| Objective:Understand the current status and characteristics of energy intake and energy expenditure of Chinese adults in the north and south of my country.To provide data support for later adjustment of dietary intake and recommended amount of physical activity.Validation of methods that can be used to screen the physical activity of a large sample of people.Provide validation data for the application of the International Physical Activity Questionnaire(IPAQ)and Bouchard Activity Dairy(Bouchard AD)in China,and to provide suggestions for later revision.Methods:From November 2019 to October 2020,200 people were recruited in Ningbo and Nanyang each,a total of 400 people.After passing the acceptance criteria,366 people(193 people in Ningbo area and 173 people in Nanyang area)were enrolled in the group.adults were required to wear an Actigraph wGT3x-BT triaxial accelerometer for 3 consecutive days and fill in a 3-d Bouchard activity diary at the same time,with face-to-face inquiries by the investigator completing IPAQ.The investigator enters the household to conduct a 24-hour diet recall method combined with condiments to weigh the survey subjects for 3 consecutive days.,and their energy intake,the three macronutrients,and energy ratio were measured,and check the contents of the Bouchard activity diary after entering the household every day,and deal with the unreasonable or suspicious places in a timely manner.The investigator recorded the subject’s weight and body fat ratio using TANITA BC601,the subject’s height and the waist circumference using a measuring tape.Contact on-site investigations to local health institutions for collective blood collection,and use Hitachi 7600-210 automatic biochemical analyzers in the laboratory to de-tect blood sugar,blood lipids and other biochemical indicators.The Wilcoxon rank sum test or Kruskal-wallis test was used to analyze the differences in the study adults with different characteristics,and the multi-factor logistic regression was used to analyze the relationship between dietary intake and physical activity and obesity.Results:1.Energy IntakeThe average daily energy intake(EI)of the survey adults was 1663.8kcal/d.The average daily El of men was 1738.0kcal/d greater than that of women,1602.3kcal/d(P<0.05),and the average daily EI of Ningbo was 1524.3kcal/d,which was generally lower than that of Nanyang of 1766.7kcal/d(P<0.01).The three macronutrients intakes of the survey adults were 75.1,55.3 and 206.6g/d.The protein intake of adults in Ningbo was 97.8g/d higher than that in Nanyang was 54.2g/d(P<0.01).Adults carbohydrate intake in Nanyang was 259.3g/d higher than that in Ningbo was 165.8g/d(P<0.01).There was no significant difference in fat intake between the two regions.The carbohydrate/energy ratio in Nanyang was 58.2%higher than that in Ningbo was 44.5%(P<0.01),and the fat/energy ratio and protein/energy ratio in Ningbo were 32.3%and 25.0%higher than that in Nanyang were 29.2%and 12.1%(P<0.01).2.Energy ExpenditureThe average daily EE was 1845.5kcal/d.The average daily EE of male residents was 2043.7kcal/d higher than that of females 1626.5kcal/d,the difference was statistically significant(P<0.01).The average daily EE and energy expenditure per kilogram of body weight in Nanyang area were 1969.4kcal/d and 30.0kcal/d-kg-1,which were higher than the 1689.2kcal/d and 28.2kcal/d·kg-1 in Ningbo area.The difference was statistically significant.(P<0.01).Taking BMI,body fat,waist and blood fat as the cut-point EE of the obesity group were 2227.8,1925.5,2023.8 and 1882.8kcal/d respectively,which were higher than those of the normal group(P<0.01),but after correction per kilogram of body weight,The EE of each obesity group changed to 26.2,28.3,29.1,and 28.6 kcal/d·kg-1,which were lower than the normal group.The difference in BMI and body fat as the cut-off point was significant,while the other two groups had no significant difference.The sedentary behavior(SB)time of adults in Ningbo was 20.7h/d higher than that in Nanyang was 19.6h/d(P<0.01).The MVPA,MET and daily walking steps in Nanyang were higher than those in Ningbo(P<0.01)That is to say,the level of physical activity in Nanyang is higher than that in Ningbo.3.Energy BalanceThe energy balance of Nanyang was-172.3 and-158.0kcal/d respectively,and the difference was not significant(P>0.05).The average daily energy balance of male is-303.8kcal/d lower than that of female was-78.9kcal/d(P<0.01).There is no significant difference between all age groups,education level group and occupational group.Grouped by BMI,waist,and blood lipids,the negative energy bal-ance becomes more serious with the degree of obesity,but there is no significant differ-ence between the two groups based on body fat ratio as the cut off point.There is no significant difference in energy balance between the two regions as a whole.However,the average daily energy balance of the 44～52-year-old age group,the education level of primary school and below,and the central obesity group in Ningbo is lower than that in Nanyang,and the difference is significant.4.Relationship between dietary intake,physical activity and obesityAfter multi-factor logistic regression analysis,controlling for age,gender and other confounding factors,when BMI is used as the cut-off point for obesity,the average daily protein/energy ratio of residents is in the range of 10～15%,and the average daily fat/energy ratio is in the range of 20～30%.Walking more than 6000 steps per day,MVPA time of more than 150 minutes per week,and AEE per day of more than 3kcal/d·kg-1 per kilogram of body weight are protective factors for maintaining a healthy weight.Taking body fat as the cut-off point for obesity,walking more than 10,000 steps per day,more than 300 minutes of MVPA per week,and more than 5 kcal/d·kg-1 per kilogram of AEE per day are protective factors for maintaining healthy weight.When waist circumference is the cut-off point for obesity,walking more than 6000 steps per day,more than 300 minutes of MVPA per week,and more than 5kcal/d·kg-1 per kilogram of body weight per day are protective factors for maintaining healthy weight.5.Validity of IPAQ and Bouchard ADTaking the accelerometer as standard,IPAQ measures the EE,the time of SB and MVPA,and the correlation coefficients are 0.50,0.04,and 0.47,respectively.The Bland-Altman scatter plot shows that the average line of IPAQ is higher than the 0 line in the measurement of EE indicating that IPAQ underestimates EE as a whole;the average line is close to the 0 line and the scattered points are clus tered when measuring MVPA.In terms of time,the average line is lower than th e 0 line and the scatter regression equation is negatively correlated(r=-1.66),s uggesting that IPAQ will overestimate the MVPA time,and as the MVPA time in creases,the overestimation will increase.Taking the accelerometer as standard,the diary measures EE,the time of SB,LPA,and MVPA,and the correlation coefficients are 0.78,0.21,0.20,and 0.11,respectively.The Bland-Altman scatter plot shows that the diary measures the EE,the average line is lower than the 0 line,and the scatter regression equation is negatively correlated,indicating that the diary will overestimate EE and as EE increases,the overestimation will become more and more.Large;the diary measures SB time and LPA,the average line is lower than the 0 line and the scatter regression equation is negatively correlated(r=-0.92),suggesting that the greater the overestimation of the diary is with the increase of the sitting time and the less active time;the average of the diary is the estimated MVPA time The line is higher than the 0 line and the scatter plot is negatively correlated,suggesting that as the MVPA time increases,the overestimation will increase.Conclusion:1.The average daily energy intake of residents in Nanyang is higher than that in Ningbo.2.The average daily protein intake of residents in Ningbo is twice the RNI,but the carbohydrate intake has not reached the RNI,and the fat intake is reasonable;the three macronutrients of the residents in Nanyang are within the recommended intake range.3.The average daily energy expenditure of residents in Nanyang area is greater than that in Ningbo area.4.The overall energy expenditure in the two regions is higher than the energy intake5.Macronutrients are within the RNI range and when physical activity reaches the WHO recommended amount,they are a protective factor for maintaining a healthy weight.6.The International Physical Activity Questionnaire has good validity in measuring the time of MVPA and EE.The Bouchard Activity Diary has good validity in measuring energy expenditure. |
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