Nutrient intake of adult women in Jilin Province, China, with special reference to urban-rural differences in nutrition in the Chinese continent

Analysis of dietary trends in Chinese adolescents from 1991 to 2011

BACKGROUND AND OBJECTIVES

To examine temporal trends in dietary energy, fat, carbohydrate, protein, sodium and potassium intake of Chinese adolescents aged 12 - 17 years by sex and urbanicity, using data from the China Health and Nutrition Survey.

METHODS AND STUDY DESIGN

Individual level, consecutive 3 - day 24-hour recalls were analyzed from survey years 1991 (n=504), 2000 (n=665), and 2011 (n=267) from nine provinces representing a range of geography, economic development, and health indicators in China. Linear multivariable regression models were conducted to predict mean intakes of energy, macronutrients, sodium, and potassium. Models were adjusted for age, per capita income, parental education, region, and family size.

RESULTS

From 1991 to 2011, total energy consumption decreased among both sexes and all urbanicity groups (p<0.05). Sodium intake decreased in all sex and urbanicity groups except the high urbanicity group, which was the only group to show significant change in potassium intake (p<0.05). Sodium-potassium ratios decreased overall and across both sexes (p<0.05). However, the major observed shift was a structural change from carbohydrates to fat and protein. Both sexes showed decrease in carbohydrate-derived energy (p<0.05). Proportion of fat-derived energy increased in female adolescents. Proportion of protein-derived energy increased in male adolescents, as well as in the low and high urbanicity groups (p<0.01).

CONCLUSIONS

This suggests Chinese adolescents are transitioning to a low carbohydrate diet. Urbanicity appears to play a role in sodium, potassium and protein intake. Improvements of sodiumpotassium ratios are primarily due to decreased sodium intake and require further reduction efforts.

Food Patterns during An Economic Crisis among Pregnant Women in Purworejo District, Central Java, Indonesia

A cross-sectional study was conducted between 1996 and 1998. Six 24-hour recalls were performed during the second trimester of pregnancy among 450 women in Purworejo District, Central Java, Indonesia. The objectives of the study were to assess the food intake and food pattern among pregnant women before and during the economic crisis. Before the crisis, rich women had the highest intakes of animal foods, fats and oils, and sugar. Food intake among the urban poor and the rural landless poor subgroups was influenced by the emerging economic crisis. Although the price of rice increased, the intake of rice also increased among all subgroups. Rural poor women with access to rice fields increased their intake of rice and decreased their intake of nonrice staple foods (p < .05). There were significant decreases in the consumption of chicken by rich women and rural poor women with access to rice fields (p < .05). Rice was a strongly inferior good and remained an important supplier of energy, protein, and carbohydrate. Nuts and pulses were important suppliers of calcium and iron, and vegetables were an important supplier of vitamin A. Rich women increased their intake of nuts and pulses, vegetables, fats and oils, and sugar when their intake of rice increased (p < .05). The food patterns were based on rice, nuts and pulses, and vegetables, i.e., plant food. All but the rich women decreased their intake of nutritious foods such as meat, chicken, and fruits. The intake of nuts and pulses and of vegetables increased, whereas the intake of cooking oil and sugar remained constant.

Correlation between waist and mid-thigh circumference and cardiovascular fitness in Korean college students: a case study

[Purpose] We investigated whether waist and mid-thigh circumference correlated with cardiovascular fitness (VO₂max) in a selected sample of Korean college students. [Subjects and Methods] The subjects were 41 college students (25 males, 16 females; age, > 19 years) who visited the sports medicine laboratory at the Korea National University of Transportation in Chungju-si, Republic of Korea, to undergo measurements of body composition, cardiovascular fitness, and waist and mid-thigh circumference. [Results] VO₂max did not correlate with waist circumference or mid-thigh circumference in males, whereas VO₂max was negatively correlated with mid-thigh circumference, but not waist circumference, in females. [Conclusion] Mid-thigh circumference was not associated with cardiovascular fitness or waist in male college students. However, it was associated with cardiovascular fitness in female college students. Well-designed studies are needed to investigate this further.

Dietary intake and food habits of pregnant women residing in urban and rural areas of Deyang City, Sichuan Province, China

Micronutrient deficiencies and imbalanced dietary intake tend to occur during the reproductive period among women in China. In accordance with traditional Chinese culture, pregnant women are commonly advised to follow a specific set of dietary precautions. The purpose of this study was to assess dietary intake data and identify risk factors for nutritional inadequacy in pregnant women from urban and rural areas of Deyang region, Sichuan province of China. Cross-sectional sampling was applied in two urban hospitals and five rural clinics (randomly selected) in Deyang region. Between July and October 2010, a total of 203 pregnant women in the third trimester, aged 19-42 years, were recruited on the basis of informed consent during antenatal clinic sessions. Semi-structured interviews on background information and 24-h dietary recalls were conducted. On the basis of self-reported height and pre-pregnancy weight, 68.7% of the women had a pre-pregnancy body mass index (BMI) within the normal range (18.5 ≤ BMI < 25), 26.3% were found to be underweight with a BMI <18.5 (20.8% in urban vs. 35.6% in rural areas), while only 5.1% were overweight with a BMI ≥30. In view of acceptable macronutrient distribution ranges (AMDRs) the women's overall dietary energy originated excessively from fat (39%), was low in carbohydrates (49.6%), and reached the lower limits for protein (12.1%). Compared to rural areas, women living in urban areas had significantly higher reference nutrient intake (RNI) fulfillment levels for energy (106.1% vs. 93.4%), fat (146.6% vs. 119.7%), protein (86.9% vs. 71.6%), vitamin A (94.3% vs. 65.2%), Zn (70.9% vs. 61.8%), Fe (56.3% vs. 48%), Ca (55.1% vs. 41%) and riboflavin (74.7% vs. 60%). The likelihood of pregnant women following traditional food recommendations, such as avoiding rabbit meat, beef and lamb, was higher in rural (80%) than in urban (65.1%) areas. In conclusion, culturally sensitive nutrition education sessions are necessary for both urban and rural women. The prevalence of underweight before conception and an insufficient supply of important micronutrients were more pronounced in rural areas. Therefore, attention must be given to the nutritional status, especially of rural women before, or at the latest, during pregnancy.

Breast milk macro- and micronutrient composition in lactating mothers from suburban and urban Shanghai

AIM

The objective of this study was to measure and compare the macro- and micronutrient composition of breast milk in urban and suburban lactating mothers living in Shanghai, China.

METHODS

Primiparous women residing in three urban regions (n= 30/region) and a suburban area of Shanghai (n= 30) were recruited. Breast milk samples were collected 8-10 days postpartum and dietary intake was determined.

RESULTS

Women from the suburban area were of lower socio-economic status as indicated by levels of education, occupation and income. With the exception of carbohydrates, mothers in all urban areas had significantly higher macronutrient intake levels than suburban area mothers. Sodium, potassium, phosphorus and calcium intake levels were significantly lower in suburban compared to all urban women. Concentrations of protein, lipids, copper, sodium, potassium, chlorine, zinc, manganese, phosphorus and iron were all significantly lower in milk obtained from suburban compared to urban women. Concentrations of carbohydrates in milk from suburban women were significantly higher than concentrations in than two of the three urban groups. Offspring from women in Chongming county gained significantly less weight between birth and 6 months than did offspring born to women from the three other counties.

CONCLUSIONS

In summary, there were significant differences in macro- and micronutrient intake levels and breast milk concentrations between women from urban and suburban Shanghai. These differences may have important implications for the growth and development of breastfed infants.

Assessment of dietary intake among pregnant women in a rural area of western China

BACKGROUND

Adequate maternal nutrient intake during pregnancy is important to ensure satisfactory birth outcomes. There are no data available on the usual dietary intake among pregnant women in rural China. The present study describes and evaluates the dietary intake in a cohort of pregnant women living in two counties of rural Shaanxi, western China.

METHODS

1420 pregnant women were recruited from a trial that examined the effects of micronutrient supplementation on birth outcomes. Dietary information was collected at the end of their trimester or after delivery with an interviewed-administrated semi-quantitative food frequency questionnaire (FFQ). Nutrients intake was calculated from the FFQ and compared to the Estimated Average Requirements (EAR). The EAR cut-offs based on the Chinese Nutrition Society Dietary Reference Intakes (DRIs) were used to assess the prevalence of inadequate dietary intakes of energy, protein, calcium, zinc, riboflavin, vitamin C and folate. Mann-Whitney U and Kruskal Wallis tests were used to compare nutrient intakes across subgroups.

RESULTS

The mean nutrient intakes assessed by the FFQ was similar to those reported in the 2002 Chinese National Nutrition and Health Survey from women living in rural areas except for low intakes of protein, fat, iron and zinc. Of the participants, 54% were at risk of inadequate intake of energy. There were high proportions of pregnant women who did not have adequate intakes of folate (97%) and zinc (91%). Using the "probability approach", 64% of subjects had an inadequate consumption of iron.

CONCLUSION

These results reveal that the majority of pregnant women in these two counties had low intakes of nutrients that are essential for pregnancy such as iron and folate.

TRIAL REGISTRATION

ISRCTN08850194.

China's transition: the effect of rapid urbanization on adult occupational physical activity

China has recently undergone rapid social and economic change. Increases in urbanization have led to equally rapid shifts toward more sedentary occupations through the acquisition of new technology and transitions away from a mostly agricultural economy. Our purpose was to utilize a detailed measure of urbanicity comprising 10 dimensions of urban services and infrastructure to examine its effects on the occupational physical activity patterns of Chinese adults. Longitudinal data were from individuals aged 18-55 from the years 1991-1997 of the China Health and Nutrition Survey (N=4376 men and 4384 women). Logistic multilevel regression analyses indicated that men had 68% greater odds, and women had 51% greater odds, of light versus heavy occupational activity given the mean change in urbanization over the 6-year period. Further, simulations showed that light occupational activity increased linearly with increasing urbanization. After controlling for individual-level predictors, community-level urbanization explained 54% and 40% of the variance in occupational activity for men and women, respectively. This study provides empirical evidence of the reduction in intensity of occupational activity with modernization. It is likely that urbanization will continue unabated in China and this is liable to lead to further transitions in the labor market resulting in additional reductions in work-related activity. Because occupational activity remains the major source of energy expenditure for adults, unless alternative forms are widely adopted, the Chinese population is at risk of dramatic increases in the numbers of overweight and obese individuals.

Food composition table-based estimation of energy and major nutrient intake in comparison with chemical analysis: a validation study in Korea

This study was initiated to examine the accuracy of conventional food composition table-based estimation of intakes of energy, protein, lipid and carbohydrate, in comparison with chemical analysis. For this purpose, 66 women (at the ages of 29 to 54 years) in three locations in Jeju Island, Republic of Korea, volunteered to offer 24-hour food duplicate samples. A half of them were house-wives, and the remaining half were farmers or fishers. The duplicate samples were subjected 1) to the chemical analysis for daily intake of energy, protein, lipid and carbohydrate after official methods in Korea (measured values), and 2) to the estimation of intakes of the same items taking advantage of Korean Food Composition Tables (estimated values). The two sets of the results, i.e., the measured and estimated values, were compared by paired and unpaired t-test, and linear regression analysis. The estimated values correlated closely with the measured values, irrespective of energy or the three major nutrients. A close agreement was observed for energy intake (the estimated/measured ratio of > 98%), and it was also the case for protein intake (101%). Under- and over-estimation was observed, however, in regard to carbohydrate (by - 8%) and lipid intake (by + 24%), respectively. It was concluded that the Korean Food Composition Tables are sufficiently accurate when applied for estimation of total energy intake as well as protein intake. Cares should be taken, however, in applying the tables for estimation of lipid and carbohydrate intake, because there may be the risk of over- and under-estimation for the former and the latter, respectively.

Dietary patterns and nutrient intake of adult women in south-east China: a nutrition study in Zhejiang province

This study documents the dietary patterns and nutrient intake of 652 adult women living in south-east China. Compared with data from previous national surveys and other nutrition studies in China, the results show different dietary patterns. The major differences include a greater consumption of vegetables, fruits and animal foods, but a lower consumption of cereal and tuber foods. The mean daily nutrient intakes of the urban women met the Chinese recommended dietary allowances. However, the situation was different in rural areas, where women had lower mean intakes of vitamins and minerals. There were also significant differences in dietary pattern and food consumption between these two groups of women. Further improvements in dietary intake for those residing in the south-east rural areas of China are needed.

Comparison of urinary bromide levels among people in East Asia, and the effects of dietary intakes of cereals and marine products

Groups of people with no occupational exposure to Br-containing chemicals (29-54 year old, mostly women) in Japan, China and Korea, respectively, offered spot urine samples. Those in China and Korea offered 24 h duplicates of foods of the day. Urine samples were analyzed for Br by ECD-gas chromatography (ECD-GC) after derivatization to methyl bromide, and the Br-U was adjusted for a specific gravity of 1.016. Food intake data were based on national statistics and supplemented by the food duplicate data. Mean Br-U was 5.4 and 6.5 mg/l for Japanese men and women, respectively. Mean levels were in a range of 1.8-2.8 mg/l for four groups of Chinese, and 8-12 mg/l for the four groups of women in Korea. Br-U levels among Korean women were close levels reported for occupational exposure to 1- or 2-bromopropane, or methyl bromide. Regression analyses showed that Br-U levels were influenced by the intake of marine products (such as sea algae, sea fish and shellfish) and fruits, and inversely relate to intakes of cereals and potato.

Number of dishes as an indicator of nutrient intake in China

The objectives of this analysis are to investigate if counting the number of dishes consumed per day is a rapid procedure for estimating daily nutrient intake in China, and to explore if urban-rural differences exist in the daily number of dishes. A nutritional survey (including dish number counting) was conducted on 499 adult women in six urban and four rural communities in China. The number of dishes was an influential variable in estimating intake of protein, animal protein, fat, animal fat, and some vitamins (e.g., vitamin B2) and minerals (e.g., zinc), but not of energy and carbohydrate. Intake of some nutrients (e.g., protein) was sufficient when people consume more than 10 dishes per day. Thus, the number of dishes is a useful indicator of sufficient intake of animal protein and fat as well as some micro-nutrients. The application of the dish number counting method showed that there was a significant difference between urban (11.9 dishes per day) and rural populations (7.9 dishes).

Estimation of nutrient intake by the new version of Japanese food composition tables in comparison with that by the previous version

This study was initiated to examine if the revision of the food composition tables from the 4th version to the 5th version has induced any substantial changes in nutrient intake estimation, and if so, in which nutrient item and to what extent. For this purpose, 24-hour duplicates of food samples were collected in 1996 to 1998 from 71 girl university students, together with food menus of the day. The nutrients in the duplicates were estimated by use of the 4th and the 5th version food composition tables in parallel, with supplements of other databases. The results of the estimation with the two databases were compared by Student's paired t-test. Compared with the results with the 4th version, the estimation utilizing the 5th version gave 3 to 8% increases in intakes of major nutrients including energy (except for protein), a 20% increase in vitamin A, and decreases in iron (-13%) and NaCl (-3%), whereas there were only small or essentially no changes in other minerals and vitamins. The largest increment in energy through the re-calculation came from the cereals (especially rice), and it was meats for the increment in lipid intake. The increment in vitamin A with the 5th version is primarily due to the re-evaluation of fruits and vegetables. The present observation suggests that care should be practiced in examining secular trends in nutrition when the basis of estimation is shifted from one database of the 4th version of food composition tables to another of the 5th version. Further study of a larger scale is apparently warranted to confirm the conclusions.