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[俄罗斯学龄前儿童和学龄儿童的钙膳食摄入量:主要食物来源和用餐场合]

[Dietary intake of calcium in pre-school and school children in Russia: main food sources and eating occasions].

作者信息

Martinchik A N, Keshabyants E E, Kambarov A O, Peskova E V, Bryantseva S A, Bazarova L B, Semenova Ya A

机构信息

Federal Research Centre of Nutrition and Biotechnology, Moscow.

Nestle Russia LLC, Moscow.

出版信息

Vopr Pitan. 2018;87(2):24-33. doi: 10.24411/0042-8833-2018-10015. Epub 2018 Feb 26.

Abstract

It is known that adequate calcium intake determines formation of skeleton and genetic predisposition of its weight and density peak. Optimal calcium intake in the childhood determines risk reduction of density loss and osteoporosis in the adulthood. This research explored contribution of different food sources, as well as eating occasions on calcium dietary intake among preschool and school children (4-13 years old). Mean daily Calcium intake and dairy products consumption depending on family income have been analyzed. Dietary intake was evaluated by 24-hour recall method. National food composition data tables have been used to estimate mean nutrient intake. Dairy products were classified in accordance with local food grouping system. Percent of children consuming products - sources of calcium, amount per consumer, contribution of eating occasions to Calcium intake, foods consumed at breakfast as well as Calcium intake and dairy products consumption depending on household income has been analysed. Nationally representative sample of preschool and school age children, Russia National Nutritional Survey, was conducted in all regions of Russia in 2013 by state Federal Statistics Service - Rosstat. Sample size was 22 771 children split in four age groups: 4-6 y.o. (n=7303), 7-8 y.o. (n=4391), 9-10 y.o. (n=4691) and 11-13 y.o. (n=6386). The study confirmed the indications in the domestic and foreign literature that calcium intake was insufficient in children aged 4-13 years. Data showed age related particularities in consumption of products-sources of Calcium: percent of children consuming milk and milk-based beverages, milk porridges, cottage cheese declined rapidly in older age groups in comparison to preschoolers. A slight increase of cheese consumption was shown in older age groups. Breakfast is an important eating occasion that provides a significant proportion (23-28%) into calcium daily intake in children. Habit of skipping breakfast puts calcium daily intake at risk as it is not compensated throughout the day at other eating occasions. Our results indicate lower daily Calcium intake in breakfast skippers (11-14% of children) compared with kids of the same age who had breakfast at the day of survey. Sweetened tea and coffee consumption increased in older age groups and contrary, a milk and milk based beverages consumption droped in school age. We found lower Calcium intake and lower accessibility to variety of Calcium food sources in low socio-economic class of the children population, where milk seems to be the main product from milk and dairy food group. The findings can assist in developing food-based recommendations for optimal intake of calcium in children's daily diet. Consumption of dairy products is required to meet adequate intake and to low down prevalence of inadequate intake. There is room for improvement of dairy product consumption in terms of variety and number of serving a day especially, for children in older age groups. More attention to be dedicated to breakfast as it is an important eating occasion that contributes significantly to calcium daily intake. Study findings call for intervention programs aiming to correct the inadequacies of calcium intake in schoolchildren's diets, including nutrition education for families and support for accessibility of the products rich in calcium by low socio-economic population groups; for example, by inclusion of milk and dairy products into the school feeding programs.

摘要

众所周知,充足的钙摄入量决定骨骼的形成及其重量和密度峰值的遗传易感性。儿童时期的最佳钙摄入量可降低成年后患密度降低和骨质疏松症的风险。本研究探讨了不同食物来源以及进餐时间对学龄前和学龄儿童(4至13岁)钙膳食摄入量的影响。分析了根据家庭收入的平均每日钙摄入量和乳制品消费量。通过24小时回忆法评估膳食摄入量。使用国家食物成分数据表来估计平均营养素摄入量。乳制品根据当地食物分类系统进行分类。分析了食用钙源产品的儿童百分比、每个消费者的食用量、进餐时间对钙摄入量的贡献、早餐食用的食物以及根据家庭收入的钙摄入量和乳制品消费量。俄罗斯国家统计局(Rosstat)于2013年在俄罗斯所有地区对具有全国代表性的学龄前和学龄儿童样本进行了俄罗斯国家营养调查。样本量为22771名儿童,分为四个年龄组:4至6岁(n = 7303)、7至8岁(n = 4391)、9至10岁(n = 4691)和11至13岁(n = 6386)。该研究证实了国内外文献中的观点,即4至13岁儿童的钙摄入量不足。数据显示了钙源产品消费的年龄相关特殊性:与学龄前儿童相比,年龄较大的年龄组中食用牛奶及牛奶饮料、牛奶粥、凝乳的儿童百分比迅速下降。年龄较大的年龄组中奶酪消费量略有增加。早餐是一个重要的进餐时间,为儿童每日钙摄入量提供了很大比例(约23%至28%)。不吃早餐的习惯会使每日钙摄入量面临风险,因为在其他进餐时间无法弥补。我们的结果表明,与在调查当天吃早餐的同龄儿童相比,不吃早餐的儿童(占儿童的11%至14%)每日钙摄入量较低。年龄较大的年龄组中甜茶和咖啡的消费量增加,相反,学龄儿童中牛奶及牛奶饮料的消费量下降。我们发现,在社会经济地位较低的儿童群体中,钙摄入量较低,且获取各种钙食物来源的机会较少,在这些群体中,牛奶似乎是牛奶及乳制品组中的主要产品。这些发现有助于制定基于食物的建议,以实现儿童日常饮食中钙的最佳摄入量。需要食用乳制品以满足充足摄入量并降低摄入不足的患病率。在乳制品消费的种类和每日食用量方面,尤其是年龄较大的年龄组儿童,仍有改进空间。应更加关注早餐,因为它是对每日钙摄入量有重要贡献的进餐时间。研究结果呼吁开展干预计划,旨在纠正学童饮食中钙摄入不足的问题,包括对家庭进行营养教育以及支持社会经济地位较低群体获取富含钙产品的机会;例如,将牛奶及乳制品纳入学校供餐计划。

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