Study On Dietary Quality And Influencing Factors Of Related Chronic Diseases Among Adult Residents In Six Cities (Counties) Of Guangxi

Objective:（1）To understand the dietary nutrition intake of adult residents in Guangxi.（2）To analyze and evaluate the dietary pattern and dietary quality of adult residents in Guangxi.（3）To understand the prevalence of diet-related chronic diseases such as overweight/obesity,hypertension and diabetes among adult residents in Guangxi.（4）To analyze the influencing factors of diet-related chronic diseases among adult residents in Guangxi,and put forward feasible prevention and control measures,so as to provide scientific basis and research basis for nutrition intervention and improving dietary quality in the future.Methods:The data of the tenth follow-up survey conducted by China Health and Nutrition Survey（CHNS）in Guangxi in 2015 were used.Using the method of multi-stage stratified cluster random sampling,6 survey sites were selected from3 counties（Cangwu County,Rong County and Fusui County）in 3 cities of Guangxi（Nanning City,Wuzhou City and Yulin City）.Each survey site investigated 4 communities（village committees）a total of 24 community neighborhood committees（village committees）,each community（village）randomly selected 20 residents,all household members belong to the survey.In this study,residents over 18 years old with complete dietary survey data were selected as the object of study.Face-to-face household survey and personal survey were conducted by questionnaire,dietary review method and seasoning weighing method were used for dietary survey,height,weight,waistline,blood pressure（SBP,DBP）and other information of residents were obtained by medical physical examination,and hemoglobin（HGB）and fasting blood glucose（GLU）were obtained by laboratory biochemical test.The data were inputted and calculated through the national unified input system,statistically analyzed by SPSS24.0,the measurement data were compared and analyzed by non-parametric test,the rate was compared by chi-square test,and binary logistic regression analysis was used to analyze the related chronic diseases such as obesity,hypertension,diabetes and so on.Results:Excluding dietary incompleteness and unreasonable data,a total of 1169people with complete dietary survey data aged 18 and above were selected,including 348（29.77%）in urban areas,821（70.23%）in rural areas,568（48.59%）in males and 601（51.41%）in females.1.Dietary intake of adult residents in Guangxi:according to the standard person（18 years old,male,light manual labor）,the results are as follows:cereal and potato 362.90g,vegetables 309.96g,fruit 40.16g,milk 7.02g,beans 9.91g,livestock meat 167.31g,fish and shrimp 28.95g,eggs 22.12g,cooking oil 20.38g,salt 6.09g.Compared with the reference dietary intake of nutrients（DRIs）in the Dietary guidelines for Chinese residents,it was found that the intake of cereals,livestock and poultry meat exceeding RNI;vegetables in the overall dietary structure of adult residents in Guangxi is 68.88%of RNI;the intake of fruits,milk and legumes,fish and shrimp,eggs and cooking oil is on the low side,which does not reach at least 2.34%of RNI;salt intake is close to the recommended range.Compared with urban and rural residents,it was found that the intake of cereals,vegetables,fruits,milk,legumes,livestock meat,fish and shrimp,eggs and salt in urban residents was significantly higher than that in rural areas（P<0.05）,and the intake of cooking oil in rural areas was higher than that in urban areas（P<0.05）.Among different genders,female intake of cereals,vegetables and fruits was higher than that of male（P<0.05）,and salt intake of male was higher than that of female（P<0.05）.2.The intake of energy and nutrients of adult residents in Guangxi:in terms of energy and three major capacity nutrients per standard person/day,the energy intake of adult residents in Guangxi was 2205.43 Kcal,which was close to RNI（2250kcal）,while the intake of protein and fat was 71.82g and 84.49g respectively,which exceeded the RNI;carbohydrate intake of 276.76g,which did not meet the RNI,but reached the average required（EAR）standard（120g）.On the whole,the intake of urban residents was higher than that of rural residents（P<0.05）,and that of females was higher than that of males（P<0.05）.In terms of micronutrients and minerals,the intake of dietary fiber of adult residents in Guangxi is obviously uneven.The dietary fiber intake is 9.44g,which is only 37.76%of the AI standard,of which 10.70g in urban areas and9.06g in rural areas are lower than the appropriate intake standards.The intake of vitamin A per standard person per day is 373.29μg RAE,which is 46.66%of the RNI standard.The intake of potassium,sodium,calcium,magnesium,iron,zinc,copper,phosphorus and selenium in urban areas was higher than that in rural areas（P<0.05）,and that in female was higher than that in male（P<0.05）.The lack of calcium intake per standard person is the most serious,less than half of RNI,only 44.08%,and sodium intake is 3926.16mg,more than twice the AI standard.3.Dietary quality of adult residents in Guangxi:the overall dietary imbalance of male residents was more serious than that of female residents,and that of rural residents was more serious than that of urban residents（P<0.05）.The DBI＿DQD score of≥60 years old group（34）was higher than that of the other three age groups（P<0.05）,indicating that the overall dietary imbalance was more serious than that of other age groups.People with cereal（C1）intake at an appropriate level accounted for 42.51%;vegetables and fruits（C2）intake did not reach the recommended amount（C2<-2）as high as 97.69%;severely inadequate intake（C2<-8）accounted for 19.67%;insufficient intake of vegetables,fruits,milk and soybeans among adult residents in Guangxi is relatively serious;The intake of condiments,alcoholic beverages and cooking oil is appropriate for most people,and more than 75%of the population’s intake is at or close to RNI.94.95%of Guangxi residents’food intake is not rich（C7<-2）,which indicates that Guangxi adult residents eat fewer kinds of food,and 84.86%of the people have a score of-8 food 4,which means that most people eat only about 6 kinds of food a day for 3 days.Among the residents surveyed,there were four dietary patterns A,B,D and E,but the main patterns were B and E,with 580 cases（49.62%）and 311 cases（26.60%）respectively.4.Prevalence of chronic diseases among adult residents in Guangxi:the survey results showed that the prevalence rate of hypertension among people aged 18 and above was 30.62%,including 25.44%in cities and 32.39%in rural areas,which was higher in rural areas than in urban areas（P<0.05）.The prevalence rate increased with age（P<0.05）.The rate of central obesity was23.61%,which was higher in urban areas than in rural areas（P<0.05）,and lower in males than in females（P<0.05）.The rate of central obesity increased with age（P<0.05）.The anemia rate and diabetes prevalence rate of adult residents in Guangxi were low,which were 5.41%and 5.53%respectively,and there was no significant difference between urban and rural areas and between different genders（P>0.05）.5.Analysis of diet and related chronic diseases among adult residents in Guangxi:through binary logistic regression analysis,the results showed that:（1）Age（35-44 years old）,age（45-59 years old）,age（over 60 years old）,fat energy supply ratio（>40%）,cholesterol intake quartile（75%）,cholesterol intake quartile（100%）,livestock and poultry meat quartile（100%）are risk factors for overweight/obesity.At the same time,area（rural）,fruit quartile（50%）,fruit quartile（75%）,fruit quartile（100%）are all protective factors.（2）Age,area（rural）,central obesity,diabetes,BMI（overweight）,BMI（obesity）,salt quartile（75%）,salt quartile（100%）,egg quartile（75%）,egg quartile（100%）are risk factors for hypertension,BMI（emaciation）,dietary fiber intake（>12g/d）are protective factors.（3）Energy intake（>2400kcal/d）,central obesity,BMI（obesity）and hypertension are the risk factors of diabetes.Conclusions:1.The average daily intake of vegetables,fruits,milk,legumes,fish and shrimp and eggs of adult residents in Guangxi did not reach the recommended intake range.Vegetables account for 68.88%of RNI,fruits only 13.39%of RNI,milk 2.34%of RNI,and legumes,fish and eggs all consume less than half of RNI.Compared with the results of the 2009 Guangxi survey of China Health and Nutrition,the intake of milk,legumes,fish and shrimp and eggs increased,while the intake of vegetables and fruits decreased.The food intake of Guangxi residents is not rich,and 84.86%of the residents eat an average of about 6 kinds of food group food every day.The problem of unreasonable dietary structure still exists,the intake of cereal and livestock meat is too much,and the intake of fruit,milk and legumes is on the low side.Insufficient intake of dietary fiber,vitamin A,vitamin B₁,vitamin B₂,potassium,calcium,magnesium,zinc and selenium.It is recommended that residents eat more fruit,milk and legume products,use more fish and shrimp instead of livestock and poultry meat,and reduce fat intake.2.The epidemic situation of chronic diseases is becoming more and more serious.compared with the results of the survey in Guangxi in 2011,the rate of overweight/obesity and the prevalence rate of hypertension in Guangxi are on the rise,and the proportion of the sick population is getting younger.Multivariate analysis showed that age,BMI,central obesity and region were the risk factors of overweight/obesity,hypertension,diabetes and other chronic diseases in Guangxi.The health management of residents can be strengthened through dietary nutrition publicity and education such as eating more fruits and vegetables,eating and dynamic balance,and carrying out health literacy actions in the whole region.