Evaluation of the effects of Chinese Dietary Guidelines on nutrition,environment,and cost

National dietary guidelines serve as a strategic tool to facilitate dietary adjustments,improve human nutrition,and reduce environmental strain by guiding individuals toward healthier dietary choices.This study examines the evolution of Chinese Dietary Guidelines(CDG)and compares them with Chinese residents’current dietary structure.The effects of the CDG on nutrition,the environment,and cost were evaluated.The results demonstrated that the gap between Chinese residents’dietary structure and the CDG predominantly manifests as a severe deficiency in dairy consumption.The nutrients currently recommended in the CDG cannot meet the needs of the human body and have significant environmental impacts.In terms of cost,rural residents’incomes may not be sufficient to fully adhere to CDG recommendations.We propose that future updates to the CDG should address issues related to inadequate nutrition and significant environmental impacts.Simultaneously,the government should prioritize facilitating access to the nutritionally adequate food recommended in the CDG for low-income groups.

Probiotics in dietary guidelines and clinical recommendations outside the European Union

Fermented foods have been consumed for centuries across many geographical locales and have traditionally been considered healthy foods, partly because of the live microbes contained in them. The concept of “probiotics” further requires that the microbes be defined and their health effects be demonstrated through human intervention studies or other suitable investigations before marketing with corresponding health messages. Here, we review recommendations for fermented foods and probiotics in several countries outside the EU, focusing on food-based dietary guidelines. We emphasize recommendations on yoghurt and probiotics made by expert bodies. We found that dietary guidelines commonly advocate the consumption of yoghurt or similar products, but specific comments on probiotics are rare. Further, we reviewed guidelines from clinical associations. In general, they acknowledge the beneficial effects of probiotics, but often suggest the need for further research. This is true despite good quality evidence supporting the role of probiotics for certain health effects, such as prevention of eczema in infants, management of side effects from antibiotics and alleviation of functional bowel symptoms. Additional research to support future dietary recommendations should focus on determining effect size, identifying responders and non-responders, clarifying strain-specificity of effects and confirming mechanisms.

Qualitative Study among African American Parents to Inform an Intervention to Promote Adoption of the Dietary Guidelines for Americans Food and Physical Activity Recommendations

This qualitative study was conducted to enable the research team to culturally tailor an intervention to increase adherence to Dietary Guidelines for Americans (DGA) in African American parents and their children living in Lower Mississippi Delta (LMD) communities. Focus group results guided the planning of an obesity prevention intervention utilizing the We Can! (Ways to Enhance Children’s Activity and Nutrition) obesity prevention program. Main outcome measure was perceptions of approaches to use in culturally tailoring a nutrition and physical activity intervention. Six focus group sessions were conducted with 86 African American adults to identify cultural concerns, intervention strategies in two Louisiana parishes in the LMD. Focus groups discussions were audio recorded, transcribed, and analyzed to identify recurring trends and patterns among focus groups. Major themes that emerged included cultural influences on food habits and physical activity, challenges of meeting the DGA and the CDC physical activity guidelines, facilitators and barriers to adhering to healthy food and physical activity guidelines and program development. Wider acceptance and use of the DGA recommendations are needed by LMD populations, leading to reduced prevalence of overweight and obesity and parallel reductions in the prevalence of chronic diseases. Interventions are needed that will enhance adherence to the DGA particularly for diverse subpopulations in the U.S. This study provides important insights for culturally tailoring an intervention to promote adoption of the DGA in two low-income African American Delta communities.

Dietary Guidelines for Chinese Residents(2016):comments and comparisons

A high quality diet is believed to play a functional role in promoting the healthy growth of mankind and preventing many kinds of chronic degenerative diseases, including cancer, cardiovascular disease, diabetes, and obesity. Adherence to a high quality diet has been strongly associated with a lower risk of mortality. To help promote healthy lifestyles and physical strength, the Chinese government has produced a new revised version of the Dietary Guidelines for Chinese Residents （2016） and the Chinese Food Pagoda, as guidance for dietary intake among its population. Similarly, the Japanese government has produced the Japanese Food Guide Spinning Top Model, and the US government has recently published revised dietary recommendations in its 2015-2020 eighth edition of Dietary Guidelines for Americans. The evidence from all respective cohort studies involved in producing these guidelines shows a reduced risk of many chronic diseases and mortality if the guidelines are followed. All scientific findings support encouraging the general population to consume a broad variety of food on the basis of nutrient and food intakes in order to prevent deficiency diseases and a surplus of energy and nutrients, and recommend daily physical activity for health promotion.

基于卡尔加里-剑桥指南的沙龙培训模式提升全科规培医师医患沟通技能的对照研究

背景医患沟通技能是全科医生的核心岗位胜任力之一,高水平的医患沟通能力是创建和谐医患关系的基石,有助于提高患者就医获得感和满意度。而我国全科医生沟通能力普遍偏低,有待探索出一种适应我国国情、满足我国全科医生沟通需求的医患沟通培训模式来提高其医患沟通能力。目的探索基于卡尔加里-剑桥指南的沙龙培训模式在全科规培医师医患沟通技能培训中的应用效果,为构建适合我国国情的医患沟通培训体系提供参考依据。方法选取成都市第五人民医院2019—2020年度全科规培医师40名作为研究对象,按照随机数字表法分为沙龙组和对照组,每组20名,其中沙龙组使用基于卡尔加里-剑桥指南的沙龙培训模式进行医患沟通培训,对照组设置为空白对照,培训前、培训后1周分别对两组学员采用标准化病人(SP)模式进行接诊,使用医患沟通评价量表(SEGUE量表)进行现场观察评分,比较两组学员的医患沟通培训效果。结果最终纳入28名,其中沙龙组15名,对照组13名,培训后沙龙组规培医师SEGUE量表评分从(11.80±4.36)分提高至(18.07±4.11)分,对照组规培医师SEGUE量表评分从(12.15±4.63)分提高至(14.46±3.71)分。沙龙组培训后的SEGUE量表评分与培训前的比较,差异有统计学意义(t=3.250,P<0.001);对照组培训后的SEGUE量表评分与培训前比较,差异无统计学意义(t=2.582,P=0.624);培训后对SEGUE量表中的25个项目进行分析,沙龙组与对照组SEGUE量表评分比较,差异有统计学意义(P<0.05)。沙龙组以下5个项目结果优于对照组,准备阶段中的“建立个人信任关系”(93.3%比7.7%)、“保护患者的隐私/尊重患者选择权”(53.3%比15.4%);理解患者阶段中的“认同患者为疾病所付出的努力、改变及其遇到的困难”(33.3%比23.1%)、“表达关心,使患者感到温暖/树立信心”(100.0%比69.2%);结束问诊阶段中的“询问患者是否还有其他的问题需要探讨”(66.7%比23.1%)。结论基于卡尔加里-剑桥指南的沙龙培训模式对全科规培医师进行医患沟通技能培训可增强学员主动参加培训的兴趣和积极性,对于医患沟通能力的提升具有较好的培训效果,值得借鉴和推广。

Teaching Ultrasound Imaging for Central Line Placement—A Resident’s Perspective

The availability of ultrasound (US) devices has refined techniques for vascular access. The resident trainee’s ability to learn US techniques depends upon device availability, skills, and motivation of instructors. We hypothesized that hands-on teaching program of US techniques for vascular access would have a positive impact on the trainee’s perceptions. After IRB approval, PGY3 anesthesiology residents with limited prior experience in US-guided vascular access underwent close supervision by attending staff as they performed US-guided Internal Jugular Vein (IJV) central line placements. A total of 66 land mark (LM) and 75 US-guided IJV cannulation performed by 19 residents were supervised. Residents completing the study were more proactive with 68.4% agreeing to use US based techniques for an anticipated difficulty in accessing central lines. The graduating residents involved in the study all strongly agreed that US imaging for vascular access was within the scope of practice of all anesthesiologists, and that training guidelines be established and incorporated in their practice. Fifty eight percent of residents stated that their confidence and skill levels had significantly improved. Teaching US-guided techniques resulted in an increase employment of such techniques by graduating residents with no impediment attributed to knowledge deficits or inexperience. Residents were more proactive with using US for anticipated difficulty in IJV placement. A short neck, poor landmark, anticoagulation, morbid obesity favored US use by residents. Systematic teaching of US techniques is justified as it significantly improves the resident’s perceptions and confidence.

香蕉中啶氧菌酯残留行为和膳食风险评估

香蕉生产中普遍使用啶氧菌酯,这可能对消费者健康造成潜在风险。为了评估膳食风险,我们拟研究香蕉中啶氧菌酯残留行为,在海南和云南两地分别开展香蕉中啶氧菌酯消解动态和最终残留试验,于施药后不同时间采样检测样品中啶氧菌酯残留,并计算膳食风险商。结果表明,在添加浓度0.02~1.0 mg/kg范围内,香蕉中啶氧菌酯的平均回收率为101.4%~109.2%,相对标准偏差为2.1%~4.0%,最小检出量为0.01 ng,最低检出浓度为0.02 mg/kg。香蕉中啶氧菌酯降解符合一级动力学方程,降解半衰期为8.7~13.8 d,最终残留量的最大值为0.045 mg/kg,施药60 d后香蕉中啶氧菌酯降解率大于99.62%。我国普通成人啶氧菌酯的估算每日摄入量估计为0.35 mg,风险商(RQ)为0.06,远远小于1。说明在该试验条件下,香蕉中啶氧菌酯的残留水平不会对普通成人造成膳食风险。

基于指南的案例教学法在血液科住院医师规范化培训中的应用探索

血液病专业的临床指南和专家共识是血液科医生进行疾病诊断和规范化治疗的依据。本文探讨了基于指南的案例教学法(Case-based Learning,CBL)在血液科住院医师规范化培训中的应用,证明基于指南的CBL模式可以激发规培医生的学习兴趣,提高临床思维能力、临床决策能力、医患沟通能力和岗位胜任力,可带来较好的教学效果。

总结病例特点在培养住院医师临床思维中的重要作用

临床思维是医生将其所掌握疾病的一般规律用到判定患者个体的假设、推理的逻辑思维的过程,有直觉思维和逻辑思维两种方式。病例特点主要包括症状、体征及辅助检验和检查结果,因此病例特点与病例脚本极为相似。总结病例特点是临床思维教学构架中的必经步骤,也是对患者临床问题的高度凝练和精确表达,还反映出住院医师个性化的临床思维。住院医师因对病例特点把握不全、临床疾病脚本数量不足,所以指导医师应注重培养他们的逻辑思维能力,可以指导他们从病例特点总结并从中确定切入点着手,采用定位、定性、定因和定方案的“假设演绎推理”思维模式进行培训。住院医师只有多接触患者、反复训练,诊断过程才会随着临床经验和疾病脚本数量的增加,逐渐产生直觉判断与模式识别能力,并能随时根据需要转换成逻辑分析。

基于新版膳食指南培养高职生低碳健康膳食行为

2030年前实现碳达峰,2060年前实现碳中和,是中国政府向联合国的庄严承诺。围绕“双碳”目标,从《中国居民膳食指南》的修订过程入手,介绍了新版《中国居民膳食指南》的主要特点,结合13种常见食物的碳排放系数,阐述了培养高职生低碳健康膳食行为的6条具体做法,分别是食物多样、科学搭配,天天运动、低碳出行,多吃蔬果、奶类、大豆,适量吃鱼、禽、蛋、瘦肉,少盐少油、足量饮水,公筷分餐、杜绝浪费。

超声医学科住院医师规范化培训:妇产超声培训中国指南(2024版)

为进一步提升妇产超声亚专业规范化培训质量,中国医师协会超声医师分会组织国内相关专家,参考《住院医师规范化培训基地标准(2022年版)》及《住院医师规范化培训内容与标准(2022年版)》,结合自身经验,经过充分讨论形成本指南,旨在指导实施妇产超声教学工作。

我国城市成年居民早餐食物种类调查

目的:分析我国城市居民早餐食物食用情况及影响因素,为相关部门及供餐企业指导、改善居民早餐状况提供科学参考。方法:问卷调查早餐食物摄入和人口、社会经济学等相关信息。共纳入31省、自治区、直辖市城市居民10444人。应用SAS 9.4软件进行统计分析,并采用多因素Logistic回归模型分析早餐是否营养充足的影响因素。结果:10444名城市成年居民在调查期间早餐食用比例最高的食物是谷薯类(89.4%),其次是肉蛋类(53.9%)、奶豆坚果类(49.3%),最低的是蔬菜水果(42.2%)。分别有26.5%、28.8%、28.2%、16.5%的调查对象早餐的食物种类为1类、2类、3类、4类。不同城市、性别、年龄、婚姻状况、文化程度、家庭人均年收入之间差异均有统计学意义(P均<0.001)。多因素Logistic回归分析结果显示,一线及新一线城市、女性、30岁~、40岁~、50~80岁、家庭人均年收入≥7万元的调查对象早餐营养充足(早餐食物种类达到四类)的可能性更高。结论:我国居民早餐膳食不够均衡,早餐质量还有待提高。需要个人-供餐企业-相关部门等共同努力,达到均衡膳食、合理营养的目标。

从健康营养卫生的角度浅析一般人群膳食指南

从健康营养卫生的角度结合新版中国居民膳食对民众的饮食健康进行科学分析,将现代社会中的科学饮食理念与优秀传统健康膳食理念结合,让日常饮食更加科学健康,更能够适应中国人的体质,从而达到合理营养、促进健康的目的。

Health effects of fruit juices and beverages with varying degrees of processing

The degree of processing is rarely considered an independent factor in the health effects of fruit juices and beverages(FJBs)consumption.In fact,the consumption of ultra-processed foods has been shown to pose health risks.In this study,we first integrated 4 systems used to classify the degree of food processing and then classified FJBs into three major categories,low(minimal),moderate and high.Second,we compared the differences in attitudes towards FJBs in dietary guidelines.Third,we integrated the results of existing epidemiological surveys,randomized controlled trials,and animal experiments to explore the health risks associated with consuming FJBs.Deepening the processing of FJBs has been found to lead to an increased risk of diseases.Dietary pattern,nutrients,addition agents and consumer preferences may be influential factors.Finally,we investigated whether there were any changes in the health benefits of 100%fruit juices produced by different processing methods.In conclusion,minimally/moderately processed 100%fruit juices provide more health benefits than highly processed fruit beverages.The results support the need to consider the extent of FJBs processing in future studies to adjust official nutritional recommendations for beverage consumption.

A cross-cultural study of sustainable nutrition and its environmental impact in Asia and Europe:A comparison of China and Germany

Global challenges such as climate change,biodiversity loss,and health crises necessitate a shift towards sustainable diets.Incorporating sustainability into food-based dietary guidelines(FBDGs)is essential for this shift,and cultural considerations also play a vital role,as food culture significantly influences dietary habits.Considering that Asia and Europe exhibit distinct food cultures,tailored approaches are necessary.Additionally,countries face diverse nutritional challenges,ranging from malnutrition to diet-related diseases,and regional variation in environmental impact necessitates context-specific strategies.Achieving sustainable nutrition depends on understanding cultural influences and regional dynamics.This paper compares China’s and Germany’s dietary guidelines and dietary patterns and their impact on sustainability.It shows that Chinese and German FBDGs only slightly differ,despite the different eating cultures and habits of each country.Alone the recommended amounts for eggs and fish are considerably higher in China than in Germany.However,in both China and Germany,actual dietary patterns deviate from the dietary guidelines.In China,concomitant with economic growth and urbanization,a dietary shift towards increased consumption of animal products and decreased consumption of vegetables and cereals has been observed in the last decades,which has led to a decline in nutritional deficiencies but an increase in obesity and overweight.Obesity and overweight are also on the rise in Germany.A dietary shift could therefore also be beneficial for public health.While following the respective national guidelines would benefit the environment,alternative diets such as a plant-based diet offer even lower environmental footprint.Revising guidelines to prioritize sustainability in addition to health aspects while considering regional contexts and cultural preferences is recommended to foster sustainable eating habits globally.This approach is pivotal for promoting dietary shift towards sustainability on a global scale.

R2C2联合思维导图在肿瘤指南教学中的实践

目的 探索R2 C2联合思维导图在肿瘤指南教学中的效果。方法 回顾性分析2020年12月—2023年12月内科在培住院医师75人,其中,2022级和2023级41人为观察组,2020级和2021级34人为对照组。在肿瘤指南的学习中观察组采取R2 C2联合思维导图的教学模式,对照组采取传统教学模式。比较两组住院医师的理论知识及满意度调查。结果 两组在性别、年龄和学历上差异无统计学意义(均P> 0.05)。观察组理论考核成绩高于对照组,差异有统计学意义(P<0.05)。满意度调查结果,观察组教学方式、学习兴趣、知识掌握、临床思维和团队协作得分均高于对照组,差异有统计学意义(均P<0.05)。结论 基于R2 C2的思维导图肿瘤指南学习易学易操作能够提高临床教学的满意度,激发住院医师的自主学习能力。

以全面提升内涵建设为目标的内科入专业基地教育实践探索

目的 根据《住院医师规范化培训入专业基地教育指南(2022年版)》探索以内涵建设为目标的内科入专业基地教育,帮助住院医师了解内科专业基地的总体情况,了解本专业的培训目标,尽快融入新的学习和培训环境。方法 在充分发挥复旦大学附属中山医院内科专业基地优势和特色的基础上探索新的指南框架下入专业基地教育的组织实施路径,聚焦内涵建设,强化入专业基地培训目标、课程建设、教学模式与方法、考核方式和课程反馈等六大模块课程。结果 选取住院医师43人,从5个维度对课程进行评价,得分(24.6±0.17)分;理论课程得分(94.06±3.17)分;技能操作得分(88.31±5.68)分。结论 新入专业基地住院医师对本次入内科专业基地教育课程内容、授课形式、时间安排满意度高,对培训过程中的各个环节做好充分准备,有效提升了住院医师的自信心。

“中国居民膳食指南”营养教育项目效果分析

通过对山东、广东、四川和黑龙江四省五个城市抽样调查 5 145人的营养知识、态度、行为的分析 ,显示“中国居民膳食指南”营养教育项目的开展是具有成效的 ,特别是在居委会住户、中小学生及一些老年活动站的老年人群中取得了明显的宣传效果。例如在开展“膳食指南”营养教育宣传前后住户了解“膳食指南”的人数百分比从 11 97%上升到 93 38% ,老年人也从 2 9 15 %上升为 99 0 0 % ,中小学生了解“膳食指南”的人数百分比也从 15 2 %上升为 91 9%。有近 90 %的住户和老年人是从项目所发放的宣传材料上获得“膳食指南”知识的。从营养知识得分情况可见 ,以上人群在项目开展宣传前后的营养知识水平得到了明显提高 ,具有良好的学习营养知识的态度 ,同时某些膳食行为和生活方式也有了一些改变。充分说明营养教育对提高大众营养知识水平、改变人们不良的生活和饮食习惯具有极为重要的作用。

中国居民平衡膳食模式的践行——《中国居民膳食指南(2022)》解读

比较了5个版本的中国居民膳食指南,提炼出了每一版膳食指南坚持的健康理念,包括合理搭配、能量平衡与健康体重、三减(降盐、降脂和降糖)以防止慢性非传染性疾病的发生等理念,分析了新版《中国居民膳食指南》的时代性和实践性特性,包括东方健康膳食模式、会烹会选、公筷分餐等理念。在此基础上,基于中国居民平衡膳食宝塔分析了平衡膳食模式的践行。

拉萨社区藏族居民高血压患病情况与不同饮食习惯相关性研究

目的探讨拉萨社区藏族居民高血压患病的重要危险因素以及居民饮食习惯与高血压疾病的相关性,为该地区高血压的防治提供相应理论依据。方法 2016年4—8月,在拉萨市两个社区通过分层定点抽样,抽取参与全民体检人数的10%,同时获取体格检查与生化指标检测资料,并进行问卷调查,了解饮食生活习惯等,通过多因素回归等方法分析高血压的重要影响因素。在此基础上进一步对饮食结构进行分层分析,着重考查饮食习惯与高血压风险的相关性。结果共收集351名藏族社区居民的相关资料,其中高血压患者为120名,患病率34.19%。结合单因素2分析及多因素回归分析结果显示,体重指数(BMI)、血胆固醇、工作压力、吸烟、生活规律和教育程度是拉萨市藏族社区居民高血压患病的重要影响因素。进一步考查饮食习惯发现,高盐、高糖、高脂等非健康饮食习惯是高血压患病危险因素,而蔬菜、水果为保护性因素,不同饮食习惯组间差异有统计学意义(P<0.001)。结论在拉萨藏族社区居民高血压发病的影响因素中,良好的健康饮食习惯是藏族社区居民重要的独立保护因素。