发展中世界背景下儿童的添加糖、常量和微量营养素摄入量与人体测量学
Added Sugar, Macro- and Micronutrient Intakes and Anthropometry of Children in a Developing World Context.
作者信息
Maunder Eleni M W, Nel Johanna H, Steyn Nelia P, Kruger H Salome, Labadarios Demetre
机构信息
School of Agricultural, Earth and Environmental Sciences, University of KwaZulu-Natal, KwaZulu-Natal, South Africa.
Department of Logistics, University of Stellenbosch, Stellenbosch, Western Cape, South Africa.
出版信息
PLoS One. 2015 Nov 11;10(11):e0142059. doi: 10.1371/journal.pone.0142059. eCollection 2015.
OBJECTIVE
The objective of this study was to determine the relationship between added sugar and dietary diversity, micronutrient intakes and anthropometric status in a nationally representative study of children, 1-8.9 years of age in South Africa.
METHODS
Secondary analysis of a national survey of children (weighted n = 2,200; non weighted n = 2818) was undertaken. Validated 24-hour recalls of children were collected from mothers/caregivers and stratified into quartiles of percentage energy from added sugar (% EAS). A dietary diversity score (DDS) using 9 food groups, a food variety score (FVS) of individual food items, and a mean adequacy ratio (MAR) based on 11 micronutrients were calculated. The prevalence of stunting and overweight/obesity was also determined.
RESULTS
Added sugar intake varied from 7.5-10.3% of energy intake for rural and urban areas, respectively. Mean added sugar intake ranged from 1.0% of energy intake in Quartile 1 (1-3 years) (Q1) to 19.3% in Q4 (4-8 years). Main sources of added sugar were white sugar (60.1%), cool drinks (squash type) (10.4%) and carbonated cool drinks (6.0%). Added sugar intake, correlated positively with most micronutrient intakes, DDS, FVS, and MAR. Significant negative partial correlations, adjusted for energy intake, were found between added sugar intake and intakes of protein, fibre, thiamin, pantothenic acid, biotin, vitamin E, calcium (1-3 years), phosphorus, iron (4-8 years), magnesium and zinc. The prevalence of overweight/obesity was higher in children aged 4-8 years in Q4 of %EAS than in other quartiles [mean (95%CI) % prevalence overweight 23.0 (16.2-29.8)% in Q4 compared to 13.0 (8.7-17.3)% in Q1, p = 0.0063].
CONCLUSION
Although DDS, FVS, MAR and micronutrient intakes were positively correlated with added sugar intakes, overall negative associations between micronutrients and added sugar intakes, adjusted for dietary energy, indicate micronutrient dilution. Overweight/obesity was increased with higher added sugar intakes in the 4-8 year old children.
目的
本研究旨在确定在一项针对南非1至8.9岁儿童的全国代表性研究中，添加糖与饮食多样性、微量营养素摄入量及人体测量状况之间的关系。
方法
对一项全国儿童调查（加权n = 2200；未加权n = 2818）进行二次分析。从母亲/照料者处收集经验证的儿童24小时饮食回顾，并根据添加糖提供的能量百分比（%EAS）分为四分位数。计算了使用9个食物组的饮食多样性得分（DDS）、单个食物项目的食物种类得分（FVS）以及基于11种微量营养素的平均充足率（MAR）。还确定了发育迟缓以及超重/肥胖的患病率。
结果
农村和城市地区添加糖的摄入量分别占能量摄入量的7.5 - 10.3%。添加糖的平均摄入量从第一四分位数（1 - 3岁）（Q1）中能量摄入量的1.0%到第四四分位数（4 - 8岁）（Q4）中的19.3%不等。添加糖的主要来源是白糖（60.1%）、清凉饮料（果汁饮料类）（10.4%）和碳酸清凉饮料（6.0%）。添加糖摄入量与大多数微量营养素摄入量、DDS、FVS和MAR呈正相关。在调整能量摄入量后，发现添加糖摄入量与蛋白质、纤维、硫胺素、泛酸、生物素、维生素E、钙（1 - 3岁）、磷、铁（4 - 8岁）、镁和锌的摄入量之间存在显著的负偏相关。在%EAS的第四四分位数中，4 - 8岁儿童超重/肥胖的患病率高于其他四分位数[平均（95%CI）超重患病率在Q4中为23.0（16.2 - 29.8）%，而在Q1中为13.0（8.7 - 17.3）%，p = 0.0063]。
结论
尽管DDS、FVS、MAR和微量营养素摄入量与添加糖摄入量呈正相关，但在调整饮食能量后，微量营养素与添加糖摄入量之间总体呈负相关，这表明存在微量营养素稀释现象。在4 - 8岁儿童中，添加糖摄入量越高，超重/肥胖的情况越严重。
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