2016年中国八城市成年人酸奶摄入量及其与代谢综合征的关系

目的 了解中国城市人群酸奶摄入水平及其与代谢综合征及其组分的关系.方法 于2016年对中国八城市人群进行抽样,分别进行膳食调查、体格检查和血样收集,计算并评价人群酸奶摄入水平,采用Logistic回归分析酸奶摄入与代谢综合征及其组分的关系.其中酸奶摄入量采用膳食频率问卷进行调查,记录过去1个月内酸奶摄食频率与摄入量.结...     

应用膳食质量快速评价表评价样本人群膳食质量

[目的]为了有针对性地开展中国居民膳食指南宣传工作,应用以中国膳食平衡指数法为基础的膳食质量快速表对样本人群的食物摄入状况进行快速评价。[方法]采用方便抽样原则,对5省市10个项目点的414名研究对象进行调查和评价。采用1d24h回顾结合1d食物记录得到研究对象2d的食物摄入情况,应用膳食质量快速评价表进行快速评价。[结果]样本人群中蔬菜水果、奶类豆类摄入不足,谷类和动物性食物既有摄入不足也有摄入过量,食盐和食用油摄入过量;食物摄入不足程度农村点高于城市点;摄入过量程度男性高于女性。[结论]膳食质量快速评价表是中国膳食平衡指数的表格化,其设计直观、简洁,使用快速、方便,既可用于营养工作人员进行现场快速评价,也可作为大众平时进行自我监测的工具。     

中国八城市成年女性水产品摄入频次与血脂水平相关性分析

目的分析中国八城市成年女性水产品摄入频次与血脂水平的关系。方法本研究数据来自2016年3月至7月进行的中国八城市成人营养健康状况调查。采用多阶段分层抽样法,获得来自8个城市的1107名成年女性调查对象,对其社会人口学特征、身体测量指标、膳食摄入和血脂水平进行调查。结果与摄入水产品每周不足1次者相比,每周摄入3次及以上者具有较高的血清低密度脂蛋白胆固醇(LDL-C)(β=0.20,95%CI:0.08~0.32,P=0.001)、总胆固醇(TC)(β=0.15,95%CI:0.02~0.29,P=0.027)和较低的甘油三酯(TG)(β=-0.20,95%CI:-0.39~0.00,P=0.049)。淡水产品和海产品对血脂的影响存在差异。结论膳食水产品摄入对中国成年女性血脂水平存在显著影响。     

中国八城市成人钙摄入状况研究

目的通过横断面调查,了解中国八城市成人钙摄入情况、钙的餐次分布和钙的食物来源。方法采用立意抽样和分层随机抽样相结合的多阶段抽样方法,通过问卷调查获得其一般情况,通过24h膳食回顾调查获得其膳食情况。结果有效调查对象1716人,膳食总钙摄入量为351.4(203.6,566.9)mg/d,均值为467.1 mg/d;食物中的钙(不包含膳食补充剂)的摄入量为325.6(191.7,497.5)mg/d,均值为402.7mg/d,不同年龄组和南北方之间钙摄入量存在差异。补充含钙膳食补充剂占总调查人群的10.6%,平均摄入量为367.3(250.0,650.1)mg/d,女性补充率为12.8%,高于男性(P0.001);50岁及以上人群的含钙补充剂补充率为14.2%,高于18~49岁年龄组(P0.001)。调查对象整体钙摄入量低于EAR的比例为85.2%,高于RNI的为8.5%。就食物来源,本研究膳食钙主要来源于蔬菜和奶类食品,分别占25.5%和22.8%;豆类、肉类和谷类对膳食钙的贡献率均超过10%。早餐钙的摄入量较少,中位数为63.5 mg/d;午餐和晚餐的钙摄入相近,中位数分别为73.3、72.0 mg/d;三餐钙的摄入量差异有显著性(P0.05)。结论城市成年人膳食钙摄入不足的发生率仍旧较高,含钙补充剂在成年人群中使用率低;应该合理安排餐次,调整饮食结构,增加富含钙食物摄入以提高钙的摄入水平。     

成都市社区居民食物摄入频率研究

本次调查研究旨在了解中国西部代表城市———成都市的社区居民食物摄入频率现状和膳食结构 ,为今后在城市开展社区居民营养教育和营养改善工作提供科学依据。1　对象与方法1 1　对象采用整群抽样法选取成都市玉林社区 15岁以上居民 94 7人作为调查对象。1 2　方法1 2 1　调查     

中国农村地区高血压患者果蔬摄入对血压进展的影响研究

目的 基于前瞻性队列研究探讨我国农村地区高血压患者果蔬摄入与血压进展的关系.方法 中国代谢综合征社区干预研究暨中国家庭健康研究于2007-2008年开展基线调查,收集膳食、体力活动和血压等信息,并于2012-2015年进行随访调查.膳食资料采用食物频率问卷获取,按照研究对象总果蔬、水果和蔬菜摄入量是否达到推荐摄入水平和...     

北京市通州区外来务工子弟小学生膳食营养知识与行为现况调查

目的分析北京市通州区流动儿童膳食营养相关知识与行为现状。方法采用典型抽样方法 ,选取通州区4所以流动儿童为全部生源的流动务工子弟小学,以班级为最小抽样单位,整群抽取三-五年级全部学生1 395名,采用自行编制调查问卷进行匿名自填式问卷调查。结果调查对象膳食与疾病、平衡膳食和膳食营养知识知晓率分别为54.5%、26.2%和29.4%,不同调查特征被调查对象膳食营养、膳食与疾病知识知晓率差异均有统计学意义(P0.05)。64.5%的被调查对象达到每日吃早餐,奶制品、肉类、蛋类、豆制品达到"每天和经常"摄入的占49.1%、32.8%、32.2%和26.0%。结论流动儿童膳食营养相关知识知晓率较低,蛋白质类食物摄入不足,应从学校、家长、学生三方面开展膳食营养教育,改善膳食营养行为。     

2010～2012年中国居民膳食维生素摄入状况

目的分析中国居民主要膳食维生素的摄入状况。方法本文数据来自2010~2012年中国居民营养与健康状况监测中连续3 d 24 h膳食回顾调查。采用多阶段分层与人口成比例的整群随机抽样方法进行抽样,研究对象为中国内地31个省份150个监测点18岁及以上居民,调查总人数为64038人。不同人群平均维生素摄入量及摄入充足率采用2009年国家统计局公布的人口数据,经过复杂抽样加权处理。结果中国居民膳食来源的维生素摄入量为:视黄醇当量441.9μg,视黄醇活性当量为291.5μg;维生素E为35.7 mg,其中α维生素E为8.5 mg;硫胺素为0.9 mg;核黄素为0.8 mg;烟酸为14.3 mg,烟酸当量为21.0 mg;抗坏血酸为80.1 mg;叶酸摄入量为180.9μg。我国居民总体膳食维生素充足率为32%,烟酸的充足率最高为79.3%,叶酸的充足率最低仅为9.0%。结论中国居民膳食维生素摄入不足问题普遍存在,至少有2/3的人群存在膳食维生素摄入不足。应通过营养教育、营养强化等干预措施以提高膳食维生素的摄入水平。     

应用调整的膳食平衡指数评价厦门市区成年居民膳食质量

目的利用调整的中国膳食平衡指数(DBI-07)综合评价厦门市城区18~65岁居民膳食质量,为开展营养干预提供依据。方法采用多阶段分层整群抽样方法于2010年10—12月对厦门市区6个社区居委会成年居民进行调查,采用连续3天24 h回顾法对其中的520人进行了膳食调查,采用DBI-07的评分方法评价厦门城区成年居民膳食质量水平。结果被调查的厦门市城区成年居民的膳食质量处于中度失衡状态,摄入不足和摄入过量并存;女性的摄入不足程度高于男性;各年龄段中,40~50岁人群摄入不足程度最高,摄入过量程度最低。结论被调查的厦门市城区成年居民水果、奶类及豆类摄入不足,肉类、食用油及盐类摄入过量;成年居民的主要膳食模式为A模式,且A模式反映了膳食中摄入不足与摄入过量的问题均较少,为最优模式。     

中国9省/自治区成年居民膳食胆固醇摄入与高胆固醇血症关系的前瞻性研究

目的 探讨成年居民膳食胆固醇摄入与高胆固醇血症的关系. 方法 利用“中国健康与营养调查”数据,本研究中纳入的研究对象为同时参加2004年和2009年2轮调查、且在2009年调查时年龄为25～65岁、血样检测和膳食调查数据完整的成年居民,共4 244人.以《中国成人血脂异常防治指南2007》为标准,血清TC≥6.22 mmol/L时,判定为高胆固醇血症.采用非条件logistic回归方法,研究膳食胆固醇摄入与高胆固醇血症的关系.结果 2009年成年居民平均血清TC水平为4.9 mmol/L,高胆固醇血症患病率为9.6%.2004－2009年膳食胆固醇摄入量总体呈大幅增长,尤其是低摄入量组的增幅最大.男性成年居民中2004年膳食胆固醇摄入中低水平者和2009年膳食胆固醇摄入高水平者,高胆固醇血症患病风险增加.女性膳食胆固醇摄入与高胆固醇血症之间未见统计学关联.结论 膳食胆固醇摄入与高胆固醇血症的关系具有性别差异.膳食胆固醇摄入水平升高,可增加男性居民发生高胆固醇血症的危险性.     

Cut-off points for muscle mass — not grip strength or gait speed — determine variations in sarcopenia prevalence

Objectives

The European Working Group on Sarcopenia in Older People (EWGSOP) has proposed different methods and cut-off points for the three parameters that define sarcopenia: muscle mass, muscle strength and physical performance. Although this facilitates clinical practice, it limits comparability between studies and leads to wide differences in published prevalence rates. The aim of this study was to assess how changes in cut-off points for muscle mass, gait speed and grip strength affected sarcopenia prevalence according to EWGSOP criteria.

Methods

Cross-sectional analysis of elderly individuals recruited from outpatient clinics (n=298) and nursing homes (n=276). We measured muscle mass, grip strength and gait speed and assessed how changes in cut-off points changed sarcopenia prevalence in both populations.

Results

An increase from 5.45 kg/m² to 6.68 kg/m² in the muscle mass index for female outpatients and nursing-home residents increased sarcopenia prevalence from 4% to 23% and from 9% to 47%, respectively; for men, for an increase from 7.25 kg/m² to 8.87 kg/m², the corresponding increases were from 1% to 22% and from 6% to 41%, respectively. Changes in gait speed and grip strength had a limited impact on sarcopenia prevalence.

Conclusion

The cut-off points used for muscle mass affect the reported prevalence rates for sarcopenia and, in turn, affect comparability between studies. The main factors influencing the magnitude of the change are muscle mass index distribution in the population and the absolute value of the cut-off points: the same difference between two references (e.g., 7.5 kg/m² to 7.75 kg/m² or 7.75 kg/m² to 8 kg/m²) may produce different changes in prevalence. Changes in cut-off points for gait speed and grip strength had a limited impact on sarcopenia prevalence and on study comparability.

     

Effectiveness of cardiac rehabilitation for prevention and treatment of sarcopenia in patients with cardiovascular disease - a retrospective cross-sectional analysis

Objective

Sarcopenia is a syndrome characterized by progressive and generalized loss of skeletal muscle mass and strength, with the risk of frailty and poor quality of life. This study aimed to clarify the clinical characteristics of sarcopenia and to investigate the effects of comprehensive cardiac rehabilitation (CCR), including nutrition, physical exercise and medication, in patients with cardiovascular disease (CVD).

Methods

We retrospectively studied 322 inpatients with CVD (age 72±12 years). Muscle mass, muscle strength and physical performance were assessed before and after exercise training in patients with and without sarcopenia, which was defined as either a gait speed of <0.8 m/s or reduced handgrip strength (<26 kg in males and <18 kg in females), together with lower skeletal muscle index (SMI) (<7.0 kg/m2 in males and <5.7 kg/m2 in females). The actual daily total calorie and nutrient intake was also calculated.

Results

Sarcopenia was identified in 28% of patients with CVD, these patients having a higher prevalence of symptomatic chronic heart failure and chronic kidney disease. SMI was significantly associated with protein intake and statin treatment. The ratio of peak VO₂ and SMI was significantly higher in the statin treatment group. Handgrip strength, gait speed, leg weight bearing index, and nutritional intake improved after exercise training in patients both with and without sarcopenia.

Conclusions

The present findings suggest that CCR is a promising strategy for prevention and treatment of sarcopenia in patients with CVD.

     

Sarcopenia: an undiagnosed condition in older adults. Current consensus definition: prevalence, etiology, and consequences. International working group on sarcopenia

Sarcopenia, the age-associated loss of skeletal muscle mass and function, has considerable societal consequences for the development of frailty, disability, and health care planning. A group of geriatricians and scientists from academia and industry met in Rome, Italy, on November 18, 2009, to arrive at a consensus definition of sarcopenia. The current consensus definition was approved unanimously by the meeting participants and is as follows: Sarcopenia is defined as the age-associated loss of skeletal muscle mass and function. The causes of sarcopenia are multifactorial and can include disuse, altered endocrine function, chronic diseases, inflammation, insulin resistance, and nutritional deficiencies. Although cachexia may be a component of sarcopenia, the 2 conditions are not the same. The diagnosis of sarcopenia should be considered in all older patients who present with observed declines in physical function, strength, or overall health. Sarcopenia should specifically be considered in patients who are bedridden, cannot independently rise from a chair, or who have a measured gait speed less that 1 m/s(-1). Patients who meet these criteria should further undergo body composition assessment using dual energy x-ray absorptiometry with sarcopenia being defined using currently validated definitions. A diagnosis of sarcopenia is consistent with a gait speed of less than 1 m·s(-1) and an objectively measured low muscle mass (eg, appendicular mass relative to ht(2) that is ≤ 7.23 kg/m(2) in men and ≤ 5.67 kg/m(2) in women). Sarcopenia is a highly prevalent condition in older persons that leads to disability, hospitalization, and death.     

High Salt Diet Impacts the Risk of Sarcopenia Associated with Reduction of Skeletal Muscle Performance in the Japanese Population

The World Health Organization has recommended 5 g/day as dietary reference intakes for salt. In Japan, the averages for men and women were 11.0 g/day and 9.3 g/day, respectively. Recently, it was reported that amounts of sodium accumulation in skeletal muscles of older people were significantly higher than those in younger people. The purpose of this study was to investigate whether the risk of sarcopenia with decreased muscle mass and strength was related to the amount of salt intake. In addition, we investigated its involvement with renalase. Four groups based on age and salt intake (“younger low-salt,” “younger high-salt,” “older low-salt,” and “older high-salt”) were compared. Stratifying by age category, body fat percentage significantly increased in high-salt groups in both younger and older people. Handgrip strength/body weight and chair rise tests of the older high-salt group showed significant reduction compared to the older low-salt group. However, there was no significant difference in renalase concentrations in plasma. The results suggest that high-salt intake may lead to fat accumulation and muscle weakness associated with sarcopenia. Therefore, efforts to reduce salt intake may prevent sarcopenia.     

Sarcopenia Prevalence and Risk Factors among Residents in Aged Care

The aim of this study was to investigate the prevalence of sarcopenia and associated risk factors among older adults living in three residential aged care (RAC) facilities within Auckland, New Zealand. A total of 91 older adults (63% women, mean age ± SD; 86.0 ± 8.3 years) were recruited. Using the European Working Group on Sarcopenia in Older People criteria, sarcopenia was diagnosed from the assessment of: appendicular skeletal muscle mass/height², using an InBody S10 body composition analyser and a SECA portable stadiometer or ulna length to estimate standing height; grip strength using a JAMAR handheld dynamometer; and physical performance with a 2.4-m gait speed test. Malnutrition risk was assessed using the Mini Nutrition Assessment–Short Form (MNA-SF). Most (83%) of residents were malnourished or at risk of malnutrition, and 41% were sarcopenic. Multivariate regression analysis showed lower body mass index (Odds Ratio (OR) = 1.4, 95% CI: 1.1, 1.7, p = 0.003) and lower MNA-SF score (OR = 1.6, 95% CI: 1.0, 2.4, p = 0.047) were predictive of sarcopenia after controlling for age, level of care, depression, and number of medications. Findings highlight the need for regular malnutrition screening in RAC to prevent the development of sarcopenia, where low weight or unintentional weight loss should prompt sarcopenia screening and assessment.     

Association of Serum Phosphate with Low Handgrip Strength in Patients with Advanced Chronic Kidney Disease

Muscle wasting and hyperphosphatemia are becoming increasingly prevalent in patients who exhibit a progressive decline in kidney function. However, the association between serum phosphate (Pi) level and sarcopenia in advanced chronic kidney disease (CKD) patients remains unclear. We compared the serum Pi levels between advanced CKD patients with (n = 51) and those without sarcopenia indicators (n = 83). Low appendicular skeletal muscle mass index (ASMI), low handgrip strength, and low gait speed were defined per the standards of the Asian Working Group for Sarcopenia. Mean serum Pi level was significantly higher in advanced CKD patients with sarcopenia indicators than those without sarcopenia indicators (3.88 ± 0.86 vs. 3.54 ± 0.73 mg/dL; p = 0.016). Univariate analysis indicated that serum Pi was negatively correlated with ASMI, handgrip strength, and gait speed. Multivariable analysis revealed that serum Pi was significantly associated with handgrip strength (standardized β = −0.168; p = 0.022) and this association persisted even after adjustments for potential confounders. The optimal serum Pi cutoff for predicting low handgrip strength was 3.65 mg/dL, with a sensitivity of 82.1% and specificity of 56.6%. In summary, low handgrip strength is common in advanced CKD patients and serum Pi level is negatively associated with handgrip strength.     

Glycemic Control and Insulin Improve Muscle Mass and Gait Speed in Type 2 Diabetes: The MUSCLES-DM Study

ObjectivesType 2 diabetes is a risk factor for sarcopenia. Evidence on the prevention of sarcopenia using blood glucose–lowering therapy is limited. We aimed to examine the relationship between changes in glycemic control and sarcopenia and the effect of antidiabetic agents against sarcopenia in patients with type 2 diabetes.DesignWe conducted an observational longitudinal study.Setting and ParticipantsIn total, 588 Japanese patients with diabetes of an ongoing multicenter study completed 1-year follow-up measurements for sarcopenia and clinical data.MethodsThe data set of the Multicenter Study for Clarifying Evidence for Sarcopenia in patients with Diabetes Mellitus (the MUSCLES-DM study) was analyzed.ResultsDuring the follow-up period, the frequency of sarcopenia marginally increased, and the means of skeletal muscle mass index (SMI), handgrip strength, and gait speed did not show any changes. However, on dividing into 5 groups depending on the degree of changes in glycated hemoglobin (HbA_1c) value, the patients with a decrease of ≥1% in HbA_1c exhibited a significant increase in SMI. Our analysis revealed similar results for gait speed but not handgrip strength. Using the multiple linear regression model, we identified that a ≥1% decrease in HbA_1c value was an independent determinant of the changes in SMI and gait speed. We also determined that insulin use at baseline was an independent factor for the changes in SMI.Conclusions and ImplicationsCorrection of poor glycemic control and use of insulin were significantly associated with the increase in skeletal muscle mass or gait speed in Japanese patients with type 2 diabetes. The current finding increases our understanding of the importance of glycemic control for the prevention of cardiovascular diseases and sarcopenia.     

Associations between Consumption of Ultra-Processed Foods and Intake of Nutrients Related to Chronic Non-Communicable Diseases in Mexico

BackgroundUltra-processed foods are highly palatable and can be consumed anywhere at any time, but typically have a poor nutritional profile. Therefore, their contribution to total energy intake has been proposed as an indicator for studying overall dietary quality.ObjectiveThe aim of this study was to investigate the associations between the energy contribution from ultra-processed foods and the intake of nutrients related to chronic non-communicable diseases in Mexico.DesignThis study used a secondary analysis of cross-sectional data from the 2012 Mexican National Health and Nutrition Survey.Participants/settingThis study included participants aged 1 year and older (n=10,087) who had completed a 1-day 24-hour recall.Main outcome measuresIntake from added sugar (% kcal), total fat (% kcal), saturated fat (% kcal), protein (% kcal), dietary fiber (g/1,000 kcal), and dietary energy density (kcal/g) were measured.Statistical analysisMultiple linear regression models adjusted for sociodemographic variables were fitted to assess the association between quintiles of energy contribution from ultra-processed foods and nutrient intake.ResultsMean reported energy contribution from ultra-processed foods to the Mexican population’s diet ranged from 4.5% kcal in quintile 1 (Q1) to 64.2% kcal in quintile 5 (Q5). An increased energy contribution from ultra-processed foods was positively associated with intake from added sugar (Q1: 7.4% kcal; Q5: 17.5% kcal), total fat (Q1: 30.6% kcal; Q5: 33.5% kcal) and saturated fat (Q1: 9.3% kcal; Q5: 13.2% kcal), as well as dietary energy density (Q1: 1.4 kcal/g; Q5: 2.0 kcal/g) (P≤0.001); and inversely associated with intake from protein (Q1: 15.1% kcal; Q5: 11.9% kcal) and dietary fiber (Q1: 16.0 g/1,000 kcal; Q5: 8.4 g/1,000 kcal) (P≤0.001).ConclusionsIn the Mexican population, an increased energy contribution from ultra-processed foods was associated with a lower dietary quality with regard to intake of nutrients related to chronic non-communicable diseases. Future research is needed to identify barriers to eating a variety of unprocessed and minimally processed foods for the Mexican population, as well as effective public health strategies and policies to overcome these barriers.     

Effects of Internet-Based Nutrition and Exercise Interventions on the Prevention and Treatment of Sarcopenia in the Elderly

Effective nutrition and exercise interventions may improve sarcopenia in the elderly. The purpose of our study was to investigate the effectiveness of Internet-based nutrition and exercise interventions in the elderly with sarcopenia. Participants were divided into 4 groups: control, nutrition, exercise, and comprehensive (nutrition plus exercise) groups; there was at least 50 participants in each group. Our trial lasted 12 weeks. We conducted dietary and exercise interventions through an app and collected feedback from the participants every three weeks. Information on the diet, skeletal muscle mass, and muscle function was collected before and after the interventions. The comprehensive group had higher high-quality protein intake than the control (p = 0.017) and exercise (p = 0.012) groups. After the interventions, we obtained differences in skeletal muscle mass, skeletal muscle mass/height², skeletal muscle mass/weight, muscle mass/BMI, and skeletal muscle mass/body fat percentage (p < 0.05). Changes in average daily energy and total daily protein intakes were not significantly different; however, there was an overall improvement in the intervention groups relative to baseline data. There were no changes in the average daily time of moderate physical activity. The Internet was an effective tool of nutrition intervention in the elderly with sarcopenia. The Internet-based nutrition intervention improved high-quality protein intake and skeletal muscle mass in the elderly with sarcopenia.     

Physical activity, protein intake, and appendicular skeletal muscle mass in older men.

BACKGROUND: Aging is associated with physical inactivity, low energy intake, and loss of skeletal muscle mass. It is not clear whether regular physical activity and adequate dietary protein intake can attenuate the loss of skeletal muscle mass. OBJECTIVE: We hypothesized that the maintenance of physical activity and dietary protein intake would attenuate the age-related decline in total appendicular skeletal muscle mass. DESIGN: Total appendicular skeletal muscle mass was determined by dual-energy X-ray absorptiometry in 44 healthy, older white men aged 49-85 y. Physical activity level was determined by using a uniaxial accelerometer over a 9-d period. Dietary protein intake was estimated from a 3-d food record. RESULTS: Aging was inversely associated with total appendicular skeletal muscle mass in older men (r = -0.43; slope: -0. 119 +/- 0.039 kg/y; P < 0.01). An effect of age on appendicular skeletal muscle mass persisted after standing height and physical activity were controlled for (r = -0.34; slope: -0.120 +/- 0.052 kg/y; P = 0.03). Furthermore, an effect of age on appendicular skeletal muscle mass persisted after standing height and dietary protein intake per kilogram body mass was controlled for (r = -0.41; slope: -0.127 +/- 0.045 kg/y; P < 0.01). CONCLUSIONS: Maintaining regular physical activity and adequate protein intake may not offset the age-related loss of appendicular skeletal muscle mass in older men. Prospective studies are needed to confirm these results and to determine whether anabolic physical activity (eg, strength training) can attenuate the age-related loss of muscle mass in the elderly.