卫生研究

目的 分析1982—2015年新疆18～64岁成年居民膳食结构及能量、营养素摄入的变化特征。方法 研究对象来源于五次全国性营养调查和监测(1982年、1992年、2002年、2010—2012年、2015年),选取新疆18～64岁数据完整的成年居民为研究对象，剔除孕妇、乳母及能量异常(<500 kcal/d或>5000 kcal/d)者，各年份分别纳入2660人、1672人、789人、391人、1384人。膳食调查采用称重法、记账法、3天24小时膳食回顾法及调味品称重法(不同年份方法略有差异),结合食物成分表将食物消费量转换为每日能量及各类营养素摄入量。依据《中国居民膳食营养素参考摄入量(2023版)》中宏量营养素可接受范围(acceptable macronutrient distribution range, AMDR:蛋白质10%～15%、脂肪20%～30%、碳水化合物50%～65%)评估宏量营养素摄入适宜性。采用SAS软件进行统计分析，分类变量以频数(百分比)描述，能量及营养素摄入量以均值±标准差描述；不同年份人群特征差异采用卡方检验，2015年宏量营养素摄入量与膳食营养素参考摄入量的趋势分析采用非参数Jonckheere-Terpstra检验，能量和营养素摄入量随时间的变化趋势采用线性回归分析，以α=0.05为差异具有统计学意义。结果 1982—2015年新疆成年居民膳食结构经历了从高碳水化合物、低脂肪向高脂肪、适量蛋白质的转型，能量摄入呈现先升后降趋势，蛋白质供能比在AMDR范围内的人群比例总体上呈上升趋势，从1982年的38.6%升至2015年的66.2%,蛋白质供能比高于15%的比例逐年增加，说明蛋白质营养状况在改善。脂肪供能比超过30%的人群比例从26.3%升至43.9%,碳水化合物供能比低于50%的人群比例升至22.5%。能量和营养素的摄入情况中，城乡和性别间存在显著差异，城市居民能量摄入下降幅度更大(从2561.6 kcal/d降至2067.2 kcal/d),女性平均每日能量摄入下降幅度更大(从2405.3 kcal降至2059.8 kcal);农村居民脂肪摄入在2002年后加速上升(从68.2 g升至77.5 g),钙等微量营养素摄入普遍呈下降趋势。结论 新疆18～64岁成年居民膳食营养状况有所改善，但仍存在营养失衡问题，需结合地域特点制定针对性营养干预策略。

OBJECTIVE To analyze changes in dietary structure and energy and nutrient intakes among adult residents aged 18-64 years in the Xinjiang Uygur Autonomous Region from 1982 to 2015.METHODS Study participants were drawn from five national nutrition surveys and surveillance programs(1982, 1992, 2002, 2010-2012, and 2015). Adult residents aged 18-64 years in the Xinjiang Uygur Autonomous Region with complete data were included; pregnant women, lactating women, and individuals with abnormal energy intake(<500 kcal/d or >5000 kcal/d) were excluded. The numbers of participants included for each year were 2660, 1672, 789, 391, and 1384, respectively. Dietary assessment method included the weighed food record method, household food inventory method, 3-day 24-hour dietary recall method, and condiment weighing method(with slight method ological differences across years). Food consumption data were converted into energy and nutrient intakes per day using food composition tables. The adequacy of macronutrient intake was evaluated according to the acceptable macronutrient distribution ranges(AMDRs: protein 10%-15%, fat 20%-30%, carbohydrate 50%-65%) specified in the Chinese Dietary Reference Intakes(2023 edition). Statistical analyses were conducted using SAS software. Categorical variables were described as frequencies(percentages), and energy and nutrient intakes were described as mean±standard deviation. Differences in population characteristics across years were assessed using the chi-square test. Trend analyses of macronutrient intakes relative to DRIs in 2015 were performed using the nonparametric Jonckheere-Terpstra test. Temporal trends in energy and nutrient intakes were analyzed using linear regression. An α value of 0.05 was considered statistically significant.RESULTS This study showed that from 1982 to 2015, the dietary structure of adult residents in the Xinjiang Uygur Autonomous Region underwent a transition from a high-carbohydrate, low-fat pattern to a high-fat, moderate-protein pattern. Energy intake exhibited a trend of initial increase followed by decrease. Overall, the proportion of the population with protein energy contribution within the AMDR increased, rising from 38.6% in 1982 to 66.2% in 2015, while the proportion with protein energy contribution exceeding 15% increased year by year, indicating improvement in protein nutritional status. The proportion of individuals with fat energy contribution exceeding 30% increased from 26.3% to 43.9%, and the proportion with carbohydrate energy contribution below 50% rose to 22.5%. Significant differences in energy and nutrient intakes were observed between urban and rural residents and between sexes. Urban residents experienced a greater decline in energy intake(from 2561.6 kcal/d to 2067.2 kcal/d), and women showed a larger reduction in mean daily energy intake(from 2405.3 kcal/d to 2059.8 kcal/d). Among rural residents, fat intake accelerated after 2002(from 68.2 g to 77.5 g), while intakes of micronutrients such as calcium generally showed a declining trend.CONCLUSION The dietary nutritional status of adult residents aged 18-64 years in the Xinjiang Uygur Autonomous Region has improved; however, nutritional imbalance persists. Targeted nutritional intervention strategies should be developed in conjunction with regional characteristics.