中国哺乳期膳食平衡指数修订及产褥期膳食质量评价

REVISION OF CHINESE DIET BALANCE INDEX FOR LACTATION AND EVALUATION OF DIET QUALITY IN WOMEN DURING PUERPERIUM

目的修订中国哺乳期膳食平衡指数(diet balance index for lactation,DBI-L)并评价广州市产褥期妇女的膳食质量。方法在中国成人DBI-16基础上,依据中国居民膳食营养素参考摄入量(2013)和哺乳期妇女膳食指南(2016),建立DBI-L。基于队列研究,于2017~2018年在广州市纳入560名孕妇并于产褥期进行随访。采用经信效度检验的膳食频率问卷以面对面的方式调查产后1月内的膳食摄入情况并进行评价。结果超过80%的产妇存在谷薯类、果蔬、奶类及大豆坚果类、鱼虾类、饮用水摄入不足;畜禽肉类摄入过量者占83.21%;油、盐及添加糖摄入过量者均小于10%;食物种类不符合推荐者占95.18%。产妇膳食正端分均值为7.73,27.32%的产妇存在低度摄入过量;负端分均值为31.47,37.50%的产妇存在低度摄入不足,中度及以上的摄入不足者占59.29%;膳食质量距均值为39.20,46.79%的产妇存在低度膳食不均衡,中度及以上不均衡者占51.97%。结论本研究所修订的DBI-L评分系统,可反映产妇整体膳食状况,适合国内产妇的膳食评价。广州市妇女产褥期膳食摄入不均衡,畜禽肉类摄入过量与果蔬、奶豆、鱼虾类摄入不足并存。应加强产褥期营养健康教育,改善产妇膳食质量。

Objective To revise the diet balance index for lactation(DBI-L)and to assess the overall diet quality among Chinese women during puerperium in Guangzhou.Methods DBI-L was developed based on DBI-16,Dietary Guidelines for Chinese Lactating women(2016),and the Dietary Reference Intakes for Chinese(2013).We enrolled a total of 560 pregnant women in Guangzhou in 2017-2018 and followed up at postpartum.Food intake during the first month after delivery was assessed using a validated semi-quantitative food frequency questionnaire by face-to-face interviews.Results More than 80%of postpartum women had inadequate intake of cereals,fruits and vegetables,milk and beans,fish and shrimp,and drinking water.The proportion of women with excessive intake of meat and poultry was 83.21%.Less than 10%of postpartum women had excessive intake of oil,salt and added sugar.The proportion of women who was below recommended levels of diet variety was 95.18%.Among the postpartum women,the mean high bound score was 7.73,with 27.32%of women having a low level of excessive dietary intake.The mean low bound score was 31.47,with 37.50%of women having a low level of inadequate food intake,while 59.29%of women had moderate or high levels of inadequate intake.The mean diet quality distance was 39.20,with 46.79%of women having a low level of imbalanced food intake,and 51.97%of women had moderate or high levels of imbalanced food intake.Conclusion The Diet Balance Index for Lactation is appropriate for dietary evaluation in Chinese postpartum women.The dietary intake of postpartum women was imbalanced.Excessive intake of meat and poultry and inadequate intake of cereals,fruits and vegetables,milk and beans,fish and shrimp were both observed.Diet quality of postpartum women needs to be improved.