应用调整的孕期膳食平衡指数评价孕妇膳食质量

Evaluate the dietary quality of pregnant women using the adjusted diet balance index for pregnancy

目的更新中国孕期膳食平衡指数(diet balance index for pregnancy,DBI_P)并对孕期妇女膳食质量进行评价,分析其影响因素。方法依据最新发布的《中国居民膳食指南(2022)》中孕期妇女不同阶段各类食物的建议摄入量及孕期妇女平衡膳食宝塔,对DBI_P进行更新调整。应用此调整后的DBI_P评价521名江苏太仓地区孕妇的膳食质量,采用问卷调查和连续3天的膳食称重记录法收集孕妇基本情况及孕早、中、晚期各类食物摄入量,利用DBI_P中负端分、正端分、膳食质量距评价孕期各阶段膳食质量,应用多重线性回归方法分析孕期膳食质量影响因素。结果孕期各阶段均存在谷类、蔬果、奶类、大豆坚果类、水产品以及食物种类数的摄入不足,蛋类在各孕期摄入充足,畜禽肉类食物在孕期各阶段均存在摄入过量。孕早、中、晚期蔬菜摄入不足的孕妇比例均超过70%,奶类摄入不足比例均超过60%,每日摄入食物种类数不足比例均超过90%,孕期各阶段畜禽肉摄入过量比例从孕早期的74.5%增加到孕晚期的84.1%。孕早、中、晚期膳食负端分均值分别为16.0、15.5和15.1,中高度摄入不足比例分别为14.2%、12.2%和9.2%;膳食正端分均值为4.3、4.8和4.9,中高度摄入过量的比例分别为4.3%、5.4%和4.5%;孕期各阶段膳食质量距均值分别为20.3、20.3和20.0,中高度摄入不均衡比例为26.9%、26.1%和21.7%。各孕期膳食质量均处于低度及以下摄入不均衡的孕妇占比为51.1%。相较于25岁以下的孕妇,≥25岁的孕妇膳食摄入不均衡程度有所降低(β=-0.99,95%CI-1.94~-0.03);随文化程度增加,孕妇膳食摄入不足程度和摄入不均衡程度均呈下降趋势,而摄入过量程度仅在大专学历者中有所增加(β=0.66,95%CI 0.11~1.22);与居住在农村的孕妇相比,居住在城镇的孕妇膳食摄入过量的程度较低(β=-0.59,95%CI-0.97~-0.21)。结论江苏太仓地区孕妇在各孕期均存在膳食结构不均衡问题,膳食质量受到社会人口学特征的影响。

OBJECTIVE To update the Chinese diet balance index for pregnancy(DBI_P),evaluate the dietary quality of pregnant women at different stages of pregnancy and analyze the influencing factors.METHODS The DBI_P was adjusted according to the recommended intake of various foods for pregnant women at different stages in the newly released Dietary Guidelines for Chinese Residents(2022)and and the balanced dietary pagoda for pregnant women.A total of 521 pregnant women in Taicang were investigated by questionnaire and 3-day food records method.Their basic information and food intake in the first,second and third trimester were collected.Low bound score(LBS),high bound score(HBS),diet quality distance(DQD)of DBI_P were used to evaluate the dietary quality of each stage of pregnancy and multiple linear regression method was used to analyze the influencing factors of dietary quality.RESULTS There was insufficient intake of cereals,vegetables,fruits,dairy products,soy nuts,aquatic products and food categories at all stages of pregnancy.The intake of eggs was sufficient at each stage of pregnancy.The intake of meat and poultry was excessive at all stages of pregnancy.The proportion of pregnant women with insufficient vegetable intake in the first,second and third trimester all exceeded 70%.The proportion with insufficient daily food categories in each term was more than 90%.The proportion with excessive intake of meat and poultry increased from 74.5%in the first trimester to 84.1%in the third trimester.The mean of LBS in each stage of pregnancy were 16.0,15.5 and 15.1,and the proportion with moderate to severe insufficient intake were 14.2%,12.2%and 9.2%,respectively.The mean of HBS in each stage of pregnancy were 4.3,4.8 and 4.9,and the proportion with moderate to severe excessive intake were 4.3%,5.4%and 4.5%,respectively.The mean of DQD in each stage of pregnancy were 20.3,20.3 and 20.0,and the proportion with moderate to severe imbalanced intake were 26.9%,26.1%and 21.7%,respectively.The proportion of pregnant women with low imbalanced intake or balanced diet during the whole pregnancy was 51.1%.Compared with pregnant women under 25 years of age,pregnant women≥25 years of age had a lower degree of insufficient and unbalanced dietary intake(β=-0.99,95%CI-1.94--0.03).With the increase of education level,the degree of insufficient and unbalanced dietary intake of pregnant women showed a downward trend,while the degree of excessive intake increased only in college graduates(β=0.66,95%CI 0.11-1.22).Compared with pregnant women living in rural areas,pregnant women living in urban areas had a lower degree of excessive dietary intake(β=-0.59,95%CI-0.97--0.21).CONCLUSION The dietary structure of pregnant women in Taicang is imbalanced,and the dietary quality is affected by sociodemographic characteristics.