1989-2018年中国九省不同职业类型人群能量及宏量营养素摄入变化趋势OA

[Background]With China's socio-economic development,the dietary structure of Chinese resi-dents has gradually shifted from a traditional Eastern pattern characterized by high carbohydrate intake to a relatively high-fat Western dietary model,alongside a growing burden of chronic dis-eases.However,dietary changes may vary across different occupational groups. [Objective]To analyze the long-term trends in dietary energy and three major macronutrient intake among various occupational groups aged 18-59 years in nine provinces of China from 1989 to 2018,providing a scientific basis for developing occupation-specific dietary intervention strategies. [Methods]Based on 11 waves of data(1989-2018)from the China Health and Nutrition Survey(CHNS),57458 employed individuals aged 18-59 years were selected as observation subjects after applying inclusion and exclusion criteria.Joinpoint regression was used to analyze temporal trends by calculating the annual percentage change(APC)and average annual percentage change(AAPC)with 95％confidence intervals.The analysis covered the energy supply ratio from the three major macronutrients and the proportion of the partici-pants within the acceptable macronutrient distribution ranges(AMDR)for the total occupational population and specific occupational group. [Results]From 1989 to 2018,the dietary structure of the occupational population in the nine provinces gradually Westernized.The car-bohydrate energy supply ratio showed a decreasing trend(AAPC=-0.77％,95％CI:-1.00％,-0.55％,P<0.05),while the fat energy supply ratio increased(AAPC=1.42％,95％CI:1.07％,1.77％,P<0.05).The protein energy supply ratio remained largely unchanged(AAPC=-0.19％,95％CI:-0.08％,0.46％,P>0.05),and the total energy intake declined(AAPC=-0.62％,95％CI:-0.94％,-0.30％,P<0.05).Among the occupational groups studied,white-collar workers were the first to show characteristics of dietary Westernization.Using the AMDR as the criterion,their average fat energy supply ratio first exceeded the AMDR upper limit(30％)in 1993,and their average carbo-hydrate energy supply ratio first fell below the AMDR lower limit(50％)in 2006,both time points being earlier than other occupational groups.Agricultural workers lagged in this transition(their average fat energy supply ratio first reached≥30％in 2011),but their rate of increase in the fat energy supply ratio was the fastest among all occupational groups(AAPC=1.59％,95％CI:0.90％,2.30％,P<0.05;P for trend comparison between groups<0.05).The other three occupational groups(blue-collar workers,service workers,and others)generally fell between these two extremes.Taking the fat energy supply ratio as an example,their AAPCs of increase were 1.02％(95％CI:0.73％,1.32％,P<0.05)for blue-collar workers,0.85％(95％CI:0.61％,1.09％,P<0.05)for service workers,and 0.88％(95％CI:0.58％,1.17％,P<0.05)for others. [Conclusion]From 1989 to 2018,the macronutrient structure of the occupational population aged 18-59 years in nine China provinces is gradually Westernized.The energy supply ratios of carbohydrates and proteins primarily face issues of potential inadequacy,while the fat energy supply ratio is excessively high.Furthermore,the patterns of change vary among different occupational groups.It is recom-mended to propose personalized dietary advice tailored to specific occupations.