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目的分析午餐在外就餐与儿童肥胖等慢性病发生率之间的关系.为制定相应的干预措施提供依据。方法采用随机整群抽样法从哈尔滨等6城市抽取6-13岁小学生7083名,使用问卷调查收集他们的年龄、性别及家庭经济情况等信息。按照标准程序进行体格检查和血压测量以及空腹血糖、总胆固醇、低密度脂蛋白胆固醇、高密度脂蛋白胆回醇和甘油三酯等指标的测试。结果经常在学校、家里及在外就餐的儿童肥胖率[比值比(0R),95%可信区间(Cl))]依次为10.1%(参照组)、11.2%(1.01,0.84-1.2)、11.3%(1.06,0.89-1.34);腹型肥胖的发生率(OR,95%Cl)在各组间依次为:13.5%(参照组)、16.1%(1.05,0.89-1.23)、17.2%(1.24,1.03-1.51);代谢综合征的发生率(OR,95%C1)依次为:0.8%(参照组)、1.4%(1.34,0.79-2.26)、1.6%(1.71,1.01-3.26)。调整年龄、性别、出生体重、出生4个月内喂养方式、父母文化程度、家庭人均收入等混杂因素后,腹型肥胖、代谢综合征的发生率在各组间仍有显著差异。结论经常在外吃午餐,可增加儿童患肥胖及代谢异常的危险:学校午餐可为儿童提供更加均衡的营养摄入,应大力推广学校营养午餐,以保证儿童健康成长。
Objective To analyze the relationship between lunchtime eating out of children and incidence of chronic diseases such as childhood obesity, and to provide basis for formulating corresponding interventions. Methods A total of 7083 pupils aged 6 to 13 were collected from 6 cities in Harbin using random cluster sampling method. The questionnaires were used to collect information such as their age, gender and family economic status. Physical examination and blood pressure measurement as well as tests for indicators such as fasting blood glucose, total cholesterol, low density lipoprotein cholesterol, high density lipoprotein cholesterol and triglycerides were performed according to standard procedures. Results The prevalence of obesity (odds ratio (OR), 95% confidence interval (CI)) among children who dined regularly at school, at home and outside meals was 10.1% (reference group), 11.2% (1.01,0.84-1.2), and 11.3 % (1.06,0.89-1.34). The incidence of abdominal obesity (OR, 95% Cl) was 13.5% in the control group, 16.1% in the control group, and 1.24% , 1.03-1.51). The incidence of metabolic syndrome (OR, 95% CI) was 0.8% (reference group), 1.4% (1.34,0.79-2.26), 1.6% (1.71,1.01-3.26). After adjusting for such factors as age, sex, birth weight, feeding pattern, educational level of parents and per capita income of the family within 4 months after birth, there was still significant difference in abdominal obesity and metabolic syndrome between the groups. Conclusions Eating lunch often can increase children’s risk of obesity and metabolic disorders. School lunches can provide more balanced nutrition for children. School nutrition lunches should be vigorously promoted to ensure the healthy growth of children.