戴一鸣, 王铮, 丁佳韵, 张济明, 郭剑秋, 张沁雨, 张磊, 许思楠, 邬春华, 常秀丽, 周志俊. 江苏某县农村地区9~10岁儿童膳食模式与生长发育和肥胖的关系[J]. 环境与职业医学, 2021, 38(9): 979-985. DOI: 10.13213/j.cnki.jeom.2021.21126
引用本文: 戴一鸣, 王铮, 丁佳韵, 张济明, 郭剑秋, 张沁雨, 张磊, 许思楠, 邬春华, 常秀丽, 周志俊. 江苏某县农村地区9~10岁儿童膳食模式与生长发育和肥胖的关系[J]. 环境与职业医学, 2021, 38(9): 979-985. DOI: 10.13213/j.cnki.jeom.2021.21126
DAI Yiming, WANG Zheng, DING Jiayun, ZHANG Jiming, GUO Jianqiu, ZHANG Qinyu, ZHANG Lei, XU Sinan, WU Chunhua, CHANG Xiuli, ZHOU Zhijun. Associations of dietary patterns with physical growth and obesity in school-age children in rural areas of Jiangsu[J]. Journal of Environmental and Occupational Medicine, 2021, 38(9): 979-985. DOI: 10.13213/j.cnki.jeom.2021.21126
Citation: DAI Yiming, WANG Zheng, DING Jiayun, ZHANG Jiming, GUO Jianqiu, ZHANG Qinyu, ZHANG Lei, XU Sinan, WU Chunhua, CHANG Xiuli, ZHOU Zhijun. Associations of dietary patterns with physical growth and obesity in school-age children in rural areas of Jiangsu[J]. Journal of Environmental and Occupational Medicine, 2021, 38(9): 979-985. DOI: 10.13213/j.cnki.jeom.2021.21126

江苏某县农村地区9~10岁儿童膳食模式与生长发育和肥胖的关系

Associations of dietary patterns with physical growth and obesity in school-age children in rural areas of Jiangsu

  • 摘要: 背景

    学龄期儿童肥胖现状日益严峻,膳食模式作为衡量膳食情况的综合指标,是影响儿童肥胖的重要因素。

    目的

    总结农村地区学龄期儿童的膳食模式,评价其与儿童生长发育和肥胖的关系。

    方法

    选取“射阳小型出生队列”中481名9~10岁随访儿童作为研究对象,采用24 h膳食回顾调查法收集膳食资料,使用因子分析法对儿童膳食模式进行分析,并将膳食模式因子得分按三分位数定义为T1、T2、T3三个水平;测量学龄期儿童的体格生长指标,并使用广义线性模型评估膳食模式因子得分与儿童身体质量指数(BMI)-Z评分(经年龄、性别校正的BMI,肥胖评价指标)的关系,利用logistic回归模型评估膳食模式因子得分与儿童肥胖的关系。

    结果

    本次研究中,学龄期儿童的肥胖检出率为17.26%。因子分析法提取5种膳食模式,累计贡献率为58.46%,分别为蔬菜蛋类、油脂肉类、谷薯油脂类、水果肉类、富含维A蔬果类。5种膳食模式T3组之间的能量及营养素的摄入量差异均具有统计学意义(P < 0.05)。广义线性模型显示:与谷薯油脂类因子得分T1组相比,T3组儿童的BMI-Z评分更低(全体,T3:T1b=-0.44,95% CI:-0.74~-0.15),性别分层分析发现女童中也有此关联(女童,T2:T1b=-0.41,95% CI:-0.78~-0.04;女童,T3:T1b=-0.39,95% CI:-0.77~-0.01);水果肉类膳食模式与儿童BMI-Z评分呈正相关(全体,b=0.16,95% CI:0.01~0.31)。logistic回归模型显示:富含维生素A蔬果类膳食模式的因子得分与儿童肥胖发生风险呈负相关(全体,OR=0.46,95% CI:0.27~0.77,P < 0.05;女童,T2:T1OR=0.25,95% CI:0.06~1.00,P < 0.05)。

    结论

    该地学龄期儿童肥胖检出率较高。谷薯油脂类膳食模式不利于儿童体格的健康生长,而水果肉类膳食模式与之相反,富含维生素A蔬果类的膳食模式与低肥胖率有关。

     

    Abstract: Background

    Obesity among school-age children is an increasingly serious problem. Dietary pattern, as a comprehensive index to measure the dietary intake, is an important factor affecting childhood obesity.

    Objective

    This study is conducted to analyze dietary patterns and explore the associations of dietary patterns with physical growth and obesity in rural school-age children.

    Methods

    A total of 481 children aged 9-10 years in Sheyang Mini Birth Cohort were enrolled. Dietary information was collected using 24-h dietary recall survey. A factor analysis was conducted to define dietary patterns, and dietary pattern scores were divided into three groups by tertiles (T1, T2, T3; from low to high levels). Anthropometric indicators were measured and a generalized line model was used to examine the associations between dietary patterns and body mass index (BMI)-Z scores (a measure of obesity defined by sex- and age- standardized according to the World Health Organization criteria). Logistic regression models were performed to evaluate the association between dietary patterns and children obesity.

    Results

    The prevalence rate of obesity was 17.26% in selected school-age children. Five dietary patterns were identified by the factor analysis, explaining 58.46% of the diet variation, including vegetables and eggs, oil and meat, cereals and oil, fruit and meat, vegetables and fruit rich in vitamin A patterns, respectively. The intakes of energy and nutrients were significantly different among the T3 groups of the five dietary patterns (P < 0.05). The results of generalized line model showed that the children of the cereals and oil pattern T3 group had a lower BMI-Z score compared with the T1 group (total, T3: T1, b=-0.44, 95% CI: -0.74﹣-0.15), and the associations were also found in girls (T2: T1, b=-0.41, 95% CI; -0.78﹣-0.04; T3: T1, b=-0.39, 95% CI: -0.77﹣-0.01); the fruit and meat pattern was significantly positively associated with BMI-Z score (total, b=0.16, 95% CI: 0.01-0.31). The results of logistic regression model showed that the factor score of vegetables and fruit rich in vitamin A pattern negatively correlated with the risk of obesity (total, OR=0.46, 95% CI: 0.27-0.77, P < 0.05; girls, T2: T1, OR=0.25, 95%CI: 0.06-1.00, P < 0.05).

    Conclusion

    The prevalence rate of obesity among selected school-age children is high. Contrast to the fruit and meat pattern, the cereals and oil pattern is detrimental to children's growth. The vegetables and fruit rich in vitamin A pattern is related to a low prevalence rate of obesity.

     

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