医学生膳食质量评价及其影响因素分析  

Evaluation of dietary quality and its influencing factors among medical students

作　　者：张祎萌 顾丹彤 彭洪 刘少杰 贾英男[1] ZHANG Yi-meng;GU Dan-tong;PENG Hong;LIU Shao-jie;JIA Ying-nan(Department of Preventive Medicine and Health Education,School of Public Health,Fudan University,Shanghai 200032,China;Clinical Research and Achievement Translation Center,Eye and ENT Hospital,Fudan University,Shanghai 200031,China;Department of Nutrition,the First Affiliated Hospital of Xiamen University,Xiamen 361003,Fujian Province,China)

机构地区：[1]复旦大学公共卫生学院预防医学与健康教育教研室,上海200032 [2]复旦大学附属眼耳鼻喉科医院临床研究与转化中心,上海200031 [3]厦门大学附属第一医院营养科,厦门361003

出　　处：《复旦学报（医学版）》2024年第4期594-601,共8页Fudan University Journal of Medical Sciences

基　　金：上海市哲学社会科学规划青年课题(2018EGL008)。

摘　　要：目的了解医学生的营养膳食摄入情况,评价其膳食质量,并分析可能的影响因素。方法招募复旦大学上海医学院在读学生,采用7 d 24 h膳食记录法,收集日常饮食摄入数据。通过比较实际摄入量与指南推荐摄入量的差异,计算中国健康饮食指数(Chinese Healthy Eating Index,CHEI)得分,综合评价学生膳食质量。采用因子分析提取膳食模式。依据CHEI得分将研究对象分为高分组和低分组,利用二元Logistic回归确定膳食质量的影响因素。结果最终纳入221名研究对象,平均能量摄入为(2057.02±501.87)kcal/d,其中80%的能量摄入来自校内食堂。产能营养素碳水化合物、蛋白质、脂肪的供能比分别为48.90%、16.55%、36.07%。CHEI总分中位数为67.55分,薯类、蔬菜、水果、乳制品、水产品、坚果条目分低于该条目总分的60%,膳食结构存在不合理。处于研究生阶段(OR=0.53,95%Cl:0.28~0.98)和不合理的理想体重期望(OR=0.37,95%Cl:0.17~0.81)的学生CHEI总分较低,水果-奶制品膳食模式(OR=8.20,95%Cl:3.39~19.84)、薯类-蔬菜膳食模式(OR=3.41,95%Cl:1.58~7.32)和校内就餐率低(OR=1.92,95%Cl:1.02~3.59)的学生CHEI总分较高。结论复旦大学上海医学院在读学生的总能量摄入水平较为理想,脂肪供能比较高,膳食结构不尽合理,整体膳食质量有待提高。学生的膳食质量主要受到学历、体重期望和膳食模式的共同影响。Objective To assess the nutritional status and dietary quality of medical students and its influencing factors.Methods Students from Shanghai Medicial College of Fudan University were recruited to complete the 7-day and 24-hour dietary records,with food consumption measured by weight.A comprehensive evaluation of the students’dietary quality was carried out by comparing their actual nutrient intake against recommended levels and calculating the component score of the Chinese Healthy Eating Index(CHEI).Factor analysis was used to extract dietary patterns.All subjects were further divided into high score group and low score group based on total CHEI.Binary Logistic regression was used to determine the factors influencing dietary quality.Results The study participants had an average daily energy intake of(2057.02±501.87)kcal/d,80%from on-campus canteen meals.Carbohydrates,proteins and fats contributed to 48.90%,16.55%and 36.07%of the total energy intake,respectively.The CHEI median score was 67.55.Component scores for tubers,vegetables,fruits,dairy,fish and seafood,and nuts were below 60%,indicating an unbalanced diet.Being in the graduate stage(OR=0.53,95%CI:0.28-0.98)and having unreasonable body weight expectations(OR=0.37,95%CI:0.17-0.81)were associated with lower CHEI scores.Conversely,higher CHEI scores were associated with the fruit-dairy dietary pattern(OR=8.20,95%CI:3.39-19.84),the tuber-vegetable dietary pattern(OR=3.41,95%CI:1.58-7.32),and lower rates of on-campus dining(OR=1.92,95%CI:1.02-3.59).Conclusion The energy intake of students at Shanghai Medical College of Fudan University appears to be adequate.However,a relatively high proportion of energy supply from fat intake indicates a need for improvement in their dietary structure.The dietary quality of students is mainly influenced by their educational level,weight expectations and dietary patterns.

关 键 词：膳食质量 能量摄入 中国健康饮食指数(CHEI) 医学生 

分 类 号：R151.4[医药卫生—营养与食品卫生学] R153.9[医药卫生—公共卫生与预防医学]