1991—2015年我国十五省(自治区)农民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]随着我国居民膳食结构的变化,微量营养素摄入不足以及与之密切相关的健康问题逐渐凸显。我国农村人口有5.9亿,随着农民收入水平的提高,对食物的消费观念也在转变。[目的]本研究旨在分析我国十五省(自治区)18岁及以上农民微量营养素摄入的长期变化趋势,为指导农民的营养干预和慢性病防治工作提供依据。[方法]利用1991—2015年间"中国健康与营养调查"中有完整膳食及相关数据的18岁及以上农民作为研究对象,共计29 119名。膳食调查采用连续"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),借助食物成分表将食物消费量转换成能量及各类营养素摄入量。[结果] 2015年,农民平均每日视黄醇和硫胺素、核黄素、尼克酸、维生素C、维生素E、钾、钠、钙、磷、镁、铁、锰、锌、铜及硒摄入量分别为564.42μg(以视黄醇活性当量计)和0.89、0.72、15.06、72.87、31.04、1 546.99、4 932.13、332.09、927.31、276.86、22.14、6.02、10.74、1.75 mg及41.72μg。与1991年相比,2015年农民视黄醇、硫胺素、尼克酸、维生素C、钾、钠、钙、磷、镁、铁、锰、锌和铜平均每日摄入量分别下降25.44μg和0.31、1.75、29.20、214.62、2 395.02、24.22、243.15、46.87、0.73、2.98、1.07、0.74 mg,核黄素、维生素E和硒分别增加0.04、9.85 mg和12.14μg。2015年,65岁及以上年龄组农民硫胺素、核黄素、尼克酸、维生素C、钾、钙、磷、镁、铁、锰、锌、铜、硒的摄入量低于其他年龄组(均P <0.05);中收入水平农民硫胺素、核黄素、维生素C的摄入量低于低、高收入农民(均P <0.05),高收入农民钠的摄入量高于低、中收入农民(P <0.05),低收入农民的锰摄入量高于中、高收入农民(P <0.05)。2015年,视黄醇、核黄素和钙摄入量小于平均需要量的农民人口比例分别超过了60%、85%和95%,硫胺素和维生素C摄入量小于平均需要量的比例基本在50%以上。[结论] 1991—2015年,我国十五省(自治区)农民人群普遍存在视黄醇、硫胺素、核黄素、维生素C和钙等微量营养素摄入不足的问题,钙缺乏问题应重点关注。
[Background] With the changes in dietary pattern of Chinese residents, insufficient micronutrient intakes and related health problems have gradually become prominent. The 590 million rural population in China have changed their consumption concept of food as their income rises.[Objective] This study aims to analyze the long-term trends of micronutrient intakes of farmers aged 18 years and over in 15 provinces(autonomous regions) of China, and provide guidance for farmers' nutritional intervention and the prevention and treatment of chronic diseases.[Methods] A total of 29 119 farmers aged 18 years or above with complete dietary and demographic data were selected for the study from the China Health and Nutrition Surveys in 1991-2015. 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] In 2015, the farmer's average daily intakes of retinol, thiamine, riboflavin, niacin, vitamin C, vitamin E, potassium, sodium, calcium, phosphorus, magnesium, iron, manganese,zinc, copper, and selenium were 564.42 μg(in retinol activity equivalent, thereafter), 0.89 mg, 0.72 mg, 15.06 mg, 72.87 mg, 31.04 mg, 1 546.99 mg, 4 932.13 mg, 332.09 mg, 927.31 mg, 276.86 mg, 22.14 mg, 6.02 mg, 10.74 mg, 1.75 mg, and 41.72 μg, respectively. Compared with 1991, the average daily intakes of retinol, thiamine, niacin, vitamin C, potassium, sodium, calcium, phosphorus, magnesium, iron, manganese, zinc, and copper decreased by 25.44 μg, 0.31 mg, 1.75 mg, 29.20 mg, 214.62 mg, 2 395.02 mg, 24.22 mg, 243.15 mg, 46.87 mg, 0.73 mg, 2.98 mg, 1.07 mg, and 0.74 mg, respectively, whereas the average daily intakes of riboflavin, vitamin E, and selenium increased by 0.04 mg, 9.85 mg, and 12.14 μg, respectively. In 2015, the intakes of thiamine, riboflavin, niacin, vitamin C, potassium, calcium, phosphorus, magnesium, iron, manganese, zinc, copper, and selenium in farmers aged 65 years and over were lower than those of the other age groups(Ps < 0.05). Middle-income farmers had lower intakes of thiamine, riboflavin, and vitamin C than other income groups(Ps < 0.05), high-income farmers had a higher intake of sodium than other income groups(P < 0.05), and low-income farmers had a higher intake of manganese than other income groups(P < 0.05). The proportions of farmers with intakes of retinol, riboflavin, and calcium less than corresponding estimated average requirements were over 60%, 85%, and 95% of total surveyed farmers, respectively, and the proportions of farmers with thiamine and vitamin C intakes less than corresponding estimated average requirements were over 50% in general.[Conclusion] From 1991 to 2015, insufficient intakes of retinol, thiamine, riboflavin, vitamin C, and calcium are pervasive among farmers in 15 provinces(autonomous regions) of China, especially calcium deficiency which deserves high priority.
[Background] With the changes in dietary pattern of Chinese residents, insufficient micronutrient intakes and related health problems have gradually become prominent. The 590 million rural population in China have changed their consumption concept of food as their income rises.[Objective] This study aims to analyze the long-term trends of micronutrient intakes of farmers aged 18 years and over in 15 provinces(autonomous regions) of China, and provide guidance for farmers' nutritional intervention and the prevention and treatment of chronic diseases.[Methods] A total of 29 119 farmers aged 18 years or above with complete dietary and demographic data were selected for the study from the China Health and Nutrition Surveys in 1991-2015. 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] In 2015, the farmer's average daily intakes of retinol, thiamine, riboflavin, niacin, vitamin C, vitamin E, potassium, sodium, calcium, phosphorus, magnesium, iron, manganese,zinc, copper, and selenium were 564.42 μg(in retinol activity equivalent, thereafter), 0.89 mg, 0.72 mg, 15.06 mg, 72.87 mg, 31.04 mg, 1 546.99 mg, 4 932.13 mg, 332.09 mg, 927.31 mg, 276.86 mg, 22.14 mg, 6.02 mg, 10.74 mg, 1.75 mg, and 41.72 μg, respectively. Compared with 1991, the average daily intakes of retinol, thiamine, niacin, vitamin C, potassium, sodium, calcium, phosphorus, magnesium, iron, manganese, zinc, and copper decreased by 25.44 μg, 0.31 mg, 1.75 mg, 29.20 mg, 214.62 mg, 2 395.02 mg, 24.22 mg, 243.15 mg, 46.87 mg, 0.73 mg, 2.98 mg, 1.07 mg, and 0.74 mg, respectively, whereas the average daily intakes of riboflavin, vitamin E, and selenium increased by 0.04 mg, 9.85 mg, and 12.14 μg, respectively. In 2015, the intakes of thiamine, riboflavin, niacin, vitamin C, potassium, calcium, phosphorus, magnesium, iron, manganese, zinc, copper, and selenium in farmers aged 65 years and over were lower than those of the other age groups(Ps < 0.05). Middle-income farmers had lower intakes of thiamine, riboflavin, and vitamin C than other income groups(Ps < 0.05), high-income farmers had a higher intake of sodium than other income groups(P < 0.05), and low-income farmers had a higher intake of manganese than other income groups(P < 0.05). The proportions of farmers with intakes of retinol, riboflavin, and calcium less than corresponding estimated average requirements were over 60%, 85%, and 95% of total surveyed farmers, respectively, and the proportions of farmers with thiamine and vitamin C intakes less than corresponding estimated average requirements were over 50% in general.[Conclusion] From 1991 to 2015, insufficient intakes of retinol, thiamine, riboflavin, vitamin C, and calcium are pervasive among farmers in 15 provinces(autonomous regions) of China, especially calcium deficiency which deserves high priority.
引文
[1]韩军花,李晓瑜,严卫星.微量营养素风险等级的划分[J].营养学报,2012,34(3):212-215,219.
[2]贾海先.国内外强化食品对人群重点微量营养素的贡献率[J].卫生研究,2015,44(1):137-142.
[3]中华人民共和国国家统计局.中国统计年鉴[M].北京:中国统计出版社,2017:31.
[4]《农村·农业·农民B》编辑部.《中国食物与营养发展纲要(2014—2020年)》发布实施[J].农村·农业·农民(B版),2014(2):4-5.
[5]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.
[6]“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.
[7]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.
[8]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.
[9]杨月欣,王光亚,潘兴昌.中国食物成分表[M]. 2版.北京:北京大学医学出版社,2009:3-301.
[10]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.
[11]王柳森,郭春雷,张一平,等. 1991—2011年中国9省(自治区)农民食物摄入变化趋势[J].环境与职业医学,2018,35(6):495-499.
[12]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.
[13]WHO. 2012 Guideline:Sodium intake for adults and children[EB/OL].[2018-11-29].http//www.Who.int/nutrition/publications/guidelines/sodium_intake/en/.
[14]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.
[15]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.
[16]魏跃胜.食物烹饪加工中维生素的损失与保护[J].中国食物与营养,2009(9):57-59.
[17]马冠生,崔朝辉,李艳平,等.中国成年居民营养补充剂的消费现状[J].营养学报,2006,28(1):8-10,18.
[18]LAWRENCE M,WINGROVE K,NAUDE C,et al. Evidence synthesis and translation for nutrition in terventions to combat micronutrient deficiencies with particular focus on food fortification[J]. Nutrients,2016,8(9):555.
[19]ZHAI F,WANG H,DU S,et al. Prospective study on nutrition transition in China[J]. Nutr Rev,2010,67 Suppl 1:S56-S61.
[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]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.
[22]张继国,张兵,王惠君,等.食物强化策略对我国居民营养状况的改善作用[J].中国健康教育,2012,28(12):1053-1054,1058.
[23]王志宏,翟风英,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.
[2]贾海先.国内外强化食品对人群重点微量营养素的贡献率[J].卫生研究,2015,44(1):137-142.
[3]中华人民共和国国家统计局.中国统计年鉴[M].北京:中国统计出版社,2017:31.
[4]《农村·农业·农民B》编辑部.《中国食物与营养发展纲要(2014—2020年)》发布实施[J].农村·农业·农民(B版),2014(2):4-5.
[5]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.
[6]“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.
[7]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.
[8]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.
[9]杨月欣,王光亚,潘兴昌.中国食物成分表[M]. 2版.北京:北京大学医学出版社,2009:3-301.
[10]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.
[11]王柳森,郭春雷,张一平,等. 1991—2011年中国9省(自治区)农民食物摄入变化趋势[J].环境与职业医学,2018,35(6):495-499.
[12]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.
[13]WHO. 2012 Guideline:Sodium intake for adults and children[EB/OL].[2018-11-29].http//www.Who.int/nutrition/publications/guidelines/sodium_intake/en/.
[14]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.
[15]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.
[16]魏跃胜.食物烹饪加工中维生素的损失与保护[J].中国食物与营养,2009(9):57-59.
[17]马冠生,崔朝辉,李艳平,等.中国成年居民营养补充剂的消费现状[J].营养学报,2006,28(1):8-10,18.
[18]LAWRENCE M,WINGROVE K,NAUDE C,et al. Evidence synthesis and translation for nutrition in terventions to combat micronutrient deficiencies with particular focus on food fortification[J]. Nutrients,2016,8(9):555.
[19]ZHAI F,WANG H,DU S,et al. Prospective study on nutrition transition in China[J]. Nutr Rev,2010,67 Suppl 1:S56-S61.
[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]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.
[22]张继国,张兵,王惠君,等.食物强化策略对我国居民营养状况的改善作用[J].中国健康教育,2012,28(12):1053-1054,1058.
[23]王志宏,翟风英,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.
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