应用中国孕期膳食平衡指数评价成都市孕妇膳食质量

Evaluation of the dietary quality by diet balance index for pregnancy among pregnant women

目的建立中国孕期膳食平衡指数（DBI-P）并评价成都市孕妇膳食质量及变化,为孕妇营养干预提供依据。方法依据孕妇平衡膳食原则和中国孕妇DRIs（2013）,在中国成人DBI基础上,建立中国孕期膳食平衡指数（DBI-P）;采用24 h膳食回顾法对成都市610名健康孕妇进行追踪调查,收集孕早、中、晚期各类食物摄入量,利用DBI-P评价和分析其各孕期整体膳食质量及变化。结果孕妇各孕期水果、蛋类摄入量达到推荐量,畜禽肉类摄入量高于推荐量,而谷类、蔬菜、奶类、大豆及坚果类和水产品类摄入量低于推荐量。孕妇各孕期水果达标率较高（59.0%～79.0%）,其他类食物达标率均较低（5.7%～48.4%）,以谷类最低（5.7%～7.4%）。孕妇各孕期DBI-P总分（中位数）均小于0,提示膳食总体水平趋向于摄入不足;孕早、中、晚各期正端分（中位数）分别为3、4和4,提示轻微摄入过量,过量程度在各孕期相同（P〉0.05）,摄入过量比例分别为21.0%、33.1%和24.1%;负端分（中位数）分别为24、19和21,提示低度摄入不足,不足程度在孕早期最高（P〈0.017）,摄入不足比例分别为96.1%、88.0%和91.3%;膳食质量距（中位数）分别为27、23和25,提示整体膳食质量存在中～低度摄入不均衡,不均衡程度在孕早期最高（P〈0.017）,摄入不均衡比例分别为97.9%、96.9%、97.4%。结论成都市孕妇膳食摄入不均衡,以孕早期较突出,以摄入不足为主。

Objective To establish the Diet Balance Index for Pregnancy（ DBI-P）and utilize it to evaluate the dietary quality among pregnant women in Chengdu,and to provide the basis for maternal nutrition interventions. Methods According to the Chinese dietary principles and the nutritional standards（ 2013） of pregnant women,the Diet Balance Index for Pregnancy（ DBI-P） was established on the foundation of the DietBalance Index（ DBI）. 610 healthy pregnant women in Chengdu were recruited and were followed up from early pregnancy to the third trimester,and food intakes of them were collected by 24-hour dietary recall method in each trimester. The overall dietary quality in each trimester was evaluated by DBI-P and the variation of dietary quality was analyzed.Results In each trimester,the intakes of fruits and eggs were optimal,but the meats were over-consumed,and the intakes of cereals,vegetables,milk,soybean and nuts,and fish and shrimp were insufficient. The median total score（ TS） was negative in each trimester,suggesting the food intakes of pregnant women were tend to be insufficient. The compliance rate was higher in fruits（ 59. 0%- 79. 0%）,and lower in the other food groups（ 5. 7%- 48. 4%）,especially in cereals（ 5. 7%- 7. 4%）. In the first,second and third trimester,the median high bound scores（ HBS） were 3, 4 and 4, respectively,suggesting the women were in relatively low surplus of food intake,and the degree of over intake were same in the three trimesters（ P〉0. 05）,and the percent of over intake were21. 0%,33. 1% and 24. 1%,respectively. The median low bound scores（ LBS） were24,19 and 21,respectively,suggesting they were in low deficit of food intake,and the degree of under intake was highest in the first trimester（ P〈0. 017）,and the percent of under intake were 96. 1%,88. 0% and 91. 3%,respectively. The median diet quality distance scores（ DQD） were 27,23 and 25,respectively,suggesting they were in moderate to low dietary imbalance,and the degree of imbalance was highest in the first trimester（ P〈0. 017）,and the percent of overall imbalance were 97. 9%,96. 9% and97. 4%,respectively. Conclusion The dietary intake of pregnant women in Chengdu is unbalanced,especially during the first trimester,and the deficit of food intake is the main problem.