Establishing new principles for nutrient reference values (NRVs) for food labeling purposes

Many countries such as The Republic of Korea have established their own nutritional standards, collectively termed Nutrient Reference Values(NRVs), and they vary due to the science which was reviewed, the purposes for which they are developed, and issues related to nutrition and food policy in the country. The current effort by the Codex Alimentarius Committee on Nutrition and Foods for Special Dietary Uses (CNFSDU) to update the NRVs that were established following the Helsinki Consultation in 1988 represents an opportunity to develop a set of reference values reflecting current scientific information to be used or adapted by many countries. This paper will focus on possible approaches to selecting or developing reference values which would serve the intended purpose for nutrition labeling to the greatest extent possible. Within the United States, the Food and Drug Administration (U.S. FDA) is currently reviewing regulations on nutrition labeling to better address current health issues, and is expected to enter into a process in the next few months to begin to explore how best to update nutrient Daily Values (DVs), most of which are still based on the Recommended Dietary Allowances (RDAs) of the Food and Nutrition Board, U.S. National Academy of Sciences, last reviewed and revised in 1968. In this presentation, I review the current purposes in the U.S. for nutrition labeling as identified in the 1938 Food, Drug, and Cosmetic Act as amended, the scientific basis for current nutrition labeling regulations in the United States, and the recommendations made by the recent Committee on Use of Dietary Reference Intakes in Nutrition Labeling of the Institute of Medicine (2003) regarding how to use the DRIs in developing new DVs to be used on the label in the United States and Canada. Based on these reviews, I then provide examples of the issues that arise in comparing one approach to another. Much of the discussion focuses on the appropriate role of nutrient labeling within the Nutrition Facts panel, one of the three major public nutrition education tools in the United States (along with MyPyramid and Dietary Guidelines for Americans).     

Validation of a self-administered diet history questionnaire using multiple diet records

The validity of a self-administered diet history questionnaire has been estimated using as the reference data the mean of three 4-day diet records collected over the year prior to the administration of the questionnaire, in 1985–1986. Subjects were women ages 45–70 years, participants in the Women's Health Trial Feasibility Study, a multi-center clinical trial in which some women were randomized to be taught to adopt and maintain a low-fat diet, while others maintained their usual diet. The questionnaire produced group mean nutrient estimates closely approximating the values obtained by three 4-day records, e.g. in the usual-diet group, 37.7% of calories from fat by both food records and by questionnaire, and in the low-fat, group, 21.3% of calories from fat by food records and 23.7% of calories from fat by questionnaire. Correlations between questionnaire and diet records for per cent of calories from fat were 0.67 and 0.65 respectively in the two groups; most correlations were in the 0.5–0.6 range, and were similar to those achievable by a single 4-day food record.     

三峡地区大学生膳食调查与分析

目的：为开展大学生膳食营养教育提供依据。方法：采用记录和询问相结合的方法对301名大学生进行膳食调查。结果：男生的膳食营养状况比女生好。男生对热能、磷、铁、维生素A和维生素B1的摄入量均超过推荐量（Recommended Nutrient Intake，RNI），蛋白质达到RNI的94％，但钙、维生素B2和维生素C摄入不足，分别达到RNI的54％、71％、69％。女生磷、铁、维生素B1的摄取量超过RNI，维生素A达到RNI的90％，基本满足需要，但蛋白质、能量、钙、维生素B2和维生素C分别达到RNI量的76％、78％、57％和54％。男女生摄入的优质蛋白质均达到总摄入量的41％。男女生均有早上餐能量过低，晚餐量过高的现象。结论：大学生的膳营养水平比以往有所提高，但某些营养素仍严重缺乏，应加强对大学生的膳食营养教育。     

2010—2019年江西省居民食物消费量变化趋势研究

目的 分析2010—2019年间江西省居民食物消费变化趋势。方法 采用多阶段分层的整群抽样的方法,2010—2012年和2018—2019年分别抽取调查对象1 967人和1 130人。采用非连续的3天24小时回顾询问法、称重法收集和食物频率法对居民开展膳食调查,利用t检验对2010—2012年和2018—2019年居民各类食物摄入量进行统计分析。结果 2010—2019年间江西省城乡居民谷薯类食物消费量总体呈下降趋势（t = - 14.816,P＜0.001）,平均每标准人日摄入量由469.2 g降至398.3 g,但城市却呈上升趋势。蔬菜（t = - 22.258,P＜0.001）和水果（t = - 11.105,P＜0.001）消费量总体呈下降趋势,平均每标准人日摄入量分别由316.5 g和66.9 g降至240.5 g和48.0 g,但城市居民水果消费量呈上升趋势。禽畜肉类（t = 6.591,P＜0.001）、水产品（t = 12.531,P＜0.001）、蛋类（t = 13.944,P＜0.001）、奶类（t = 5.071,P＜0.001）和大豆及坚果类（t = 17.880,P＜0.001）呈上升趋势,平均每标准人日摄入量分别由97.6 g、24.0 g、18.1 g、19.5 g和16.6 g增至111.7 g、43.0 g、27.9 g、26.3 g和40.4 g,其中城市禽畜肉和奶类增幅都明显高于农村。油脂类（t = - 18.444,P＜0.001）和食盐（t = - 40.029,P＜0.001）消费量都呈下降趋势,平均每标准人日摄入量分别由43.8 g和9.1 g降至31.1 g和7.8 g,其中城市油脂类降幅高于农村。结论 江西省居民食物消费状况总体有所改善,但仍存在不合理,蔬菜水果、奶类摄入不足,而禽畜肉、油脂类和食盐过高,导致膳食纤维和钙的摄入不足,而脂肪摄入过多。     

北京市郊区某中学初中生膳食矿物质和维生素摄入与近视发生的调查研究

目的 了解初中生膳食矿物质和维生素摄入状况,分析饮食行为与近视之间的关系。方法 采用整群抽样法,选取2018年7月至2019年3月北京市郊区某中学的所有初中生,应用24 h膳食回顾调查表及自编“1周内饮食行为问卷”进行膳食调查,采用NCCW营养软件分析矿物质和维生素摄入情况,采用全国通用的E字标准视力表对初中生进行视力检查。结果 本次共调查181名初中生,其中女生92人（50.8%）,男生89人（49.2%）。年龄10~16岁,平均（13.06±0.96）岁。蛋类、粗粮及大豆制品的食用情况不佳,能坚持一周内食用5~6次粗粮的初中生只有20人（11.0%）。24 h膳食回顾调查NCCW软件分析结果发现,该校初中生膳食矿物质的摄入中仅磷的摄入量男、女生均达到推荐摄入量的90%以上,其余矿物质和维生素摄入整体不足,其中钙的摄入量处于严重不足情况,摄入量仅为推荐摄入量的23.50%、26.62%。近视筛查发现,该校56.7%的初中生处于重度近视范围,其中女生左眼近视程度高于男生（P<0.05）。不同程度近视随着矿物质和维生素摄入量不同出现差异,钙的摄入量在重度近视学生中要高于轻度及中度近视,差异有统计学意义（P<0.05）。结论 该校初中生矿物质和维生素摄入量不足,其中矿物质钙与近视程度存在一定联系,建议家长及学校应在学生饮食上做到科学膳食均衡搭配,从饮食方面降低青少年近视发生风险。     

Nutrient Intake following Vertical Banded Gastroplasty or Gastric Bypass

Background: This study explored eating habits, nutrient intake, and blood vitamin and mineral levels to determine whether severely obese subjects (BMI 40-50 kg m⁻²) post-vertical banded gastroplasty (VBG) or gastric bypass Roux-en-Y (GBR) are at risk of developing compounded under-nutrition. Methods: A dietary follow-up of 36 VBG and 19 GBR was maintained for 18 months via 7-day food intake diaries and 24-h recalls. Food intake was analysed for energy and nutrient composition and for its relative amount to recommended dietary allowances (RDA). Results: Weight loss was greatest during the first 6 months, continued at a slower rate for the next 6 months, nearly ceasing thereafter. The results following GBR were not substantially different from those following VBG 18 months postoperatively. The median weight loss at 1 year postoperatively was 48, 46, 48 and 36 kg; expressed as residual excess body weight: 0.2, 16, 13 and 22% for GBR Men, Women, VBG Men, Women, respectively. According to the classification proposed by Reinhold, all subjects achieved excellent treatment outcomes 18 months postoperatively. Despite the relatively low reported energy intake (20-50% below RDA), no correlation was found between rate of weight loss and energy intake at 6 months postoperatively. The intake of most vitamins and minerals was below 50% of RDA during the 18 months follow-up. The increase in energy intake did not improve the level of the nonenergy-contributing nutrients. Compliance to multivitamin and mineral supplement intake deteriorated with time. Conclusion: The low to within-normal range of blood vitamin and mineral levels 12 months postoperatively suggests the slow development of subclinical nutritional deficiency which could jeopardize the subjects' long-term health status.     

复合营养素提高机体高原急性缺氧耐力的研究

用两种复合营养制剂对90 名空运入藏战士进行了提高机体急性缺氧耐力的研究。PWC170机能试验、血压、血乳酸、血丙酮酸含量测定及急性高原反应症状调查结果表明, 两种复合营养制剂都有助于维持正常的心血管功能、增强组织有氧代谢和减轻急性高原反应症状, 因此能有效的提高机体急性缺氧耐力, 其中以Ⅱ号配方的作用更佳     

脑泰营养素治疗帕金森病临床疗效观察

[目的]考察脑泰营养素对帕金森病(PD)临床症状的控制和改善。[方法]选择PD病人41例,随机分为治疗组和对照组,对照组采用美多巴治疗,治疗组在此基础上加用脑泰营养素。分别比较两组治疗前后Hoehn-Yahr(H-Y)分级和改良Webster量表评分变化及两组间的疗效差异。[结果]与对照组比较,治疗组的H-Y分级和改良Webster量表评分明显减少(P<0.05),总有效率明显提高(P<0.05)。[结论]在使用美多巴的基础上加用脑泰营养素治疗PD,可明显增强疗效。     

肿瘤患者营养支持药物利用调查分析

目的　了解我院肿瘤患者营养支持药物使用情况。方法　通过调查我院 1999年～ 2 0 0 2年药库明细帐和 2 0 0 2年 10 14份病历 ,用药物利用研究方法 ,分析我院营养支持药物的用药结构、用药合理性等。结果　 4年间这类药物的使用品种、数量、金额上升了 5 8 82 %、71 6 6 %和 2 8 16 % ;在调查病历中 4 9 30 %的肿瘤患者使用了这类药物 ,肠外营养 (PN)和肠内营养 (EN)药物使用数量比为 14∶1;人次比为 13∶1;其中营养不良患者为 19 80 % ;在可判定DDD值的PN药物中 ,大部分DUI值大于 1,EN药物大部分DUI值小于 1。结论　营养支持药物的使用品种、数量、金额 4年间提升很快 ;PN药物的使用数量和人次远高于EN药物 ;对部分患者实施营养支持治疗的适应症掌握令人质疑 ;部分营养支持药物的使用剂量不尽合理。如何合理应用营养支持治疗需要进一步探讨。