达能营养中心第二届学术研讨会论文集

　　评价饮食习惯是制定营养教育干预措施和改善人群营养状况的基础。选取Friuli, Piemonte, Lazio, Sicilia代表全国不同的社会经济发展水平的地区，在35,072名7-11岁的意大利学龄儿童中开展了全国营养模式调查。

　　我所参考已开展的营养调查，设计了应用于学生的食物频数表。选择116项食物进入食物频数表,调查学生的饮食习惯。其中又抽取部分学生使用24小时回顾法和食物称重法评估食物频数表的可信度。

　　营养素摄入量,如能量，脂肪（总脂肪，饱和脂肪酸，多不饱和脂肪酸，单不饱和脂肪酸），碳水化物，蛋白质，胆固醇，钙，铁，可溶性和非可溶性膳食纤维含量，利用意大利国立营养研究所的营养数据库,通过每项食物的食用量和食用频率相乘进行计算。

　　表1中的营养素摄入用均数及标准差表示。结果发现，意大利学生平均膳食摄入有以下特点：能量摄入与RDA要求基本一致，达RDA的103%，其中蛋白质和脂肪，尤其是动物性脂肪的摄入很高。碳水化物、膳食纤维低于推荐量而食糖摄入量相对过多。钙摄入水平低而铁摄入充分。

　　从性别上看：男生能量摄入水平较高而女生蛋白质摄入水平较高(女:82.5克/天,男: 76.9克/天)，这种不同主要归结于动物性蛋白质的摄入。脂肪酸的摄入女生略高于男生，尤其是饱和脂肪酸，女生胆固醇的摄入量比男生高30%。男女生钙、铁和膳食纤维的摄入无显著性差异。

　　用营养素密度进行分析时发现，Lazio地区有高蛋白质、高脂肪、高胆固醇摄入现象。表2说明不同地区主要食物种类每周的消费频率，Lazio地区牛奶消费量非常低，奶酪消费只能补偿其中小部分，而肉类消费量最高,这可以解释为什么该地区动物蛋白消费非常高。鱼类摄入量尤其在北方地区低于推荐量,而蔬菜水果的摄入在整个人群都低于推荐量。意大利通心粉或大米的消费平均每周4.2到5.7次，面包的食用少于每天一次，更经常的是甜点和烘制食品的消费。

　　意大利学生的营养习惯不符合膳食指南，而且与发达国家的成人膳食一致，需要制定战略提高健康营养模式。

(本文发表在The Journal of International Medical Research 96；24：169) 　

Prof. Marcello Giovannini
mailto:marcello.giovannini@unimi.it

NUTRITIONAL SURVEY IN A SAMPLE OF 35.000 ITALIAN SCHOOLCHILDREN
The Journal of International Medical Research 1996; 24:169 -184
M.GIOVANNINI
Department of Pediatrics, University of Milan, Italy

　　Evaluation of dietary habits is fundamental in order to plan an intervention of nutritional education and to improve nutritional status of a population. A nationwide survey of nutritional patterns was carried out in a large-scale sample (n 35.072 children) of Italian school-age population (7-11 years). Friuli, Piemonte, Lazio and Sicilia regions were selected as representative of the whole nation's socio-economic areas.

　　Nutritional habits were investigated by the food frequency questionnaire FFQ) specific for schoolchildren performed at our Department, consisting of 116 food items selected on the basis of previous nutritional investigations; in sub-samples were used 24-h dietary recall and weighted food diary to assess the validity of the food frequency questionnaire.

　　Nutrient intake, expressed as energy, lipids (total, saturate, polyunsaturate and monounsaturate), carbohydrates, proteins, cholesterol, calcium, iron soluble and non-soluble fiber content, was calculated by multiplying consumption frequency by the quantity of each item consumed, using the nutrient database of the Italian National Institute of Nutrition.

　　In Table 1 nutrient intake data are expressed as means and SD

　　Analysis of our data reveals that the average diet of Italian schoolchildren is marked by energy intake that roughly coincides (103%) with RDA, very high protein and lipid intake (especially from animal origin) and by a carbohydrate and fiber intake lower than recommended with a relative excess of sugars. Calcium intake is relatively low while iron is more adequate.

　　Analyzing the data by sex, caloric intake was found to be higher among boys and protein intake was higher among girls (82.5g/day vs. 76.9 mg/day) with difference largely due to animal protein intake. Fatty acid intake was also slightly higher among girls; especially regarding saturated fatty acids and girls' cholesterol intake was 30% higher than boys'. Calcium, iron and fiber intakes are no significantly different.

　　When expressed as nutrient density a higher protein, lipid and cholesterol intake is found in Lazio. Table 2 shows the weekly consumption frequency of the main food categories in the various regions. In Lazio milk consumption is particularly low, only partially compensated by cheese and there is also the highest meat consumption, which accounts for the exaggerate animal protein intake found in this region. Lower than recommended are intake of fish, especially in the northern regions, of fruit and vegetable in the whole population. Pasta or rice consumption ranges between 4.2 and 5.7 times a week on average and even bread is eaten less than once daily. Of more frequent consumption are sweets and bakery products.

　　Nutritional habits of Italian schoolchildren are not adequate to dietary recommendations and are similar to adult's diet in industrialized countries. There is need to develop strategies to improve healthy nutritional style.