1991—2015年我国九省(自治区)成年人膳食微量营养素摄入的变化趋势及其人口学特征
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摘要
[背景]我国居民生活方式发生了深刻的变化,居民营养素摄入状况随之改变,微量营养素摄入不足成为主要营养问题之一。[目的]本研究旨在分析我国九省(自治区)18～59岁成年人微量营养素摄入的长期变化趋势,为改善成年人膳食及指导营养干预提供依据。[方法]利用"中国健康与营养调查"1991—2015年膳食随访数据,以18～59岁的成年人作为研究对象,删除人口学信息缺失和膳食数据缺失及能量摄入异常的观测值后,共选取63 723个观测对象进行研究。采用连续"3天24小时膳食回顾法"和家庭称重记账法(食用油和调味品)收集膳食资料,借助食物成分表将食物消费量转换成能量及微量营养素摄入量。[结果] 1991—2015年,调整年龄后,我国九省(自治区)18～59岁成年人硫胺素、尼克酸、钾、钠、钙、磷、镁、铁、锰、锌和铜的平均摄入量均呈下降的趋势,视黄醇、维生素E、硒的平均摄入量波动上升,核黄素无明显变化。2015年成年人视黄醇及硫胺素、核黄素、尼克酸、维生素C、维生素E、钾、钠、钙、磷、镁、铁、锰、锌、铜和硒的平均摄入量分别为682.99μg/d(以视黄醇活性当量计)及0.85、0.75、14.49、81.13、29.87、1 555.19、4 520.84、345.03、909.84、267.67、21.64、5.54、10.29、1.66 mg/d和43.56μg/d。男性的钙摄入量高于女性;低年龄组(18～44岁)人群视黄醇、硫胺素、尼克酸摄入量高于高年龄组(45～59岁),低年龄组维生素E、钠、钙摄入量低于高年龄组;中、高收入水平人群尼克酸、钾、磷、铁、锌、铜摄入量大于低收入人群,高收入水平人群硫胺素摄入量大于低收入水平人群,中收入水平人群维生素C摄入量高于低收入人群,核黄素、维生素E、钙、硒的平均摄入量随收入水平增加而增高;城市成年人硫胺素、核黄素、尼克酸、钾、钙、磷、镁、铁、锌、铜、硒的摄入量高于农村。视黄醇、硫胺素和维生素C摄入量小于平均需要量的成年人比例超过50%,核黄素、钙摄入不足人口比例分别超过85%、95%。[结论]我国九省(自治区)成年人微量营养素摄入不足的发生率较高,钙缺乏问题严重。建议优化膳食结构,增加富含微量营养素食物的摄入以提高微量营养素的摄入水平。
[Background] Chinese residents has undergone profound changes in lifestyle, followed by the intake of nutrients, and the lack of micronutrient intakes has become one of the main nutritional problems.[Objective] The aim of this study is to analyze the long-term trends of micronutrient intakes in adults aged 18-59 years in nine provinces(autonomous regions) of China, and to provide evidence for improving adult diet and guiding nutritional interventions.[Methods] The data of China Health and Nutrition Surveys from 1991 to 2015 were used. In this study, the adults aged 18-59 years were selected as study subjects. After excluding those with missing demographic and dietary data or with abnormal energy intake, a total of 63 723 subjects were included in the study. Dietary intakes were collected by 3-day 24-hour dietary recall, and edible oil and condiment intakes were collected by weighing method. Food consumption was converted into energy and various micronutrient intakes by an established food composition table.[Results] From 1991 to 2015, the age-adjusted average intakes of thiamine, niacin, potassium, sodium, calcium, phosphorus, magnesium, iron, manganese, zinc, and copper in adults aged 18-59 years in nine provinces(autonomous regions) of China showed downward trends; whereas the age-adjusted average intakes of retinol, vitamin E, and selenium showed upward trends, and riboflavin intake was basically flat. In 2015, the average daily intakes of retinol, thiamine, riboflavin, niacin, vitamin C, vitamin E, potassium, sodium, calcium, phosphorus, magnesium, iron, manganese, zinc, copper, and selenium were 682.99 μg(in retinol activity equivalent), 0.85 mg, 0.75 mg, 14.49 mg, 81.13 mg, 29.87 mg, 1 555.19 mg, 4 520.84 mg, 345.03 mg, 909.84 mg, 267.67 mg, 21.64 mg, 5.54 mg, 10.29 mg, 1.66 mg, and 43.56 μg, respectively. The calcium intake of males was higher than that of females. The intakes of retinol, thiamine, and niacin in the young-age group(18-44 years) were higher than those of the old-age group(45-59 years), and the intakes of vitamin E, sodium, and calcium in the young-age group were lower than those of the old-age group. The intakes of niacin, potassium, phosphorus, iron, zinc, and copper were higher in the middle-and high-income groups than in the low-income group; the intake of thiamine was higher in the high-income group than in the low-income group; the intake of vitamin C was higher in the middle-income group than in the low-income group; the average intakes of riboflavin, vitamin E, calcium, and selenium increased with higher income level. The urban adults had higher intakes of thiamine, riboflavin, niacin, potassium, calcium, phosphorus, magnesium, iron, zinc, copper, and selenium than the rural adults. The proportions of adults with intakes of retinol, thiamine, and vitamin C less than estimated average requirements all exceeded 50% of total surveyed adults. The proportions of adults with riboflavin and calcium intakes less than corresponding estimated average requirements exceeded 85% and 95% respectively.[Conclusion] The adults in nine provinces(autonomous regions) of China show highly prevalent micronutrient insufficiency, especially calcium deficiency. Therefore, it is suggested to increase food diversity and intakes of micronutrient-rich foods to increase micronutrient intakes.
[Background] Chinese residents has undergone profound changes in lifestyle, followed by the intake of nutrients, and the lack of micronutrient intakes has become one of the main nutritional problems.[Objective] The aim of this study is to analyze the long-term trends of micronutrient intakes in adults aged 18-59 years in nine provinces(autonomous regions) of China, and to provide evidence for improving adult diet and guiding nutritional interventions.[Methods] The data of China Health and Nutrition Surveys from 1991 to 2015 were used. In this study, the adults aged 18-59 years were selected as study subjects. After excluding those with missing demographic and dietary data or with abnormal energy intake, a total of 63 723 subjects were included in the study. Dietary intakes were collected by 3-day 24-hour dietary recall, and edible oil and condiment intakes were collected by weighing method. Food consumption was converted into energy and various micronutrient intakes by an established food composition table.[Results] From 1991 to 2015, the age-adjusted average intakes of thiamine, niacin, potassium, sodium, calcium, phosphorus, magnesium, iron, manganese, zinc, and copper in adults aged 18-59 years in nine provinces(autonomous regions) of China showed downward trends; whereas the age-adjusted average intakes of retinol, vitamin E, and selenium showed upward trends, and riboflavin intake was basically flat. In 2015, the average daily intakes of retinol, thiamine, riboflavin, niacin, vitamin C, vitamin E, potassium, sodium, calcium, phosphorus, magnesium, iron, manganese, zinc, copper, and selenium were 682.99 μg(in retinol activity equivalent), 0.85 mg, 0.75 mg, 14.49 mg, 81.13 mg, 29.87 mg, 1 555.19 mg, 4 520.84 mg, 345.03 mg, 909.84 mg, 267.67 mg, 21.64 mg, 5.54 mg, 10.29 mg, 1.66 mg, and 43.56 μg, respectively. The calcium intake of males was higher than that of females. The intakes of retinol, thiamine, and niacin in the young-age group(18-44 years) were higher than those of the old-age group(45-59 years), and the intakes of vitamin E, sodium, and calcium in the young-age group were lower than those of the old-age group. The intakes of niacin, potassium, phosphorus, iron, zinc, and copper were higher in the middle-and high-income groups than in the low-income group; the intake of thiamine was higher in the high-income group than in the low-income group; the intake of vitamin C was higher in the middle-income group than in the low-income group; the average intakes of riboflavin, vitamin E, calcium, and selenium increased with higher income level. The urban adults had higher intakes of thiamine, riboflavin, niacin, potassium, calcium, phosphorus, magnesium, iron, zinc, copper, and selenium than the rural adults. The proportions of adults with intakes of retinol, thiamine, and vitamin C less than estimated average requirements all exceeded 50% of total surveyed adults. The proportions of adults with riboflavin and calcium intakes less than corresponding estimated average requirements exceeded 85% and 95% respectively.[Conclusion] The adults in nine provinces(autonomous regions) of China show highly prevalent micronutrient insufficiency, especially calcium deficiency. Therefore, it is suggested to increase food diversity and intakes of micronutrient-rich foods to increase micronutrient intakes.
引文
[1]郭齐雅,赵丽云,何宇纳,等. 2010-2012年中国居民营养素摄入状况[J].中华预防医学杂志,2017,51(6):519-522.
[2]POPKIN B M,DU S,ZHAI F,et al.Cohort Profile:the China Health and Nutrition Survey-monitoring and understanding socio-economic and health change in China,1989-2011[J].Int J Epidemiol,2010,39(6):1435-1440.
[3]“中国健康与营养调查”项目组.1989-2009年中国九省区居民膳食营养素摄入状况及变化趋势(一)健康与营养调查项目总体方案[J].营养学报,2011,33(3):234-236.
[4]张兵,王惠君,杜文雯,等.队列研究的进展及其对中国健康与营养调查的启示[J].中华预防医学杂志,2011,45(4):295-298.
[5]王志宏,张兵,王惠君,等.中国成年人红肉摄入量对体重指数、体重及超重危险性影响的多水平纵向研究[J].中华流行病学杂志,2013,34(7):661-667.
[6]杨月欣,王光亚,潘兴昌.中国食物成分表[M].北京:北京大学医学出版社,2009:3-301.
[7]荫士安.平均需要量(estimated average requirement)[J].中华预防医学杂志,2001,35(6):380.
[8]中国营养学会.中国居民膳食营养素参考摄入量(2013版)[M].北京:科学出版社,2014:656.
[9]于冬梅,何宇纳,郭齐雅,等.2002-2012年中国居民能量营养素摄入状况及变化趋势[J].卫生研究,2016,45(4):527-533.
[10]赵丽云,房玥晖,何宇纳,等.1992-2012年中国城乡居民食物消费变化趋势[J].卫生研究,2016,45(4):522-526.
[11]何宇纳,王竹,赵丽云,等.2010-2012年中国居民膳食维生素摄入状况[J].营养学报,2017,39(2):112-115.
[12]王志宏,翟凤英,何宇纳,等.经济收入水平对中国城乡居民膳食营养素摄入及膳食结构的影响[J].卫生研究,2008,37(1):62-64.
[13]O’DONNELL M,MENTE A,RANGARAJAN S,et al.Urinary sodium and potassium excretion,mortality,and cardiovascular events[J].N Engl J Med,2014,371(7):612-623.
[14]HAVAS S,ROCCELLA E J,LENFANT C.Reducing the public health burden from elevated blood pressure levels in the United States by lowering intake of dietary sodium[J].Am JPublic Health,2004,94(1):19-22.
[15]HE F J,CAMPBELL N R,MACGREGOR G A.Reducing salt intake to prevent hypertension and cardiovascular disease [J].Rev Panam Salud Publica2012324293-300.
[16]于冬梅,赵丽云,郭海军,等.2010-2012年中国18岁及以上成年居民膳食钠摄入状况[J].卫生研究,2018,47(1):13-17.
[17]程义勇.《中国居民膳食营养素参考摄入量》2013修订版简介[J].营养学报,2014,36(4):313-317.
[18]刘爱东,张兵,王惠君,等.1991-2009年中国九省区膳食营养素摄入状况及变化趋势(六)18~49岁成人膳食钙摄入量及变化趋势[J].营养学报,2012,34(1):10-14.
[19]王美辰,赵艾,司徒文佑,等.中国八城市成人钙摄入状况研究[J].营养学报,2017,39(4):332-336.
[20]范轶欧,刘爱玲,何宇纳,等.中国成年居民营养素摄入状况的评价[J].营养学报,2012,34(1):15-19.
[21]Da SILVA FERREIRA T,TORRES M R,SANJULIANI A F.Dietary calcium intake is associated with adiposity,metabolic profile,inflammatory state and blood pressure,but not with erythrocyte intracellular calcium and endothelial function in healthy pre-menopausal women[J].Br J Nutr,2013,110(6):1079-1088.
[22]THORNING T K,RABEN A,THOLSTRUP T,et al.Milk and dairy products:good or bad for human health?An assessment of the totality of scientific evidence[J].Food Nutr Res,2016,60:32527.
[23]中国营养学会.中国居民平衡膳食宝塔(2016)[EB/OL].[2019-02-26].http://www.cnsoc.org/content/details_60_20270.html.
[2]POPKIN B M,DU S,ZHAI F,et al.Cohort Profile:the China Health and Nutrition Survey-monitoring and understanding socio-economic and health change in China,1989-2011[J].Int J Epidemiol,2010,39(6):1435-1440.
[3]“中国健康与营养调查”项目组.1989-2009年中国九省区居民膳食营养素摄入状况及变化趋势(一)健康与营养调查项目总体方案[J].营养学报,2011,33(3):234-236.
[4]张兵,王惠君,杜文雯,等.队列研究的进展及其对中国健康与营养调查的启示[J].中华预防医学杂志,2011,45(4):295-298.
[5]王志宏,张兵,王惠君,等.中国成年人红肉摄入量对体重指数、体重及超重危险性影响的多水平纵向研究[J].中华流行病学杂志,2013,34(7):661-667.
[6]杨月欣,王光亚,潘兴昌.中国食物成分表[M].北京:北京大学医学出版社,2009:3-301.
[7]荫士安.平均需要量(estimated average requirement)[J].中华预防医学杂志,2001,35(6):380.
[8]中国营养学会.中国居民膳食营养素参考摄入量(2013版)[M].北京:科学出版社,2014:656.
[9]于冬梅,何宇纳,郭齐雅,等.2002-2012年中国居民能量营养素摄入状况及变化趋势[J].卫生研究,2016,45(4):527-533.
[10]赵丽云,房玥晖,何宇纳,等.1992-2012年中国城乡居民食物消费变化趋势[J].卫生研究,2016,45(4):522-526.
[11]何宇纳,王竹,赵丽云,等.2010-2012年中国居民膳食维生素摄入状况[J].营养学报,2017,39(2):112-115.
[12]王志宏,翟凤英,何宇纳,等.经济收入水平对中国城乡居民膳食营养素摄入及膳食结构的影响[J].卫生研究,2008,37(1):62-64.
[13]O’DONNELL M,MENTE A,RANGARAJAN S,et al.Urinary sodium and potassium excretion,mortality,and cardiovascular events[J].N Engl J Med,2014,371(7):612-623.
[14]HAVAS S,ROCCELLA E J,LENFANT C.Reducing the public health burden from elevated blood pressure levels in the United States by lowering intake of dietary sodium[J].Am JPublic Health,2004,94(1):19-22.
[15]HE F J,CAMPBELL N R,MACGREGOR G A.Reducing salt intake to prevent hypertension and cardiovascular disease [J].Rev Panam Salud Publica2012324293-300.
[16]于冬梅,赵丽云,郭海军,等.2010-2012年中国18岁及以上成年居民膳食钠摄入状况[J].卫生研究,2018,47(1):13-17.
[17]程义勇.《中国居民膳食营养素参考摄入量》2013修订版简介[J].营养学报,2014,36(4):313-317.
[18]刘爱东,张兵,王惠君,等.1991-2009年中国九省区膳食营养素摄入状况及变化趋势(六)18~49岁成人膳食钙摄入量及变化趋势[J].营养学报,2012,34(1):10-14.
[19]王美辰,赵艾,司徒文佑,等.中国八城市成人钙摄入状况研究[J].营养学报,2017,39(4):332-336.
[20]范轶欧,刘爱玲,何宇纳,等.中国成年居民营养素摄入状况的评价[J].营养学报,2012,34(1):15-19.
[21]Da SILVA FERREIRA T,TORRES M R,SANJULIANI A F.Dietary calcium intake is associated with adiposity,metabolic profile,inflammatory state and blood pressure,but not with erythrocyte intracellular calcium and endothelial function in healthy pre-menopausal women[J].Br J Nutr,2013,110(6):1079-1088.
[22]THORNING T K,RABEN A,THOLSTRUP T,et al.Milk and dairy products:good or bad for human health?An assessment of the totality of scientific evidence[J].Food Nutr Res,2016,60:32527.
[23]中国营养学会.中国居民平衡膳食宝塔(2016)[EB/OL].[2019-02-26].http://www.cnsoc.org/content/details_60_20270.html.
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