天津市居民超重(肥胖)控制中膳食关键因素分析

Analysis of Key Factors in Diet of Residents with Overweight/Obesity Control in Tianjin

目的了解天津市居民超重(肥胖)患者的膳食结构和营养状况,分析天津居民超重(肥胖)与膳食因素的关系。方法采用多阶段分层整群随机抽样的方法,在已经建立的天津市慢性非传染病综合示范社区中随机抽取1542户,共2886人,分别测量身高、体重,计算体重指数(BMI),并采用称重法和24 h回顾法对调查对象进行膳食调查。结果能量、蛋白质、脂肪摄入越高,人群超重(肥胖)的患病风险越高。随着膳食碳水化合物供能比的增加,人群患超重(肥胖)风险降低。膳食纤维是超重(肥胖)的保护因素。膳食纤维日摄入量不低于20 g,可以降低患超重(肥胖)的风险。每天摄入蔬菜、水果≥500 g可以预防超重(肥胖)。热能和16种营养素摄入量中,热能、蛋白质、脂肪、碳水化合物、钙、锌、铁、膳食纤维、维生素A、维生素E、维生素B1、维生素B2、维生素C与每人每天营养素标准供给量(RDA)比较,差异均有统计学意义(P<0.01)。与膳食宝塔相比,超重肥胖患者膳食中蔬菜水果、奶类、豆类摄入不足,鱼虾类、畜肉类摄入过多,食盐和油脂的摄入量严重超标。结论天津市居民膳食结构与肥胖率升高有内在联系,所以要针对性地改进膳食结构。

[ Objective ] To understand the dietary patterns and nutritional status of residents with overweight/obesity in Tianjin, and analyze the relationship between overweight/obesity and dietary factors. [ Methods ] Multi-stage stratified cluster random sampling method was adopted to select 2886 persons from 1542 families in established comprehensive model community of chronic non-communicable diseases. Height, weight and body mass index（ BMI） were calculated. Weighing method and 24 h retrospective study were used to conduct dietary survey. [ Results ] The more energy, protein, fat people ingested, the higher risk of overweight/obesity was. With the increasing ratio of carbohydrate energy intake, the risk of overweight/obesity reduced. Dietary fiber was protective factor against overweight / obesity. Eating at least 20g dietary fiber per day can reduce the risk of overweight/obesity. ≥500 g intake of vegetables and fruits per day can prevent overweight / obesity. Compared energy, protein, fat, carbohydrates, calcium, zinc, iron, dietary fiber, vitamin A, vitamin E, vitamin B1, vitamin B2, vitamin C with standards for the supply of nutrients per person per day （RDA） , the difference was significant （ P 〈 0. 01 ）. The patients with overweight/obesity did not take adequate vegetables, fruits, milk and beans, but too much fish and shrimp, and much more salt and fat seriously exceeding standard. [ Conclusion ] There is a strong relation between dietary structure and overweight/obesity in Tianjin residents. Therefore, dietary patterns of residents should be improved with direction.