Zhang Qiang, Chen Xinguang, Liu Zhitao, Varma Deepthi S, Wan Rong, Zhao Shiwen
Department of Nutrition and Food Hygiene, Yunnan Center for Disease Control and Prevention, Kunming, China.
Department of Epidemiology, University of Florida, Gainesville, Florida, United States of America.
PLoS One. 2017 Feb 23;12(2):e0172406. doi: 10.1371/journal.pone.0172406. eCollection 2017.
With rapid urbanization in the past decades, diet diversity continues to increase in China. The present cross-sectional study aims to explore the association between dietary diversity and nutritional status among adults in southwest China.
This study used data from 2011-2012 National Nutritional Survey in Yunnan Province, southwest China (N = 1105).Data of three consecutive 24-hour dietary recalls were used to calculate dietary diversity scores (DDS) and nutrient adequacy ratio (NAR). Body mass index and waist circumference were used to determine nutritional status. Surveylogistic procedure of SAS 9.2 software was used to examine the association between DDS and obesity by estimating odds ratio (OR) and 95% confidence intervals (CI).
The mean DDS was 5.2 (SD 1.1) out of nine points. Being female, younger age, belonging to Han ethnicity, having higher educational level and household income were positively associated with DDS (all P<0.05). As DDS increased, consumption also increased in most food groups except grains and vegetables. People with medium and high DDS (DDS = 5 and DDS ≥6, respectively) ingested more energy than the recommended quantity(NAR = 1.1 and 1.2, respectively). However, the intakes of Calcium and Vitamin A were seriously inadequate even for people with high DDS (NAR≤0.5). With potential confounders adjusted, people with medium and high DDS were at higher risk of general and central obesity than people with DDS ≤4 (OR = 1.4-1.9, P<0.01).
Our data indicated that high DDS was associated with excessive energy intake and obesity among adults in southwest China. Although dietary diversity is widely recommended, public health messages should give less emphasis on dietary diversity.
在过去几十年快速城市化的进程中,中国的饮食多样性持续增加。本横断面研究旨在探讨中国西南部成年人饮食多样性与营养状况之间的关联。
本研究使用了2011 - 2012年中国西南部云南省全国营养调查的数据(N = 1105)。连续三天24小时饮食回顾的数据用于计算饮食多样性得分(DDS)和营养素充足率(NAR)。体重指数和腰围用于确定营养状况。使用SAS 9.2软件的Survey logistic程序,通过估计比值比(OR)和95%置信区间(CI)来检验DDS与肥胖之间的关联。
在满分9分中,平均DDS为5.2(标准差1.1)。女性、较年轻、汉族、较高教育水平和家庭收入与DDS呈正相关(均P<0.05)。随着DDS增加,除谷物和蔬菜外的大多数食物组的摄入量也增加。DDS为中等和高的人群(分别为DDS = 5和DDS≥6)摄入的能量超过推荐量(NAR分别为1.1和1.2)。然而,即使是DDS高的人群,钙和维生素A的摄入量也严重不足(NAR≤0.5)。在调整潜在混杂因素后,DDS为中等和高高的人群比DDS≤4的人群发生全身肥胖和中心性肥胖的风险更高(OR = 1.4 - 1.9,P<0.01)。
我们的数据表明,在中国西南部成年人中,高DDS与能量摄入过多和肥胖有关。尽管广泛推荐饮食多样化,但公共卫生信息应减少对饮食多样性的强调。