小学生饮食知识、态度、行为干预实验研究

目的 探讨对小学生饮食知识、态度、行为进行干预的方法、途径和内容。方法 通过对山西省太原市桃园小学3～5年级小学生的饮食知识、态度和行为现况进行测查，发现小学生在上述各方面存在一定问题。在基线测查的基础上，根据研究目的将小学生分为干预组和对照组，经统计学检验两组被试的均衡性较好。对干预组小学生进行了1学期的干预实验。干预后进行了复测。结果 干预组小学生饮食知识、态度、行为得分均显高于对照组。结论 干预实验方法可行，内容适当。     

Revised Finnish dietary supplement database

The aim of the project was to revise the Finnish dietary supplement database used for the purpose of estimating total dietary intakes in food consumption surveys, and as a valuable tool for dietary risk assessment. Data for the revised database were compiled from the relevant governmental agencies and from the dietary supplement database of the Type I Diabetes Prediction and Prevention Nutrition study. In addition, information on dietary supplements was obtained from product labels and manufacturers’ websites. The dietary supplement database thus compiled contained a total of 491 dietary supplements, including 154 vitamin and mineral products, 138 vitamin supplements, 106 mineral supplements, and 93 other dietary supplement products. The total number of nutrients per dietary supplement ranges from 1 to 36 (median 2). The dietary supplement database is now integrated into the national food composition database. In conclusion, for the purposes of estimating total dietary intakes, there is an increasing need to revise and update the dietary supplement database. The rapidly developing dietary supplement market makes the updating of the dietary supplement database a challenging and time-consuming task. Thus, a recommendation for the construction and compilation of dietary supplement databases, together with a standard for data transfer, is needed.     

广东省成人居民膳食模式与血清尿酸的关系

目的 分析广东省成人居民膳食模式与血清尿酸的关系。方法 使用 2015 年广东省慢性病及营养监测数据,采用多阶段整群随机抽样的方法,对广东省成人居民进行个人基本情况调查、一般体检、实验室检查和膳食调查。采用因子分析方法提取广东省成人居民的膳食模式,应用二元logistic回归模型探讨各膳食模式与血清尿酸的关系。 结果 本次研究得到5种广东省成人居民膳食模式:盐酱油膳食模式、水果奶类膳食模式、糖类水产类膳食模式、红肉谷薯类膳食模式、酒饮料膳食模式。不同膳食模式的广东省成人居民血清尿酸差异和高尿酸血症检出率的差异有统计学意义,其中血清尿酸均值最高的膳食模式为酒饮料膳食模式(355.31 μmol/L),均值最低的膳食模式为水果奶类膳食模式(329.26 μmol/L),高尿酸血症检出率最高的膳食模式为糖类水产类膳食模式(30.07%),最低的膳食模式为水果奶类膳食模式(23.14%)。二元logistic回归分析结果提示,糖类水产类膳食模式(OR=2.25,95%CI:1.19～4.27)和酒饮料膳食模式(OR=2.76,95%CI:1.34～5.71)均为高尿酸血症患病的危险因素。结论 水果奶类膳食模式可能与血清尿酸水平的降低及较低的高尿酸血症检出率有关,是预防高尿酸血症提倡的膳食模式。糖类水产类膳食模式和酒饮料膳食模式与血清尿酸水平升高密切相关,是高尿酸血症患病的危险因素。     

不同膳食调查方法在托幼机构膳食管理中的应用

[目的 ]　了解集体托幼机构膳食监测开展的效果及存在问题。 [方法 ]　对近 2 0年来用称重和记帐方法获得的上海市区托幼机构儿童膳食营养资料加以分析、比较。 [结果 ]　称重和记帐调查结果高于儿童平日实际的营养素摄入水平 ,其差别大小与调查的方法、持续期限、时间以及被调查儿童的年龄有关。 [结论 ]　膳食调查已起到了良好的监测作用 ,但合理的评估尚需不断改进调查方法和管理水平。     

Perceptions of Tailored Dietary Advice to Improve the Nutrient Adequacy of the Diet in French Pregnant Women

Tailored dietary counseling could be specifically efficient during pregnancy, a period accompanied by a rise in nutrition awareness, but little is known about the expectations of pregnant women in this regard. We studied these expectations regarding tailored dietary advice in French women during their pregnancy, as well as their motivations and the perceived barriers and enablers. In French pregnant women, we evaluated the perceptions of tailored dietary advice provided by stepwise dietary counseling based on three types of dietary changes, consisting of: (1) a modification of the amounts consumed, (2) substitutions within the food subgroups, and (3) substitutions between food subgroups. A sequential explanatory mixed-method approach was designed. Using qualitative data from a focus group study (n = 40), we intended to explore in depth the women’s expectations regarding dietary advice and adherence to a tailored approach. These were combined with quantitative and qualitative data from a 6-week online longitudinal study (n = 115), using questionnaires designed to assess the modifications of dietary habits during pregnancy and to evaluate each type of dietary change. Both studies confirmed that most women in our samples did indeed intend to institute changes regarding healthier dietary practices during pregnancy. The principal motivation behind changes to their habits was to ensure the health and well-being of both their babies and themselves. The proposal of dietary advice that is tailored to both the current diet and the specific needs of pregnant women, but that is also positive and credible, was perceived as enabling implementing healthier dietary practices during pregnancy. Regarding the implementation of the dietary changes proposed, the enablers and barriers identified differed between modifications of the amounts consumed and substitutions. The women displayed interest in all types of dietary changes. This gave relevance to combining different types of changes in order to propose dietary counseling during pregnancy. Tailored dietary counseling was identified by French pregnant women in our samples as enabling them to adopt a healthier diet. However, perceived barriers might limit the implementation of dietary changes, especially when they involved marked modifications to their usual diet.     

饮食模式与癌症发生的关系研究进展

营养饮食得分是饮食模式量化的方式,越来越多的研究通过应用饮食得分来研究饮食模式对癌症发病率及死亡率的影响。本文通过对目前世界不同地区的不同的饮食模式进行梳理,并对各类饮食模式得分与癌症之间的关系进行综述,为促进我国饮食模式量化的探索提供学术依据。     

应用调整的膳食平衡指数评价中老年肌少症患者的膳食质量

目的 了解中老年肌少症患者的膳食质量,为中老年肌少症患者的营养防治提供理论依据。 方法 采集本院体检中心及营养科门诊符合肌少症诊断条件者188人,使用3d 24h膳食回顾法,记录并分析其膳食情况,应用调整的中国膳食平衡指数法评价患者膳食质量。结果 被调查的中老年肌少症患者膳食处于低度失衡状态,已趋向于中度失衡状态;他们的水果、奶类、蛋类、鱼类摄入严重不足,而油、盐的摄入量过多;钙、膳食纤维的摄入量不足;主要膳食模式为E模式。结论 中老年肌少症患者膳食摄入情况有待改善,需要大力宣传平衡膳食的理念,改变不良的饮食习惯,以降低或延缓肌少症的发生与发展。     

即时性图像法膳食调查技术应用于学龄前儿童膳食调查的效果评价

目的对即时性图像法应用于学龄前儿童膳食调查进行效果评价。方法招募60位幼儿园儿童及其家长,为儿童提供食物原料经严格称重后烹制的午餐。进餐前家长从三个角度对食物进行拍摄,同样方法拍摄剩余食物,并将图像文件发送至固定邮箱,次日接受针对儿童的24h膳食回顾调查,膳食估量小组成员对图片中的食物进行估重。得到称量数据、图像法数据和24h回顾法数据,归类汇总三组数据并进行营养计算。结果与24h回顾法数据相比,除水果和带鱼外,图像法数据与称重数据的相关性更好。除畜禽肉类和带鱼外,图像法的数据与称重法更接近。基于图像法数据计算的能量与各营养素的摄入量数据,与称重数据的计算结果更接近。结论与24h回顾法相比,用即时性图像法膳食调查技术对学龄前儿童进行膳食调查,可获得与实际重量更接近的食物消费量数据。     

Validity of repeated dietary measurements in a dietary intervention study.

The aim of the study was to evaluate the compliance in a dietary intervention study. When drawing conclusions about the relationship between dietary intake and disease occurrence/disease-related variables it is important to obtain valid dietary data. 20 healthy, non-smoking normal-weight omnivores changed from a mixed to a lactovegetarian diet. Dietary surveys (four 24 h recalls per person and time-period), urinary and faecal sample collections were performed before and 3, 6 and 12 months after the dietary shift. The validation of energy, protein, sodium and potassium yielded approximately the same ratio of dietary intake to biological marker at 0 and 3 months. This ratio decreased towards 6 months and continued to decrease towards 12 months. The fibre intake was compared to the total faecal weight directly and indirectly by calculating the fibre intake from the stool weight, the water content in faeces and the excretion of short-chain fatty acids (SCFAs). These four methods of fibre validation showed that the ratio of dietary intake to biological marker was always highest at 12 months, indicating an overestimation of the fibre intake at the end of the study. This is the first time these methods of validating fibre intake have been used in an epidemiological study. The ratio of dietary calcium intake to urinary and faecal calcium excretion did not show any statistical difference between the period before and 3 months after the dietary shift. To conclude, almost all investigated dietary data show approximately the same validity before and 3 months after the dietary shift, and show the least validity 12 months after the dietary shift. Thus, this study demonstrates that it is difficult to obtain valid dietary data 1 year after a drastic dietary change, indicating a decreased compliance to the new dietary regimen at the end of the 1 year study period. This represents important information when attempting to relate biological effects to dietary intake, and illustrates the importance of using biological markers for food intake in dietary surveys.     

Dietary patterns and breast cancer: a review with focus on methodological issues

Available information on dietary patterns (multiple dietary components operationalized as a single exposure) and cancer is still sparse. This review presents papers published to date that have identified dietary patterns according to all the existing approaches and have assessed their association with breast cancer. Nineteen articles published since 1995 were identified based on studies conducted in various populations across many countries. The majority of them identified a posteriori dietary patterns, mainly using principal component factor analysis. Six studies did not find associations between any of the identified dietary patterns and breast cancer. Nine studies identified one dietary pattern significantly associated with breast cancer, and the remaining four identified two to four dietary patterns related to breast cancer. Although the body of literature has recently increased, a meaningful assessment of the association between dietary patterns and breast cancer still calls for extra effort to refine the statistical techniques and to address the issue of reproducibility of dietary patterns.     

居民饮食行为分阶段转变的现状调查研究

目的　探讨行为分阶段转变理论模型在我国人群行为研究上的应用以及改变居民不良饮食行为的方法。方法　抽取杭州市 1388名 18岁以上的常住居民作为目标人群 ,用行为分阶段转变理论模式 ,分析居民饮食行为分阶段流行特点和居民行为改变意向。结果　杭州市居民 35 .9%的居民经常摄入动物类脂肪 ,不良饮食行为发生率较高 ;居民性别、文化程度的不同 ,饮食行为也有所差异 ,男性饮食行为较女性差 ,文化程度低的居民饮食行为较文化程度高的差 ;居民饮食行为转变呈阶段式变化 ,包括前意向阶段、意向阶段、准备阶段、行动阶段和维持阶段 ;健康知识的增长并不伴随有不良饮食行为的改变 ,部分居民了解健康饮食的知识 ,但仍然无改变不良饮食行为的意向。结论　影响居民饮食行为转变的因素较多 ;居民饮食行为分阶段逐步转变 ;对处于行为转变的各阶段、具有不同行为转变意向的居民应采取不同的健康教育与健康促进的方法 ,进行行为干预。     

泸州市青少年膳食模式与超重肥胖的相关性研究

目的 探讨泸州市青少年膳食模式与超重和肥胖的关系,为青少年的膳食干预提供理论依据.方法 通过多阶段分层整群抽样,于泸州市抽取3 869名青少年作为调查对象;通过问卷调查收集调查对象的基本信息、膳食习惯,并通过膳食频率法获取调查对象近1年内摄取各种食物的频率以及每次的摄入量;采用因子分析法提取泸州市青少年的膳食模式,并通...     

The results of dietary advice on lipoprotein levels among patients attending for lipid-lowering drugs

The aim of this study was to evaluate the changes in fasting lipoproteins levels before and after a dietary advice among the patients attending for a lipid-lowering treatment. In total 286 patients attending for reimbursement of a lipid-lowering drug were recorded at two regional health insurance offices. Lipid levels measured at least three months after the dietary advice were compared with those before the dietary advice. The mean age of the included patients was 61 years. The average fasting total cholesterol (TC) was 7.4 mmol/l before the dietary advice as well as after the dietary advice. Fasting TC did not decrease with the dietary advice in 51% of the included patients. In the logistic regression not one of the studied factors was correlated with a successful dietary advice. Half of the patients receiving lipid-lowering drugs in Belgium were not able to decrease their TC with dietary advice before the initiation of the treatment.     

Dietary patterns are associated with physical growth among school girls aged 9-11 years

The purpose of this study was to identify dietary patterns among Korean elementary school girls based on the change in body mass index (BMI), body fat, bone mineral density (BMD), and bone mineral content (BMC) during 22 months and to explore the characteristics of dietary patterns identified. Girls aged 9-11 years were recruited and 3-day dietary data were collected four times. Subjects with a diet record of 8 or more days and anthropometric data measured at baseline and 22 months later were included (n = 198). Reduced rank regression was utilized to derive dietary patterns using a change in BMI, body fat, and calcaneus BMD and BMC as response variables. Two dietary patterns were identified: the "Egg and Rice" dietary pattern and "Fruit, Nuts, Milk Beverage, Egg, Grain" (FNMBEG) dietary pattern. Subjects who had high score on the FNMBEG pattern consumed various food groups, including fruits, nuts and seeds, and dairy products, whereas subjects in the "Egg and Rice" dietary pattern group did not. Both dietary patterns showed a positive association with change in BMI and body fat. However, subjects who had a higher score on the "Egg and Rice" dietary pattern had less of a BMC increase, whereas subjects who had a higher score on the FMBEG dietary pattern had more increased BMC over 22 months after adjusting for age, body and bone mass, and Tanner stage at baseline. Our results provide evidence that a well-balanced diet contributes to lean body mass growth among young girls.     

Do Overweight Adolescents Adhere to Dietary Intervention Messages? Twelve-Month Detailed Dietary Outcomes from Curtin University’s Activity,Food and Attitudes Program

Dietary components of adolescent obesity interventions are rarely evaluated with comprehensive reporting of dietary change. The objective was to assess dietary change in overweight adolescents, including adherence to dietary intervention. The dietary intervention was part of a multi-component intervention (CAFAP) targeting the physical activity, sedentary and healthy eating behaviors of overweight adolescents (n = 69). CAFAP was a staggered entry, within-subject, waitlist controlled clinical trial with 12 months of follow up. Diet was assessed using three-day food records and a brief eating behavior questionnaire. Changes in dietary outcomes were assessed using linear mixed models, adjusted for underreporting. Food record data suggested reduced adherence to dietary intervention messages over time following the intervention, despite conflicting information from the brief eating behavior questionnaire. During the intervention, energy intake was stable but favorable nutrient changes occurred. During the 12 month maintenance period; self-reported eating behaviors improved, energy intake remained stable but dietary fat and saturated fat intake gradually returned to baseline levels. Discrepancies between outcomes from brief dietary assessment methods and three-day food records show differences between perceived and actual intake, highlighting the need for detailed dietary reporting. Further, adherence to dietary intervention principles reduces over time, indicating a need for better maintenance support.     

The effect of high salt and high protein intake on calcium metabolism, bone composition and bone resorption in the rat

The effects of salt (NaCl) supplementation of rat diets (50 g/kg diet), with normal (200 g/kg) or high (500 g/kg) dietary casein content, were studied in 3-week-old male rats over a 3-week period. Weight gain was reduced by dietary salt but was unaffected by dietary casein. Salt-supplemented rats exhibited a two- and three-fold increase in urinary Mg and Ca excretion respectively, irrespective of dietary casein content. Dietary casein had no effect on urinary Ca or Mg. Salt reduced femoral mass but not femoral mass expressed relative to body weight, but neither variable was affected by dietary casein. Femoral Mg and P contents and concentrations were unaffected by dietary salt or casein. While femoral Ca concentration was unaffected by dietary salt, the Ca content was reduced by salt supplementation, irrespective of dietary casein content. Neither the content nor concentration of Ca in femora was affected by dietary casein. Urinary pyridinoline and deoxypyridinoline levels were increased by salt supplementation, irrespective of dietary casein content, but were unaffected by casein. Net Ca absorption was unaffected by dietary salt or casein. In conclusion, these results show that salt supplementation over the short-term increased the rate of bone resorption in rats. This was as a consequence of Na-induced calciuria. On the other hand, a high dietary protein intake had no effect on Ca metabolism, bone composition or bone resorption, nor did it augment the Na-induced calciuria or increased rate of bone resorption.     

Dietary patterns and health outcomes

A systematic review of the literature on dietary patterns (multiple dietary components operationalized as a single exposure) in relation to nutrient adequacy, lifestyle and demographic variables, and health outcome was conducted. Most of the published reports on the subject have used one of two methods to determine dietary patterns: (a) diet indexes or scores that assess compliance with prevailing dietary guidance as dietary patterns, and (b) data-driven methods that use factor or cluster analysis to derive dietary patterns. Irrespective of the approach used, patterns characterized by fruit/vegetable/whole grain/fish/poultry consumption generally have been reported to relate to micronutrient intake, and to selected biomarkers of dietary exposure and disease risk in the expected direction. Age, income, and education have been reported to be among positive predictors of the so-called more healthful dietary patterns. An inverse association of healthful dietary patterns with all-cause mortality and cardiovascular disease risk was reported in most studies. However, the magnitude of risk reduction was modest and was attenuated after control for confounders. Few published studies showed an association between risk of most incident cancers and dietary patterns. Both of the currently used approaches for extracting dietary patterns have limitations, are subject to dietary measurement errors, and have not generated new diet and disease hypotheses.     

Gender,age, socio-demographic and lifestyle factors associated with major dietary patterns in the Spanish Project SUN (Seguimiento Universidad de Navarra)

OBJECTIVE: To ascertain the major dietary patterns in the cohort 'SUN' and to assess the association of several sociodemographic (including age and gender) and lifestyle variables with the adherence to these dietary patterns. DESIGN: This study is a cross-sectional analysis of 3847 subjects (1587 men and 2260 women) belonging to a prospective cohort study based on self-reported questionnaires. A factor analysis based on 30 predefined food groups was conducted to ascertain the major dietary patterns in the cohort. Multiple regression models were fitted to assess the relationship between several sociodemographic and lifestyle variables and the adherence to these dietary patterns (measured using two scores with observed values ranging from -3.2 to +4.6 for the Western pattern and -3.1 to +5.5 for the Mediterranean pattern). RESULTS: Two major dietary patterns were found. The first pattern was labelled as a 'Western' dietary pattern and the other as a 'Spanish-Mediterranean' dietary pattern. Younger subjects were more likely to follow a 'Western' dietary pattern; the coefficient representing the change for every 10 y increase in age was b=-0.24 (P<0.001) for men and b=-0.12 (P<0.001) for women. More physically active subjects were less likely to follow a 'Western' dietary pattern and more likely to follow a 'Spanish-Mediterranean' dietary pattern. CONCLUSIONS: An association between a higher level of physical activity during leisure time and adherence to a 'Spanish-Mediterranean' diet was apparent. However, the profile of being a young, sedentary and single male was identified as the most likely to exhibit a departure from the traditional 'Spanish-Mediterranean' diet and follow a 'Western' dietary pattern.     

Dietary trace elements and esophageal cancer mortality in Shanxi, China.

To explore the relation between esophageal cancer and dietary trace elements in humans, we estimated the average daily intake of zinc, copper, iron, selenium, molybdenum, silicon, cadmium, and nickel in 21 Chinese communes, where the annual mortality rate from esophageal cancer among the population 30 years of age and over ranged from 0 to 495/100,000 person-years. We also estimated the relative level of calcium consumption. Zinc and copper intake were inversely related to esophageal cancer mortality, and calcium intake levels was positively related to esophageal cancer mortality. The predicted esophageal cancer mortality among a vegetarian population with a high level of dietary calcium and a low level of dietary zinc was 5.3 times as high as that in a vegetarian population with a low level of dietary calcium and a high level of dietary zinc. The influence of a high level of dietary calcium in a vegetarian population may be explained by a reduction in the absorption of dietary zinc.     

The interaction between dietary fructose and magnesium adversely affects macromineral homeostasis in men

OBJECTIVE: Studies with rats have found that an interaction between fructose and magnesium affects macromineral metabolism; high dietary fructose significantly increased kidney calcification in both male and female rats, particularly when dietary magnesium was low. This study tests the hypothesis that an interaction between dietary fructose and magnesium adversely affects macromineral homeostasis in men. METHODS: Eleven men aged 22 to 40 years were fed a mixed, Western diet for four 42-day dietary periods in which dietary magnesium was either approximately 170 or 370 mg/day and dietary fructose was either 4% or 20% of energy. A decaffeinated beverage containing high fructose corn syrup replaced cornstarch, bread and rice in the low fructose diet to give the high fructose diet. RESULTS: High dietary fructose significantly (p<0.01) increased magnesium balance during both low and high dietary magnesium intakes. Ultrafilterable and ionized serum magnesium also apparently were related to magnesium and fructose intakes; they were higher when fructose was fed and when Mg intakes were high. High fructose depressed calcium balance: the effect tended to be more marked when dietary Mg was low. High dietary fructose also significantly (p<0.005) decreased phosphorous balance. Urinary phosphorous losses were significantly (p<0.001) higher when high dietary fructose was fed. High dietary fructose also increased the concentration of serum alkaline phosphatase (p<0.005). CONCLUSION: These findings indicate that dietary fructose adversely affects macromineral homeostasis in humans and suggest further studies to see if a high fructose diet coupled with low dietary magnesium and marginal calcium leads to bone loss.