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Vitamin A and vitamin D deficiencies or insufficiencies in children remain global public health problems. The deficiencies of both vitamin A and vitamin D exist in Chinese children, the deficiency of vitamin A is mainly marginal (about 30%) in children aged 0 - 12 years.Vitamin D deficiency and prevalence are common in healthy children aged 0 - 18 years, among which the severe deficiency rate is 2.46%, the deficiency rate is 21.57%, and the marginal deficiency rate is 28.71%.The deficiency rate gradually increases with the increase of age.Since the respective bioactive metabolites of vitamin A and vitamin D, retinoic acid and 1 and 25-dihydroxyvitamin D3 have hormone-like properties, and both metabolites are synthesized from their vitamin precursors by different tissues and cells in the body, there may be a synergistic effect between both on target cells remotely by binding to nuclear hormone receptors.A high proportion of concurrent vitamin A and vitamin D deficiencies (comorbidities) in malnourished children under 5 years of age in low- and middle-income countries and poor areas will affect the immune response in a highly specific way, in addition to causing growth and developmental disorders (e.g., growth retardation, motor retardation), it also increases susceptibility to infectious diseases (e.g., recurrent respiratory infections, diarrhea), allergic diseases (e.g., asthma, atopic dermatitis), and neurodevelopmental disorders (touretic disorder, autism spectrum disorder).Therefore, children in the period of growth and development may benefit from supplementing with vitamin A and vitamin D.
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Objective@#To investigate the prevalence of calf muscle cramps and possible influencing factors for pregnant women in China.@*Methods@#Using a multi-stage stratified probability proportional to size cluster randomization sampling method during 2010-2012. A total of 3 582 pregnant women were investigated at 150 counties from 31 provinces in China mainland. Information on calf muscle cramps, demographic socio-economic status, pregnancy information, and the physical activities was collected through questionnaires. The semi-quantitative food frequency questionnaire (FFQ) was used to collect food intake of pregnant women. Dynamic cluster analysis was used to assess dietary pattern. Multiple logistic regression was used to investigate the possible influencing factors for calf muscle cramps.@*Results@#The prevalence of calf muscle cramps was 32.9% (1 180/3 582) in Chinese pregnant women, which was 11.6% (87/748), 28.2% (420/1 492), and 50.2% (673/1 342), respectively, during the first, second and third trimester. There were significant differences between them (χ2=349.16, P<0.001). Dietary patterns of the pregnant women were classified into three groups, which called relatively balanced pattern, high vegetables and fruits pattern, and high dairy pattern. Among the three groups, the prevalence of calf muscle cramps was 32.0% (952/2 971), 37.2% (186/500), and 37.8% (42/111), with significant differences (χ2=6.39, P=0.041). The OR (95%CI) values of calf muscle cramps in the second and third trimester was 2.96 (2.28-3.83), and 8.02 (6.16-10.44), respectively, comparing with the first trimester. The OR (95%CI) values of calf muscle cramps in the women taking calcium before pregnant was 1.45 (1.19-1.76), comparing with the one who was not taken. The OR (95%CI) values of calf muscle cramps in the women who had been diagnosed by pregnancy-induced hypertension was 5.76 (2.06-16.12), comparing with the one who had not been diagnosed. The OR (95%CI) values of calf muscle cramps in the high vegetables and fruits pattern and high dairy pattern was 1.13 (0.91-1.41), and 1.18 (0.76-1.81), respectively, comparing with the relatively balanced pattern.@*Conclusion@#The prevalence of calf muscle cramps was relatively high in Chinese pregnant women, which was significantly different among three trimesters. The residential areas, occupation, and pregnancy-induced hypertension might be related to the prevalence of calf muscle cramps. However, there was no significant difference among different dietary patterns.
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Objective@#To investigate the prevalence of anemia and related risk factors for pregnant women in China.@*Method@#Based on Chinese National Nutrition and Health Surveillance 2010-2012, a total of 3 501 pregnant women were investigated from 150 counties of 31 provinces, municipalities and autonomous regions in China, using a multi-stage stratified cluster randomization sampling method. General information of pregnant women, health status, and food intake during the gestation, was collected through a questionnaire investigation. 6 ml fasting venous blood was collected for the determination of hemoglobin concentration. Data were analyzed using multiple logistic regression to investigate the prevalence of anemia and the related influencing factors.@*Results@#The 605 of 3 501 pregnant women had anemia. The prevalence of anemia was 17.2%; and mild anemia accounted for about 61.0% (369/605). Compared with the pregnant women living in the large cities, the OR (95%CI) of those living in the poor rural areas was 1.46 (1.08-1.98). Compared with the pregnant women living in the south area of China, the OR (95%CI) of those living in the north area of China was 1.39 (1.15-1.68); Compared with the pregnant women in the first trimester, the OR (95%CI) of those in the second trimester and the third trimester were 1.79 (1.33-2.43) and 2.11 (1.56-2.85), respectively. The OR (95%CI) of pregnant women who had used folic acid supplementation within the 6 months prior to gestation was 0.76 (0.63-0.93) compared with those who had not used.@*Conclusion@#From 2010 to 2012, the epidemic characteristics of anemia was mild for the pregnant women in China, and pregnant women residential areas, periods of pregnancy and whether to take folic acid were related to anemia.
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Objective@#To examine the status and related factors for gestational weight gain of Chinese pregnant women at different trimesters in 2010-2012.@*Methods@#Participants were from Chinese National Nutrition and Health Surveillance in 2010-2012. Using a multi-stage stratified cluster random sampling method, we recruited 2 805 singleton pregnant women with gestational age 13 weeks or more from 31 provinces of China. A standard questionnaire was used to collect general information and pre-pregnancy weight; body weight and height of pregnant women were measured using a unified weighing scale and stadiometer, dietary intake during the previous year was collected using a food frequency questionnaire. A multiple logistic regression was used to analyze potential factors associated with appropriate gestational weight gain.@*Results@#Among 2 805 pregnant women, 1 441 were in the second (13-27 weeks) and 1 364 in the third trimesters (≥28 weeks) . In the 2nd trimester, 229 cases (15.9%), 440 cases (30.5%) and 772 cases (53.6%) were insufficient gestational weight gain, appropriate gestational weight gain and excessive gestational weight gain respectively. So were 256 cases (18.8%), 474 cases (34.8%), 634 cases (46.5%) in the 3rd trimester respectively. In the multivariate unconditional logistic model, less fruit intake was associated with insufficient weight gain for women in the 2nd trimester (OR (95%CI): 1.58 (1.06-2.34)). Pregnant women with Han ethnicity who live in the small/medium city had lower risk of insufficient weight gain in the 3rd trimester (OR (95%CI): 0.58 (0.34-0.98)). Those pregnant women with physical activity <1 hour/day had a higher risk of excessive weight gain (OR (95%CI): 1.33 (1.02-1.73)).@*Conclusion@#The prevalence of appropriate gestational weight gain was low in China. Our study suggests that pregnant weight gain is associated with fruit intake, types of residential area and physical activity.
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Objective@#To analyze the status of gestational weight gain (GWG) among Chinese mothers who gave singleton and full-term births, and to look at optimal GWG ranges.@*Methods@#In 2013, using the multi-stage stratified and population proportional cluster sampling method, we investigated 8 323 mother-child pairs at their 0-24 months postpartum from 55 counties (cities/districts) of 30 provinces (except Tibet) in mainland China. Questionnaire was used to collect data on body weight before pregnancy and delivery, diseases during gestation, hemorrhage or not at postpartum, child birth weight and length, and other information about pregnant outcomes. We measured mother's body weight and height, and child's body weight and length. Based on 'Chinese Adult Body Weight Standard’, we divided mothers into four groups according to their body weight before pregnancy: low weight (BMI<18.5 kg/m2), normal weight (BMI 18.5-23.9 kg/m2), overweight (BMI 24.0-27.9 kg/m2) and obesity (BMI≥28.0 kg/m2). The status of GWG was assessed by IOM optimal GWG guidelines. Chinese optimal GWG ranges were calculated according to the association of GWG with pregnant outcomes and anthropometry of mothers and children, and according to P25-P75 of GWG among mothers who had good pregnant outcomes and good anthropometry, and whose children had good anthropometry. The status of GWG was assessed by the new optimal ranges.@*Results@#P50 (P25-P75) of GWG among the 8 323 mothers was 15.0 (10.0-19.0) kg. According to the proposed optimal GWG ranges of IOM, the proportions of inadequate, optimal and excessive GWG accounted for 27.2% (2 263 mothers), 36.2% (3 016 mothers) and 36.6% (3 044 mothers). The optimal GWG ranges for low weight, normal weight, overweight and obesity were 11.5-18.0, 10.0-15.0, 8.0-14.0 and 5.0-11.5 kg. Based on these optimal GWG ranges established in this study, the rates of inadequate, optimal and excessive GWG were 15.7% (1 303 mothers), 45.0% (3 744 mothers) and 39.3% (3 276 mothers), and these rates were significantly different from that defined by the IOM standards (χ2=345.36, P<0.001).@*Conclusion@#The median of GWG among Chinese mothers is 15.0 kg, which is at a relatively higher level. This study suggests the optimal GWG ranges for Chinese women who give singleton and full-term babies, which appears lower than IOM's.
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Improvement of the nutrition and health status of pregnant women should be one of the top priority strategies of improving the physical fitness of next generation and reserve of talented person for national sustainable development. This paper reviews the nutrition and health status of pregnant women in China over the recent ten years and discusses the underlying factors and changing trends. The most popular nutrition-related problem is dietary imbalance, and many micronutrient intakes are lower than the recommended dietary intakes or adequate intakes, and some of nutrient intakes are still at a very low level for a long time such as vitamin D and calcium. The nutrition-related health problems are mainly anemia, vitamin D and vitamin A deficiencies; iodine intake is not in optimal state with a large proportion of inadequate and individual cases facing excessive intake risk. Overweight and obesity, pregnancy complications such as gastrocnemius muscle spasms, pregnancy hypertensive disorders and gestational diabetes were prevalent among pregnant women. We should address both malnutrition and nutrition imbalance in the same time in order to improve the nutrition and health status of pregnant women, by developing and implementing relevant laws and regulations, giving higher attention to pregnant women with advanced age, which in turns prevent a variety of micronutrient deficiencies, reduce adverse pregnant outcomes, and improve nutrition and health status of maternal and child.
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Objective@#To investigate anemia rate and to analyze related factors in maternal women in Taicang of Jiangsu province.@*Methods@#There were 13 278 pregnant women who had prenatal care and gave birth in 25 hospitals during 2014-2016 in Taicang of Jiangsu Province. We excluded 1 179 women who registered after 12 weeks of gestation, 144 women who did not test hemoglobin during gestation, and 25 women whose gestational weeks were incorrect. Finally, data from 11 930 pregnant women were analyzed. From the electronical medical record system of maternal and child health care, we obtained basic information of these pregnant women, their hemoglobin levels and related data during gestation and postpartum. Anemia rate was descripted, and factors associated with anemia were identified using multiple unconditional logistic regression.@*Results@#Age of the 11 930 pregnant women was (27.0±4.5) years old, and the P50 (P25-P75) of BMI at the first trimester was 21.4 (19.6-23.7) kg/m2. The anemia rate during gestation was 37.2% (4 434/11 930). The anemia rate was 5.5% (276/5 035), 24.4% (1 802/7 377), and 47.8% (3 328/6 966) at the first, second and third trimesters, respectively. Anemia rate at 42 days postpartum was 19.9% (680/3 418). Multiple unconditional logistic regression indicated that anemia during gestation was related with maternal age <21 years old at prenatal registration (OR (95%CI): 1.28 (1.07-1.53)), body mass index(BMI) <18.5 kg/m2 at the first trimester (OR (95%CI): 1.14 (1.00-1.29)), non-local residence (OR (95%CI): 1.35 (1.20-1.52)), education of middle school and lower (OR (95%CI): middle school: 1.24 (1.05-1.47), primary school: 1.36 (1.01-1.82)), occupation of housewife or farmer (OR (95%CI): housewife: 1.21 (1.06-1.38), farmer: 1.21 (1.03-1.44)). Anemia at 42 days postpartum was associated with multipara (OR(95%CI): 1.59 (1.12-2.27)), anemia at the first trimester (OR(95%CI): 3.26 (1.92-5.55)), no folic acid supplementation at the first trimester (OR(95%CI): 1.34 (1.00-1.80)), and hemorrhage≥500 ml during 24 h postpartum (OR(95%CI): 2.26 (1.02-4.97)).@*Conclusion@#Anemia rate was low for maternal women in Taicang of Jiangsu Province. The factors associated with gestational anemia included pregnant women's age, BMI, local or non-local residence, occupation, and education. The factors associated with postpartum anemia included multipara, anemia at the first trimester, no folic acid supplementation at the first trimester, and hemorrhage 24 h postpartum.
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<p><b>OBJECTIVE</b>To investigate the status of exclusive breastfeeding(EBF) and possible influencing factors during 0-7 days postpartum in China.</p><p><b>METHODS</b>During 2011 to 2013, healthy mothers and neonates who were in the period of 0- 7 days postpartum from 8 provinces across different regions of China were recruited to take the questionnaire investigations and physical examinations. Information about socio-economic, pregnant, and delivery status, infant healthy situation and feeding indicators was collected to calculate the rate of exclusive breastfeeding during 0- 7 days postpartum and analyze the influencing factors.</p><p><b>RESULTS</b>A total of 1 882 pairs of mothers and neonates were covered by this study. The rate of EBF was 13.3% (250 cases) during 0- 7 days postpartum. Bottle feeding (OR=0.08, 95% CI: 0.05- 0.12), the mothers themselves mixed fed at their 0-4 months old (OR=0.22, 95%CI: 0.08-0.58), the mothers who had used methods to stimulate milk secretion (OR=0.58, 95% CI: 0.35- 0.94) might decrease the EBF rate. Compared with the mothers who believed that their breast milk was not enough for their infants, the mothers who believed breastmilk was enough may increase the EBF rate (OR=6.04, 95%CI: 3.34-10.94). Comparing to the EBF rate of Beijing, Yunnan (OR=0.10, 95%CI: 0.04-0.24), and Gansu(OR=0.03,95%CI: 0.01-0.08) had lower EBF rate during 0-7 days postpartum. What's more, the EBF rate increased with the increasing neonates' age (OR=1.33, 95% CI: 1.16- 1.53).</p><p><b>CONCLUSION</b>The EBF rate during 0- 7 days postpartum is still low in China and had significant differences in different regions. Suboptimal feeding knowledge and practices affected the EBF rate significantly.</p>
Sujet(s)
Femelle , Humains , Nouveau-né , Grossesse , Alimentation au biberon , Allaitement naturel , Chine , Lait humain , Mères , Période du postpartum , Enquêtes et questionnairesRÉSUMÉ
The average daily selenium intake of staff of the Institute of Health in Beijng was surveyed to be 66.4?g and that of children in nursery and kindergarten was 34.7?g, which could meet the Recommended Dietary Allowance as suggested. Cereals were the major source of dietary selenium which accounted for 63.6% of total dietary intake, and animal and plant foods provided about 25.9% and 10.5% respectively. Both cereals and animal foods were the major sources of selenium in children diet, which accounted for 48.9% and 44.3% respectively, and intake of selenium from other sources was negligible.The selenium concentrations in whole blood and hair of the population were 0.146ppm and 0.578ppm respectively, and both correlated well with the daily selenium intake.The daily intake of mercury, arsenic, and cadmium for population in Beijing were estimated to be 3.4, 52.7, and 42.7*g respectively, which were within the normal range of intake and would not significantly interfere with the bioavailability of selenium ingested. It was suggested thal these levels of selenium daily intake surveyed would be adequate for human consumption and could be helpful as a reference for the establishment of dietary allowance.
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The content of selenium and several antagonistic metals such as mercury, arsenic, and cadmium in foods from Beijing market has been determined. Results showed that marine products, Viscera (particularly kidney), eggs, and mushroom were good dietary sources of selenium. The selenium contents of imported cereals and pulse are much higher than those grown in China as far as the sample analysed. Most vegetables and fruits contained selenium below a level of 0.010ppm with exception of garlic and mushroom.The selenium content of human milk was higher than other kinds of milk, milk products and milk-substitutes. Selenium content of Beijing foods was far higher than those in affected area of Keshan disease. The mercury, arsenic, and cadmium content of foods was below the National Allowance Standard except a few marine products.The selenium content of natural plant foods was positively correlated with its protein content (r=0.844, p
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Results obtained from previous studies shoved that at low level of dietary selenium(0.03 ppm) weanling rats fed with diets of low protein level usually possessed higher selenium concentration and GSHPx activity in their blood and tissues. The results were reproduced in chickens in this observation. Furthermore, even the original selenium level could not be maintained in blood and tissues of chickens fed with low protein diet (12.4%) because of faster growth rate and the lower selenium content (0.01 ppm) of the diet used in this study.Of the 27 chickens consuming 18.2% protein diet in the 14 days expe- riment, 23 suffered from exudative diathesis and 3 died without any sign of exudative diathesis, while in the 12.4% protein group only one of the 26 chickens suffered from exudative diathesis during the 14 days experiment and 6 of the 12 chickens in this group observed for another two weeks showed exudative diathesis. In the 18.2% protein group the first chicken with signs of exudative diathesis appeared on the 9th day while it appeared on the 14th day in the 12.4% protein group.How to improve the selenium nutritional status of the residents in Ke-shan Disease areas was discussed.
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Objective:To study the effect of multi-micronutrients supplementation on nutritional status of children. Method:220 students aged 8-12 years were observed for 6 months and 1 year follow-up. A half of them was given the supplements, another half as placebo. Results:In comparison with the placebo, the supplemented children had a higher urine excretion of vitamin B2 and vitamin C after loading; a higher concentration of serum 1.25(OH)2D3, hydroxyproline and hydroxyproline/creatinine ratio in fasting urine, and a higher bone mineral content and bone mass density in mid-ulna. The supplemented children performed significantly better than the placebo in reading speed, learning capacity and arithmetic examinations. After one year there was still significant difference between intervention and control group in hemoglobin content and marginal vitamin A deficiency. Conclusion:The micronutrients supplementation played a notable rule in resulting better nutritional status and learning ability of school children, and intervention would have a long effect on their health and nutritional status.
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Objective:To study the different feeding practices of Chinese infants within four months of age in 2002. Method:The method of multi-steps cluster sampling was adopted. In order to ensure the sample size sufficient additional subjects were included in this survey. Results:More than two thirds (71.6%) of infants within four months of age had been almost exclusively breastfed, 65.5% and 74.4% in urban and rural areas respectively. The average percentage of mixed feeding was 23.0% (27.0% in urban and 21.2% in rural areas); and that of artificial feeding was 5.4% (7.5% in urban and 4.4% in rural areas). The rate of breastfeeding decreased with the increase of family income. Conclusion:Although the rate of almost exclusive breastfeeding is increasing, there is still far away from the aim of 85% in 2001-2010 National Outline for Children.