Preplanned Studies: Intake of Vitamin A, Thiamine, Riboflavin, Vitamin C, and Niacin Among Children Aged 6−11 Years Old — China, 2016−2017

Vitamins are essential substances for life and were recognized by the World Health Organization (WHO) as malnutrition and undernutrition are always accompanied with vitamin deficiency, which has become a significant child health challenge in many developing countries. Millions of children are more susceptible to disease and death due to vitamin deficiency (1). Previous domestic regional surveys in China had shown that significant proportions of school age populations suffered from nutrition deficiency, including insufficient vitamin intakes (2-3). The results drawn from China National Nutrition and Health Survey (2002) and China Nutrition and Health Surveillance (2010–2013) had revealed that vitamin deficiencies were still severe health problems in the Chinese population, especially in children and adolescents. China Nutrition and Health Surveillance of Children and Lactating Mothers in 2016–2017 was conducted by China CDC in 31 provincial-level administrative divisions (PLADs). Nationally and provincially representativeness of the study population was tested. Multistage stratified random sampling method was used in this survey. Four methods were designed to obtain the survey data, including interviews, physical examinations, laboratory tests, and dietary interviews (4). The study aimed to analyze the nutritional status of the Chinese population, including the conditions of vitamin intakes. The data in this paper were from the China Nutrition and Health Surveillance conducted between 2016 and 2017, which focused on the key vitamin intakes of children aged 6–11 years. This survey found that vitamin deficiencies were still severe in children aged 6–11 years old, and conditions were worse in rural populations. Systematic measures should be applied to solve the nutrition problems in children aged 6–11 years in China.

China Nutrition and Health Surveillance of Children and Lactating Mothers in 2016–2017 was a cross-sectional study conducted in 31 PLADs (4), and data of this paper was collected from the participants in this survey. Four methods were designed to obtain the survey data, including interviews to collect demographic information; physical examinations to observe the indicators of growth; laboratory tests to evaluate health conditions; and dietary interviews to obtain food intake information. The information on vitamins intake was drawn and assessed through 3 consecutive days of 24 hour dietary recalls and household weight records of edible oil, salt, and flavoring. Calculation of vitamins was conducted with reference to China Food Composition Tables (5-6). Study subjects were divided into different groups by sex and regions. The vitamin intakes of subjects were presented as means, standard errors, and 10, 25, 50, 75, 90 quantiles. Intake amounts of vitamin were assessed by the criteria of dietary reference intakes (DRIs), including estimated average criteria (EAR) and recommended nutrient intakes (RNI) (7). According to the assessing results, the subjects were allocated into <EAR, EAR–RNI, and ≥RNI groups. SAS (version 9.4, SAS Institute Inc., Cary, NC, USA) was used to conduct all the analyses. The protocol of this study was evaluated and approved by the ethical committee of China CDC (201614).

A total of 8,777 subjects were included for the calculation, with 4,364 males (2,034 in urban areas and 2,330 in rural areas) and 4,413 females (2,111 in urban areas and 2,302 in rural areas). The average ages of subjects were 9.2 ± 1.6 in total for both genders. The numbers of subjects for urban areas and rural areas were 4,145 and 4,632, respectively.

The intakes of vitamin A, thiamine, riboflavin, vitamin C, and niacin for children aged 6–11 years in China during 2016–2017 were shown in Table 1 and Table 2. The total average intakes of vitamin A, thiamine, riboflavin, vitamin C, and niacin were 336.4 μgRAE/d, 0.7 mg/d, 0.7 mg/d, 51.5 mg/d, and 11.4 mg/d, respectively. The total intakes of the five nutrients in urban areas were higher than that in rural areas, and similar trends were observed in different gender groups. For vitamin A, the average intake for males was 402.0 μgRAE/d, which was lower than the intakes of females (403.6 μgRAE/d) in urban areas, whereas vitamin A intake in rural areas was higher in males (283.1 μgRAE/d) than that in females (270.7 μgRAE/d). The intake characteristics of other four nutrients in both urban areas and rural areas were higher in males than in females.

Table 3 demonstrated the results of assessing the intakes of five nutrients based on EARs and RNIs values. The proportions of intakes that reached the RNIs of vitamin A, thiamine, riboflavin, vitamin C, and niacin were 18.2%, 13.8%, 14.95%, 24.6%, and 51.3%, respectively. The proportions in rural groups were all far below that in urban groups. In gender analyses, the proportions of the fives nutrients intakes reaching RNIs in males were higher than in females, except for the proportions of niacin intakes. The status of nutrient intakes in urban areas was better than that in rural areas, and same trends were observed in gender analyses between the two regions.