目的 应用中国哺乳期膳食平衡指数(DBI-L)评估5个城市、不同泌乳阶段乳母的膳食质量及分布特征。方法 本研究在天津、兰州、成都、广州、长春五个城市,招募1531名产褥期健康乳母入组,使用自设问卷和 1d 24h 膳食回顾法收集基本信息和膳食情况,修订并利用 DBI-L 计算各食物组的评分并进行评价。结果 入组乳母的膳食摄入存在过量和不足的问题,摄入不足的问题更显著,大部分乳母存在膳食失衡的问题。产褥期妇女的谷类、畜禽肉、鸡蛋类食品摄入不足和过量同时存在,而水果、蔬菜、奶类、大豆、坚果与鱼虾的摄入明显不足,近一半的乳母盐摄入超标。乳母在不同泌乳期膳食质量差异具有显著性（P<0.01）,成熟泌乳期的膳食摄入过量问题更为明显,初乳泌乳期的膳食摄入不足的问题更为突出,膳食失衡问题更明显。乳母在不同城市的膳食质量差异具有显著性（P<0.01）, 兰州的谷类摄入显著高于其他城市,蔬菜、蛋类、大豆与坚果类摄入普遍低于其他城市。广州的蔬菜、鱼虾及畜禽肉的摄入显著高于其他城市。兰州市的摄入过量及摄入不足问题同时存在,膳食摄入不足更为突出,失衡问题较其它四个城市更为明显。结论 我国产褥期乳母膳食存在失衡问题,表现为摄入过量和摄入不足并存。应该加强对产褥期乳母,尤其是初乳泌乳期和经济欠发达地区乳母的营养宣教和膳食干预。

Objective This study applied the Chinese Dietary Balance Index for Lactation (DBI-L) to assess the dietary quality and distribution characteristics of lactating mothers at different stages of lactation in five cities. Methods A total of 1531 healthy lactating mothers during puerperium were recruited from five cities, namely Tianjin, Lanzhou, Chengdu, Guangzhou, and Changchun. Basic information and dietary status were collected using a self-administered questionnaire and 1d 24h dietary recall method, and scores for each food group were calculated and evaluated using DBI-L. Results The dietary intakes of puerperal lactating mothers were characterized as excessive and insufficient, and the problem of insufficient intake was more significant, and most of the lactating mothers had dietary imbalances. Insufficient and excessive intakes of cereals, livestock and poultry meat, and chicken egg existed simultaneously, while the intakes of fruits, vegetables, milk, soy, nuts, fish, and shrimp were significantly insufficient. Nearly half of the lactating mothers had excessive salt intake. The difference in dietary quality among lactating mothers in different lactation periods was significant (P<0.01), and the problem of excessive dietary intake was more obvious in mature lactation, while the problem of insufficient dietary intake was more prominent in colostrum lactation. The problem of dietary imbalance was more obvious. The dietary quality of lactating mothers in different cities differed significantly (P<0.01), with cereal intake in Lanzhou significantly higher than in other cities and vegetables, egg, soybean and nut intakes generally lower than in other cities. The intakes of vegetables, fish and shrimp, livestock and poultry meat in Guangzhou were significantly higher than in other cities. The problem of over-intake and under-intake existed simultaneously in Lanzhou, where dietary under-intake was more prominent and the imbalance problem was more pronounced compared to the other four cities. Conclusion There was an imbalance in the dietary intakes of puerperal lactating mothers in China, as manifested by both excessive and insufficient intakes. Nutritional education and dietary intervention should be strengthened for puerperal lactating mothers, especially during the first lactation and in economically less developed areas.