甘肃中老年人膳食质量与骨量关系的研究

Association between dietary quality and bone mass among middle-aged and elderly people in Gansu Province

目的采用膳食平衡指数(DBI_16)评价甘肃中老年人的膳食质量及膳食质量与骨量之间的关系,为改善甘肃人群的膳食和骨健康状况提供依据。方法基于“西北区域自然人群队列研究”项目甘肃课题基线调查收集的35岁及以上中老年人的食物摄入种类和数量等膳食信息和骨量测量数据,采用DBI_16评价研究对象的谷类、蔬菜、水果、奶类、大豆类、鱼虾类和蛋类等食物的摄入水平及膳食摄入不足、摄入过量和摄入不均衡的程度,并采用多重线性回归评价DBI_16的3个组成指标[负端分(DBI_LBS)、正端分(DBI_HBS)、膳食质量距(DBI_DQD)]和DBI_16的7个单项指标与骨量之间的关系。结果对11840名研究对象的膳食和骨量数据的分析结果显示,与推荐摄入量相比,44.8%的研究对象谷类摄入过量;分别有96.3%、90.6%、90.1%、71.9%、95.1%和60.3%的研究对象的蔬菜、水果、奶类、大豆类、鱼虾类和蛋类摄入不足;47.7%的研究对象摄入食物种类<10。2.3%的研究对象DBI_LBS得分较适宜,54.7%的研究对象DBI_HBS得分较适宜,仅1.2%的研究对象的DBI_DQD得分达到均衡水平。该人群的骨量水平为(2.5±0.6)kg[男性(2.8±0.5)kg,女性(2.3±0.5)kg]。调整了社会人口学特征、生活行为方式、膳食总能量和体质量指数后,DBI_LBS和DBI_DQD与骨量呈负相关[β值及其95%CI分别为-0.00201(-0.00362~-0.00040)和-0.00176(-0.00309~-0.00043)]。结论甘肃中老年人普遍存在膳食摄入不平衡,且膳食摄入不平衡程度越严重,骨量水平越低。

Objective To evaluate the dietary quality with the dietary balance index(DBI_16)and the association between dietary quality and bone mass among middle-aged and elderly people in Gansu Province so as to provide evidence for improving dietary quality and bone health status of Gansu population.Methods Based on the information of the type and quantity of food intake and the bone mass of middle-aged and elderly people aged 35 years and above collected by the Gansu Project in the Regional Ethnic Cohort Study in Northwest China,DBI_16 was used to evaluate the intake level of cereals,vegetables,fruits,milk,beans,fish and shrimp,eggs and other foods,and the degree of inadequate,excessive and unbalanced dietary intake of the participants.Multiple linear regression was used to evaluate the associations of three component indexes of DBI_16,high bound score(DBI_HBS),low bound score(DBI_LBS),diet quality distance(DBI_DQD),and seven single indexes of DBI_16 with bone mass.Results Analyses of the dietary and bone mass data of 11,840 participants showed that 44.8% of participants consumed excessive amounts of cereals compared to the dietary recommendation.96.3%,90.6%,90.1%,71.9%,95.1% and 60.3% of participants’intake of vegetables,fruits,milk,soybeans,fish and shrimp,and eggs,respectively,were inadequate.47.7%participants consumed less than 10 types of food.2.3% participants’DBI_LBS levels were appropriate.54.7% participants’DBI_HBS levels were appropriate.Only 1.2% participants’DBI_DQD reached a balanced level.The bone mass level in the study population was(2.5±0.6)kg[(2.8±0.5)kg for men and(2.3±0.5)kg for women].After adjusting for sociodemographic characteristics,lifestyle,total dietary energy intake and body mass index,DBI_LBS and DBI_DQD were negatively associated with bone mass[β and 95%CI was-0.00201(-0.00362--0.00040)and-0.00176(-0.00309--0.00043),respectively].Conclusion Dietary intake imbalance is common among middle-aged and elderly people in Gansu Province,and the more severe the dietary intake imbalance,the lower the bone mass level.