate nutrient intake can lead to worse outcomes in patients with heart failure (HF). This prospective cohort study aimed to assess the prevalence of inadequate micronutrient intake and their association with prognosis in 121 adult and elderly outpatients with HF. Habitual micronutrient intake was evaluated using 24-h dietary recalls (minimum 2 and maximum 6). Participants were grouped into moderate (n = 67) and high (n = 54) micronutrient deficiency groups, according to the individual assessment of each micronutrient intake. Patients’ sociodemographic, clinical, and anthropometric data and clinical outcomes (hospitalization and mortality) within 24 months were collected. Overall and event-free survival rates were calculated using Kaplan–Meier estimates, and curves were compared using the log-rank test. The death risk rate (hazard ratio (HR)) was calculated using Cox’s univariate model. The rate of inadequate intake was 100% for vitamins B1 and D and above 80% for vitamins B2, B9, and E, calcium, magnesium, and copper. No differences in overall survival and event-free survival were observed between groups of HF outpatients with moderate and high micronutrient deficiencies (HR = 0.94 (CI = 0.36–2.48), p = 0.91, and HR = 1.63 (CI = 0.68–3.92), p = 0.26, respectively), as well as when the inadequacy of each micronutrient intake was evaluated alone (all p > 0.05). In conclusion, a high prevalence of inadequate micronutrient intake was observed in outpatients with HF. Inadequate micronutrient intake was not associated with hospitalization and mortality in this group of patients.     

Supplementation with vitamin D and calcium in long-term care residents

Vitamin D deficiency is a common finding in institutionalized older persons. Vitamin D-deficient elderly persons are at higher risk of falls and fractures. Long-term care residents should be considered at high risk of vitamin D deficiency and therefore vitamin D supplementation is highly recommended in this population. The minimal effective dose is 800 IU per day. It is recommended that vitamin D supplementation should be implemented in all patients in residential aged care facilities. In addition to vitamin D, calcium supplementation has shown to enhance the effect of vitamin D on bone. Calcium intake should be optimized (1200-1500 mg per day recommended) and supplementation offered to those with inadequate intake. The addition of calcium depends on tolerance, history of kidney stones, and emerging data regarding its cardiovascular safety.     

Micronutrients and Child Health: Studies in International Nutrition and HIV Infection

Increasing data link micronutrient deficiencies to excess childhood morbidity and mortality, and similar relationships have been noted in the study of nutrition and HIV infection. We review epidemiologic studies that have examined the relationship between micronutrient deficiencies and health outcomes in childhood and HIV infection, as well as clinical trials of micronutrient supplementation. Vitamin A supplementation among communities at risk of deficiency effectively reduces mortality and morbidity in children younger than age 5, and vitamin A may be especially effective in HIV-infected children. Vertical transmission of HIV has not to date been affected by maternal micronutrient supplementation. In children with poor dietary zinc intake and/or bioavailability, zinc supplementation reduces the incidence and severity of diarrheal diseases, as well as the occurrence of pneumonia. Vitamin A therapy has not been associated with improved growth, whereas some trials have shown that zinc supplementation is associated with greater increments in height. Further trials of micronutrient supplementation are warranted.     

Perspective: Practical Approach to Preventing Subclinical B12 Deficiency in Elderly Population

Vitamin B12 (also known as cobalamin) is an essential water-soluble vitamin that plays a pivotal role for several physiologic functions during one’s lifespan. Only certain microorganisms are able to synthetize B12, thus humans obtain cobalamin exclusively from their diet, specifically from animal-derived foods. Specific sub-group populations are at risk of vitamin B12 subclinical deficiency due to different factors including poor intake of animal source foods and age-dependent decrease in the capacity of intestinal B12 uptake. Consumption of animal products produces some negative health issues and negatively impacts sustainability while a plant-based diet increases the risk of B12 deficiency. Taking a cue from the aforementioned considerations, this narrative review aims to summarize facts about B12 deficiency and the burden of inadequate dietary intake in elderly population, as well as to discuss sustainable approaches to vitamin B12 deficiency in aging population.     

Vitamin B12 and Folate Status of a Selected Group of Free-Living Older Persons

Vitamin B12 and folate status was determined in 50 male and 47 female free-living subjects (65-77 years) in winter and summer. The mean intake calculated from 3-day food records met the Canadian recommended intake (RNI) for both gender and season, however, probability analysis of dietary data revealed a number of subjects at risk of deficiency. Although the mean plasma levels were within the acceptable range for both vitamins, some 9 to 14% of individual subjects had folate plasma levels below normal. Fewer subjects had subnormal plasma vitamin B12 levels. Although mean values for dietary intake and plasma concentration of folate and vitamin B12 may indicate nutritional adequacy, a proportion of an older population may be at nutritional risk.     

Changes in time-trends of nutrient intake from fortified and non-fortified food in German children and adolescents--15 year results of the DONALD study. Dortmund Nutritional and Anthropometric Longitudinally Designed Study

Summary Background: Although fortified products have played an increasing role in food marketing since the 1980 s in Germany, data as to the consumption of fortified food is sparse. Aim of the study: To assess long-term data on changes in fortified food supply or consumption patterns, nutrient intake, and time trends in the DONALD Study (Dortmund Nutritional and Anthropometric Longitudinally Designed Study). Methods: Between 1985 and 2000 consumption of nutrient intake (total and from fortified foods) was evaluated and time trends in energy and nutrient intake were assessed on the basis of 3-day weighed dietary records (n = 4193) of 2–14 year-old males (n = 383) and females (n = 404) enrolled in the DONALD Study. Nutrient intake was expressed as percentage of the current German recommendations. Food products were defined as fortified if enriched with at least one of the following nutrients: Vitamin A or provitamin A carotenoids (summarised as Vitamin A), Vitamins E, B1, B2, B6, C, niacin, folate, calcium or iron. Nutrient supplements and medicine were excluded from this evaluation. Time trends were analysed using linear and non-linear regression models (PROC MIXED, SAS^? 6.12). Results: In percent of German references [3], non-fortified food contributed to folate intake by 20–30 %, to Vitamin E by about 40 %, to Vitamin B1 by 50–65 %, to Vitamin A, C, B2, calcium, iron by about 65–95 %, and to Vitamin B6 and niacin intake by 100 % and more. Fortified food alone provided no more than 5 % of calcium intake, about 10–20 % of iron, Vitamin A and folate intake, up to 40–50 % of Vitamin C, B 1, B2, E, niacin and up to 80 % of Vitamin B6 intake. During the 15 year period of the DONALD Study with total food, we only found a significant linear time trend for Vitamin C, whereas significant non-linear time trends were found for calcium, Vitamin E, B1, B2, B6, niacin and folate. In the latter there was a uniform increase until 1994 and a decrease thereafter. For iron and Vitamin A no significant time trend could be identified. Only iron and Vitamin A intake from fortified food showed a significant linear time trend. All other nutrients studied here gave significant non-linear time trends. Nutrient intake with fortified food reached maximum values between 1994 and 1996 followed by a decrease thereafter. Conclusions: Signs of changing food consumption patterns were found, pointing to an almost uniform decrease of nutrient intake since 1994/96 in our population of German children and adolescents. This could be an alarming indicator of a slight but unpreferable tendency to eat energydense, nutrient-poor foods. Received: 22 January 2001 / Accepted: 19 April 2001