Total,Added, and Free Sugars: Are Restrictive Guidelines Science-Based or Achievable?

Sugar consumption, especially added sugars, is under attack. Various government and health authorities have suggested new sugar recommendations and guidelines as low as 5% of total calories from free sugars. Definitions for total sugars, free sugars, and added sugars are not standardized, nor are there accepted nutrient databases for this information. Our objective was to measure total sugars and added sugars in sample meal plans created by the United States Department of Agriculture (USDA) and the Academy of Nutrition and Dietetics (AND). Utilizing the Nutrition Data System for Research (NDSR) nutritional database, results found that plans created by the USDA and AND averaged 5.1% and 3.1% calories from added sugar, 8.7% and 3.1% from free sugar, and 23.3% and 21.1% as total sugars respectively. Compliance with proposed added sugar recommendations would require strict dietary compliance and may not be sustainable for many Americans. Without an accepted definition and equation for calculating added sugar, added sugar recommendations are arbitrary and may reduce intakes of nutrient-rich, recommended foods, such as yogurt, whole grains, and tart fruits including cranberries, cherries, and grapefruit. Added sugars are one part of excess calorie intake; however, compliance with low added sugar recommendations may not be achievable for the general public.     

红细胞游离原卟啉在非缺铁婴幼儿中的分布特征及正常值探讨

本文分析了336名非缺铁婴幼儿红细胞游离原卟啉(Free Erythro-cyte Protoporphyrin,FEP)水平。结果表明,336名婴幼儿FEP呈正态分布,正常值为360μg/L全血,界限值500μg/L;FEP水平无年龄和性別的差异;FEP与Hb之间呈负相关,r=-0.6784(P<0.01);诊断铁缺乏症的灵敏性为87％,特异性88％,与Hb的诊断符合串为81％。同时比较了国产930型简易荧光计与日本F-3000型荧光分光光度计测定FEP效果,其结果基本一致,但930机测定值离散度较大。     

The impact of added sugar consumption on overall dietary quality in Irish children and teenagers

Background There is concern that added sugar may dilute micronutrients and displace nutrient dense foods from the diet. Methods The data for this analysis was based on the National Children’s Food Survey and National Teen Food Survey, which used 7‐day food diaries to collect food and beverage intake data in representative samples of Irish children (5–12 years, n = 594) and teenagers (13–17 years, n = 441) respectively. Results High consumption of added sugars was associated with a decrease in the micronutrient density of the diet and increased prevalence of dietary inadequacies in children and teenagers. The decrease in micronutrient density was significant for several micronutrients, including magnesium (P < 0.001), calcium (P < 0.01 children; P < 0.001 teenagers), zinc (P < 0.05) and vitamins B₁₂ (P < 0.01 children; P < 0.001 teenagers) and C (P < 0.05). There was wide variation in the micronutrients for which prevalence of dietary inadequacies increased depending on gender and population group. Conclusions Clinical data are required before conclusions can be made on whether micronutrient dilution is a concern in Ireland. A change in the consumption of several foods across level of added sugar intake may explain the decrease in the intake of several micronutrients and the decrease in the compliance with macronutrient recommendations in high consumers of added sugars in children and teenagers.     

成都市婴幼儿营养补充剂应用及影响因素探讨

目的了解成都市婴幼儿营养补充剂使用现状及影响因素。方法随机选取成都市两个社区257名0～3岁婴幼儿及其家长作为研究对象,通过问卷调查收集婴幼儿营养补充剂使用相关信息和家庭基本情况,分析影响营养补充剂使用的相关因素。结果婴幼儿营养补充剂总使用率为87.5%,各类营养补充剂使用率依次为维生素D 76.3%、维生素A 75.5%、钙33.5%、锌16.3%、铁3.9%;除铁制剂外,不同月龄组间婴幼儿营养补充剂使用率差异有显著性(P<0.05),随月龄增加钙、锌使用率呈上升趋势,维生素D和维生素A在6～11月龄段使用率最高;营养补充剂使用分别与家长对婴幼儿期营养重视程度(OR=0.186,P<0.05)和婴幼儿生长发育状况(OR=2.317,P<0.05)有关。结论成都市婴幼儿营养补充剂使用已较普遍,需加强专业指导以保证营养补充剂的合理应用。     

Changes in intakes of total and added sugar and their contribution to energy intake in the U.S

This study was designed to document changes in total sugar intake and intake of added sugars, in the context of total energy intake and intake of nutrient categories, between the 1970s and the 1990s, and to identify major food sources contributing to those changes in intake. Data from the NHANES I and III were analyzed to obtain nationally representative information on food consumption for the civilian, non-institutionalized population of the U.S. from 1971 to 1994. In the past three decades, in addition to the increase in mean intakes of total energy, total sugar, added sugars, significant increases in the total intake of carbohydrates and the proportion of carbohydrates to the total energy intake were observed. The contribution of sugars to total carbohydrate intake decreased in both 1-18 y and 19+ y age subgroups, and the contribution of added sugars to the total energy intake did not change. Soft drinks/fluid milk/sugars and cakes, pastries, and pies remained the major food sources for intake of total sugar, total carbohydrates, and total energy during the past three decades. Carbonated soft drinks were the most significant sugar source across the entire three decades. Changes in sugar consumption over the past three decades may be a useful specific area of investigation in examining the effect of dietary patterns on chronic diseases.     

门诊就诊141 331例婴幼儿贫血患病情况分析

【目的】 对来院就诊北京地区常住人口婴幼儿贫血患病情况进行统计分析,为保健干预提供依据。 【方法】 回顾分析2011年1-12月来首都儿科研究所附属儿童医院就诊141 331例6月龄~3岁儿童末梢血或静脉血血常规五分类检测结果。按照血红蛋白低于110g/L为贫血筛查标准,MCV和MCHC水平差异为贫血类型筛选标准,6月龄组(6~12月龄)、1~岁组和 2~岁组共3个年龄组进行统计学分析。 【结果】 本次回顾分析人群中,婴幼儿贫血总患病率为10.29%,6月龄~组贫血患病率为22.1%,1~岁组为8.52%,2~岁组为1.97%,χ²检验结果表明年龄组间患病率差异有统计学意义。贫血类型分析发现小细胞低色素贫血为12.43%,大细胞性贫血为0.24%,正细胞性贫血为17.03%以及单纯小细胞性贫血为69.78%。贫血程度情况分析表明轻度贫血13 276例,患病率为9.39%;中度贫血1 247例,患病率为0.88%;重度贫血19例,患病率为0.013%。 【结论】 以婴幼儿6月龄组贫血患病率最高,轻度贫血患病率居首位,本次资料分析结果可作为现阶段门诊就诊儿童人群营养保健干预的实验参考依据。     

2009年中国西部贫困农村6～23月龄婴幼儿喂养状况分析

目的分析2009年我国西部贫困农村6～23月龄婴幼儿喂养状况。方法利用科技支撑项目"贫困农村地区儿童营养缺乏改善适宜技术的研究"资料,调查对象6～23月龄婴幼儿2933名。应用SAS软件进行统计分析。结果 2009年,中国西部贫困农村6月龄内婴儿的母乳喂养率为38.3%。婴幼儿开始添加辅食时间为5个月,断奶时间为10个月。结论我国西部贫困农村婴幼儿喂养不合理。     

成都地区城乡母乳喂养持续时间及其影响因素研究

目的研究成都地区母乳喂养持续时间及其影响因素。方法采用分层整群随机抽样法选取成都地区城乡1178名6～24月龄婴幼儿作为研究对象,通过问卷调查收集婴幼儿及家庭基本情况和母乳喂养相关信息,运用Kaplan-Meier法和Cox比例风险模型分析母乳喂养持续时间及其影响因素。结果调查对象母乳喂养持续时间(P50)分别为城市6.0个月(P25～P75:3～8.5个月)和农村8.0个月(P25～P75:5～11个月),城乡差异有显著性(P<0.05);婴幼儿饮食月消费与母乳喂养持续时间呈负相关(城乡RR值分别为0.163和0.312),母亲产假与母乳喂养持续时间呈正相关(城乡RR值分别为1.508和2.191)。结论成都地区母乳喂养时间普遍不足,需采取针对性的干预措施给予改善。     

中国2岁以下婴幼儿喂养状况研究

目的分析中国2岁以内婴幼儿喂养状况及变化趋势。方法采用多阶段分层随机整群抽样的方法,在全国14个省、自治区、和直辖市的43个调查点中选取7204名2岁以下婴幼儿,利用婴幼儿家长调查问卷了解儿童喂养状况。结果2006年中国6个月内婴儿母乳喂养率为49.2%,城市为51.9%,农村为48.5%。6～24个月婴幼儿配方奶、普通奶类、谷类、畜肉类、水产品、蛋类、豆类及蔬菜水果的平均添加率分别为41.8%、47.6%、94.4%、78.0%、59.9%、87.4%、64.9%和90.2%。结论中国2岁以内婴幼儿喂养状况需要关注,纯母乳喂养率偏低,过早添加辅食与辅食添加不及时同时存在。尤其农村6个月内婴儿母乳喂养率呈下降趋势明显。     

湖北农村地区6~23月龄婴幼儿贫血状况分析

目的 了解湖北省农村地区6~23月龄婴幼儿贫血状况。方法 采用整群随机抽样的方法,对8个农村县的婴幼儿喂养行为进行入户问卷调查,对血红蛋白和身长、体重进行现场测量。结果 813名6~23月龄婴幼儿中,贫血患病率为30.6%,男童为29.2%,女童为32.2%;6~11月龄婴幼儿贫血患病33.6%,高于12~17月龄的31.2%和18~23月龄的24.6%（P<0.05）;母亲贫血的婴幼儿贫血患病率37.6%,高于母亲不贫血婴幼儿的28.8%（P<0.05）;有初乳喂养史的婴幼儿贫血患病率27.4%,低于无初乳喂养者的48%（P<0.01）;产后1~24 h内开奶的婴幼儿贫血患病率18.4%,低于24 h后开奶者的39.9%（P<0.01）;营养不良的婴幼儿贫血患病率32.7%,高于无营养不良婴幼儿的22.2%（P<0.05）。结论 尽早开奶、初乳喂养、改善母亲贫血和儿童营养不良状况有助于降低农村地区婴幼儿贫血患病率。     

中国西部五省农村婴幼儿营养不良及影响因素分析

  目的  了解中国6～24月龄婴幼儿生长迟缓情况及喂养行为对其的影响。  方法  利用2013年中国居民营养与健康状况监测数据,共得到10 084名6～24月龄婴幼儿体测数据及喂养行为现状,计算获得年龄别身长（HAZ）,分析各喂养行为与HAZ之间的相关性。  结果  2013年中国6～24月龄婴幼儿生长迟缓率为7.17 %,男童（8.87 %）高于女童（5.35 %）;家庭年人均收入较高和母亲学历较高者婴幼儿生长迟缓发生率较低;大城市、中小城市、非贫困县和贫困县生长迟缓发生率分别为2.83 %、5.33 %、7.66 %和14.36 %,呈依次增加趋势;各组之间比较差异均有统计学意义（P < 0.05）。logistic回归分析显示,影响6～24月龄婴幼儿生长迟缓的主要喂养行为因素为过去1周各类食物摄入频次。  结论  中国6～24月龄婴幼儿生长迟缓患病状况在贫困农村依然呈较高水平,而喂养行为是否科学直接影响婴幼儿的生长发育状况。建议倡导科学喂养,尤其应重视婴幼儿的辅食添加质量。     

中国儿童营养状况15年变化分析——中国婴幼儿辅食喂养的改善

目的利用中国食物与营养监测数据,描述1992~2005年中国婴幼儿喂养的改善情况。方法以各种辅助食品开始添加的时间和添加频率描述了我国婴幼儿辅助喂养的改善。以logistic回归方法分析了中国儿童各种辅食添加时间和添加频率与生长发育的关系。结果1992年~2005中国婴幼儿,特别是农村婴幼儿辅食喂养的模式有了很大的改善。婴儿6个月龄按时添加奶及其制品、蔬菜/水果、动物性食品与婴幼儿生长迟缓率、低体重率呈负相关。没有按时添加奶及其制品对婴幼儿生长迟缓的相对危险度为1.378,对低体重的相对危险度1.189。每天添加牛奶,动物性食物,蔬菜\水果对婴幼儿身高增长和体重增长有非常重要的作用。结论15年来中国儿童生长发育的改善,与农民收入增加后婴幼儿辅助喂养的改善有关。     

宁夏贫困地区婴幼儿营养包服用情况及影响因素

目的 了解宁夏贫困地区婴幼儿营养包服用情况并对其影响因素进行分析。方法 2017-2018年期间,采用多阶段PPS抽样调查法和随机等距抽样相结合的方法,对宁夏7个贫困县(区)2 120名6~24月龄婴幼儿看护人进行问卷调查分析,内容包括婴幼儿出生基本情况、营养包服用、看护人喂养和营养知识情况等。结果 婴幼儿营养包有效服用率为80.3%,汉族营养包有效服用率高于回族,无不适反应高于有不适反应,随着婴幼儿月龄增加有效服用率升高,母亲、父亲学历越高有效服用率越高,不同民族、月龄、不适反应、母亲学历组间的差异有统计学意义(P＜0.05)。多因素非条件Logistic回归分析显示,汉族(OR=0.635,95%CI:0.487~0.827,P=0.001)、无不适反应(OR=0.286,95%CI:0.192~0.425,P<0.001)、月龄(OR=0.970,95%CI:0.951~0.990,P=0.003)为婴幼儿营养包食用依从性保护因素,母亲年龄是其危险因素(OR=1.023,95%CI:1.002~1.045,P=0.029)。结论 宁夏贫困地区婴幼儿营养包食用依从性有待进一步提高,需针对其影响因素采取相关干预措施。     

陕西宁强6~24月龄婴幼儿营养包干预半年效果评价

【目的】 评价营养包对陕西宁强农村地区6~24月龄婴幼儿营养干预6个月的效果。 【方法】 对宁强县所有6~24月龄婴幼儿每天补充1包富含优质蛋白、多种维生素和矿物质的营养包,在干预开始前和干预6个月后共抽取634名婴幼儿进行身长、体重测量和指血血红蛋白检测。 【结果】 营养包干预6个月后,婴幼儿平均血红蛋白、身长、体重、年龄别体重(WAZ)、身高别体重(WHZ)分别提高7.4 g/L、3.3 cm、1.2 kg、0.6分、0.6分,差异均具有统计学意义(P<0.01);经χ²检验,干预后比干预前贫血患病率下降25.1%(P<0.01),生长迟缓率下降1.0%,低体重率下降5.4%(P<0.01),消瘦率下降4.0%(P<0.01)。 【结论】 给6~24月龄婴幼儿补充营养包6个月后可以显著降低婴幼儿的贫血患病率、低体重率和消瘦率。