| Background:With the development of social economy,changes of populations’ structure and peoples’ life style,the incidence and mortality of chronic diseases have raised as a public health issue.Chronic diseases have been recognized as a major killer of peoples’ health in China.The prevalence of chronic diseases such as obesity and diabetes are increasing year by year.According to the report of the China National Nutrition and Chronic Diseases(2015),the prevalence of overweight and obesity aged 18 and above increased from 22.8% &7.1% in 2002 to 30.1% &11.9% in 2012,respectively.The prevalence of diabetes increased from 4.2% to 9.7%.The prevalence of hypertension increased from 18.8% to 22.8%.The prevalence of dyslipidemia increased from 18.6% to 40.4%.The prevalence of chronic diseases among ethnic groups are various in China.For example,the prevalence of chronic diseases among Miao people in Yunnan province is significantly lower than Han people,while the prevalence of chronic diseases among Hani people is significantly higher than Han people.Chronic disease data among ethnic populations are unavailable according to the surveillance of chronic diseases,nutrition of Chinese in the past five years(2015-2017),the previous surveillance of chronic diseases and their risk factors are all lack of survey data of minorities.Therefore,it is particularly important to carry out researches on the prevalence of chronic diseases of Chinese ethnic population and factors associated with chronic diseases.The nutrition and health among ethnic population in China are different from each other under different environment,beliefs,tradition,customs,etc.The number of 25 ethnic populations with more than 5,000 people in Yunnan Province lived in a concentrative area.And Yunnan has its own 15 ethnic populations,which is different from others,including the Nu population.Nu populations have special dietary patterns under different geographical environment,climate conditions,customs,social environment,etc.To explore the relationship between nutriton and chronic diseases of Nu populations in Yunnan Province,nutritional survey of Nu population and the factors associated with chronic diseases were conducted in Gongshan County,which was Dulong and Nu Autonomous County of Yunnan Province.The intake of all kinds of food,the prevalence and related factors of nutrition-related chronic diseases(overweight/obesity,hypertension,diabetes mellitus and dyslipidemia)among Nu populations were investigated in 2016.We further explored the relationship between nutrition,dietary behavior,and nutrition-related chronic diseases.The nutrition,health problems and related risk factors associated with chronic diseases among Nu population was also analyzed.The present study provided basic information in order to improve the nutrition and health,as well as chronic diseases prevention and control among Nu populations.Objective:1.To investigate dietary and nutrition among Nu population.2.To investigate the prevalence of nutrition-related chronic diseases(overweight,obesity,hypertension,diabetes mellitus,and dyslipidemia)and the related factors among Nu population.3.To investigate the relationship between nutrition and chronic diseases among Nu population.Methods:1.The population characteristics,socio-economy,environmental distribution were considered in the sampling method in order to make participants representative.Participants were recruited using a stratified cluster sampling method.Three towns at different levels of economic development were included in Gongshan County.Then four villages were randomly selected from each township.In each village,twenty households were randomly selected.All Nu ethnicity aged above six years old were invited to take part in face to face interview,dietary survey and blood test.Altogether,678 participants aged 6-80 years completed all parts of the study.The present study was conducted from September to December in 2016.Selected household and members aged six years or over were visited and collect their information of dietary intake by the 24 h dietary recall and food frequency questionnaire over three consecutive days(including two weekdays and one weekend day).All foods intake were recorded including having at home and outside before the pasting 24 h.Oil and flavoring such as salt,soy sauce and spices were weight and recorded at the first day of surveying.Then the remainder of oil and flavoring were weight and record after three days.Medical examination and laboratory tests: height,weight,and blood pressure were measured according to the national standard methods;fasting plasma was extracted to detect fasting blood glucose and blood lipid related indexes(cholesterol,triglycerides,high-density lipoprotein cholesterol,and low-density lipoprotein cholesterol).2.EpiData 3.1 was used to establish database.SPSS20.0 was used to analyze data.The continuous data were described as x ±s or M±Q.If each group satisfies normality and the variance between the two groups is equal,t-test was used to compare between two groups.Otherwise,the nonparametric Wilcoxon rank sum test was used to compare between the groups.Classification data were described by frequency.When comparing between groups,we use analysis of variance.Chi-square test was performed for the disordered outcome data and nonparametric Wilcoxon rank sum test was performed for the ordered data.Multivariate analysis was performed by unconditional logistic regression analysis.The test standard is P< 0.05.Results:1.Sample population characteristics: In this study,a total of 678 6-80-year-old Nu ethnic residents were selected at random,and 290 were males(42.8%)and 388 were females(57.2%).The average age was 39.4 years old.The people aged 6-10,11-13,14-17,18-44,45-59,60-80 accounted for 6.6%,7.4%,4.9%,41.4%,25.8%,and 13.9% of the population,respectively.In terms of educational levels,illiterate,primary school,middle school,high school/technical secondary school,junior college,college and above accounted for 9.9%,57.4%,27.7%,4.4%,0.3%,and 0.3%,respectively.In terms of occupations,students,farmers,un-employees,retired personnel,professional and technical personnel,forestry and fishing water production personnel,and other occupations accounted for 17.9%,48.4%,1.0%,0.6%,0.7%,31.1%,and 0.3%,respectively.The single,married,divorced,and widowed accounted for 5.6%,79.3%,2.7%,and 12.4% of the people aged over 18 years,respectively.Household per capita income in the previous year was < 5000 Yuan,5,000-9999 Yuan,10,000-14,999 Yuan,15,000-19,999 Yuan and ≥20,000 Yuan for 76.3%,13.7%,6.3%,1.5%,and 2.2% of the population,respectively.2.Food and nutrient intake status: In 2016,the consumption rate of rice and its products was the highest,and the average rate was about 96.9%.Among the various types of animal food consumption,pork consumption rate was the highest(77.3%),followed by aquatic products(53.8%)and eggs(42.3%).The average consumption rate of light vegetables was 80.8%.The average consumption rate of beans and its products was 52.8%.The average consumption rate of milk and its products was 40.7%.The average consumption rate of nuts was 2.3%.The average intakes of all kinds of food per standard person-day for 6-80-year-old Nu residents in Gongshan County,Yunnan Province,were 610.3g for cereal and potato food(rice and its products 368.0g,noodles and their products 124.1g,other cereals 7.3g,potato 110.9g),201.2g for vegetable(dark vegetables 68.1g,light vegetables 133.1g),140.0g for animalistic food(pork 121.5g,aquatic products 13.4g,egg 5.1g),19.0g for fruit,28.8g for milk and its products,10.5g for beans and its products,1.0g for nuts,34.6g for cooking oil,and 6.7g for salt,respectively.The intake of cereal and potato food,pork,milk and its products for Nu residents aged 6-80 years was higher than the average dietary intake of residents in China from 2010 to 2013.However,the intake of vegetable,fruit,aquatic products,egg,beans and its products,nuts,cooking oil and salt for Nu residents aged 6-80 years was lower than the average dietary intake for residents in China from 2010-2013(P<0.05).The average daily energy intake of 6-80-year-old Nu residents in Gongshan County,Yunnan Province was 2587.9 Kcal per standard person.The average intakes of nutrients per standard person-day were as follows: protein 85.3g,fat 110.3g,carbohydrate 329.4 g,dietary fiber 7.7g,vitamin A 191.8μg,thiamine 1.2mg,riboflavin 0.9mg,ascorbic acid 98.0mg,total vitamin E 21.3 mg;Potassium 2343.6mg,sodium 4070.6mg,calcium 433.7mg,magnesium 377.9mg,iron 24.2mg,zinc 13.5mg,copper 1.8mg,phosphorus 1231.7 mg,selenium 46.0 mg,manganese 6.5mg.The intakes of energy,protein,fat,carbohydrates,thiamine,riboflavin,ascorbic acid,potassium,calcium,magnesium,iron,zinc and phosphorus for Nu residents aged 6-80 years were higher than the average dietary intakes for residents in China from 2010 to 2013,while the intakes of dietary fiber,vitamin A,vitamin E,sodium,and copper for Nu residents aged 6-80 years were lower than the average dietary intakes of residents in china in 2010-2013(P<0.05).3.Relationship between food intake and nutrition-related chronic noncommunicable diseases: The prevalence of overweight/obesity,hypertension,diabetes and dyslipidemia for the 368 Nu ethnics aged 6-80 years in Yunnan province was 18.5%,18.5%,41.3%,and 53.8%,respectively.The chronic diseases was closely related to food intake status.The status of chronic diseases in adults aging over 18 years in Yunnan province cannot be ignored.Sex,occupation,marital status,education level and consumption of dried beans and products(soybeans)in the past 12 months were associated with hypertension.Marital-status,cereals and products(cereals and other products)intake meat and meat products(fresh or frozen poultry)and sugar(bread,biscuits)food intake in the past 12 months were associated with prevalence of diabetes in residents of Nu nationality.Sex,occupation,and consumption of vegetables and products(solanaceous vegetables)during the past 12 months were linked to the prevalence of overweight.Marital status,consumption of livestock meat and products(fresh or frozen poultry)and fish(grass carp)in the past 12 months were associated with dyslipidemia among the Nu minority residents.Conclusion:1.The intakes of cereal and potato food,pork,milk and its products for Nu nationality residents in Gongshan County were higher than the average dietary intakes of our country residents in 2010-2013 while the intakes of aquatic products,vegetable,fruit,egg,beans and its products,nuts,cooking oil and salt were lower than those of our country residents in 2010-2013.It is suggested that the dietary structure of Nu people in Gongshan County of Yunnan Province was unreasonable.Nutritional education and intervention should be carried out widely to promote healthy food consumption behaviors and improve nutrition and health status of residents.2.The intakes of dietary fiber,vitamin A,vitamin E,sodium and copper were lower than the average dietary intakes for our country residents in 2010-2013 while the intakes of energy,protein,fat,carbohydrate,thiamine,riboflavin,ascorbic acid,potassium,calcium,magnesium,iron,zinc and phosphorus were higher than the average dietary intake for the residents in china in 2010-2013.It is suggested that the energy and nutrient intakes of Nu people in Gongshan County of Yunnan Province were unbalanced,which should be paid attention to.3.The nutritional status of Nu people in Gongshan County,Yunnan Province improved in 2016 compared with that in 10 years ago(2006).The prevalence of overweight/obesity,hypertension,diabetes and dyslipidemia was high for the Nu nationality residents.The chronic diseases were closely related to food intake status.Sex,occupation,marital status,education level,consumption of dried beans and products were the associated factors of hypertension.Marital status,cereals and products,animal meat and products and carbohydrates were associated with diabetes.Gender,occupation,eating vegetables and products were associated with overweight and obesity.Marital status,eating animal meat and products and fish were associated with dyslipidemia.It is important to reduce the occurrence of chronic diseases by carrying out health education on diet and nutrition knowledge among targeted minority groups and change the behavioral risk factors of chronic diseases. |
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