2013-09-06
2013-09-06
2013-09-05
2013-09-02
2013-09-02
2013-09-12
(卫生部 科技部国家统计局 2004年10月12日)
第一部分 背景
一、调查目的与意义
国民营养与健康状况是反映一个国家或地区经济与社会发展、卫生保健水平和人口素质的重要指标。良好的营养和健康状况既是社会经济发展的基础,也是社会经济发展的重要目标。世界上许多国家,尤其是发达国家均定期开展国民营养与健康状况调查,及时颁布调查结果,并据此制定和评价相应的社会发展政策,以改善国民营养和健康状况,促进社会经济的协调发展。
我国曾于1959年、1982年和1992年分别进行过三次全国营养调查;1959年、1979年和1991年分别开展过三次全国高血压流行病学调查;1984年和1996年分别开展过两次糖尿病抽样调查。上述调查对于了解我国城乡居民膳食结构和营养水平及其相关慢性疾病的流行病学特点及变化规律;评价城乡居民营养与健康水平;制定相关政策和疾病防治措施发挥了积极的作用。由于近十年来,我国社会经济得到了快速发展,一方面为消除营养缺乏和改善居民健康提供了经济、物质基础,另一方面也导致了膳食结构、生活方式和疾病谱的变化。为及时了解居民膳食结构、营养和健康状况及其变化规律,揭示社会经济发展对居民营养和健康状况的影响,为国家制定相关政策、引导农业及食品产业发展、指导居民采纳健康生活方式提供科学依据,2002年8-12月,在卫生部、科技部和国家统计局的共同领导下,由卫生部具体组织各省、自治区、直辖市相关部门在全国范围内开展了“中国居民营养与健康状况调查”。
这是我国首次进行的营养与健康综合性调查。它将以往由不同专业分别进行的营养、高血压、糖尿病等专项调查进行有机整合,并结合社会经济发展状况,增加了新的相关指标和内容,在充分科学论证的基础上,统一组织、设计和实施。调查覆盖全国31个省/自治区/直辖市(不含香港、澳门特别行政区及台湾),对全国和不同类型地区具有良好的代表性。本次调查设计科学,内容丰富,充分体现了多部门、多学科合作的优势,不仅大量节约了人力、物力资源,而且避免了调查内容和指标的重复,并为深入分析相互之间的关系奠定了基础。
本次调查正值我国全面建设小康社会的重要时期。通过调查不但可以建立中国居民营养与健康状况数据库,为科学研究和制定相关政策提供重要资源,也是坚持以人为本,树立和落实全面、协调、可持续科学发展观的具体体现。
二、调查方法与内容
按经济发展水平及类型将全国各县(市、区)划分为大城市、中小城市、一类农村、二类农村、三类农村、四类农村,共6类地区。采用多阶段分层整群随机抽样,在全国31个省、自治区、直辖市的132个县(区、市)(见图1)共抽取71 971户(城市24 034户、农村47 937户), 243 479人(城市68 656人、农村174 823人)。为保证孕妇、乳母、婴幼儿和12岁及以下儿童的调查人数,以满足各组样本量的要求,在样本地区适当补充调查人数,本次调查总计272 023人。
本次调查包括询问调查、医学体检、实验室检测和膳食调查四个部分,其中膳食调查23 463户(城市7 683户、农村15 780户)、69 205人,体检221 044人,血压测量153 259人,血脂测定94 996人,血红蛋白测定211 726人,血糖测定98 509人,血浆维生素A测定13 870人。
图1 132个调查点分布图
2002年8-10月在北方地区, 2002年9-12月在南方地区进行现场调查;2003年1-8月完成各类实验室检验和数据录入;2003年5-12月完成数据清理和数据库建立;2004年1-7月完成数据分析报告。
为确保调查数据的准确性,对整个调查进行了严格的全程质量控制。所有质控结果表明,本次调查各个环节均达到方案设计的质控要求。
将样本人口资料与2000年第五次人口普查数据和国家统计局2002年人口学指标(性别比例、负担系数、家庭规模、少数民族人口比例)比较,表明样本人群对总体有较好的代表性。
由于抽样人口中有10.1%的人外出未能参加体检,致使调查样本中15-25岁各年龄组人口比例偏低。因此,采用2000年第五次人口普查数据作为标准人口,首先对6类地区样本患病率进行年龄别校正,各类地区校正后的患病率再用该地区的人口比例作为权重进行加权,推算全国的患病率。
第二部分 主要结果
最近十年我国城乡居民的膳食、营养状况有了明显改善,营养不良和营养缺乏患病率继续下降,同时我国仍面临着营养缺乏与营养失衡的双重挑战。
一、居民营养与健康状况明显改善
(一) 居民膳食质量明显提高。我国城乡居民能量及蛋白质摄入得到基本满足,肉、禽、蛋等动物性食物消费量明显增加,优质蛋白比例上升。城乡居民动物性食物分别由1992年的人均每日消费210克和69克上升到248克和126克。与1992年相比,农村居民膳食结构趋向合理,优质蛋白质占蛋白质总量的比例从17%增加到31%、脂肪供能比由19%增加到28%,碳水化合物供能比由70%下降到 61%。(详见表1,2)。
(二)儿童青少年生长发育水平稳步提高。婴儿平均出生体重达到3309克,低出生体重率为3.6%,已达到发达国家水平。全国城乡3-18岁儿童青少年各年龄组身高比1992年平均增加3.3厘米。但与城市相比,农村男性平均低4.9厘米,女性平均低4.2厘米。
(三)儿童营养不良患病率显著下降。5岁以下儿童生长迟缓率为14.3%,比1992年下降55%,其中城市下降74%,农村下降51%;儿童低体重率为7.8%,比1992年下降57%,其中城市下降70%,农村下降53%。
(四)居民贫血患病率有所下降。城市男性由1992年的13.4%下降到10.6%;城市女性由23.3%下降到17.0%;农村男性由15.4%下降至12.9%;农村女性由20.8%下降至18.8%。
二、居民营养与健康问题不容忽视
(一)城市居民膳食结构不尽合理。畜肉类及油脂消费过多,谷类食物消费偏低。2002年城市居民每人每日油脂消费量由1992年的37克增加到44克,脂肪供能比达到35%,超过世界卫生组织推荐的30%的上限。城市居民谷类食物供能比仅为47%,明显低于55-65%的合理范围。此外,奶类、豆类制品摄入过低仍是全国普遍存在的问题。
(二)一些营养缺乏病依然存在。儿童营养不良在农村地区仍然比较严重,5岁以下儿童生长迟缓率和低体重率分别为17.3%和9.3%,贫困农村分别高达29.3%和14.4%。生长迟缓率以1岁组最高,农村平均为20.9%,贫困农村则高达34.6%,说明农村地区婴儿辅食添加不合理的问题十分突出。
铁、维生素A等微量营养素缺乏是我国城乡居民普遍存在的问题。我国居民贫血患病率平均为15.2%;2岁以内婴幼儿、60岁以上老人、育龄妇女贫血患病率分别为24.2%、21.5%和20.6%。3-12岁儿童维生素A缺乏率为9.3%,其中城市为3.0%,农村为11.2%;维生素A边缘缺乏率为45.1%,其中城市为29.0%,农村为49.6%。全国城乡钙摄入量仅为391毫克,相当于推荐摄入量的41%。
(三)慢性非传染性疾病患病率上升迅速
1、高血压患病率有较大幅度升高
我国18岁及以上居民高血压患病率为18.8%,估计全国患病人数1.6亿多。与1991年相比,患病率上升31%,患病人数增加约7 000多万人。农村患病率上升迅速,城乡差距已不明显。大城市、中小城市、一至四类农村高血压患病率依次为20.4%、18.8%、21.0%、19.0%、20.2%和12.6%。
我国人群高血压知晓率为30.2%,治疗率为24.7%,控制率为6.1%;与1991年的26.6%、12.2%和2.9%相比有所提高,但仍处于较差水平。
2、糖尿病患病增加
我国18岁及以上居民糖尿病患病率为2.6%,空腹血糖受损率为1.9%。估计全国糖尿病现患病人数2 000多万,另有近2 000万人空腹血糖受损。城市患病率明显高于农村,一类农村明显高于四类农村。与1996年糖尿病抽样调查资料相比,大城市20岁以上糖尿病患病率由4.6%上升到6.4%、中小城市由3.4%上升到3.9%。
3、超重和肥胖患病率呈明显上升趋势
我国成人超重率为22.8%,肥胖率为7.1%,估计人数分别为2.0亿和6 000多万。大城市成人超重率与肥胖现患率分别高达30.0%和12.3%,儿童肥胖率已达8.1%,应引起高度重视。与1992年全国营养调查资料相比,成人超重率上升39%,肥胖率上升97%,由于超重基数大,预计今后肥胖患病率将会有较大幅度增长。
4、血脂异常值得关注
我国成人血脂异常患病率为 18.6%,估计全国血脂异常现患人数1.6亿。不同类型的血脂异常现患率分别为:高胆固醇血症2.9%,高甘油三酯血症11.9 %,低高密度脂蛋白血症7.4%。另有3.9%的人血胆固醇边缘升高。值得注意的是,血脂异常患病率中、老年人相近,城乡差别不大。
5、膳食营养和体力活动与相关慢性病关系密切
本次调查结果表明,膳食高能量、高脂肪和少体力活动与超重、肥胖、糖尿病和血脂异常的发生密切相关;高盐饮食与高血压的患病风险密切相关;饮酒与高血压和血脂异常的患病危险密切相关。特别应该指出的是脂肪摄入最多体力活动最少的人,患上述各种慢性病的机会最多.
第三部分 拟采取的措施
为实现全面建设小康社会的战略目标,根据本次调查结果,从国情出发,从急需入手,以不失时机和分类指导为原则,将从政策支持、市场指导和群众教育三方面加强居民营养改善和慢性病预防工作:第一,加强政府的宏观指导,尽快制定相关法规,将国民营养与健康改善工作纳入国家与地方政府的“十一.五”发展规划;第二,加强对农业、食品加工、销售流通等领域的科学指导,发挥其在改善营养与提高人民健康水平中的重要作用;第三,加强公众教育,倡导平衡膳食与健康生活方式,提高居民自我保健意识和能力。
为充分利用本次调查信息,将组织有关部委和机构完成中国国民营养与健康状况白皮书、论文集和系列科普丛书,并尽快向社会公开调查数据库,实现信息共享。
本次调查得到了世界卫生组织、联合国儿童基金会等部门的支持。
表 1 1982,1992,2002年全国城乡居民的食物摄入量(克/标准人日)
|
|
城乡合计 |
|
|
|
城市 |
|
|
|
农村 |
|
|
1982年 |
1992年 |
2002年 |
|
1982年 |
1992年 |
2002年 |
|
1982年 |
1992年 |
2002年 |
米及其制品 |
217 |
226.7 |
239.9 |
|
217 |
223.1 |
217.8 |
|
217 |
255.8 |
248.4 |
面及其制品 |
189.2 |
178.7 |
138.5 |
|
218 |
165.3 |
132.0 |
|
177 |
189.1 |
141.0 |
其它谷类 |
103.5 |
34.5 |
23.3 |
|
24 |
17 |
16.3 |
|
137 |
40.9 |
25.9 |
薯类 |
179.9 |
86.6 |
49.5 |
|
66 |
46 |
31.9 |
|
228 |
108 |
56.2 |
干豆类 |
8.9 |
3.3 |
4.2 |
|
6.1 |
2.3 |
2.6 |
|
10.1 |
4 |
4.8 |
豆制品 |
4.5 |
7.9 |
11.8 |
|
8.2 |
11 |
12.9 |
|
2.9 |
6.2 |
11.4 |
深色蔬菜 |
79.3 |
102 |
91.5 |
|
68 |
98.1 |
88.1 |
|
84 |
107.1 |
92.8 |
浅色蔬菜 |
236.8 |
208.3 |
183.7 |
|
234 |
221.2 |
163.8 |
|
238 |
199.6 |
191.3 |
腌菜 |
14 |
9.7 |
10.3 |
|
12.1 |
8 |
8.4 |
|
14.8 |
10.8 |
11.0 |
水果 |
37.4 |
49.2 |
45.7 |
|
68.3 |
80.1 |
69.3 |
|
24.4 |
32 |
36.6 |
坚果 |
2.2 |
3.1 |
3.9 |
|
3.5 |
3.4 |
5.4 |
|
1.7 |
3 |
3.3 |
畜禽类 |
34.2 |
58.9 |
79.5 |
|
62 |
100.5 |
104.4 |
|
22.5 |
37.6 |
69.9 |
奶及其制品 |
8.1 |
14.9 |
26.3 |
|
9.9 |
36.1 |
65.8 |
|
7.3 |
3.8 |
11.2 |
蛋及其制品 |
7.3 |
16 |
23.6 |
|
15.5 |
29.4 |
33.2 |
|
3.8 |
8.8 |
19.9 |
鱼虾类 |
11.1 |
27.5 |
30.1 |
|
21.6 |
44.2 |
44.9 |
|
6.6 |
19.2 |
24.4 |
植物油 |
12.9 |
22.4 |
32.7 |
|
21.2 |
32.4 |
40.2 |
|
9.3 |
17.1 |
29.9 |
动物油 |
5.3 |
7.1 |
8.7 |
|
4.6 |
4.5 |
3.8 |
|
5.6 |
8.5 |
10.5 |
糖、淀粉 |
5.4 |
4.7 |
4.4 |
|
10.7 |
7.7 |
5.2 |
|
3.1 |
3 |
4.1 |
食盐 |
12.7 |
13.9 |
12.0 |
|
11.4 |
13.3 |
10.9 |
|
13.2 |
13.9 |
12.4 |
酱油 |
14.2 |
12.6 |
9.0 |
|
32.5 |
15.9 |
10.7 |
|
6.5 |
10.6 |
8.4 |
标准人:18岁轻体力活动男子
表2 1982,1992,2002全国城乡居民平均营养素的摄入量(每标准人日)
|
城乡合计 |
|
城市 |
|
农村 |
||||||
|
1982年 |
1992年 |
2002年 |
|
1982年 |
1992年 |
2002年 |
|
1982年 |
1992年 |
2002年 |
能量(kcal) |
2491.3 |
2328.3 |
2253.5 |
|
2450.0 |
2394.6 |
2137.5 |
|
2509.0 |
2294.0 |
2297.9 |
(KJ) |
10423.5 |
9740.3 |
9428.8 |
|
10250.8 |
10019 |
8943.2 |
|
10497.7 |
9598.1 |
9614.2 |
蛋白质(g) |
66.7 |
68.0 |
66.1 |
|
66.8 |
75.1 |
69.1 |
|
66.6 |
64.3 |
64.9 |
脂肪(g) |
48.1 |
58.3 |
76.2 |
|
68.3 |
77.7 |
85.6 |
|
39.6 |
48.3 |
72.6 |
膳食纤维(g) |
8.1 |
13.3 |
12.0 |
|
6.8 |
11.6 |
11.2 |
|
8.7 |
14.1 |
12.4 |
视黄醇(μg) |
53.8 |
156.5 |
152.9 |
|
103.9 |
277.0 |
226.5 |
|
32.7 |
94.2 |
124.6 |
视黄醇当量(μg) |
119.5 |
476.0 |
478.8 |
|
147.3 |
605.5 |
552.8 |
|
107.8 |
409.0 |
450.3 |
硫胺素(mg) |
2.5 |
1.2 |
1.0 |
|
2.1 |
1.1 |
1.0 |
|
2.6 |
1.2 |
1.0 |
核黄素(mg) |
0.9 |
0.8 |
0.8 |
|
0.8 |
0.9 |
0.9 |
|
0.9 |
0.7 |
0.7 |
抗坏血酸(mg) |
129.4 |
100.2 |
89.8 |
|
109.0 |
95.6 |
83.1 |
|
138.0 |
102.6 |
92.3 |
钙(mg) |
694.5 |
405.4 |
390.6 |
|
563.0 |
457.9 |
439.3 |
|
750.0 |
378.2 |
371.8 |
铁(mg) |
37.3 |
23.4 |
23.3 |
|
34.2 |
25.5 |
23.8 |
|
38.6 |
22.4 |
23.1 |
磷(mg) |
1623.2 |
1057.8 |
980.3 |
|
1574.0 |
1077.4 |
975.1 |
|
1644.0 |
1047.6 |
982.1 |
标准人:18岁轻体力活动男子
The Nutrition and Health Status of the Chinese People
October 12, 2004
Part I The Background
1. The objective and significance of this Survey
The nutrition and health status of people is an important indicator for the economy and social development, health care level and the population diathesis of a country or region. Good nutrition and health status not only forms the foundation for the social and economic development, but is also the goal of the country’s social and economic development. Many countries in the world in particular the advanced countries, have been conducting regular surveys on the status of nutrition and health among the people, with survey results being released in time, and based on the survey results, relevant social development policies have been formulated and evaluated accordingly in a view to improve the status of nutrition and health among the people and to promote the coordinated development of social economy.
In China, three national surveys on nutrition were conducted respectively in 1959, 1982 and 1992, three national epidemiological surveys on hypertension were conducted respectively in 1959, 1979 and 1991, and two sampled surveys on diabetes were conducted respectively in 1984 and 1996. The above surveys have played positive roles in: understanding the current dietary patterns and nutrition level of the urban and rural residents in China, and the epidemiological characteristics and trends of the relevant chronic diseases; evaluating the nutrition and health status of the urban and rural population; and formulating the relevant policies and disease prevention strategies. In the past ten years, rapid social & economic development in China has on the one hand, provided the economic and physical foundation in eliminating malnutrition and improving the health of the people, on the other hand, has resulted in changes in the dietary patterns, lifestyles and the disease patterns among the Chinese population. In order to timely understand the current dietary structure and the status of nutrition and health among Chinese people and their trends, to demonstrate the effects of social economic development on the people’s nutrition and health status, and to provide the scientific basis for formulating relevant state policies, inducting the development of agricultural and food industries and guiding the people to adopt healthy lifestyles, a “Survey on the Status of Nutrition and Health of the Chinese People” under the joint leadership of the Ministry of Health, the Ministry of Science and Technology and the National Bureau of Statistics was conducted from August to December, 2002. The Ministry of Health was responsible for organizing the related departments in all the provinces, autonomous regions and the municipalities directly under the Central Government to carry out the survey.
This was China’s first comprehensive survey ever in the field of nutrition and health. It has systematically integrated several previously separately organized surveys on nutrition, hypertension, diabetes, etc. into one survey, and it has increased some new and relevant indicators and contents taking into account of the status of social economic development. The survey was organized, designed and implemented in a unified manner, based on adequate scientific augmentation. This survey covered China’s 31 provinces, autonomous regions and the municipalities directly under the Central Government (excluding Hong Kong and Macao Special Administrative Regions and Taiwan), and it has exhibited good representatives of the nation, taking into account of the different regions in China. This survey was scientifically designed with abundant contents, sufficiently embodying the advantage of cooperation among the multi-sectors and the application of multi-disciplinary scientific knowledge and by so doing, it has not only saved a large number of manpower and the material resources, but has also avoided the overlap of survey contents and indicators, laying the foundation for further analysis on the inter-relationships among different factors.
This survey was conducted at the time of the important period of constructing the well-being society of China. The survey has not only established the database for the status of nutrition and health of the Chinese people, provided important resources for the scientific research and for formulating relevant policies, but has also adhered to the principle of proceeding from the human needs and a full embodiment of establishing and implementing a complete, coordinated and sustained scientific development views.
2. Survey methodologies and contents
According to various economic development levels and types, all counties (cities, districts) were classified as the large cities, medium and small cities, 1st class rural areas, 2nd class rural areas, 3rd class rural areas and 4th class rural areas, i.e. altogether six classified areas. The method of multi-steps cluster sampling was adopted, 71,971 households (24,034 urban households and 47,937 rural households) were chosen from 132 counties (districts, cities) (refer to Chart 1) of China’s 31 provinces, autonomous regions and the municipalities directly under the Central Government, 243,479 persons (68,656 persons in the cities and 174,823 persons in the rural areas) were chosen in the sample. In order to ensure sufficient number of pregnant women, breast-feeding mothers, infants, babies and children under the age of 12 years old in the survey and to ensure enough sample size in each group, additional subjects were included in the sample and the total number of subjects in this survey reached 272,023.
This survey included four parts, i.e. the questionnaire survey, health examination, laboratory tests, and dietary surveys by which, the dietary surveys covered 23,463 households (7,683 urban households, 15,780 rural households) involving 69, 205 subjects, and 221,044 subjects participated in the health examination, 153,259 subjects participated in the blood pressure measurement, 94,996 subjects participated in the blood cholesterol test, 211,726 subjects participated in the blood hemoglobin test, 98,509 subjects participated in the blood sugar tests, and 13,870 subjects participated in the plasma vitamin A measurement.
Chart 1 Geographical distribution of the 132 survey sites
From August to October 2002, field surveys were conducted in China’s northern areas, and from September to December, 2002, in the southern part of China. From January to August 2003 various laboratory tests and data entry were completed; from May to December 2003, all data was cleaned and the database was established; from January to July 2004, the preliminary data analysis report was finished.
In order to ensure the accuracy of the survey data, a whole process quality control was performed throughout the survey, and all quality control results indicated that every part of this survey met the requirements of the quality control plans in the program design.
3. Data quality assessment and the interpretation of the survey results
The sample demographic data was compared with the 5th national census data in 2000 and the demographical indicators data (gender proportion, weight coefficient, size of the households, proportion of the minority nationalities) in 2002 from the National Bureau of Statistics and the results showed that the sample is a good representation of the total Chinese population.
Due to 10.1% of the choosen subjects were not available at the time of the survey, it lowered the proportion of the age group of 15-25 years old in the survey sample. Therefore, age specific adjustments were firstly made for the disease prevalence in the six areas, based on the data collected in the 5th national census in 2000, and after the adjustments were made, the prevalence rates were further weighted based on the population of each of the 6 areas, hence the national disease prevalence was calculated.
Part II, Major Results
In the past ten years, the status of diet and nutrition among the urban and rural Chinese population has been improved significantly, and the prevalence of malnutrition and nutrition deficiency has been continuously decreased. However, in the meantime China is still facing the dual challenges of nutrition deficiency and nutrition imbalance.
1. The status of nutrition and health among the Chinese people has been significantly improved
(1) The quality of the average diet of the Chinese people has been improved significantly. The energy and protein intake among the urban and rural population have been basically satisfactory, the consumption of meat, poultry, egg and other animal products has been increased significantly, and the percentage of good quality protein in the diet has been increased. The daily consumption of animal products for the people living in the urban and the rural areas has been increased from 210 g and 69 g respectively in 1992 to 248 g and 126 g respectively according to the survey. Compared with the figures in 1992, the dietary pattern of the rural residents has become more reasonable, the percentage of good quality protein among the total protein intake has been increased from 17% to 31%, energy contribution from fat increased from 19% to 28%, energy contribution from carbohydrate has been decreased from 70% to 61% (see Table 1 & 2)
(2) The growth of children and teenagers has been steadily improved. The average weight of new-borne infants has reached 3,309 grams, low birth weight accounted for 3.6% of the total live birth, by which it has reached the level of the industrialized countries. The average height of the 3-18 years old age group in the urban and rural areas was 3.3 centimeters more than the average of that in 1992. Compared with the urban residents, rural males were on average, 4.9 centimeters lower and females are 4.2 centimeters lower.
(3) The malnutrition prevalence among the children was significantly decreased. The prevalence of growth retardation among children under the age of 5 was 14.3%, compared with the figure in 1992, it has been decreased by 55%, among which the number in the urban areas has been decreased by 74% and in the rural areas the number has been decreased by 51%. The prevalence of low body weight in children was 7.8%, compared with the figure in 1992, it has been decreased by 57%, among which the figure in the urban areas has been decreased by 70% and the prevalence in the rural areas has been decreased by 53%.
(4) The prevalence of anemia among Chinese was slightly decreased.
The prevalence of anemia in the urban males has dropped from 13.4% in 1992 to 10.6%, and the prevalence among the urban females has dropped from 23.3% in 1992 to 17.0%. The prevalence of the rural males has dropped from 15.4% to 12.9%, and the prevalence of the rural females dropped from 20.8% to 18.8%.
2. The nutrition and health problems in the population should not be ignored.
(1) The dietary pattern among the urban residents is not reasonable to certain extent. The consumption of poultry, meat and oil/fat was too high, and cereals consumption was at a relatively low level. In 2002, daily consumption of oils/fats among the urban residents has been increased to 44 grams, compared with 37 grams in 1992. The energy contribution from fat reached 35%, exceeded the recommended upper limit of 30% by the World Health Organization. The energy contribution from cereals among the urban residents was only 47%, which is significantly lower than the recommended range between 55% and 65%. Besides, low consumption of dairy and soy products remained a common problem in China.
(2) Some problems of malnutrition among the children in China’s rural areas is still quite serious, prevalence of growth retardation and low body weight among the children under the age of 5 accounted for 17.3% and 9.3% respectively. The figure in the poor rural areas was 29.3% and 14.4% respectively. The prevalence of growth retardation was the highest among the one-year-old age group, on average in rural areas it accounted for 20.9%, in the poor areas, its accounted for 34.6%, by which this demonstrates the significant problem associated with the improper use of complementary foods in infants in the rural areas.
Micro-nutriments deficiency such as iron and vitamin A is a problem commonly existed among the urban and rural population. The prevalence of anemia among the Chinese people averages 15.2%; the prevalence of anemia among the infants and children under the age of two-years-old, the older people over the age of 60 years old and the child-bearing women was 24.2%, 21.5% and 20.6%, respectively. The prevalence of vitamin A deficiency among the children aged between 3 and 12 years old was 9.3%, among which in the urban areas it was 3.0% and in rural areas the figure was 11.2%; the prevalence of marginal vitamin A deficiency was 45.1%, among which in the urban areas it was 29.0% and in the rural areas the figure was 49.6%. The average calcium intake among the urban and the rural population was only 391 milligrams, equivalent to 41% of the recommended dietary intake level.
(3) Rapid increase of the prevalence of the chronic non-communicable diseases
① A significant increase in the morbidity of hypertension
The prevalence of hypertension in the people over the age of 18 is 18.8%, and it is estimated that more than 160 million people are suffering from this illness in China. Compared with 1991, the prevalence of hypertension increased by 31% with more than 70 million new hypertension patients since 1991. The prevalence of hypertension in the rural areas has also increased rapidly, and there is no significant difference between the prevalence in the urban and the rural areas. The hypertension prevalence in the big cities, small to medium cities and class 1 to class 4 rural areas in China was 20.4%, 18.8%, 21.0%, 19.0%, 20.2% and 12.6% respectively.
The population awareness rate about hypertension in China was 30.2%, the treatment rate was 24.7% and the rate of under-control was 6.1%; compared with the figures of 26.6%, 12.2% and 2.9% respectively in 1991, although there has been an improvement, however, the awareness is far from adequate.
② An increase of diabetic prevalence
The prevalence of type 2 diabetes for the people over the age of 18 years old in China was 2.6%, and the prevalence of impaired fasting plasma glucose was 1.9%. It is estimated that there are more than 20 million diabetic patients in China, besides, nearly 20 million people with impaired fasting blood sugar level. The prevalence of diabetes in China is significantly higher in the urban areas than the rural areas, while the prevalence in the 1st class rural areas is significantly higher than that of the 4thclass rural areas. Compared with sampled diabetes survey in 1996, in adults over the age of 20 years old, the diabetic prevalence in the big cities increased from 4.6% to 6.4%, and the prevalence in the small and medium sized cities increased from 3.4%to 3.9%.
③ The prevalence of overweight and obesity has been significantly increased
In Chinese adults, the prevalence of overweight was 22.8%, and the prevalence of obesity was 7.1%, and the estimated total numbers were 200 million and over 60 million respectively. The prevalence of overweight and obesity among the adults in big cities were 30.0% and 12.3% respectively; children’s obesity rate has reached 8.1%, hence requires more close attention. Compared with the nutrition survey data in 1992, the adult prevalence of overweight increased by 39%, and the adult prevalence of obesity increased by 97%, and it is predicted that a large increase will occur in the obesity rate in the near future.
④ The problem of abnormal blood lipid levels requires close attention
The prevalence of abnormal blood lipid levels among the adults in China was 18.6%, and it is estimated that 160 million people are suffering from it. The prevalence of various types of abnormalities were: hypercholesterolmia – 2.9%, hypertriglyceridemia – 11.9%, low blood HDL cholesterol – 7.4%. Beside, 3.9% of the subjects had borderline of high cholesterol level. It should be noted that there was no significant difference in prevalence of abnormal blood lipids levels among middle age and elderly subjects, as well as no significant difference between the urban and the rural population.
⑤ The dietary nutrition and physical activity are closely related to the chronic diseases
The survey results indicate that: high dietary energy, high dietary fat and less physical activity are closely related to the occurrence of overweight, obesity, diabetes and abnormal blood lipid level; high salt intake is closely related to the risks of hypertension; and alcohol drinking is closely related to hypertension and abnormal bloo, d lipid level. It should be particularly emphasized that those who had higher level of fat intake and least physical activity have the highest risks for the above mentioned chronic diseases.
Part III The proposed actions & measures
In order to achieve the strategic goal of building the well-being society in China, in light of the results from this survey and China’s actual situation, and to start from addressing the most urgent needs and adhere to the principle of seizing the opportunities and giving guidelines according to different categories/issues, we will consolidate our work to improve people’s nutrition status and the control and prevention of chronic diseases through policy support, market guidance and mass education:
1. To strengthen government leadership to promulgate relevant laws and regulations without loss the momentum and to integrate the improvement of people’s nutrition and health into the 11th Five Year Development Plans at the national and local levels;
2. To consolidate the scientific guidance in the fields of agriculture, food manufacturing, distribution and marketing, etc., and bring into play their important roles in improving people’s nutrition and health status;
3. To strengthen public education, advocate balanced diet and healthy lifestyles, and enhance people’s awareness and capabilities for self-health protection. In order to to make full use of the information derived from this survey, relevant government ministries, commissions and agencies will be organized to prepare and publish the white paper on Chinese people’s nutrition and health status, and series of monograph and popular scientific books. The survey database will be open to the public and the information sharing will be realized.
This survey has received support from the World Health Organization and the UNICEF, etc.
Table 1
1982,1992 and 2002 National Average Food Consumption by Urban & Rural Population in China (Gram/Reference Person/Day)
|
|
In Total |
|
|
|
Urban |
|
|
|
Rural |
|
|
1982 |
1992 |
2002 |
|
1982 |
1992 |
2002 |
|
1982 |
1992 |
2002 |
Rice & rice produce |
217 |
226.7 |
239.9 |
|
217 |
223.1 |
217.8 |
|
217 |
255.8 |
248.4 |
Flour & flour produce |
189.2 |
178.7 |
138.5 |
|
218 |
165.3 |
132.0 |
|
177 |
189.1 |
141.0 |
Other cereals |
103.5 |
34.5 |
23.3 |
|
24 |
17 |
16.3 |
|
137 |
40.9 |
25.9 |
Tubers |
179.9 |
86.6 |
49.5 |
|
66 |
46 |
31.9 |
|
228 |
108 |
56.2 |
Dried beans |
8.9 |
3.3 |
4.2 |
|
6.1 |
2.3 |
2.6 |
|
10.1 |
4 |
4.8 |
Soy bean products |
4.5 |
7.9 |
11.8 |
|
8.2 |
11 |
12.9 |
|
2.9 |
6.2 |
11.4 |
Dark color vegetables |
79.3 |
102 |
91.5 |
|
68 |
98.1 |
88.1 |
|
84 |
107.1 |
92.8 |
Light color vegetables |
236.8 |
208.3 |
183.7 |
|
234 |
221.2 |
163.8 |
|
238 |
199.6 |
191.3 |
Preserved vegetables |
14 |
9.7 |
10.3 |
|
12.1 |
8 |
8.4 |
|
14.8 |
10.8 |
11.0 |
Fruits |
37.4 |
49.2 |
45.7 |
|
68.3 |
80.1 |
69.3 |
|
24.4 |
32 |
36.6 |
Nuts |
2.2 |
3.1 |
3.9 |
|
3.5 |
3.4 |
5.4 |
|
1.7 |
3 |
3.3 |
Poultry |
34.2 |
58.9 |
79.5 |
|
62 |
100.5 |
104.4 |
|
22.5 |
37.6 |
69.9 |
Dairy products |
8.1 |
14.9 |
26.3 |
|
9.9 |
36.1 |
65.8 |
|
7.3 |
3.8 |
11.2 |
Egg & Egg products |
7.3 |
16 |
23.6 |
|
15.5 |
29.4 |
33.2 |
|
3.8 |
8.8 |
19.9 |
Fish, Shrimp |
11.1 |
27.5 |
30.1 |
|
21.6 |
44.2 |
44.9 |
|
6.6 |
19.2 |
24.4 |
Vegetable Oil |
12.9 |
22.4 |
32.7 |
|
21.2 |
32.4 |
40.2 |
|
9.3 |
17.1 |
29.9 |
Animal fat |
5.3 |
7.1 |
8.7 |
|
4.6 |
4.5 |
3.8 |
|
5.6 |
8.5 |
10.5 |
Sugar, Starch |
5.4 |
4.7 |
4.4 |
|
10.7 |
7.7 |
5.2 |
|
3.1 |
3 |
4.1 |
Salt |
12.7 |
13.9 |
12.0 |
|
11.4 |
13.3 |
10.9 |
|
13.2 |
13.9 |
12.4 |
Soy Sauce |
14.2 |
12.6 |
9.0 |
|
32.5 |
15.9 |
10.7 |
|
6.5 |
10.6 |
8.4 |
A reference person = 18 year-old man who performs light physical activity
Table 2
1982,1992 and 2002 National Average Nutrients Intake by Urban & Rural Population in China (Reference person/day)
|
National |
|
Urban |
|
Rural |
||||||
|
1982 |
1992 |
2002 |
|
1982 |
1992 |
2002 |
|
1982 |
1992 |
2002 |
Energy(kcal) |
2491.3 |
2328.3 |
2253.5 |
|
2450.0 |
2394.6 |
2137.5 |
|
2509.0 |
2294.0 |
2297.9 |
(KJ) |
10423.5 |
9740.3 |
9428.8 |
|
10250.8 |
10019 |
8943.2 |
|
10497.7 |
9598.1 |
9614.2 |
Protein(g) |
66.7 |
68.0 |
66.1 |
|
66.8 |
75.1 |
69.1 |
|
66.6 |
64.3 |
64.9 |
Fat(g) |
48.1 |
58.3 |
76.2 |
|
68.3 |
77.7 |
85.6 |
|
39.6 |
48.3 |
72.6 |
Dietary fibre(g) |
8.1 |
13.3 |
12.0 |
|
6.8 |
11.6 |
11.2 |
|
8.7 |
14.1 |
12.4 |
Retinol(μg) |
53.8 |
156.5 |
152.9 |
|
103.9 |
277.0 |
226.5 |
|
32.7 |
94.2 |
124.6 |
Retinol Equiv. (μg) |
119.5 |
476.0 |
478.8 |
|
147.3 |
605.5 |
552.8 |
|
107.8 |
409.0 |
450.3 |
Thiamin(mg) |
2.5 |
1.2 |
1.0 |
|
2.1 |
1.1 |
1.0 |
|
2.6 |
1.2 |
1.0 |
Riboflavin(mg) |
0.9 |
0.8 |
0.8 |
|
0.8 |
0.9 |
0.9 |
|
0.9 |
0.7 |
0.7 |
Ascorbic acid(mg) |
129.4 |
100.2 |
89.8 |
|
109.0 |
95.6 |
83.1 |
|
138.0 |
102.6 |
92.3 |
Calcium(mg) |
694.5 |
405.4 |
390.6 |
|
563.0 |
457.9 |
439.3 |
|
750.0 |
378.2 |
371.8 |
Iron(mg) |
37.3 |
23.4 |
23.3 |
|
34.2 |
25.5 |
23.8 |
|
38.6 |
22.4 |
23.1 |
Phosphorus(mg) |
1623.2 |
1057.8 |
980.3 |
|
1574.0 |
1077.4 |
975.1 |
|
1644.0 |
1047.6 |
982.1 |
A reference person = 18 years old man who performs light physical activity
发布时间:2004-10-12 11:05:19
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