Xu Xiaoyue, Hall John, Byles Julie, Shi Zumin
Priority Research Centre for Gender, Health and Ageing, School of Medicine and Public Health, Hunter Medical Research Institute, University of Newcastle, Newcastle, Australia; Centre for Clinical Epidemiology and Biostatistics, School of Medicine and Public Health, Hunter Medical Research Institute, University of Newcastle, Newcastle, Australia.
Centre for Clinical Epidemiology and Biostatistics, School of Medicine and Public Health, Hunter Medical Research Institute, University of Newcastle, Newcastle, Australia.
PLoS One. 2015 Mar 26;10(3):e0121618. doi: 10.1371/journal.pone.0121618. eCollection 2015.
BACKGROUND/OBJECTIVES: Few studies have applied the Chinese Diet Balance Index (DBI) in evaluating dietary quality for Chinese people. The present cross-sectional study assessed dietary quality based on DBI for older people, and the associated factors, in four socioeconomically distinct regions in China.
The China Health and Nutrition Survey (CHNS) involves 2745 older Chinese people, aged 60 or over, from four regions (Northeast, East Coast, Central and West) in 2009. Dietary data were obtained by interviews using 24 hour-recall over three consecutive days. Four indicators: Total Score (TS), Lower Bound Score (LBS), Higher Bound Score (HBS) and Diet Quality Distance (DQD) from DBI were calculated for assessing dietary quality in different aspects.
68.9% of older people had different levels of excessive cereals intake. More than 50% of older people had moderate or severe surplus of oil (64.9%) and salt (58.6%). Intake of vegetables and fruit, milk and soybeans, water, and dietary variety were insufficient, especially for milk and soybeans. 80.8% of people had moderate or severe unbalanced diet consumption. The largest differences of DQD scores have been found for people with different education levels and urbanicity levels. People with higher education levels have lower DQD scores (p<0.001), and people living in medium and low urbanicity areas had 2.8 and 8.9 higher DQD scores than their high urbanicity counterparts (p<0.001). Also, significant differences of DQD scores have been found according to gender, marital status, work status and regions (p<0.001).
DBI can reveal problems of dietary quality for older Chinese people. Rectifying unbalanced diet intake may lead to prevention of non-communicable diseases (NCDs). Dieticians and health care professionals need to increase dissemination and uptake of nutrition education, with interventions targeted at regions of lower socioeconomic status.
背景/目的：很少有研究应用中国膳食平衡指数（DBI）来评估中国人的膳食质量。本横断面研究基于DBI对中国四个社会经济状况不同地区的老年人的膳食质量及其相关因素进行了评估。
中国健康与营养调查（CHNS）在2009年纳入了来自四个地区（东北、东部沿海、中部和西部）的2745名60岁及以上的中国老年人。通过连续三天的24小时回顾性访谈获取膳食数据。计算了来自DBI的四个指标：总分（TS）、下限分数（LBS）、上限分数（HBS）和膳食质量距离（DQD），以从不同方面评估膳食质量。
68.9%的老年人谷类摄入过量程度不同。超过50%的老年人油脂（64.9%）和盐（58.6%）摄入中度或重度超标。蔬菜和水果、牛奶和大豆、水的摄入量以及食物种类均不足，尤其是牛奶和大豆。80.8%的人膳食摄入中度或重度不均衡。不同教育水平和城市化水平的人群的DQD得分差异最大。教育水平较高的人群DQD得分较低（p<0.001），生活在中低城市化地区的人群的DQD得分分别比高城市化地区的人群高2.8和8.9（p<0.001）。此外，根据性别、婚姻状况、工作状况和地区，DQD得分也存在显著差异（p<0.001）。
DBI能够揭示中国老年人的膳食质量问题。纠正不均衡的饮食摄入可能有助于预防非传染性疾病（NCDs）。营养师和医疗保健专业人员需要加强营养教育的传播和推广，并针对社会经济地位较低的地区进行干预。
