天津市孤独症谱系障碍儿童膳食营养状况

石芮; 韩钰; 高磊; 汪耿夫; 张欣

doi:10.16835/j.cnki.1000-9817.2021.09.010

天津市孤独症谱系障碍儿童膳食营养状况

doi: 10.16835/j.cnki.1000-9817.2021.09.010

天津医科大学公共卫生学院儿少卫生与妇幼保健教研室, 天津 300070

基金项目:

国家自然科学基金项目 81773459

详细信息

作者简介:
石芮(1994-), 女, 内蒙古呼和浩特人, 在读硕士, 主要研究方向为儿童青少年生长发育

通讯作者:
张欣, E-mail: zhangxin@tmu.edu.cn

中图分类号: R 153.2 R 151 R 748
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- 被引次数: 0
出版历程
- 收稿日期: 2021-03-02
- 修回日期: 2021-03-16
- 网络出版日期: 2021-09-24
- 刊出日期: 2021-09-24

Dietary intake and nutritional status of children with autism spectrum disorders in Tianjin

Department of Child and Maternal Health, School of Public Health, Tianjin Medical University, Tianjin(300070), China

摘要

摘要: 目的调查分析天津市孤独症谱系障碍(ASD)儿童的膳食营养素摄入量和营养状况，为ASD儿童制定科学有效的营养干预措施提供依据。方法采用3 d 24h膳食回顾法调查天津市某特殊教育学校90名3~9岁ASD儿童24种膳食营养素的摄入情况，并对儿童进行体格测量。结果 ASD儿童中超重肥胖儿童共31名，占34.4%；3名消瘦者占3.3%；1名生长迟缓者占1.1%。各年龄组ASD儿童维生素A、维生素B₁、维生素D、维生素B₆、叶酸、钙和碘的平均摄入量均低于推荐摄入量标准，铜、磷和锌的摄入量均高于推荐摄入量标准，其中有超过10%的ASD儿童铜和镁的摄入量超过可耐受最高摄入量。能量、脂肪、维生素A摄入情况构成在正常、超重、肥胖组差异有统计学意义(χ²值分别为9.24，10.03，P值均 <0.05)。结论孤独症谱系障碍儿童超重、肥胖率较高，营养素缺乏与过量的现象同时存在，建议采取个性化的饮食营养干预方案。
- 孤独性障碍 /
- 膳食 /
- 营养状况 /
- 参考标准 /
- 儿童
Abstract: Objective To investigate the dietary nutrient intake and nutritional status of children with autism spectrum disorder(ASD), and provide evidence for developing scientific and effective nutrition intervention measures for children with ASD. Methods Nutrient intake of 90 children with ASD were investigated by using 3-day 24-hour dietary survey, and the anthropological indexes were measured. Results Among the 90 ASD children aged 3-9, 31 of them were overweight and obese, accounting for 34.4%, three children were underweight, accounting for 3.3%, and one child was stunted, accounting for 1.1%. Dietary intakes of vitamin A, vitamin B₁, vitamin D, vitamin B₆, folic acid, calcium and iodine in all age groups of ASD children were insufficient, but the dietary intakes of copper, phosphorus and zinc exceeded the recommended intake level. More than 10% of the ASD children consume copper and magnesium more than the tolerable upper intake level. There were significant differences in the dietary intake of energy, fat and vitamin A among normal, overweight, obese and thin ASD children(χ²=9.24, 10.03, P<0.05). Conclusion Overweight and obesity, as well as the combination of insufficient and excessive nutrition in children with ASD is common. Personalized dietary nutrition intervention towards ASD children should be developed and implemented.
- Autistic disorder /
- Diet /
- Nutritional status /
- Reference standards /
- Child

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表 1 不同年龄ASD儿童常见营养素平均每日摄入量与AI或RNI比较[M(P₂₅, P₇₅)]

Table 1. Comparison of average daily intake of common nutrients with AI or RNI in ASD children of different ages[M(P₂₅, P₇₅)]

年龄/岁	人数	能量/kcal		蛋白质/g		脂肪/g		碳水化合物/g		维生素C/mg		维生素D/μg
年龄/岁	人数	摄入量	RNIs比例/%	摄入量	RNIs比例/%	摄入量	RNIs比例/%	摄入量	RNIs比例/%	摄入量	AI比例/%	摄入量	AI比例/%
3	17	1 297.3(826.5, 1 587.1)	106.4	44.5(33.4, 63.4)	180.0	29.5(21.5, 61.4)	122.0	166.2(116.3, 234.4)	141.6	50.4(25.4, 93.8)	126.0	1.1(0.5, 2.7)	11.0
4	17	1 081.0(761.7, 1 688.5)	83.2	41.0(21.7, 58.2)	136.7	23.1(16.5, 55.2)	92.3	184.5(108.3, 229.3)	153.8	41.3(14.2, 59.2)	82.6	1.1(0.2, 1.9)	11.3
5	18	1 258.8(775.5, 1 468.4)	89.9	41.5(32.1, 61.4)	138.2	36.9(23.8, 47.4)	147.5	155.3(114.2, 224.2)	129.4	51.5(19.4, 83.6)	103.1	0.9(0.3, 1.5)	9.0
6	18	1 498.0(930.6, 1 802.7)	93.6	51.0(34.8, 69.9)	170.1	39.8(25.4, 59.9)	159.0	207.9(131.5, 235.8)	173.2	49.6(36.5, 69.9)	99.2	1.4(0.3, 2.8)	14.2
7	5	1 688.5(1 460.8, 2 211.8)	99.3	61.0(56.6, 72.1)	152.5	50.1(40.8, 78.3)	200.2	250.4(206.6, 312.9)	208.7	57.5(21.8, 70.2)	88.4	0.5(0.0, 1.0)	5.5
8	5	1 326.0(1 117.0, 2 241.5)	71.7	54.6(40.2, 88.3)	136.5	30.9(21.6, 101.3)	123.6	207.2(180.5, 244.2)	172.7	93.0(51.2, 103.9)	143.1	0.7(0.2, 1.7)	7.0
9	10	1 974.0(1 580.3, 2 698.5)	98.7	95.6(60.2, 106.5)	238.9	70.3(60.9, 84.7)	281.0	262.5(169.7, 341.4)	218.7	82.3(37.8, 105.0)	126.6	1.3(0.1, 3.5)	13.0

年龄/岁	人数	维生素E/mg		叶酸/μg		维生素A/μgRE		维生素B6/mg		烟酸/mg		铜/mg
年龄/岁	人数	摄入量	AI比例/%	摄入量	RNIs比例/%	摄入量	RNIs比例/%	摄入量	AI比例/%	摄入量	RNIs比例/%	摄入量	RNIs比例/%
3	17	9.7(6.1, 15.5)	222.7	21.5(13.6, 59.7)	13.2	265.7(146.1, 425.8)	85.7	0.2(0.1, 0.3)	26.7	11.8(7.3, 13.6)	197.2	1.1(0.9, 1.5)	370.0
4	17	9.6(5.0, 16.3)	172.4	32.4(14.0, 52.8)	17.1	240.0(188.0, 376.0)	66.7	0.1(0.0, 0.2)	18.6	10.0(5.6, 11.9)	124.5	1.1(0.6, 1.6)	267.5
5	18	8.9(5.6, 13.3)	140.9	28.5(13.5, 51.5)	15.0	230.0(140.0, 467.2)	63.9	0.1(0.1, 0.3)	19.3	10.2(6.5, 13.7)	127.9	0.9(0.7, 1.3)	217.5
6	18	10.9(6.9, 21.0)	157.6	25.4(13.9, 88.6)	13.4	366.2(187.0, 587.0)	101.7	0.1(0.1, 0.3)	18.6	9.6(6.9, 16.5)	119.8	1.2(0.7, 1.9)	301.3
7	5	17.5(12.6, 22.1)	194.9	60.9(28.9, 157.4)	24.3	180.5(130.0, 575.0)	36.1	0.4(0.1, 0.9)	38.0	17.5(10.6, 19.2)	159.5	1.5(1.1, 1.7)	301.0
8	5	11.6(8.2, 28.7)	129.0	38.4(14.3, 70.4)	15.4	431.0(207.0, 550.5)	86.2	0.2(0.1, 0.4)	23.0	14.3(12.8, 23.3)	129.8	1.1(0.8, 2.6)	218.0
9	10	17.9(10.4, 21.5)	199.2	56.1(29.6, 126.3)	22.4	413.0(225.8, 609.0)	82.6	0.3(0.1, 0.6)	30.5	19.1(12.5, 30.5)	173.5	1.6(1.3, 3.4)	328.0

年龄/岁	人数	钙/mg		碘/μg		磷/mg		锌/mg		铁/mg		镁/mg
年龄/岁	人数	摄入量	RNIs比例/%	摄入量	RNIs比例/%	摄入量	RNIs比例/%	摄入量	RNIs比例/%	摄入量	RNIs比例/%	摄入量	RNIs比例/%
3	17	304.7(193.3, 500.0)	50.8	32.5(19.4, 97.7)	34.3	699.6(485.1, 922.8)	233.2	6.5(4.6, 9.1)	161.8	14.7(9.0, 18.7)	163.0	188.0(142.0, 237.7)	134.3
4	17	202.3(119.1, 290.3)	25.3	25.4(9.2, 80.7)	28.2	573.0(327.9, 766.3)	163.7	5.8(3.4, 7.8)	104.5	12.7(7.0, 14.5)	126.7	169.0(97.0, 232.8)	105.6
5	18	239.5(150.8, 485.7)	29.9	22.1(8.9, 35.7)	24.6	639.6(450.4, 857.5)	182.8	6.2(4.8, 8.6)	113.5	11.2(8.0, 15.1)	111.5	154.0(116.4, 226.5)	96.3
6	18	351.5(201.7, 518.5)	43.9	28.7(9.8, 51.4)	31.8	726.2(559.9, 975.6)	207.5	6.7(5.0, 10.0)	121.5	14.7(7.8, 20.1)	147.2	202.0(120.3, 276.3)	126.3
7	5	427.0(277.3, 585.8)	42.7	21.2(14.4, 38.0)	23.5	843.5(758.1, 1 115.2)	179.5	9.1(6.8, 10.3)	129.6	15.4(11.7, 24.7)	118.1	264.0(222.3, 308.0)	120.0
8	5	452.0(276.5, 832.0)	45.2	20.0(13.1, 46.9)	22.2	797.7(602.3, 1 291.1)	169.7	7.1(5.2, 11.3)	101.4	12.6(10.3, 22.7)	96.9	180.0(168.0, 319.5)	81.8
9	10	388.5(268.0, 590.5)	38.9	32.4(14.8, 614.3)	36.0	1 268.5(827.4, 1 487.4)	269.9	10.9(8.1, 14.1)	155.6	20.1(12.8, 27.0)	154.2	333.5(192.8, 384.5)	151.6
注：RE为视黄醇当量；1 kcal=4.18 kJ。

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表 2 ASD儿童营养素摄入量与推荐摄入量比较的分布(n=90)

Table 2. Distribution of nutrient intake compared with RNI in children with ASD(n=90)

营养素	充足	临界	不足	过量
能量	40(44.4)	17(18.9)	33(36.7)	-
蛋白质	72(80.0)	9(10.0)	9(10.0)	-
脂肪	64(71.1)	13(14.4)	13(14.5)	-
碳水化合物	72(80.0)	8(8.9)	10(11.1)	-
维生素A	31(34.4)	16(17.8)	43(47.8)	0
维生素D	2(2.2)	0	87(96.7)	1(1.1)
维生素E	65(72.2)	11(12.2)	14(15.6)	-
维生素B₁	35(38.9)	15(16.7)	40(44.4)	-
维生素B₂	40(44.4)	18(20.0)	32(35.6)	-
维生素B₆	0	2(2.2)	88(97.8)	0
维生素C	46(51.1)	12(13.3)	32(35.6)	0
叶酸	0	2(2.2)	88(97.8)	0
烟酸	67(74.4)	10(11.1)	13(14.5)	0
钙	8(8.9)	7(7.8)	75(83.3)	0
磷	81(90.0)	5(5.6)	4(4.4)	0
钾	51(56.7)	13(14.4)	26(28.9)	-
钠	30(33.3)	16(17.8)	44(48.9)	-
镁	41(45.6)	11(12.2)	25(27.8)	13(14.4)
铁	57(63.3)	15(16.7)	16(17.8)	2(2.2)
碘	24(26.7)	4(4.4)	60(66.7)	2(2.2)
锌	41(45.6)	11(12.2)	37(41.1)	1(1.1)
硒	54(60.0)	10(11.1)	25(27.8)	1(1.1)
铜	69(76.7)	4(4.4)	1(1.1)	16(17.8)
锰	64(71.1)	13(14.4)	13(14.5)	0
注： “-”在《中国居民膳食营养素参考摄入量(DRIs)》中无此营养素UL值的标准。()内数字为构成比/%。

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表 3 不同体格发育水平ASD儿童营养素摄入构成

Table 3. Comparison of nutrient intake composition of ASD children with different levels of physical development

体格发育水平	人数	能量			脂肪			维生素A
体格发育水平	人数	充足	临界	不足	充足	临界	不足	充足	临界	不足
正常	55	23(41.8)	7(12.7)	25(45.4)	38(67.9)	7(12.5)	11(19.6)	19(33.9)	7(12.5)	30(53.6)
超重	8	3(37.5)	1(12.5)	4(50.0)	3(37.5)	4(50.0)	1(12.5)	1(12.5)	2(25.0)	5(62.5)
肥胖	23	12(52.2)	8(34.8)	3(13.0)	20(87.0)	2(8.7)	1(4.3)	15(65.2)	0	8(34.8)
注：()内数字为构成比/%。

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