TC.DD & TP6 (2) - 2010 10. Robert B. Taylor, Alan K. David,
Thomas A Johnson, Jr.D. Melessa Philips, Joseph E. Scherger (2004): Roi logn lipid mdu. Y hoc gia dinh cac nguyen ly va thirc hanh, Nha xuat ban y hoc, 1708- 1720.
11. Rafal S. Filip, Lech Panasiuk, Agnieszka Hazatym-Maj, Radoslaw P. Radzki, Marek Bienko, Iwona Puzio (2006).
Serum lipid profile and metabolic syn- drome occurrence among obese rural women from Lublin region (Estern Poland). Ann Agric Environ Med; 13; 77- 80.
12. WHO, Geneva (2000). Obesity. Prevent- ing and managing the global epidemic - technical Report. Series 894.
Summary
OVERWEIGHT/OBESITY AND BLOOD LIPID DISORDERS IN PEOPLE 30-59 YEARS OLD IN HAI DUONG CITY
A cross -sectional study was conducted in 1217 subjects in Hai Duong city to determine the rate of overweight / obesity and blood lipid disorders among overweight/obesity targets ageds 30-59.
The subjects with BMI > 25 voluntarily participated in the study. Their total cholesterol, triglyc- eride, HDL-C, LDL-C were identified to determine the rate of blood lipid disorders in obese peo- ple. The results showed that: The rate of overweight was 27.9%, obesity was 20.6%, obesity grade I was 25.9%, and obesity grade II was 27.9%. Overweight and obesity in females (26.5%) was lower than in males (31.2%). The rate of lipid disorders in obese people was 84% and that in males (87.5%) was higher than in females (56.2%). The rate of high total cholesterol was 71%
(males 73.2%, females 69.8%). The rate of high triglyceride was 40.7% (males 60.7% higher than females 30.2%), low HDL - C was 0.6%, high LDL-C was 2.5%.
K.&yv/orAs: Overweight, obesity, blood lipid disorders.
TtNH TRi^NG DINH DirdjNTG, KHAU PHAN v A MOT SO YEU TO LIEN QUAN CUA HOC SINH 6-14 TUOI TAI
HUYEN S6C SdN, HA NOI
Ho Thu Mai', Pham Vdn Hoan^, Nguyin Hieu Bdc^
Nghien cuu dugc thuc hien thang 9 nam 2007 tren 2100 hpc sinh tai 4 trudng tilu hpc va trung hpc CO sd huyen Soc San, Ha Npi. Muc deu: Danh gia thuc trang dinh duong cua hpc sinh 6 din 14 tuoi va mpt so yeu to lien quan. Phuang phap: Cat ngang md ta c6 phan tich. Kit qua: Khdng c6 sir khac biet ve can nang tmng binh giira hpc sinh nam va hpc sinh nii. Q tudi 11,12 chilu cao nu cao hon nam (p<0,05) nhung din tudi 14 thi nam lai cao han nii (p<0,05). Ty le thilu dinh duong nhe can chung ciia nhdm 6-8 hidi la 14,9%, d nii cao hon nam, nhung chi din 7-8 tudi mdi cd su khac biet cd y nghia (p<0,01). Ty le thilu dinh dudng thip cdi cua nhdm 6-8 tudi la 28%;
' Ths, Bs - Vien Dinh duong '- PGS, TS - Vien Dinh duang
^ KS - Vien Dinh duong
Ty le nay d hoc sinh nij- cao hon hpc sinh nam, 34,2% so vdi 23,1% (p<0,05). Ty le giy com ciia nam cao hon nCv d hiu hit cac lii'a tudi va tang len 31,8% d nhdm 9-14 tudi. Ty le (%) ma ca thi trung binh ciia hpc sinh 9-14 tudi diu thip dudi 20%, cua nam cao hon nu d nhdm 9, 10, H, 12 tudi (p<0,01), nhung sang tudi 13 thi ty le nay ciia hpc sinh nil bit diu tang va cao han hin hpc sinh nam d nhdm 14 tudi (p<0,()l). Nang lugng an vao trung binh 1637,2 Kcal/hpc sinlVngay, mdi dat khoang 74% nhu cau khuyen nghi, dupc xae dinh la ylu id nguy ca bi thilu dinh duong nhe can. Ty le nang lugng P:L:G (%) cdn mit can ddi, la 14,9:7:78,1. Ty le protid ddng vat thip ehilm 17,8 %.
Til' khoa: Hoc sinh tieu hoe, trung hoc co sd, thieu dinh dudng nhe cdn, tJidp eoi, gdy com.
I. DAT VAN DE
Thieu dinh duang Protein nang lugng la loai thieu dinh dudng quan trgng thudng gap nhat d tre em. Liia tudi hge dudng it gap tinh trang thieu dinh dudng narig tni' khi cd nan ddi. Tuy nhien ty le thieu dinh dudng d giai doan nay rat cao, tham chi cdn cao ban giai doan trade dd, dac biet la d viing ndng thdn ngheo cua cac nude dang phat trien. An udng quan trgng ddi vdi tre em tudi hge dudng vi ca the tre dang phat trien manh ddng thai tre hoat ddng rat nhieu do dd nhu cau ye nang lugng va cac chat dinh dudng can dugc thoa man de duy tri su phat trien va tang trad'ng tam vdc.
O Viet nam, cdn rat it nhii'ng nghien ciru ve tinh trang dinh duang va khau phan cua lira tudi hge dudng [4]. Theo sd lieu tdng dieu tra nam 2000 ciia Vien Dinh dudng, ty le thieu dinh dudng cua tre 6-10 tudi toan qudc la 26,69% [1].
Mdt sd nghien cii'u kliac ciing cho thay ty le suy dinh dudng d liia tudi nay la kha cao [5]. Ket qua nghien ciru tai huyen Hoa Lu, Ninh Binh (2006) cho thiy ty le hoc sinh tii' 11-14 tudi dugc phan loai la giy (BMI/tudi <5"') ehilm 46,4% trong dd ty le gay d hge sinli nam cao hon d hoc sinh nu (51,7%o so vdi 40,8%X[2]. Mdt nghien cii'u khac tren hge sinh tieu hoc tai huyen Khoai Chau nam 2004 cho thay ty le suy dinh dudng hoc sinh tir 11-14 tudi la 23,25% [3].
Tre em lua tudi hge dudng chiem ty le khoang 1/3 dan so. Day la lira tudi ma ca the va tam ly tre bat dau chuyen sang mdt
giai doan mdi rat quan trgng cho viec phat trien the chat va tinh than ddi hdi su quan tam dac biet ve dinh dudng. Vi vay, viec cung cap day du cac chat dinh dudng cho tre trong giai doan nay la rat caii thiet.
Trong nhii'ng nam gan day van de tang tra'dng tam vdc ngudi Viet Narn da dugc quan tam [4], nganh y te da phdi hgp vdi nganh giao due trong cac hoat ddng y te hge dudng, giao due sue khde va the chat va thu dugc mot sd ket qua nhat dinh.
Chien luge Qudc gia Dinh duang va chien luge bao ve siic khoe nhan dan (giai doan 2001 - 2010) da chi rd viec cai thien tinh trang dinh dudng va sue khoe cho ddi tugng hge sinh cd y nghia to ldn ddi vdi chat lugng giao due va chat lugng con ngu'di ndi chung. De gdp phan nhin nhan day dii va cd he thdng han ve tinh trang dinh dudng va phat trien the luc ciia tre tudi hge dudng chiing tdi da thuc hien nghien ciiu vdi muc tieu: "Ddnh gid tinh trang dinh duang, khdu phdn vd mot so yen to lien quan cua hoc sinh 6-14 tuoi
tgi huyen Soc San, Hd Noi".
II. DOI TU ONG VA P H U O T V G PHAP NGHIEN c t r u
Doi tugng va dja diem nghien cii-u: Hge sinh til' 6-14 tudi khdng bj mac cac dj tat bam sinli, benh man tinh, tu' nguyen tham gia vao nghien ciiii tai 2 trudng tilu hge (Phil Linh va Due Hda) va 2 tra'dng trang hge ca sd (Tan Minh va Bac Phu), huyen Sdc San_, Ha Ndi.
Thilt ke nghien cii'u: cat ngang md ta cd phan tjeh.
Co mdu vd phuang phdp chpn mdu:
Ddnh gid tinh trgng dinh dudng: Cd mlu
TC.DD & TP6 (2) - 2010
dugc tinh dua vao cdng thiic Z'(l-oc/2)'P(l- P )
n = DE
Trong do: e-
n: So hoc sinh can dieu tra
•^'(l-oc/2) • ^^ -^'^ ' " ^ ^^•^' ^ " ^'^^
vai muc y nghia 95% (a = 5%) p. Ty le SDD ciia hoc sinh 11-14
tuoi khu vuc dong bdng song Hong Id 43,69% (Tong dieu tra dinh dudng ndm 2000)
e:Dd chinh xdc mong muon =0,03 DE:Design effect =2
Thay cac gia trj vao cdng thiic tren, tinh dugc cd man sau khi lam trdn la 2100 hge sinh.
Ddnh gid khdu phdn cua hoc sinh:
cd mau duge tinh theo cdng thiic sau:
t^*G^*N
n e^*N + t^a'^
Trong dd:
n:Cdmdu (so hoc sinh THCS).
t: Phan vi chuan = 1,96 a xdc xuat 0,954).
a: Do lech chuan ve ndng lugng (theo
diiu tra tham do bang phucmg phdp hoi : ghi ^300 Kcal).
e: Sai so cho phep (chon la 100 Kcal).
N:T6ng so hoc sinh dugc ddnh gid TTDD (2100)
Thay cac gia trj vao cdng thii'c treri, chiing tdi tinh dugc sd khau phan can dieu tra ja 34 hge sinh/liia tudi. Vay tdng sd cd mau danh gia khiu phin la: 34 hoc sinh/lua tuSi/x 9 lua tuoi = 306 hoc sinh Phuo'ng phap thu thap so lieu:
Thu thap cac sd do nhan trac: can nang, chieu cao, % md ca the
Dilu tra khiu phin ciia hge sinh: Sir dung phuang phap hdi ghi 24h qua ket hgp can kiem tra
Phan tich xii' ly so lieu:
Sd lieu dugc nhap kep tren may tinh de loai bd sai so thd va kiem tra tinh hgp^ly, phan tich xir ly cac chi tieu nhan trac bang phin mlm SPSS, vdi cac test thdng ke y hge thdng thudng. So lieu khau phan dugc nhap bang phan mem Access va tinh toan miic tieu thu thuc pham, nang lugng va cac chit dinh dudng binh quan tre/ngay dua tren co sd dir lieu la bang thanh phan dinh dudng thirc an Viet Nam 2007.
III. KET QUA NGHIEN GUtJ Bdng 1. Can nang va chilu cao trung binh cua hoc sinh 6-14 tuoi theo tuoi va gioi Tu6i (n)
6 (237) 7 (229) 8(213) 9 (208) 10(215) 11 (266) 12(217) 13(247) 14(268)
Nam 17,8 + 2,1 19,6 + 2,7 21,6 + 2,7 23,3 + 3,1 25,6 + 3,8 27,1 + 3,9
30,4 + 5,0 34,0 ±5,4 38,5 + 6,0
Can nang (kg) Nu- 17,4 + 2,6 19,0+ 3,2 20,6+ 3,1 23,1 +3,9 25,6 + 4,3 27,8 + 4,9 30,4 + 4,5 34,8 + 5,4 38,7 + 5,4
Chung 17,6 + 2,3 19,4 + 3,0 21,1+2,9 23,2 + 3,5 25,6 + 4,1 27,4 + 4,4 30,4 + 4,7 34,4 + 5,4 38,6 + 5,7
Nam 111,4 + 4,1 116,7 + 4,3 121,7 + 6,1 126,0 + 5,4 130,6 + 6,1 133,8 + 5,4 139,0 + 6,4 145,4 + 7,6 151,4 + 7,8**
Chieu cao (cm) Nir 110,4 + 4,5 115,5 + 5,9 121,2 + 5,6 126,1+6,0 132,0 + 6,2 135,8 + 6,3*
141,0 + 6,0*
146,1+6,3 149,3 + 5,3
Chung 111,0 + 4,4 116,2 + 5,1 121,5 + 5,9 126,1+5,7 131,3 + 6,2 134,8 + 5,9 140 + 6,2 145,7 + 6,9 150,4 + 6,7 p<0,05 (t-test) * khac biet giini Nie & Nam, * * khac biet giua Nam &Nu.
Can nang trang binh cua hge sinh nam d lua tudi 6-11 cao han hge sinh nii nhung sang lua tudi 12 -14 thi can nang trang binh cua hge sinh nii' cao hon hge sinh nam, nhung diu khdng cd y nghia (p>0,05). Cd su chenh lech ve can nang trang binh ciia hge sinh nam giii'a
cac lua tuoi 9-10; 11-12; 12-13 va 13-14 lin lugt la 2,3 kg; 3,3 kg; 3,6 kg va 4,4 kg. Cdn d hge sinh nii' thi su chenh lech vl can nang trung binh (tren 2 kg) xuit hien d cac lua tudi 8-9; 9-10; 10-11; 11-12; 12-13 va 13-14 la 2,7 kg; 2,5 kg; 2,2 kg; 2,7kg; 4,4kg va 3,8 kg.
Hge sinh nil' cao ban hge sinh nam cd y nghia thdng ke (p<0,05) d lua tudi 11, 12 nhung sang tudi 14 thi hge sinh nam cao ban hoc sinh nir (151,4 cm va 149,3 cm) vdi p<0,05.
Bang 2. Ty le (%) mo off the trung binh ciia hoc sinh 6-14 tu6i theo tu6i va gio^i
Ty le (%o) md ca tbi ciia hge sinh nam cao ban hge sinh nii d cac Ilia tudi 9 din 12 (p<0,01) nhung sang tudi 13 thi phan tram ma ca the d hge sinh nii' bat dau tang va den 14 tudi thi cao ban hge sinh nam (19,7% so vdi
18,8%) vdi p<0,01.
Tu6i 9 10 11 12 13 14
n 208 215 266 217 247 268
Nam 21,4 + 6,5 20,4 + 5,4 20,0 + 5,1 19,7 + 4,8 18,5 + 4,1 18,0 + 3,0
Nir 13,5 + 5,7 13,3+4,8 14,3 + 5,5 14,9 + 5,0 17,8 + 4,7 19,7 + 3,9
Chung 17,5 + 7,3 17,1+6,2 17,3+6,0 17,3 + 5,4 18,2 + 4,4 18,8 + 3,5
p (t-test)
<0,01
<0,01
<0,01
<0,01
>0,1
<0,01
30
20
10 H
9,8 7.1
BNam PNCr ^Chung
22,6
18,6 f=7\ 20,1 20,2
10,6
rrw-• • • •
^ • • •
!>•••••
• • • •
6 tuoi 7 tuoi 8 tuoi Cliung
Hinh 1. Ty le thieu dinh du'ong nhe can (%)ciia hoc sinh 6-8 tuoi theo tuoi va gioi
Hinh 1 cho thay, ty le thieu dinh dudng nhe can ciia hge sinh nii cao ban nam, nhung chi den 7-8 tudi mdi cd su khac biet (p<0,01). Ty le thieu dinh dudng nhe can chung d tudi 6-8 la 14,9%.
50
40
30
20 -
10
QNam QNiJ ^^Chung 40,5
34,3
34,2
6 tuoi Ttuoi 8 tuoi Cliung
Hinh 2. Ty le thieu dinh du'&ng thap coi (%) ciia hoc sinh 6-8 tuoi theo tuoi va gioi
TC.DD & TP6 (2) - 2010
Ty le thilu dinh duang thip cdi ciia hge sinh 6-8 tudi tai 2 trudng Phii Linh va Diic Hda (Hinh 2) la 28%). Ty le thap cdi d hge sinh nii cao han hge sinh nam (34,2%) so vdi 23,1%) mdt each cd y nghia (p<0,05). Hge sinh nii' 7 tudi cd ty le thieu dinh duang thap cdi cao nhit (40,5%).
Bang 3. Tinh trang dinh duo'ng theo BMI percentile it hoc sinh 9-14 tuoi theo tuoi va gioi Tuoi
9
10 11 12 13 14 Chung
n
101 104 132 107 119 134 696
<5th
30,6 39,8 29,5 40,0 30,3 24,8 31,4
Nam Binh thu'O'ng
68,5 57,5 69,2 59,1 68,9 75,2 67,6
>85th
0,9 2,7 1,4 0,9 0,8
1,0 n
107 111 134 110 128 134 725
<5th
29,8 38,8 36,9 36,2 29,0 23,3 32,2
Nir Binh thu'ong
68,4 60,3 61,6 62,1 70,2 23,3 66,6
2 85th
1,8 0,9 1,5 1,7 0,8 23,3
1,2 n
208 215 266 217 247 268 1421
Chung
<5th
30,2 39,3 33,1 38,1 29,7 24,1 31,8
Binh thu'O'ng
68,5 59,0 65,5 60,6 69,6 75,5 67,1
>85th
1,4 1,8 1,4 1,3 0,8 0,4 1,1
Ket qua bang 3 cho thay, ty le hge sinh 9 den 14 tudi bj gay cdm (percentile BMI<5"') chiem tdi 31,8%o. Ty le gay cdm cua hge sinh nam cao han hge sinh nir d hau het mgi lua tudi. Rieng lua tudi 11 ty le gay cdm d nir lai cao ban nam (36,9% so vdi 29,5%o).
Bang 4. Miic tieu thu LTTP va gia trj dinh du'&ng ciia khau phin
Thuc pham
Gao
Luang thuc khac Khoai Cli Dau do Dau phu
Vi!mg lac/hat co dau Rau than, hoa, la Rau oil, qua, hat Qua chin Chi so
Nang Huong (Kcal) Protid tong so (g) Protid dv/ Pts (%) Lipid tong so (g) Lipid dv / Lts (%) Ty le P:L:G (%)
Trong lu'O'ng (g/ngu6i/ngay)
332,6 29,3
3,6 1,8 43,0
4,5 85,7 17,5 108,5 Gia trj
1637,2 56,2 17,8 26,4 89,2 14,9 : 7,0 : 78,1
SD 122,2
43,2 18,2 11,9 81,2 11,2 69,2 39,9 137,4
SD 530,7
23,1 16,4 16,2 10,2
Thuc pham
Dau/mo Thit Ca
Hai san khac Triing Sua (ml) Nuae cham Duong/ banh keo Chi so
Canxi (mg) TyleCa/P Sat (mg) Vitamin A (meg) Caroten (mg) Vitamin C (mg) Vitamin Bl (mg)
Trong lu'O'ng (g/nguoi/ngay)
4,7 53,9
19,7 2,5 19,7 13,9 4,4 3,2 Gia tri
315,9 0,45
10,3 645,7 2,6 56,6
0,8
SD 8,2 76,8 48,6 9,3 35,2 48,8 6,3 10,0
SD 160,4
4,3 929,5
3,1 53,4
0,3
27
Gao la luang thuc chinh dugc tieu thu hang ngay vdi miic binh quan la 332,6 g/ngudi/ngay. Luang thuc khac dugc tieu thu vdi muc 29,3 g/ngudi/ngay. Khoai cu dugc hge sinh tieu thu vdi sd lugng rit it (3,6 g/ngudi/ngay). Dau dd va dau phu dugc tieu thu vdi muc binh quan lan lugt la 1,8 g/ngudi/ngay va 43 g/ngudi/ngay.
Mirc tieu thu viing, lac va hat cd dau mdi ehl dat trang binh 4,5 g/ngudi/ngay. Rau va qua chin la ngudn cung cap Vitamin, mudi klioang va chat xo trong kltau phan hang ngay nhung dugc tieu thu d mii'c thap (103,2 g/ngudi/ngay va 108,5 g/ngudi/ngay). Tieu thu dau/md ngudn cung cap nang lugng quan trgng cua hge sinh mdi dat trang binh 4,7 g/ngudi/ngay.
Thjt la ngudn thirc an ddng vat chu yeu tieu thu vdi muc trang binh la 53,9 g/ngudi/ngay. Muc tieu thu tning trang binh la 19,7 g/ngudi/ngay va siia la 13,9 g/ngudi/ngay.
Nang lugng binh quan trong khau phan cua hge sinh la 1637,2 kcal/ngudi/ngay.
Lugng Protid khau phan trung binh dat mu'c 56,2 g/ngudi/ngay. Ty le Protit ddng vat rat thap, chi chiem 17,8%) protid tdng sd. Lipid cua khau phan dat 26,4 g/ngudi/ngay, ty le lipid ddng vat tren lipit tdng sd lai qua cao, la 89,2%). Ty le cac chat sinh nhiet P:L:G la
14,9:7,0:78,1. Lugng vitamin A khiu phan la 645,7 meg/ngudi/ngay va Caroten 2,6 mg/ngudi/ngay. Tieu thu vi- tamin Bl la 0,8 mg/ngudi/ngay va ty le Vitamin B1/1000 kcal la 0,49. Vitamin C trang binh khau phan dat 56,6 mg/ngudi/ngay chii yeu do rau qua tu'oi cung cap. Lugng sat trong khau phan cdn thap, 10,3 mg/ngudi/ngay. Ty sd Ca/P chi dat 0,45.
Bdng 5. Lien quan giua nang lu'O'ng an vao voi thilu dinh du'O'ng nhe can Tinh trang Nang lu'ong NL dat Cong dinh du'ong <75% NCKN NCKN
Nhe can ., Binh thuang Cong
:'JS
• ! «
42 120 118 186 160 306 Ket qua phan tich (bang 5) cho thay nhii'ng hge sinh cd mirc nang lugng binh quan dau ngudi thap dudi 75%) nhu cau khuyen nghj thi cd nguy ca bj thieu dinh dudng the nhe can cao gap 3,22 lan (OR=3,22 vdi CI 95% (2,44-4,25) so vdi nhii'ng hge sinh cd muc nang lugng binh quan dat nhu cau khuyen nghi. Tuy nhien, chua tim thay lien quan giQ'a tinh trang thieu sat, thieu Vitamin C va ty le Ca/P thap vdi tinh trang dinh duo'ng.
IV. BAN LUAN
Muc can nang va chieu cao trang binh cua hge sinh tudi tir 11-14 cua nghien ciai nay thap ban so vdi ket qua nghien cina tai huyen Binh Luc, tinh Ha Nam nam 2005 cua Le Nguyen Bao Khanh [5] va ciing thap ban so vdi ket qua nghien ciru cua chinh tac gia tai huyen Hoa Lu, tinh Ninh Binh nam 2006 (32,4 kg so vdi 33 kg; 142,7 cm so vdi 144,1 cm) [2]. Sd dl cd su khac biet ve phat trien the luc nay cd Ie la do Sdc San la mdt huyen ngoai thanh ngheo, dieu kien kinh te xa hdi thap. Chinh yeu td nay da ed anh hudng tru'c tiep len su phat triln cua tre dae biet la tudi hge dudng vi day la Ilia tudi phat trien nhanh ca vl thi luc va tri luc.
Ket qua nghien cuit cho thay, ty le hge sinh 6-8 tudi d Sdc San bj suy dinh duang nhe can (14,9%)) thap ban so vdi kit qua nghien cuu cua Lai Diic Tradng tai huyen
TC.DD & TP6 (2) - 2010
BChoai Chau, tinh Hung Yen (23,3%) [3]
va ciing thap han ket qua nghien ciru ciia Le Thj Huang tai mdt sd tradng tieu hge cua Ha Ndi (41,4%)) [6]. Khi so sanh vdi ket qua tdng dilu tra Dinh dudng nam 2000 thi ket qua nghien ciru ve suy dinh du'dng thap cdi cua hge sinh tai dja ban nghien cii'u (28%) thip ban so vdi viing ddng bing Sdng Hdng (30,4%)) va cao han so vdi toan qudc (26,7%)) [1]. Tuy nhien, ty le hge sinh 9-14 tudi cd BMI thap (<5"') tai Sdc San lai kha cao (31,8%).
Muc tieu thu luang thuc, thuc pham cua hge sinh d Sdc Son ndi chung deu thip hon so vdi hge sinh tai huyen Hoa Lu, Ninh Binh [2]. Mirc tieu thu rau, cu cua hge sinh huyen Sdc Son chi bang 2/3 muc tieu thu ciia hge sinh Hoa Lu va qua chin bang 1/2 (108,5 gam/ngudi/ngay so vdi 204,8 gam/ngudi/ngay), dac biet miic tieu thu ca cua hge sinh tai Sdc San thap han nhieu so vdi hge sinh Hoa Lu (19,7 gam / ngudi / ngay va 76,3 gam/ngudi/
ngay). Tieu thu sQ'a trung binh d hge sinh Sdc Son la 13,9 ml/ngudi/ngay thap ban nhieu so vdi muc tieu thu siia trang binh cua hge sinh tai Hoa Lu (102,8 ml/ngudi/ngay). Triing la ngudn thuc pham cd gia trj dinh dudng cao nhung d Sdc Son mirc tieu thu trirng trang binh chi dat 19,7 gam/ngudi/ngay so vdi 46,2 gam/ngudi/ngay d Hoa Lu. Nang lugng khau phan cua hge sinh chu yeu van do gao cung cap (chiem 78%)), trong khi do sd lieu tai Hoa Lu, Ninh Binh ehilm 74%.
Cd the ndi, khau phan cua hge sinh 6- 14 tudi tai huyen Sdc San, Ha Ndi thilu ve sd lugng va kem ve chat lugng. Vit- amin A khau phan cua hge sinh 6-14 tudi tai huyen Sdc Son da dap iing dugc nhu
ciu khuyin nghj. Vitamin C trang binh khiu phin dat 56,6 mg/ngudi/ngay chii ylu do rau, qua tuai cung cap. Neu ap dung he sd mit mat trong qua trinh che biln va bao quan la 50%) thi vitamin C khau phan mdi chi dap irng dugc 56,6%) nhu can khuyen nghj. Khau phan cua hge sinh d Sdc San la khau phan cd gia trj sinh hge trung binh. Vi vay, vdi lugng sat tieu thu 10,3 mg/ngudi/ngay la thieu nghiem trgng so vdi nhu cau khuyen nghj.
Miic nang lugng binh quan khau phan mdi chi dat 74,4%) so vdi nhu cau khuyen nghj [8]. Protid va Lipid khau phan deu chua dap li'ng dugc nhu cau khuyen nghj cho ngu'di Viet Nam 2007 d liia tudi nay.
Ty le Protid dgng vat rat thap chi chiem 17,8%o Protid tdng sd. Ty le nay tuong duang vdi ket qua tdng dieu tra nam 2000 (18%)). Lipid cua khau phan dat 26,4 g/ngudi/ngay. Ty le Lipid dgng vat tren Lipit tdng sd lai qua cao, la 89,2%. Ty le cac chit sinh nhiet P:L:G la 14,9 : 7,0 : 78,1, trong dd nang lugng tir Lipid chi chiem 7%. Ty le nay qua thap so vdi nhu ciu khuyin nghj la 18-25% [8]. Cd thi nhan thay ca cau nang lugng khau phan hge sinh tai Sdc San mat can ddi ban so vdi Hoa Lu, la 13,4:12,6:74,0. Nang lugng khau phan cua hge sinh Sdc Son thap da dugc xae djnh la yeu td nguy ca dan den thieu dinh dudng the nhe can.
V. KET LUAN
Ket qua dieu tra tren 2100 hge sinh tai 4 tradng tieu hge va trang hge ca sd tai Sdc San Ha Ngi cho thay: . : .it I. Tinh trang dinh dwffng:
Khdng cd su khac biet cd y nghia thdng ke ve can nang trang binh ciia hge sinh nam va hge sinh nir. Chieu cao nii' d tudi II, 12 cao ban nam (p<0,05) nhung din tudi 14 thi nam lai cao ban nii (p<0,05).
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Ty le thieu dinh dudrng nhe can d nhdm 6- 8 tudi la 14,9%o, d nii' cao ban nam, nhu'ng chi den 7-8 tudi mdi cd su khac biet cd y nghia (p<0,01); Ty le thieu dinh dudng thap cdi cua hge sinh 6-8 tudi la 28%; Ty le nay d hge sinh nQ' cao ban hge sinh nam, 34,2% so vdi 23,1% (p<0,05); Ty le gay cdm tang len tdi 31,8% d nhdm 9-14 tudi va d hau bet cac lira tudi ty le nay ciia hge sinh nam deu cao ban cua nii.
Ty le (%)) md ca the trang binh cua hge sinh 9-14 tudi tai huyen Sdc San deu thap dudi 20%); Ty le nay cua nam cao ban nir d cac nhdm 9-12 tudi (p<0,01) nhung sang tudi 13 thi phan tram ma ca the cua hge sinh nii: bat dau tang va den 14 tudi thi cao ban han hge sinh nam (p<0,01).
2. Khau phan vd moi lien quan:
- Nang lugng trung binh 1637,2 kcal/ngudi/ngay, mdi dat l'^,A% nhu cau khuyen nghj. Ty le Protid ddng vat thap chiem 17,8 % protid tdng sd; Ty le P:L:G la 14,9:7,0:78,1.
- Nang lugng phau phan thap la yeu td nguy CO ddi vdi thieu dinh dudng nhe can.
TAI LIEU THAM KHAO
1. Vien Dinh Dudng (2001), Tdng dieu tra dinh duang 2000, Nha xuat ban Y hge. Ha Ngi: 105-106.
2. Hd Thu Mai, Pham Van Hoan (2007), Tinh trang dinh dudng, thilu mau va khau phin an cua hge sinh 11-14 tudi tai Hoa Lu, Ninh Binh, Tap chi y hge thuc hanh (569-570) sd 2 4/2007: 30-33.
3. Lai Dire Trudng (2004), tinh trang dinh dudng va mdt so ylu td nguy co dinh dudng d hge sinh khoai chau nam 2004
4. Ha Huy Khdi(2006), khuynh hudng gia tang ve tang trudng va y nghia siic khde cdng ddng. Tap chi dinh dudng va thuc pham. Volume 2 No. 1: 1-10.
5. Le Nguyen Bao Khanh va cdng su (2006), Tinh trang dinh duong cua hge sinh 11-14 tudi tai 6 tradng trung hge ca sd, huyen Binh Luc, Ha Nam 2005. Tap chi Dinh dudng va Thuc phim: 14-20.
6. Le Thj Huang (2000), Tinh trang dinh duang va mot sd yeu td lien quan ciia hge sinh 2 tradng tieu hoc ngi, ngoai thanh Ha Ngi, Mot so cong trinh nghien ciru ve dinh duang va ve sinh thuc pham, Nha xuat ban Y hge. Ha Ngi: 68-76.
7. Bg Y tl (2007), Nhu ciu dinh dudng khuyen nghj cho ngudi Viet Nam, Nha xuat ban Y hoc. Ha Ndi.
Summary
NUTRITIONAL STATUS, FOOD INTAKE AND RELATED FACTORS AMONG SCHOOL CHILDREN 6-14 YEARS OLD IN SOG SON DISTRICT, HANOI
The study was conducted on September 2007 in 2100 school children in 4 primary schools and middle-schools in Soc Son district, Hanoi. Objetive to assess nutritional status of school children 6-14 years old and related factors. Method: cross - sectional study. Results: There was no difference between female and male mean weight. At the age of 11 and 12, females are taller than males (p<0.05) but at the age of 14, males are taller than females (p<0.05). Underweight rate in the age of 6 to 8 years old was 28%, higher in female group but only significantly different at the age group of 7 to 8 years old (p<0.01). Stunting rate in children 6-8 years old was 14.9%; higher in fe-
TC.DD iSc TP6 (2) - 2010 males than in males (28.3% vs. 8.3% (p<0.05). Wasting rate (BMI <5thpercentile ) in males was higher than in females in all age groups, ranging from 28% in 6- 8 years old to 31.8% in 9-14 years old. The propordon of body fat in children 9-14 years old was under 20%, higher in males aged 9, 10, 11, 12 (p<0.01). However, this proportion in females aged 13 started to increase and was much higher than in males at the age of 14 (p<0.01). Average energy intake of the children was 1637.2 kcal/person/day, achieving 74% recommended requirement and thus being considered the risk factor for underweight. Animal protein took only 17.8 % of the total protein intake. Fat in- take was only 26.4g/person/day. The energy proportion of P: L: G was 14.9: 7: 78.1.
Keywords: school children, underweight, stunting, wasting
THirC TRANG VA MOT SO YEU TO LIEN QUAN
T6J[ T I N HTRANG DINH DU0Nqt TRE|,EM TAI TRTJNG TAM BAO TRO XA HOI d 15 TINH PHIA BAC 2006
Trinh Nggc Thdnit', Pham Vdn Hoan\ Hd Bd Do^
De tai dugc thuc hien tai cac Tmng tam Bao trg Xa hpi 15 tinh thanh phd phia Bac nham muc tieu budc diu mo ta thuc trang dinh duong tre em va mpt sd yeu td nguy ca. Phuong phap: Danh gia tinh trang dinh duong bang cac chi tieu nhan trac d tre em va phdng van cac cd nudi day tre va nhan vien nha bep. Ket qua cho thay: O tat ca cac nhdm tudi deu gap cac the thieu dinh dudng. Tudi ciia tre cang tang thi ty le thieu dinh dudng cang cao. Tat ca cac nhdm tudi deu gap tre thieu dinh duang do 1 va 2. Da xae dinh dugc moi lien quan giiia trinh do hpc van cua cac cd nudi day tre vdi tinh trang thieu dinh duo'ng nhe can (p<0,05) va thap chieu cao (p<0,01). Khau phan an hang ngay cua tre tai cac Tmng tam cdn thieu ve sd lugng va mat can ddi ve chat lugng cd the do dinh mirc kinh phi thap. Thuc hanh VSATTP nhat la thuc hanh ban tay sach d cac cd nudi tre va nhan vien nha bep con nhieu bat cap. Tuy nhien chua tim thay moi lien quan cd y nghTa giiia khau phan an va thuc hanh ve sinh voi tinh trang thieu dinh duong.
Tii' khoa: Tre em co hodn eanh dae biet, chi tieu nhdn trdc, thieu dinh dudng.
I. DAT VAN DE VA MUC TIEU NGHIEN GlTU
Thieu dinh dudng (TDD) la mdt benh do ca the thieu Protein - nang lugng va cac vi chat dinh duang. Benh hay gap d tre em dudi 5 tudi vdi cac mii'c do kb^c nhau, nhung it nhieu deu cd anh hudng trudc mat va lau dai den phat triln cua ca the ddng thdi anh hudng ldn din su phat
trien kinh te xa hdi. Ty le thieu dinh dudng nhe can d tre em dual 5 tudi Chau A: 25%,; Chau Phi: 24%; Chau My La Tinh: 25% (2005). Thang 12/2000 Lien hgp qudc da thdng qua muc tieu Thien nien ky, trong dd cd muc tieu giam 1/3 ty le suy dinh dudng (SDD) tre em vao nam 2015 so vdi nam 1990. SDD phu thudc vao nhieu yeu td: an udng, cham sdc.
' Ths - Vien Chien luge va ehinh sach y t8
^ PGS, TS - Vien Dinh duang 3 PGS, TS - Hoe vien Quan Y
