評價(jià)飲食習慣是制定營(yíng)養教育干預措施和改善人群營(yíng)養狀況的基礎。選取Friuli, Piemonte, Lazio, Sicilia代表全國不同的社會(huì )經(jīng)濟發(fā)展水平的地區，在35,072名7-11歲的意大利學(xué)齡兒童中開(kāi)展了全國營(yíng)養模式調查。

　　我所參考已開(kāi)展的營(yíng)養調查，設計了應用于學(xué)生的食物頻數表。選擇116項食物進(jìn)入食物頻數表,調查學(xué)生的飲食習慣。其中又抽取部分學(xué)生使用24小時(shí)回顧法和食物稱(chēng)重法評估食物頻數表的可信度。

　　營(yíng)養素攝入量,如能量，脂肪（總脂肪，飽和脂肪酸，多不飽和脂肪酸，單不飽和脂肪酸），碳水化物，蛋白質(zhì)，膽固醇，鈣，鐵，可溶性和非可溶性膳食纖維含量，利用意大利國立營(yíng)養研究所的營(yíng)養數據庫,通過(guò)每項食物的食用量和食用頻率相乘進(jìn)行計算。

　　表1中的營(yíng)養素攝入用均數及標準差表示。結果發(fā)現，意大利學(xué)生平均膳食攝入有以下特點(diǎn)：能量攝入與RDA要求基本一致，達RDA的103%，其中蛋白質(zhì)和脂肪，尤其是動(dòng)物性脂肪的攝入很高。碳水化物、膳食纖維低于推薦量而食糖攝入量相對過(guò)多。鈣攝入水平低而鐵攝入充分。

　　從性別上看：男生能量攝入水平較高而女生蛋白質(zhì)攝入水平較高(女:82.5克/天,男: 76.9克/天)，這種不同主要歸結于動(dòng)物性蛋白質(zhì)的攝入。脂肪酸的攝入女生略高于男生，尤其是飽和脂肪酸，女生膽固醇的攝入量比男生高30%。男女生鈣、鐵和膳食纖維的攝入無(wú)顯著(zhù)性差異。

　　用營(yíng)養素密度進(jìn)行分析時(shí)發(fā)現，Lazio地區有高蛋白質(zhì)、高脂肪、高膽固醇攝入現象。表2說(shuō)明不同地區主要食物種類(lèi)每周的消費頻率，Lazio地區牛奶消費量非常低，奶酪消費只能補償其中小部分，而肉類(lèi)消費量最高,這可以解釋為什么該地區動(dòng)物蛋白消費非常高。魚(yú)類(lèi)攝入量尤其在北方地區低于推薦量,而蔬菜水果的攝入在整個(gè)人群都低于推薦量。意大利通心粉或大米的消費平均每周4.2到5.7次，面包的食用少于每天一次，更經(jīng)常的是甜點(diǎn)和烘制食品的消費。

　　意大利學(xué)生的營(yíng)養習慣不符合膳食指南，而且與發(fā)達國家的成人膳食一致，需要制定戰略提高健康營(yíng)養模式。

(本文發(fā)表在The Journal of International Medical Research 96；24：169) 　

Prof. Marcello Giovannini
mailto:marcello.giovannini@unimi.it

NUTRITIONAL SURVEY IN A SAMPLE OF 35.000 ITALIAN SCHOOLCHILDREN
The Journal of International Medical Research 1996; 24:169 -184
M.GIOVANNINI
Department of Pediatrics, University of Milan, Italy

　　Evaluation of dietary habits is fundamental in order to plan an intervention of nutritional education and to improve nutritional status of a population. A nationwide survey of nutritional patterns was carried out in a large-scale sample (n 35.072 children) of Italian school-age population (7-11 years). Friuli, Piemonte, Lazio and Sicilia regions were selected as representative of the whole nation's socio-economic areas.

　　Nutritional habits were investigated by the food frequency questionnaire FFQ) specific for schoolchildren performed at our Department, consisting of 116 food items selected on the basis of previous nutritional investigations; in sub-samples were used 24-h dietary recall and weighted food diary to assess the validity of the food frequency questionnaire.

　　Nutrient intake, expressed as energy, lipids (total, saturate, polyunsaturate and monounsaturate), carbohydrates, proteins, cholesterol, calcium, iron soluble and non-soluble fiber content, was calculated by multiplying consumption frequency by the quantity of each item consumed, using the nutrient database of the Italian National Institute of Nutrition.

　　In Table 1 nutrient intake data are expressed as means and SD

　　Analysis of our data reveals that the average diet of Italian schoolchildren is marked by energy intake that roughly coincides (103%) with RDA, very high protein and lipid intake (especially from animal origin) and by a carbohydrate and fiber intake lower than recommended with a relative excess of sugars. Calcium intake is relatively low while iron is more adequate.

　　Analyzing the data by sex, caloric intake was found to be higher among boys and protein intake was higher among girls (82.5g/day vs. 76.9 mg/day) with difference largely due to animal protein intake. Fatty acid intake was also slightly higher among girls; especially regarding saturated fatty acids and girls' cholesterol intake was 30% higher than boys'. Calcium, iron and fiber intakes are no significantly different.

　　When expressed as nutrient density a higher protein, lipid and cholesterol intake is found in Lazio. Table 2 shows the weekly consumption frequency of the main food categories in the various regions. In Lazio milk consumption is particularly low, only partially compensated by cheese and there is also the highest meat consumption, which accounts for the exaggerate animal protein intake found in this region. Lower than recommended are intake of fish, especially in the northern regions, of fruit and vegetable in the whole population. Pasta or rice consumption ranges between 4.2 and 5.7 times a week on average and even bread is eaten less than once daily. Of more frequent consumption are sweets and bakery products.

　　Nutritional habits of Italian schoolchildren are not adequate to dietary recommendations and are similar to adult's diet in industrialized countries. There is need to develop strategies to improve healthy nutritional style.