广州市2016年城区中学生饮食行为模式及其影响因素分析
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摘要
目的了解广州市城区中学生饮食行为模式及其影响因素,为中学生营养教育和营养干预提供科学依据。方法依托广州市中小学生常规体检工作,对城区27所学校的初一和高一学生及其家长进行问卷调查,收集饮食行为等资料。采用探索性因子分析方法建立中学生饮食行为模式,采用多因素无序多分类Logistic回归模型分析影响因素。结果因子分析得到3种饮食行为模式:模式Ⅰ(37.09%)属于健康饮食行为模式,模式Ⅱ(33.37%)和模式Ⅲ(29.54%)属于西式饮食行为模式。Logistic回归模型分析结果显示,住校(OR_Ⅱ=1.57,95%CI=1.33～1.85; OR_Ⅲ=1.28,95%CI=1.07～1.52)、视屏时间≥2 h/d(OR_Ⅱ=2.89,95%CI=2.51～3.33; OR_Ⅲ=2.14,95%CI=1.85～2.48)与模式Ⅱ和Ⅲ呈正关联;家庭人均月收入≥5 000元(OR_Ⅲ=1.31,95%CI=1.14～1.51)与模式Ⅲ呈正关联;高中生(OR_Ⅱ=0.83,95%CI=0.73～0.95; OR_Ⅲ=0.74,95%CI=0.64～0.85)、父母为大专及以上文化程度(父OR_Ⅱ=0.64,95%CI=0.52～0.79;母OR_Ⅱ=0.67,95%CI=0.54～0.82;父OR_Ⅲ=0.72,95%CI=0.58～0.90;母OR_Ⅲ=0.73,95%CI=0.59～0.89)与模式Ⅱ和Ⅲ呈负关联。结论广州市城区中学生存在3种饮食行为模式,父母文化程度、视屏时间、年级、住校情况、家庭人均月收入是中学生饮食行为模式的主要影响因素。
Objective To explore the dietary patterns and related factors among urban middle school students in Guangzhou, and to provide the scientific reference for conducting nutritional education and intervention among the middle school students.Methods Questionnaire survey was conducted for students in two grades( grade 1 of 27 junior and senior high schools) and their parents along with the physical examination for urban primary and secondary school students in Guangzhou. Dietary patterns were established by exploratory factor analysis. Multinomial Logistic regression model was used for analyzing influencing factors of dietary pattern. Results Three major dietary patterns were identified. Type Ⅰ( 37.09%) was a healthy dietary pattern; type Ⅱ( 33.37%)and Ⅲ( 29.54%) were classified into western dietary patterns. Multinomial Logistic regression models showed that living on campus( OR_Ⅱ= 1.57, 95%CI: 1.33-1.85; OR_Ⅲ= 1.28, 95% CI: 1.07-1.52), screen time≥2 h/d( OR_Ⅱ= 2.89, 95% CI: 2.51-3. 33;OR_Ⅲ= 2.14, 95%CI: 1.85-2.48) were positively associated with type Ⅱ and Ⅲ. The monthly household income per capita≥5 000 yuan( OR_Ⅲ= 1.31, 95%CI: 1.14-1.51) was positively associated with type Ⅲ. Senior students( OR_Ⅱ= 0.83, 95%CI: 0.73-0.95;OR_Ⅲ= 0.74, 95%CI: 0.64-0.85), the level of parental education( OR_Ⅱ= 0.64, 95%CI: 0.52-0.79; OR_Ⅱ= 0.67, 95%CI: 0.54-0.82; OR_Ⅲ= 0.72, 95%CI: 0.58-0.90; OR_Ⅲ= 0.73, 95%CI: 0.59-0.89) had a negative association with type Ⅱ and Ⅲ. Conclusion There are three dietary patterns among urban middle school students in Guangzhou. The main influencing factors include parental education, screen time, grade, resident situation, and monthly household income per capita.
Objective To explore the dietary patterns and related factors among urban middle school students in Guangzhou, and to provide the scientific reference for conducting nutritional education and intervention among the middle school students.Methods Questionnaire survey was conducted for students in two grades( grade 1 of 27 junior and senior high schools) and their parents along with the physical examination for urban primary and secondary school students in Guangzhou. Dietary patterns were established by exploratory factor analysis. Multinomial Logistic regression model was used for analyzing influencing factors of dietary pattern. Results Three major dietary patterns were identified. Type Ⅰ( 37.09%) was a healthy dietary pattern; type Ⅱ( 33.37%)and Ⅲ( 29.54%) were classified into western dietary patterns. Multinomial Logistic regression models showed that living on campus( OR_Ⅱ= 1.57, 95%CI: 1.33-1.85; OR_Ⅲ= 1.28, 95% CI: 1.07-1.52), screen time≥2 h/d( OR_Ⅱ= 2.89, 95% CI: 2.51-3. 33;OR_Ⅲ= 2.14, 95%CI: 1.85-2.48) were positively associated with type Ⅱ and Ⅲ. The monthly household income per capita≥5 000 yuan( OR_Ⅲ= 1.31, 95%CI: 1.14-1.51) was positively associated with type Ⅲ. Senior students( OR_Ⅱ= 0.83, 95%CI: 0.73-0.95;OR_Ⅲ= 0.74, 95%CI: 0.64-0.85), the level of parental education( OR_Ⅱ= 0.64, 95%CI: 0.52-0.79; OR_Ⅱ= 0.67, 95%CI: 0.54-0.82; OR_Ⅲ= 0.72, 95%CI: 0.58-0.90; OR_Ⅲ= 0.73, 95%CI: 0.59-0.89) had a negative association with type Ⅱ and Ⅲ. Conclusion There are three dietary patterns among urban middle school students in Guangzhou. The main influencing factors include parental education, screen time, grade, resident situation, and monthly household income per capita.
引文
[1]刘爱东,翟凤英.膳食模式及其在营养流行病学中的研究进展[J].中华预防医学杂志,2010,44(5):452-455.
[2]孟祥坤,邹志勇,尚晓瑞,等.儿童青少年饮食行为模式与超重肥胖的关系[J].中国学校卫生,2015,36(5):648-650.
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[5]NAJA F,HWALLA N,ITANI L,et al. A Western dietary pattern isassociated with overweight and obesity in a national sample of Leba-nese adolescents(13-19 years):a cross-sectional study[J]. Br J Nu-tr,2015,114(11):1909-1919.
[6]严双琴,曹慧,顾春丽,等.学龄前儿童饮食模式及与父母文化程度影响的研究[J].中华流行病学杂志,2017,38(8):1060-1063.
[7]王素芳,穆敏,赵艳,等.大学新生膳食模式及其影响因素的研究[J].中华流行病学杂志,2011,32(9):869-872.
[8]宓伟,练武,杨曼丽,等.烟台市老年人膳食模式及其影响因素[J].卫生研究,2017,46(1):27-31.
[9]全国学生体质与健康调研组.2014年全国学生体质与健康调研工作手册[Z].北京:高等教育出版社,2014:17-24.
[10]马冠生.儿童少年的饮食行为及影响因素[J].中国健康教育,2005,21(5):337-340.
[11]陈春明.中国学龄儿童青少年超重和肥胖预防与控制指南(试用)[M].北京:人民卫生出版社,2007.
[12]American Academy of Pediatrics Committee on Public Education. A-merican academy of pediatrics:children,adolescents and television[J]. Pediatrics,2001,107(2):423-426.
[13]张继国,张兵.膳食模式研究方法的进展[J].卫生研究,2013,42(4):698-700.
[14]AMBROSINI G L,ODDY W H,ROBINSON M,et al. Adolescentdietary patterns are associated with lifestyle and family psycho-socialfactors[J]. Public Health Nutr,2009,12(10):1807-1815.
[15]GALVAN-PORTILLO M,SANCHEZ E,CRDENAS-CRDENASL M,et al. Dietary patterns in Mexican children and adolescents:characterization and relation with socio-economic and home environ-ment factors[J]. Appetite,2017,121(11):275-284.
[16]NILSEN S M,KROKSTAD S,HOLMEN T L,et al. Adolescents’health-related dietary patterns by parental socio-economic position,The Nord-Trondelag Health Study(HUNT)[J]. Eur J PublicHealth,2010,20(3):299-305.
[17]PEARSON N,BIDDLE S J. Sedentary behavior and dietary intake inchildren,adolescents and adults:a systematic review[J]. Am J PrevMed,2011,41(2):178-188.
[18]宫伟彦,郭海军,刘伟佳,等.沈阳、广州、武汉和成都四城市中小学生饮食行为调查分析[J].卫生研究,2015,44(3):486-489.
[19]李凤娟,孙经,杨汴生,等.河南省中学生饮食行为流行现况及影响因素[J].中国学校卫生,2017,38(7):1003-1006.
[20]王艳,刘维娜,甄世祺.江苏省青少年饮食行为及影响因素分析[J].江苏预防医学,2015,26(6):35-38.
[21]BORGES C A,SLATER B,SANTALIESTRA-PASIAS A M,et al.Dietary patterns in European and Brazilian adolescents:comparisonsand associations with socioeconomic factors[J]. Nutrients,2018,10(1):1-17.
[22]洪忻,李解权,王志勇,等.南京城区居民膳食模式及其影响因素研究[J].中华疾病控制杂志,2015,19(1):54-57.
[23]AL-HAZZAA H M,AL-SOBAYEL H I,ABAHUSSAIN N A,et al.Association of dietary habits with levels of physical activity and screentime among adolescents living in Saudi Arabia[J]. J Hum Nutr Diet,2014,27(S2):204-213.
[24]ARORA M,NAZAR G P,GUPTA V K,et al. Association of break-fast intake with obesity,dietary and physical activity behavior amongurban school-aged adolescents in Delhi,India:results of a cross-sec-tional study[J]. BMC Public Health,2012,10(17):1-12.
[2]孟祥坤,邹志勇,尚晓瑞,等.儿童青少年饮食行为模式与超重肥胖的关系[J].中国学校卫生,2015,36(5):648-650.
[3]FUNTIKOV A N,NAVARRO E,BAWAKED R A,et al. Impact ofdiet on cardiometabolic health in children and adolescents[J]. NutrJ,2015,14(1):1-11.
[4]SHANG X,LI Y,LIU A,et al. Dietary pattern and its associationwith the prevalence of obesity and related cardiometabolic risk factorsamong Chinese children[J]. PLoS One,2012,7(8):e43183.
[5]NAJA F,HWALLA N,ITANI L,et al. A Western dietary pattern isassociated with overweight and obesity in a national sample of Leba-nese adolescents(13-19 years):a cross-sectional study[J]. Br J Nu-tr,2015,114(11):1909-1919.
[6]严双琴,曹慧,顾春丽,等.学龄前儿童饮食模式及与父母文化程度影响的研究[J].中华流行病学杂志,2017,38(8):1060-1063.
[7]王素芳,穆敏,赵艳,等.大学新生膳食模式及其影响因素的研究[J].中华流行病学杂志,2011,32(9):869-872.
[8]宓伟,练武,杨曼丽,等.烟台市老年人膳食模式及其影响因素[J].卫生研究,2017,46(1):27-31.
[9]全国学生体质与健康调研组.2014年全国学生体质与健康调研工作手册[Z].北京:高等教育出版社,2014:17-24.
[10]马冠生.儿童少年的饮食行为及影响因素[J].中国健康教育,2005,21(5):337-340.
[11]陈春明.中国学龄儿童青少年超重和肥胖预防与控制指南(试用)[M].北京:人民卫生出版社,2007.
[12]American Academy of Pediatrics Committee on Public Education. A-merican academy of pediatrics:children,adolescents and television[J]. Pediatrics,2001,107(2):423-426.
[13]张继国,张兵.膳食模式研究方法的进展[J].卫生研究,2013,42(4):698-700.
[14]AMBROSINI G L,ODDY W H,ROBINSON M,et al. Adolescentdietary patterns are associated with lifestyle and family psycho-socialfactors[J]. Public Health Nutr,2009,12(10):1807-1815.
[15]GALVAN-PORTILLO M,SANCHEZ E,CRDENAS-CRDENASL M,et al. Dietary patterns in Mexican children and adolescents:characterization and relation with socio-economic and home environ-ment factors[J]. Appetite,2017,121(11):275-284.
[16]NILSEN S M,KROKSTAD S,HOLMEN T L,et al. Adolescents’health-related dietary patterns by parental socio-economic position,The Nord-Trondelag Health Study(HUNT)[J]. Eur J PublicHealth,2010,20(3):299-305.
[17]PEARSON N,BIDDLE S J. Sedentary behavior and dietary intake inchildren,adolescents and adults:a systematic review[J]. Am J PrevMed,2011,41(2):178-188.
[18]宫伟彦,郭海军,刘伟佳,等.沈阳、广州、武汉和成都四城市中小学生饮食行为调查分析[J].卫生研究,2015,44(3):486-489.
[19]李凤娟,孙经,杨汴生,等.河南省中学生饮食行为流行现况及影响因素[J].中国学校卫生,2017,38(7):1003-1006.
[20]王艳,刘维娜,甄世祺.江苏省青少年饮食行为及影响因素分析[J].江苏预防医学,2015,26(6):35-38.
[21]BORGES C A,SLATER B,SANTALIESTRA-PASIAS A M,et al.Dietary patterns in European and Brazilian adolescents:comparisonsand associations with socioeconomic factors[J]. Nutrients,2018,10(1):1-17.
[22]洪忻,李解权,王志勇,等.南京城区居民膳食模式及其影响因素研究[J].中华疾病控制杂志,2015,19(1):54-57.
[23]AL-HAZZAA H M,AL-SOBAYEL H I,ABAHUSSAIN N A,et al.Association of dietary habits with levels of physical activity and screentime among adolescents living in Saudi Arabia[J]. J Hum Nutr Diet,2014,27(S2):204-213.
[24]ARORA M,NAZAR G P,GUPTA V K,et al. Association of break-fast intake with obesity,dietary and physical activity behavior amongurban school-aged adolescents in Delhi,India:results of a cross-sec-tional study[J]. BMC Public Health,2012,10(17):1-12.