2018年中国老年居民蔬菜和水果摄入状况及影响因素研究

Study on the vegetables and fruit intake and influencing factors among Chinese elderly in 2018

目的 了解中国≥60岁居民蔬菜和水果摄入现况及影响因素,为老年人均衡营养膳食的宣传教育提供参考。方法 数据来源于2018年中国慢性病及危险因素监测,在全国31个省(自治区、直辖市)的298个县(区),采用分层多阶段整群随机抽样方法抽取≥18岁常住居民194 749人。问卷收集人口统计学等信息,采用食物频率表采集调查对象过去12个月内新鲜蔬菜和水果摄入频次和摄入量等信息,该研究将其中完成调查的≥60岁且蔬菜和水果摄入相关信息完整的69 246人作为研究对象。采用SAS 9.4软件进行基于复杂抽样的方差分析、logistic回归、Rao-Scottχ^(2)检验,并采用多因素logistic回归进行影响因素分析。结果 2018年中国≥60岁居民蔬菜摄入量为361.5 g/d(95%CI:351.1~371.9 g/d),水果摄入量为74.8 g/d(95%CI:69.0~80.6 g/d);蔬菜摄入量未达推荐量的比例为41.0%(95%CI:39.0%~43.0%),水果摄入量未达推荐量的比例为87.0%(95%CI:85.6%~88.5%)。多因素logistic回归分析显示,女性蔬菜和水果摄入量未达到推荐量的可能性高于男性(OR值分别为0.94和0.59)。高年龄组(与60~64岁组相比,≥80岁组的OR=1.58)、农村(OR=1.37)、未婚或独居(OR=1.15)、教育程度低(与高中及以上组相比,文盲或半文盲组的OR=1.59)和人均年收入低(5 000~元组的OR=1.28)、主食类摄入低于推荐量(OR=1.26)人群的蔬菜摄入量未达推荐量的可能性更高,而红肉摄入过多人群(OR=0.65)蔬菜摄入量未达推荐量的可能性较低。与60~64岁组相比,65~69岁组水果摄入量未达推荐量的可能性低(OR=0.91);农村(OR=1.78)、教育程度低(与高中及以上组相比,文盲或半文盲组的OR=3.82)、人均年收入低(与≥24 000元组相比,<5 000元组的OR=1.69)和已诊断为糖尿病(OR=1.38)和慢性消化系统疾病(OR=1.20)人群的水果摄入未达推荐量的可能性更高,而红肉摄入过多(OR=0.66)和超重(OR=0.84)、肥胖(OR=0.71)人群的水果摄入量未达推荐量的可能性较低,均有统计学意义(P<0.05,P<0.01)。结论 中国老年居民日均蔬菜摄入量已达到膳食指南推荐标准,但水果摄入量仍处于较低水平,需要重点关注男性、农村地区、未婚或独居、教育程度低、人均年收入低以及患糖尿病的老年居民的蔬菜和水果摄入状况。应加强老年居民均衡膳食等健康知识的普及,促进合理膳食与营养改善。

Objective To understand the current state and influencing factors of vegetables and fruit intake among adults(≥60 years old)in China,and provide the reference for the promotion and education of balanced nutritional diets for the elderly.Methods The data were from"National Chronic Disease and Risk Factor Surveillance in 2018",the multi-stage stratified cluster random sampling method was used to select 194749 permanent residents(≥18 years old)in 298 counties(districts)of 31 provinces(autonomous regions,municipalities).The investigation was performed with questionnaires(collecting demographic information),the food frequency table was used to collect information on the frequency and intake of fresh vegetables and fruit in the past 12 months.In the study,69246 residents(≥60 years old)with relative information of vegetables and fruit intake served as the subjects.The variance analysis based on complex sampling,logistic regression and Rao-Scott χ^(2) test were used to analyze the data.The multi-factor logistic regression model was used to analyze the influencing factors.Results In 2018,the vegetables intake in adults(≥60 years old)was 361.5 g/d(95%CI:351.1-371.9 g/d)and the fruit intake was 74.8 g/d(95%CI:69.0-80.6 g/d)in China;the proportion of insufficient vegetables intake was 41.0%(95%Cl:39.0%-43.0%),the proportion of insufficient fruit intake was 87.0%(95%CI:85.6%-88.8%).Multi-factor logistic regression analysis showed that the proportions of insufficient vegetables and fruit intake in females were higher than those in males(OR values were 0.94 and 0.59);the possibility of insufficient vegetables intake in high age group(as compared with 60-64 years old group,≥80 years old group OR=1.58),rural area(OR=1.37),unmarried or living alone(OR=1.15),low education(as compared with high school level,the illiterate or semi-literate group,OR=1.59),low annual per capita income(the 5000-yuan group OR=1.28),intake of staple food below the recommended amount group(OR=1.26)could be higher;the residents consuming excessive red meat(OR=0.65)were less likely to consume lessthan the recommended vegetables intake.Compared with the 60-64 years old group,the 65-69 years old group had the lower possibility of not reaching the recommended intake of fruit(OR=0.91);rural area(OR=1.78),low education level(as compare with≥high school level group,the illiterate or semi-literate group OR=3.82),low annual per capita income(as compared with≥24000 yuan group,the<5000 yuan group OR=1.69),and diagnosed diabetes group(OR=1.38),and chronic digestive diseases group(OR=1.20)were more likely to not reach the recommended fruit intake;but the eating excessive red meat group(OR=0.66),overweight group(OR=0.84)and obese group(OR=0.71)were less likely to consume less than the recommended fruit intake(P<0.05 or P<0.01).Conclusion The average daily vegetable intake of elderly residents in China has reached the recommended standard of dietary guidelines,but fruit intake is still at a relatively low level.It should pay attention to the intake of vegetables and fruit in elderly residents with male,living in rural area,unmarried or solitary,lower educational level,lower annual per capita income and diabetes.The health education of diet and nutrition balance of elderly residents should be strengthened for promoting the improvement of reasonable diet and nutrition.