吴玉婉, 刘彦鹏, 向蔓, 戎芬, 张熙. 学龄前儿童饮食行为特征与超重肥胖的关联[J]. 环境与职业医学, 2022, 39(6): 672-678. DOI: 10.11836/JEOM21593
引用本文: 吴玉婉, 刘彦鹏, 向蔓, 戎芬, 张熙. 学龄前儿童饮食行为特征与超重肥胖的关联[J]. 环境与职业医学, 2022, 39(6): 672-678. DOI: 10.11836/JEOM21593
WU Yuwan, LIU Yanpeng, XIANG Man, RONG Fen, ZHANG Xi. Association between dietary behaviors and overweight or obesity in preschool children[J]. Journal of Environmental and Occupational Medicine, 2022, 39(6): 672-678. DOI: 10.11836/JEOM21593
Citation: WU Yuwan, LIU Yanpeng, XIANG Man, RONG Fen, ZHANG Xi. Association between dietary behaviors and overweight or obesity in preschool children[J]. Journal of Environmental and Occupational Medicine, 2022, 39(6): 672-678. DOI: 10.11836/JEOM21593

学龄前儿童饮食行为特征与超重肥胖的关联

Association between dietary behaviors and overweight or obesity in preschool children

  • 摘要: 背景 儿童超重/肥胖是全球健康问题。学龄前期是儿童生长发育和饮食行为塑造的重要阶段,因此探究饮食行为特征与儿童超重/肥胖至关重要。

    目的 探索上海市学龄前儿童饮食行为特征与超重/肥胖的关联性,以及儿童饮食行为特征与其父母一致性。

    方法 通过方便抽样,在2015年选取上海市5所幼儿园在园的3~6岁儿童作为调查对象,测量身高、体重,并通过问卷获取儿童和父母的饮食行为特征等。根据世界卫生组织推荐的身高标准体重法,依据公式:肥胖度=(实测体重−实测身高对应的标准体重)/实测身高对应的标准体重×100%计算肥胖度,肥胖度超过20%判定为肥胖,肥胖度在10%~20%为超重,肥胖度在−10%~<10%为正常。采用卡方检验和t检验比较超重/肥胖组和正常体重组儿童的一般情况和饮食行为特征的差异,采用多因素logistic回归模型分析饮食行为特征与超重/肥胖的关联性。检验儿童饮食行为特征与父母饮食行为特征的一致性。

    结果 897名学龄前儿童中,超重/肥胖217人(24.2%),正常体重680人(75.8%)。超重/肥胖组儿童的出生体重(3439±472)g vs. (3361±418)g和家庭月收入不超过1万元的占比(17.1% vs. 10.7%)高于正常体重组的儿童(P<0.05),两组在性别、年龄、胎龄、添加辅食时间、每天园外户外活动时间以及父母体重指数方面差异无统计学意义。多因素logistic回归分析在校正性别、年龄、家庭收入、每天园外户外活动时间、父母超重/肥胖后,发现经常吃膨化食品(OR=2.46,95%CI:1.20~4.95)、西式快餐(OR=3.52,95%CI:1.41~8.79),经常喝碳酸饮料(OR=2.92,95%CI:1.37~6.13),经常每顿吃得很饱(OR=1.51,95%CI:1.09~2.08),食欲好(OR=2.60,95%CI:1.87~3.62),就餐时间规律(OR=1.48,95%CI:1.07~2.03),进餐速度快(OR=3.37,95%CI:2.10~5.42)与儿童超重/肥胖呈正相关关系(P<0.05)。除了儿童偏食/挑食与父亲不一致外,在其他饮食习惯方面与父母均具有一致性(P<0.05)。

    结论 学龄前儿童的饮食行为特征与超重/肥胖具有关联性,儿童的饮食行为特征受到父母的影响。早期发现问题并改善饮食行为可能对预防和控制儿童肥胖具有重要意义。

     

    Abstract: Background Overweight/obesity in children are a global health issue. Preschool age is an important stage of children's growth and development and dietary behaviors, so it is crucial to explore dietary behavior characteristics and childhood overweight/obesity.

    Objective To explore the association between dietary behavior characteristics and overweight/obesity in preschool children in Shanghai, and the consistency of children's eating behavior characteristics with their parents'.

    Methods The children aged 3 to 6 years in 5 kindergartens in Shanghai in 2015 were selected by convenience sampling and surveyed. Their height and weight were measured. Children's and parents' dietary behavior characteristics were self-reported by their parents. According to the weight-for-height recommended by the World Health Organization, excess weight was calculated by the following formula: excess-weight%=(measured weight - standard weight)/standard weight×100%; obese is determined at excess-weight% > 20%, overweight: excess-weight% at 10%-20%, normal weight: excess-weight% at −10%-<10%. Chi-squared test and t test were used to compare the differences of demographic and dietary behavior characteristics between overweight/obese and normal weight children. Multiple logistic regression models were used to evaluate the association between dietary behaviors and overweight/obesity. The consistency of dietary behavior characteristics was tested between children and their parents.

    Results Among the 897 preschool children, 217 (24.2%) were overweight/obese and 680 (75.8%) were of normal weight. The birth weight (3439±472) g vs. (3361±418) g and proportion of monthly household income < 10000 yuan (17.1% vs. 10.7%) in the overweight/obese children were significantly higher than those in the normal weight children, and there were no statistical differences in sex, age, gestational age, time of adding complementary foods, outdoor activities after school every day, and parental BMI. After adjusting for potential confounders such as sex, age, household income, outdoor activities after school every day, and parental overweight/obesity, frequently having puffed food ( OR=2.46, 95%CI: 1.20-4.95), western-style fast food (OR=3.52, 95%CI: 1.41-8.79), and carbonated drinks (OR=2.92, 95%CI: 1.37-6.13), often eating a lot (OR=1.51, 95%CI: 1.09-2.08) and having a good appetite (OR=2.60, 95%CI: 1.87-3.62), having regular meals (OR=1.48, 95%CI: 1.07-2.03), and fast eating (OR=3.37, 95%CI: 2.10-5.42) were positively associated with children's overweight/obesity (P<0.05). Children's partial/picky eating was inconsistent with fathers' behavior (P<0.05), while the other dietary behaviors were similar with both mothers' and fathers'.

    Conclusion Eating behavior characteristics of preschool children are associated with overweight/obesity, and affected by their parents. Early identifying dietary behavior problems and improving dietary habits of children might be an effective strategy in preventing and controlling the occurrence and development of obesity in childhood.

     

/

返回文章
返回