BACKGROUND: At present, there are fewer studies on the monitoring of nutritional status of the residents living in the draw-down area of ThreeGorge reservoir.OBJECTIVE: To investigate the nutritional status and dietary pattern of the residents before the formation of the draw-down area of Three-Gorge reservoir, so as to provide basic data for the continuous dynamic surveillance of food and nutrition.DESIGN: A cross-sectional study.SETTING: Department of Nutrition and Food Hygiene, School of Public Health, Chongqing University of Medical Sciences.PARTICIPANTS: The investigation was carried out between February and March 2004 in the draw-down area of Three-Gorge reservoir with denser population, larger area and greater influence, such as Kaixian and Yunyang counties, etc. The first surveillance of food nutritional status of the residents in the draw-down area was performed in 52 urban families and 50 rural families of Kaixian county, one family member was voluntarily selected from each family, whose main duty was to buy vegetables and food. Totally 102 subjects (42 males and 60 females) were investigated in this study. At the same time, the data of physical examination and detection of blood Hb in children from Kaixian county between May 1999 and November 2003 were analyzed.METHODS: The subjects were investigated in their house with questionnaires. Their general condition of family, food consumption and dietary nutrition were surveyed and analyzed. Nutrients intake was assessed by 24-hour recall, combined with food consuming frequency questionnaire, the Engel index, which was an important index for the level of family consumption, was detected in both rural and urban residents. Engel index=cost in food/total family income×100%.MAIN OUTCOME MEASURES: ① Amount of food consumption, intakes of energy and nutrients in residents of the draw-down area; ② Prevalence rate of low body mass and rate of growth retardation in children of the draw-down area.RESULTS: All the 102 residents of the draw-down area entered the analysis of results without deletion. ① Amount of food consumption in residents of the draw-down area: Among the urban residents of the draw-down area, the per capita food consumption was 243 g per day, and the consumptions of vegetable, fruit and fish were lower than the average national level, but that of grease food showed a higher level. Among rural residents of Kaixian county, the per capita food consumption was 268 g per day, and the consumption of foodstuff was obviously decreased, but those of meet and grease food showed an ascending trend. ② Energy intake in residents of the draw-down area: Among urban residents of Kaixian county, the per capita energy intake was 6 909 kJ per day, which was obviously lower than that in the urban residents of Chongqing city in 1998 and the average national urban level. The per capita energy intake in rural residents of Kaixian county was 7 577 kJ per day, which was 48.4% lower than that in the urban residents of Chongqing city in 1998 and 37% lower than the average national rural level. ③ Nutritional status in children of the draw-down area: The incidence rate of low body mass in children younger than 5 years in 1999 was close to the average national level (9.6%), it was obviously decreased from 2000, and then fluctuated between 1.0% and 4.8%. Since 1999, the incidence rate of growth retardation in children younger than 5 years of Kaixian county showed a gradually descending trend, but anemia and other common diseases still kept a higher incidence rate, the detection rate of anemia was 33.5% in 1999, and decreased to 20.8% in 2003.CONCLUSION: The current nutritional status of the Kaixian people living in draw-down area of Three-Gorge reservoir still needs further improvement, and dynamic food and nutrition surveillance in succession is necessary.%背景:目前对三峡水库消落区居民食物营养状况进行监测的相关调查较少.目的:了解三峡水库消落区形成前人群营养状况和膳食结构,为连续动态进行食物与营养监测提供基础数据.设计:横断面调查.单位:重庆医科大学公共卫生学院营养与食品卫生学教研室.对象:调查于2004-02/03完成,调查地点主要选取三峡水库人口较集中、面积较大、影响可能较大的消落区,如开县、云阳等县.其中对消落区居民食物营养状况的首次监测选择在开县进行.对开县52户城区居民和50户农村居民进行调查,每户选择1名主要担任买菜、购粮任务的成员为调查对象,均自愿参加观察.本次调查共调查了102人,男42人,女60人.同时对开县1999-05/2003-11儿童体格测量以及血色素检测等资料进行分析. 方法:采用入户问卷调查.对家庭基本情况、住户食物消费与膳食营养等方面进行调查分析.膳食调查采用24h膳食回顾结合食物消费频数调查,对农村及城镇居民进行家庭消费水平的重要指标Engel指数测定,Engel指数=用于食品的开支/家庭总收入×100%.主要观察指标:①消落区居民食物消费量、能量及营养素摄入量.②消落区儿童低体质量患病率及儿童生长迟缓率.结果:纳入消落区居民102人,全部进入结果分析,无脱落.①消落区居民食物消费量状况:开县城区居民粮食消费量为人均243g/d,其中蔬菜、水果、鱼类食品消费低于全国平均水平,而食用油脂消费却呈较高态势;开县农村居民粮食消费量为人均268 ad,其中粮食消费明显下降,而肉类、食用油脂消费出现增高趋势.②消落区居民能量摄入量状况:开县城区居民能量摄入量为人均6 909 kJ/d,较1998年重庆市城市居民和全国城市平均水平明显降低;开县农村居民能量摄入量人均7 577 kJ/d,较1998年重庆市农村居民低48.4%,比全国农村平均水平低37%.③消落区儿童营养状况:5岁以下儿童1999年低体质量发生率与全国平均水平9.6%接近,自2000年后明显下降,波动在1.0%～4.8%之间.从1999年开始,开县5岁以下儿童生长迟缓发生率有逐步降低趋势,但贫血等常见病仍保持较高发病率,1999年贫血检出率为33.5%,2003年降至20.8%.结论:重庆市开县居民某些营养素摄入量和膳食结构有待进一步改善,有必要进行连续动态食物与营养监测.
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