孕期膳食平衡指数评价及其相关因素分析

蒋桂雪; 鹿璐; 胡蕊; 滕越; 梁斌; 潘丽娜; 蒋伟; 曾小玲; 朱文丽

doi:10.11847/zgggws1137261

摘要:

目的利用膳食平衡指数评价孕期女性的整体膳食质量，并分析其相关因素。

方法于2020年11月 — 2021年4月，根据自愿原则，在北京和山东高密妇幼保健机构纳入346名孕24～30周孕妇作为研究对象，采用连续3 d 24 h膳食回顾法进行膳食调查，并利用孕期膳食平衡指数（DBI-P）评价整体膳食质量，自拟调查问卷收集研究对象的社会人口学特征、孕期营养教育等情况。

结果研究对象膳食正端分M（P₂₅ ～ P₇₅）为0（0～2.00），摄入过量占比为11 %；负端分为 – 22.00（ – 27.00～ – 15.00），摄入不足的比例为85.8 %；膳食质量距为23.00（17.75～28.00），膳食平衡的比例为21.7 %。谷薯类食物摄入量为M（P₂₅～P₇₅）为242.73 g（186.29～300.95），蔬菜类为330.68 g（191.69～498.83），水果类为23.38 g（0～129.00），奶类为104.09 g（50.98～234.48），大豆及坚果为16.33 g（0～54.52），畜禽肉类是106.41 g（61.75～168.94），鱼虾类23.64 g（0～59.37），蛋类18.84 g（0～56.24）。女性受教育程度、家庭人均收入水平与膳食质量分布表现出差异性，受教育程度、人均收入水平越高，膳食质量分布越好（与负端分、膳食质量距的χ²检验结果均P < 0.05）；计划怀孕女性膳食质量要优于非计划怀孕（与负端分和膳食质量距的χ²检验结果为P < 0.05）；社区食物环境也是影响膳食质量的重要因素，食物环境越好，其膳食质量分布越好（与负端分和膳食质量距的χ²检验结果为P < 0.05）；孕妇的营养素养对其膳食质量有正向影响，营养素养得分高的女性膳食均衡性更好（与膳食质量距的χ²检验结果为P < 0.05）。但正端分得分情况未与任何因素存在关系。

结论孕期女性的膳食质量存在较明显的不平衡情况，女性受教育程度、家庭人均收入水平及社区食物环境是影响膳食质量的主要因素，优化社区食物环境，提高适龄女性对备孕的认识及提高营养素养，是提高其膳食质量的重要措施。

Abstract:

Objective To assess diet quality of pregnant women using dietary balance index and analyze related factors of die quality.

Methods Totally 400 healthy pregnant women (24 – 30 weeks of gestation) were recruited at maternal and child health institutions in two districts of Beijing and a prefecture of Shandong province for a voluntary survey from November 2020 to April 2021. Information on dietary intake and related factors were collected by interviews with 3-day 24-hour food frequency recall instrument and a self-designed questionnaire. Diet quality was evaluated using Chinese Diet Balance Index-Pregnancy (DBI-P).

Results Valid data from 346 of the women were finally included in the analysis. The median of higher bound score (HBS) (25th percentile P₂₅, 75th percentile P₇₅) was 2.00 (0.00, 2.00) and the proportion of the women assessed as having excessive food intake was 11.00%; the median of lower bound score (LBS) was – 22.00 (– 27.00, – 15.00) and the proportion of insufficient intake was 85.80%; the median of diet quality distance (DQD) was 23.00 (17.75 – 28.00) and the proportion of dietary balance was 21.7%. For all the women, the median (P₂₅, P₇₅) was 242.73 (186.29, 300.95) g for the intake of cereal and potato food, 330.68 (191.69, 498.83) g for vegetables, 23.38 (0 , 129.00) g for fruits, 104.09 (50.98, 234.48) g for milk, 16.33 (0, 54.52) g for soybeans and nuts, 106.41 (61.75, 168.94) g for livestock and poultry meat, 23.64 (0, 59.37) g for fish and shrimp, and 18.84 (0 – 56.24) g for eggs, respectively. The women′s dietary quality differed significantly by education, household income per capita, community food environment, and nutrition literacy. The women with higher education, household income per capita, planned pregnancy, and better community food environment had significantly lower LBS and DQD scores (P < 0.05 for all) ; the women with higher nutrition literacy had significantly lower DQD score (P < 0.05); but the women′s HBS′s score was not significantly related to all of the above factors.

Conclusion For second/third trimester pregnant women in two regions of China, the dietary quality is obviously unbalanced and influenced mainly by education, household income per capita, and community environment. Targeted measures need to be promoted to improve dietary condition of the women.

孕期膳食平衡指数评价及其相关因素分析

Diet quality and its associates among women during middle and late pregnancy: a balance-index based assessment