2017年成都地区孕妇脂肪和脂肪酸摄入水平及来源的纵向研究

Intakes and sources of fat and fatty acids among pregnant women in Chengdu in 2017: a longitudinal study

目的分析成都地区孕妇各孕期脂肪和脂肪酸摄入量、食物来源。方法利用2017年成都孕妇队列数据,选取成都市某三甲妇幼医疗机构产前门诊建卡的1652名孕6~14周单胎健康孕妇作为研究对象。采用3天24小时膳食回顾法分别于孕早、中、晚期收集食物摄入种类及数量,通过问卷调查收集孕妇二十二碳六烯酸(docosahexaenoic acid,DHA)补充剂摄入剂量及频率,计算DHA补充剂平均每日摄入量。参照美国农业部国家营养数据库和《中国食物成分表(第6版)》计算孕早、中、晚期脂肪和脂肪酸平均每日摄入量,并分析食物来源。依据《中国居民膳食营养素参考摄入量(2013版)》评价脂肪和脂肪酸摄入水平。结果研究对象总脂肪和各类脂肪酸摄入量随孕期增加呈上升趋势。孕早、中、晚期总脂肪平均摄入量中位数分别为64.8.81.2和88.5 g/d,脂肪供能比高于30%E的比例分别为67.7%、77.6%和82.9%。各孕期饱和脂肪酸(saturated fatly acids,SFA)供能比中位数分别为7.9%E、8.9%E和9.7%E,SFA供能比高于10%E的比例分别为20.9%、31.9%和44.7%;单不饱和脂肪酸(monounsaturated fatty acids,MUFA)供能比中位数分别为12.9%E、13.5%E和14.2%E,多不饱和脂肪酸(polyunsaturated fatty acids,PUFA)分别为8.5%E、8.4%E和8.8%E。各孕期DHA摄入达到适宜摄入量(200mg)的比例分别为3.6%、21.7%和21.1%。SFA、MUFA和PUFA摄入量的比例(S:M:P)孕早期为1:1.6:1.1,孕中、晚期均为1:1.5:1。孕妇总脂肪和MUFA主要来源于食用油和肉类;PUFA主要来源于坚果和食用油;SFA主要来源于肉类、奶类,其中来源于奶类的SFA随孕期显著升高。结论成都地区孕妇存在孕期总脂肪、SFA摄入过量和DHA摄入不足问题。

OBJECTIVE To analyze the intake of fat and fatty acids and their food sources of pregnant women in Chengdu.METHODS Participants were from a cohort study in 2017,which was conducted among 1652 healthy singleton pregnant women within 6-14 weeks of gestation in a maternity out-patient clinic of maternal-and-child health care institution in Chengdu,Sichuan Province.Data on maternal demographic characteristics was collected by questionnaire.In three trimesters,3-day 24-hour dietary recall method was applied to collect dietary intakes data,with the information of docosahexaenoic acid(DHA)supplement intake being collected by questionnaire.The intakes and sources of daily fat and fatty acids in three trimesters were calculated using the National Nutrient Database of USDA and China Food Composition Tables(6th edition).The intake levels of fat and fatty acids were evaluated according to 2013 Chinese Dietary Reference Intakes.RESULTS The study showed that the intakes of total fat and fatty acids increased during pregnancy.The mean intake of total daily fat was 64.8 g/d,81.2 g/d,88.5 g/d in three trimesters,respectively.The proportion of energy from total fat>30%E during three trimesters were 67.7%,77.6%,82.9%,respectively.The proportions of energy from saturated fatty acids(SFA)were 7.9%E,8.9%E,9.7%E,and those higher than 10%E were 20.9%,31.9%,44.7%in three trimesters,respectively.The proportions of energy from monounsaturated fatty acids(MUFA)were 12.9%E,13.5%E,14.2%E,and the proportions of energy from polyunsaturated fatty acids(PUFA)were 8.5%E,8.4%E,8.8%E in three trimesters,respectively.The proportion of DHA intake meeting recommendation(200 mg/d)in three trimesters were 3.6%,21.7%,21.1%,respectively.The radio of SFA,MUFA and PUFA(S:M:P)was 1:1.6:1.1 in the early trimester,and S:M:P was 1:1.5:1 in the second trimester and third trimester.Total fat and MUFA mainly came from edible oil and meat,and PUFA mainly came from edible oil and nuts.SFA mainly came from meat and milk,and the contribution of milk to SFA increased during pregnancy.CONCLUSION The excessive intakes of total fat and SFA and the inadequate intake of DHA among pregnant women in Chengdu deserve attention.