延吉市朝汉族老年人膳食结构与健康关系的调查研究
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摘要
目的 了解延边地区朝鲜族和汉族老年人的膳食及营养状况。探讨延边地区朝鲜族和汉族老年人体脂指数(BMI)、内脏脂肪(VF)、体脂肪率(BFR)与血压的关系，并比较这些因素在不同民族和不同性别老年人中的差异。
方法 本研究在延吉市随机选择三个社区，随机选择1000名60岁以上的朝鲜族和汉族老年人进行问卷调查和体格检查，从中又随机选择200名老年人，用24小时回忆法进行膳食调查。
结果 本研究结果表明，朝汉族一日三餐以大米为主食，面类摄入频率汉族高于朝鲜族；肉类的摄入方面朝鲜族以牛肉为主，汉族以猪肉为主；汉族植物油类的摄入量明显高于朝鲜族(P＜0.01)，且符合膳食指南要求，朝鲜族植物油类的摄入量低于推荐量(P＜0.01)；朝汉族蔬菜摄入量明显低于推荐量(P＜0.01)。
男性每人每日热能摄入量超过推荐摄入量(RNI)，女性则基本达到RNI标准；朝鲜族男性早餐热能比偏低，晚餐热能比偏高．这与高血压患病与VF偏高有明显的关系。朝鲜族的脂肪热能比明显低于汉族(P＜0.01)，且未达到适宜摄入量范围；朝鲜族的碳水化合物热能比明显高于汉族(P＜0.01)。朝鲜族男性平均蛋白质摄入量超过RNI标准，汉族男性略低于RNI标准，且朝鲜族男性平均蛋白质摄入量显著高于汉族男性(P＜0.01)；两个民族的老年人摄入优质蛋白质的比率为35％～45％，其中大豆蛋白超过15％。两个民族的老年人钙和维生素A的摄入量仅达到RNI标准的一半，锌、硒、核黄素的摄入量均低于RNI标准。
朝鲜族男性的VF明显低于汉族男性(P＜0.05)，两个民族的男性VF水平均显著高于女性(P＜0.001)。汉族男性BMI低于汉族女性(P＜0.001)。在控制其他因素后，男性BMI与血压值呈正相关；朝鲜族女性的血压值与VF水平呈正相关；汉族女性的舒张压与BMI呈正相关，收缩压与VF水平和年龄呈正相关。当女性VF超过8，BMI超过25时，高血压与VF和BMI有显著的关联(P＜0.05)。汉族男性VF超过15时，与高血压
的发生有显著的关联护<0 .01)，朝鲜族男性vF超过11时，高血压患病率为60.8%，有
明显的关联(尸二0.018)。
结论综上可见，朝鲜族老年人脂肪摄入量明显低于汉族，且低于适宜摄入量标准。
朝鲜族和汉族应在膳食中增加新鲜蔬菜的摄入量，此外朝鲜族应同时增加脂肪的摄入。
老年人钙、维生素A、维生素B:的摄入量严重不足，锌、硒摄入量偏低，晚餐热能比
偏高与高血压和VF偏高有关。男性BMI和VF与高血压的发生有密切关系，女性只有
VF与高血压的发生有密切的关系。女性老年人VF超过8时，发生高血压的危险性增
高，朝鲜族男性老年人VF超过11时，发生高血压的危险性增高。
Objective To assess the nutritional status and dietary intake of the Korean and Han
nationality elderly in Yanji city. To research the relationship between body mass index (BMI), body fat percentage, visceral fat (VF) and blood pressure in the Korean and Han nationality elder, and investigate the difference of above between Korean and Han.
Methods We selected 1000 of the Korean and Han nationality adults aged 60 and older
and make the poll survey. Height, weight, blood pressure value were examined. VF and BFR were examined with body fat meter, and then 200 of the Korean and Han nationality elderly among them were selected to perform dietary survey with 24-hour dietary recall method.
Results The results showed that the staple food is rice in two nationality. The frequency of
flour intake in the Korean was significantly lower than in Han nationality. The intake of soybean oil in the Korean nationality was significantly lower than in Han nationality and lower than Chinese Dietary Guidelines(P<0.01). The intake of vegetable in the Korean and Han nationality is lower than Chinese Dietary Guidelines(P<0.01).
The daily average intake of energy surpassed recommended nutrient intake (RNI) \alue in male and amounted to RNI in women. For the Korean males. Breakfast energy intake ratio was slightly lower and supper energy intake ratio was slightly higher, which related to hypertension and high VF. The daily average intake of fat in the Korean was significantly lower than in Han nationality (P<0.01), and it was lower than RNI value. The daily average intake of carbohydrate in the Korean was significantly higher than in Han nationality (P<0.01). The daily average intake of protein exceeded RNI value in the Korean men and was slightly lower than RNI value in Han men and both nationality women. The daily average intake protein in the Korean men was significantly higher than in Han men (P<0.01). The ratio of good protein was 35%~45% and bean protein exceeded 15%. The daily average intakes of calcium, vitamin A were only half RNI value and vitamin 62, zinc and selenium were lower than RNI values.
VF in the Korean men was significantly lower than Han men (P<0.05) and VF in men higher than in women (P<0.001). :BMI in Han men was lower than in Han females
(P<0.01l). When controlling other factor, BMI of men positively associated with blood pressure value; blood pressure value of the Korean women was positively associated with VF; diastolic blood pressure of Han women was positively associated with BMI and systolic blood pressure was positively associated with VF and age. When VF in women was over than 8 and BMI was over than 25, hypertension was significantly related with VF and BMI (P<0.05). VF of Han men was significantly related with hypertension as it was over than 15(P<0.01), but VF of the Korean men was significantly related with hypertension as it was over than 11 (hypertension percentage was 66.8%, /MX018).
Conclusion The old people should increase the intake of fresh vegetables. Moreover, the
Korean should particularly increase the intake of fat. The daily average intake of fat in the Korean is significantly lower than in the Han nationality and lower than RN1 value. The daily intakes of calcium, vitamin A and vitamin B2 are seriously inadequate, and zinc and selenium are slightly lower. Distribution of three meals energy is irrational and the high ratio of supper energy relates to hypertension and high VF. In men elder BMI and VF correlate with hypertension, in women only VF correlates with hypertension. The risk of hypertension is higher when VF is over than 8 in women elder and over than 11 in the Korean men elder.
方法 本研究在延吉市随机选择三个社区，随机选择1000名60岁以上的朝鲜族和汉族老年人进行问卷调查和体格检查，从中又随机选择200名老年人，用24小时回忆法进行膳食调查。
结果 本研究结果表明，朝汉族一日三餐以大米为主食，面类摄入频率汉族高于朝鲜族；肉类的摄入方面朝鲜族以牛肉为主，汉族以猪肉为主；汉族植物油类的摄入量明显高于朝鲜族(P＜0.01)，且符合膳食指南要求，朝鲜族植物油类的摄入量低于推荐量(P＜0.01)；朝汉族蔬菜摄入量明显低于推荐量(P＜0.01)。
男性每人每日热能摄入量超过推荐摄入量(RNI)，女性则基本达到RNI标准；朝鲜族男性早餐热能比偏低，晚餐热能比偏高．这与高血压患病与VF偏高有明显的关系。朝鲜族的脂肪热能比明显低于汉族(P＜0.01)，且未达到适宜摄入量范围；朝鲜族的碳水化合物热能比明显高于汉族(P＜0.01)。朝鲜族男性平均蛋白质摄入量超过RNI标准，汉族男性略低于RNI标准，且朝鲜族男性平均蛋白质摄入量显著高于汉族男性(P＜0.01)；两个民族的老年人摄入优质蛋白质的比率为35％～45％，其中大豆蛋白超过15％。两个民族的老年人钙和维生素A的摄入量仅达到RNI标准的一半，锌、硒、核黄素的摄入量均低于RNI标准。
朝鲜族男性的VF明显低于汉族男性(P＜0.05)，两个民族的男性VF水平均显著高于女性(P＜0.001)。汉族男性BMI低于汉族女性(P＜0.001)。在控制其他因素后，男性BMI与血压值呈正相关；朝鲜族女性的血压值与VF水平呈正相关；汉族女性的舒张压与BMI呈正相关，收缩压与VF水平和年龄呈正相关。当女性VF超过8，BMI超过25时，高血压与VF和BMI有显著的关联(P＜0.05)。汉族男性VF超过15时，与高血压
的发生有显著的关联护<0 .01)，朝鲜族男性vF超过11时，高血压患病率为60.8%，有
明显的关联(尸二0.018)。
结论综上可见，朝鲜族老年人脂肪摄入量明显低于汉族，且低于适宜摄入量标准。
朝鲜族和汉族应在膳食中增加新鲜蔬菜的摄入量，此外朝鲜族应同时增加脂肪的摄入。
老年人钙、维生素A、维生素B:的摄入量严重不足，锌、硒摄入量偏低，晚餐热能比
偏高与高血压和VF偏高有关。男性BMI和VF与高血压的发生有密切关系，女性只有
VF与高血压的发生有密切的关系。女性老年人VF超过8时，发生高血压的危险性增
高，朝鲜族男性老年人VF超过11时，发生高血压的危险性增高。
Objective To assess the nutritional status and dietary intake of the Korean and Han
nationality elderly in Yanji city. To research the relationship between body mass index (BMI), body fat percentage, visceral fat (VF) and blood pressure in the Korean and Han nationality elder, and investigate the difference of above between Korean and Han.
Methods We selected 1000 of the Korean and Han nationality adults aged 60 and older
and make the poll survey. Height, weight, blood pressure value were examined. VF and BFR were examined with body fat meter, and then 200 of the Korean and Han nationality elderly among them were selected to perform dietary survey with 24-hour dietary recall method.
Results The results showed that the staple food is rice in two nationality. The frequency of
flour intake in the Korean was significantly lower than in Han nationality. The intake of soybean oil in the Korean nationality was significantly lower than in Han nationality and lower than Chinese Dietary Guidelines(P<0.01). The intake of vegetable in the Korean and Han nationality is lower than Chinese Dietary Guidelines(P<0.01).
The daily average intake of energy surpassed recommended nutrient intake (RNI) \alue in male and amounted to RNI in women. For the Korean males. Breakfast energy intake ratio was slightly lower and supper energy intake ratio was slightly higher, which related to hypertension and high VF. The daily average intake of fat in the Korean was significantly lower than in Han nationality (P<0.01), and it was lower than RNI value. The daily average intake of carbohydrate in the Korean was significantly higher than in Han nationality (P<0.01). The daily average intake of protein exceeded RNI value in the Korean men and was slightly lower than RNI value in Han men and both nationality women. The daily average intake protein in the Korean men was significantly higher than in Han men (P<0.01). The ratio of good protein was 35%~45% and bean protein exceeded 15%. The daily average intakes of calcium, vitamin A were only half RNI value and vitamin 62, zinc and selenium were lower than RNI values.
VF in the Korean men was significantly lower than Han men (P<0.05) and VF in men higher than in women (P<0.001). :BMI in Han men was lower than in Han females
(P<0.01l). When controlling other factor, BMI of men positively associated with blood pressure value; blood pressure value of the Korean women was positively associated with VF; diastolic blood pressure of Han women was positively associated with BMI and systolic blood pressure was positively associated with VF and age. When VF in women was over than 8 and BMI was over than 25, hypertension was significantly related with VF and BMI (P<0.05). VF of Han men was significantly related with hypertension as it was over than 15(P<0.01), but VF of the Korean men was significantly related with hypertension as it was over than 11 (hypertension percentage was 66.8%, /MX018).
Conclusion The old people should increase the intake of fresh vegetables. Moreover, the
Korean should particularly increase the intake of fat. The daily average intake of fat in the Korean is significantly lower than in the Han nationality and lower than RN1 value. The daily intakes of calcium, vitamin A and vitamin B2 are seriously inadequate, and zinc and selenium are slightly lower. Distribution of three meals energy is irrational and the high ratio of supper energy relates to hypertension and high VF. In men elder BMI and VF correlate with hypertension, in women only VF correlates with hypertension. The risk of hypertension is higher when VF is over than 8 in women elder and over than 11 in the Korean men elder.
引文
1 魏太星，邱保国，吕维善，主编．现代老年学．郑州：郑州大学出版社，2001，469．
2 佟之复，苗俊梅．中国老年人的健康状况．健康指南，2000(1)：7-9．
3 延吉市统计局．延吉市统计年鉴2002．北京：中国统计出版社，2002，6，314-315．
4 Spiegelman D, Israel RG, Bouchard C, et al. Absolute fat mass, percent body fht, and body-fat distribution: which is the real determinant of blood pressure and serum glucose?Am J Clin Nutr, 1992, 55: 1033-1044.
5 王志宏，翟风英，葛可佑．中国成年人体质指数与血压关系的探讨．卫生研究．2002，31：193-196．
6 Watanabe J, Tochikubo O. Relationship between visceral fat accumulation and hypertension in obese men. Clin Exp Hypertens, 2003, 25: 199-208.
7 Kanai H, Tokunaga K, Fujioka S, et al. Decrease in intra-abdominal visceral fat may reduce blood pressure in obese hypertensive women. Hypertension, 1996, 27:125-129.
8 陈文彬，主编．诊断学(第五版)．北京：人民卫生出版社．2001．143．
9 Bowman BA, Russell RM. Present knowledge in nutrition. Eighth ed. International life science institute press. Washington DC,2001: 13.
10 闻芝梅．陈君石主译．现代营养学．第七版，北京：人民卫生出版社．1998，475-478．
11 杨月欣．王光亚．潘兴昌．中国食物成分表 2002．北京：北京大学医学出版社．2002．24-219．
12 中国营养学会编著．中国居民膳食营养素参考摄入量．北京：中国轻工业出版社．2000．57．
13 仲来福，主编．卫生学(第五版)．北京：人民卫生出版社，2002，105．
14 陆瑞芳．抗氧化营养素与健康．上海医药，1998，19(5)：20-21．
15 中国肥胖问题工作组。中国成人超重和肥胖症预防与控制指南．营养学报．2004．26(1)： 1-4．
16 Konishi M, Iso H. Komachi Y, et al. Associations of serum total cholesterol, different types of stroke, and stenosis distribution of cerebral arteries. The Akita Pathology Study.Stroke, 1996, 24: 954-964.
17 Iso H, Stampfer MJ. Manson JE. et al. Prospective study of fat and protein intake and
risk of intraparenchymal hemorrhage in women. Circulation, 2001, 103: 856-863.
18 Hiroyasu Iso, Shinichi Sato, Akihiko Kitamura, et al. Fat and Protein Intakes and Risk of Intraparenchymal Hemorrhage among Middle-aged Japanese. Am J Epidemiol. 2003, 157: 32-39.
19 张桂英，王宝贵，赵林伊，等．老年人群营养状况调查分析．白求恩医科大学学报．2001，27：323-324．
20 蔡美琴，王少墨．王永娣．养老院老年人营养现况调查及膳食改进探讨．全科医学杂志，2003，8：13-16．
21 王安平，张艾莉，高京华，等．老年人体重指数与高血压的关系．中华临床杂志．2002，2：18-19．
22 沈璐林．内脏脂肪综合征．日本医学介绍，1998．19(1)：37-38．
23 德永胜人．综合临床，1992，141(10)：2877．
2 佟之复，苗俊梅．中国老年人的健康状况．健康指南，2000(1)：7-9．
3 延吉市统计局．延吉市统计年鉴2002．北京：中国统计出版社，2002，6，314-315．
4 Spiegelman D, Israel RG, Bouchard C, et al. Absolute fat mass, percent body fht, and body-fat distribution: which is the real determinant of blood pressure and serum glucose?Am J Clin Nutr, 1992, 55: 1033-1044.
5 王志宏，翟风英，葛可佑．中国成年人体质指数与血压关系的探讨．卫生研究．2002，31：193-196．
6 Watanabe J, Tochikubo O. Relationship between visceral fat accumulation and hypertension in obese men. Clin Exp Hypertens, 2003, 25: 199-208.
7 Kanai H, Tokunaga K, Fujioka S, et al. Decrease in intra-abdominal visceral fat may reduce blood pressure in obese hypertensive women. Hypertension, 1996, 27:125-129.
8 陈文彬，主编．诊断学(第五版)．北京：人民卫生出版社．2001．143．
9 Bowman BA, Russell RM. Present knowledge in nutrition. Eighth ed. International life science institute press. Washington DC,2001: 13.
10 闻芝梅．陈君石主译．现代营养学．第七版，北京：人民卫生出版社．1998，475-478．
11 杨月欣．王光亚．潘兴昌．中国食物成分表 2002．北京：北京大学医学出版社．2002．24-219．
12 中国营养学会编著．中国居民膳食营养素参考摄入量．北京：中国轻工业出版社．2000．57．
13 仲来福，主编．卫生学(第五版)．北京：人民卫生出版社，2002，105．
14 陆瑞芳．抗氧化营养素与健康．上海医药，1998，19(5)：20-21．
15 中国肥胖问题工作组。中国成人超重和肥胖症预防与控制指南．营养学报．2004．26(1)： 1-4．
16 Konishi M, Iso H. Komachi Y, et al. Associations of serum total cholesterol, different types of stroke, and stenosis distribution of cerebral arteries. The Akita Pathology Study.Stroke, 1996, 24: 954-964.
17 Iso H, Stampfer MJ. Manson JE. et al. Prospective study of fat and protein intake and
risk of intraparenchymal hemorrhage in women. Circulation, 2001, 103: 856-863.
18 Hiroyasu Iso, Shinichi Sato, Akihiko Kitamura, et al. Fat and Protein Intakes and Risk of Intraparenchymal Hemorrhage among Middle-aged Japanese. Am J Epidemiol. 2003, 157: 32-39.
19 张桂英，王宝贵，赵林伊，等．老年人群营养状况调查分析．白求恩医科大学学报．2001，27：323-324．
20 蔡美琴，王少墨．王永娣．养老院老年人营养现况调查及膳食改进探讨．全科医学杂志，2003，8：13-16．
21 王安平，张艾莉，高京华，等．老年人体重指数与高血压的关系．中华临床杂志．2002，2：18-19．
22 沈璐林．内脏脂肪综合征．日本医学介绍，1998．19(1)：37-38．
23 德永胜人．综合临床，1992，141(10)：2877．