卫生研究

目的建立中国老年膳食指南指数(CDGI(2018)-E),评价中国15省(自治区、直辖市)60岁及以上老年人膳食质量及影响因素。方法以中国居民膳食指南(2016)以及平衡膳食宝塔为依据,采用等权重连续性评分方法,建立CDGI(2018)-E,并利用2015年"中国健康与营养调查"数据,评价中国15省(自治区、直辖市)60岁及以上老年人的膳食质量现状及影响因素。结果 CDGI(2018)-E总分范围为0～110分,包含3个大类13个评价指标,分别为"足量"摄入类[谷薯类(碳水化合物供能比、其他谷物及杂豆)、水果、蔬菜(蔬菜总量、深色蔬菜占比)、大豆及坚果类、奶及奶制品]。"适量"摄入类(水产品、畜禽肉、蛋类)和"限量"摄入类(油、盐、酒)。2015年中国15省(自治区、直辖市)60岁及以上老年人膳食指南指数的均值为53.79分(中位数53.42分),高收入水平和高教育水平的老年人膳食指南指数较高,东部高于西部和中部,城市高于农村。"限量"摄入类的评分较高,而"适量"和"足量"摄入类的评分则主要分布于0～15和0～25,导致中国15省(自治区、直辖市)60岁及以上老年人膳食评分较低的前5个指标依次为奶及奶制品、水产品、水果、其他谷物和杂豆、畜禽肉。最高分数组的蛋白质、碳水化合物、膳食纤维、维生素A、维生素B₂、烟酸的摄入量高于其他组。结论蛋白质、脂肪、维生素以及钠、钾等一系列与心血管疾病风险相关的营养素在不同分值老年人群中存在差异,老年人的膳食质量整体偏低,奶及奶制品、水产品、水果的摄入状况亟待改善,营养教育和干预工作的主要针对对象应放在西部和中部地区、农村、低收入、低教育水平的老年人中。

OBJECTIVE The China Elderly Dietary Guidelines Index 2018(CDGI(2018)-E) was established to evaluate the dietary quality and analyze its influencing factors of the elderly aged 60 and above in 15 provinces(autonomous regions and municipalities) in China. METHODS Based on Dietary Guidelines Index 2007(CDGI-2007), the equal weight continuity scoring method was used, Chinese residents′ dietary guidelines(2016) and a balanced diet pagoda as the basis, to establish Chinese Dietary Guidelines Index 2018, and used the data of China Health and Nutrition Survey in 2015 to evaluate the elderly aged 60 and above of dietary quality status and it's influencing factors of 15 provinces(autonomous regions and municipality) in our country. RESULTS The CDGI(2018)-E score which ranges from 0 to 110 points, includes 13 evaluation index, consists of three major categories; Class "adequate intake": cereals and tubers(the percentage energy from carbohydrate and other grain and dry beans), fruit,vegetables(total vegetables and the rate of dark vegetables) soybean and nuts and dairy products; Class "moderate intake": meat and poultry, eggs and aquatic products; Class "limited intake": oil, salt and wine. In 2015, the mean of CDGI(2018)-E score for the elderly over 60 years old of 15 provinces(autonomous regions and municipality) in China was 53.79 points(median 53.42 points), high income level and high education level was higher, the eastern region was higher than the western and central region, and the urban higher than the rural. The scores of limited intake category were higher, while the scores of moderate and adequate intake category were mainly distributed within 0-15 and 0-25. The first five indicators of low dietary score of the elderly aged 60 and above in 15 provinces(autonomous regions and municipality)of China were dairy products, fruits, other grains and dry beans, meat and poultry in turn. The highest score class of protein, carbohydrate, dietary fiber, retinol, riboflavin and niacin intake was higher than the other groups. CONCLUSION A series of nutrients related to cardiovascular disease risk, such as protein, fat, vitamins, sodium and potassium are different in the elderly population with different scores. The diet quality of the elderly is relatively low, and the consumption of dairy products, aquatic products and fruit needed to be improved. The nutrition education and the intervention work should be mainly targeted at the elderly in western and central regions, rural, low income and education levels.