上海市中小学生超重肥胖行为影响因素研究
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摘要
目的分析上海市中小学生超重或肥胖发生的行为影响因素,为有针对性地制定儿童青少年超重肥胖防控策略提供理论依据。方法选取2014年中国学生体质与健康调研上海地区调研资料中9～18岁中小学生11 913名,调查项目包括形态指标和问卷调查,采用Logistic回归分析学生睡眠、饮食、体育锻炼及静态生活方式等因素对不同群体学生超重或肥胖的影响。结果男生每天睡眠时间≥10 h的超重或肥胖检出率(36.7%)高于睡眠不足8 h的学生(31.3%)(P<0.01)。女生不吃早餐的群体(36.4%)高于天天都吃早餐的群体(17.6%)(P<0.05)。小学生不喜欢上体育课(38.2%)高于喜欢上体育课的学生(30.8%)(P<0.01)。初中每天玩游戏和计算机时间≥2 h的学生(28.1%)高于<1 h的学生(23.0%)(P<0.05)。Logistic回归分析显示,不愿意参加长跑(OR=1.16,95%CI=1.05～1.27)、每天看电视时间≥1 h(OR=1.22,95%CI=1.05～1.43)的学生群体发生超重或肥胖的风险较高。女生中吃早餐的学生发生超重或肥胖的风险下降(OR=0. 33,95%CI=0.16～0.67)。城区学生每天看电视时间≥1 h(OR=1.36,95%CI=1.07～1.74)发生超重或肥胖的风险提高,郊区每天睡眠时间≥10 h(OR=2.0,95%CI=1.23～3.25)的学生发生超重或肥胖的风险增加。小学生每天玩电子游戏和计算机≥2 h(OR=1.45,95%CI=1.01～2.08)发生超重或肥胖的风险提高。结论 2014年上海市中小学生超重或肥胖检出率与睡眠、饮食习惯、锻炼意愿和静态生活方式相关,且具有明显的群体性特征。
Objective To investigate the associations between behavioral risk factors and overweight or obesity among school-age children and adolescents in Shanghai, and to provide a reference for making targeted prervention and control measures for overweight and obesity. Methods A total of 11 913 children and adolescents aged 9-18 years old were selected according to 2014 Shanghai Physical Fitness and Health Surveillance. Questionnaire survey and physical examination including height, weight and other physical index were performed. Logistic regression was used to analyze the association between overweight or obesity and sleep time, diet, physical exercise and sedentary behavior. Results The prevalence of overweight or obesity was higher among boys who slept longer than or equal to 10 hours( 36.7%), compared with those with less than 8 hours of sleep( 31.3%)( P<0.01). The rates of overweight or obesity in girls was higher among breakfast skippers( 36. 4%) than breakfast non-skippers( 17. 6%)( P < 0. 05). The prevalence of overweight or obesity was higher among pupils who did not like physical education( 38.2%) than those who preferred( 30.8%)( P<0.01). The prevalence of overweight or obesity among junior middle school students playing video games and computer over 2 hours( 28.1%) was higher than those playing less than 1 hours( 23.0%)( P<0.05). Unwilling to participate in long-distance running exercise, watching TV more than 1 h per day were risk factors for overweight or obesity( OR = 1.16, 95%CI: 1.05-1.27; OR= 1.22, 95%CI: 1.05-1.43, respectively).Girls who were breakfast non-skippers had a lower risk of overweight or obesity( OR =0.33, 95%CI: 0.16-0.67). Students in urban areas who watch TV more than 1 h per day was risk factor for overweight or obesity( OR = 1.36, 95%CI: 1.07-1.74). Students in rural areas who slept longer than 10 hours had an increased risk of being overweight or obese( OR = 2.0, 95%CI: 1.23-3.25). Pupils who played video games and computers for more than 2 hours had an increased risk of being overweight or obese( OR = 1.45, 95%CI: 1.01-2.08). Conclusion In 2014, overweight or obesity among Shanghai's primary and middle school students was highly interconnected with bad dietary behavior, static life style, and the distribution of factors shows obvious population characteristics.
Objective To investigate the associations between behavioral risk factors and overweight or obesity among school-age children and adolescents in Shanghai, and to provide a reference for making targeted prervention and control measures for overweight and obesity. Methods A total of 11 913 children and adolescents aged 9-18 years old were selected according to 2014 Shanghai Physical Fitness and Health Surveillance. Questionnaire survey and physical examination including height, weight and other physical index were performed. Logistic regression was used to analyze the association between overweight or obesity and sleep time, diet, physical exercise and sedentary behavior. Results The prevalence of overweight or obesity was higher among boys who slept longer than or equal to 10 hours( 36.7%), compared with those with less than 8 hours of sleep( 31.3%)( P<0.01). The rates of overweight or obesity in girls was higher among breakfast skippers( 36. 4%) than breakfast non-skippers( 17. 6%)( P < 0. 05). The prevalence of overweight or obesity was higher among pupils who did not like physical education( 38.2%) than those who preferred( 30.8%)( P<0.01). The prevalence of overweight or obesity among junior middle school students playing video games and computer over 2 hours( 28.1%) was higher than those playing less than 1 hours( 23.0%)( P<0.05). Unwilling to participate in long-distance running exercise, watching TV more than 1 h per day were risk factors for overweight or obesity( OR = 1.16, 95%CI: 1.05-1.27; OR= 1.22, 95%CI: 1.05-1.43, respectively).Girls who were breakfast non-skippers had a lower risk of overweight or obesity( OR =0.33, 95%CI: 0.16-0.67). Students in urban areas who watch TV more than 1 h per day was risk factor for overweight or obesity( OR = 1.36, 95%CI: 1.07-1.74). Students in rural areas who slept longer than 10 hours had an increased risk of being overweight or obese( OR = 2.0, 95%CI: 1.23-3.25). Pupils who played video games and computers for more than 2 hours had an increased risk of being overweight or obese( OR = 1.45, 95%CI: 1.01-2.08). Conclusion In 2014, overweight or obesity among Shanghai's primary and middle school students was highly interconnected with bad dietary behavior, static life style, and the distribution of factors shows obvious population characteristics.
引文
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[11]周婷,王婉宜,孙晓蒙,等.中国7~18岁儿童青少年超重肥胖危险因素Meta分析[J].中国公共卫生,2016,32(10):1444-1448.
[12]WU J,WU H,WANG J,et al. Associations between sleep durationand overweight/obesity:results from 66817 Chinese adolescents[J].Sci Rep,2015,5(11):16686.
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[14]YEOH Y J,SHIM J E,CHUNG S J. Factors associated with skippingbreakfast in Korean children:analysis of data from the 2001 NationalHealth and Nutrition Survey[J]. Korean J Commun Nutr,2008,13(1):62-68.
[15]SMITH K J,GALL S L,MCNAUGHTON S A,et al. Skipping break-fast:longitudinal associations with cardiometabolic risk factors in thechildhood determinants of adult health study[J]. Am J Clin Nutr,2010,92(6):1316-1325.
[16]SO H,NELSON E,LI A M,et al. Breakfast frequency inversely as-sociated with BMI and body fatness in Hong Kong Chinese childrenaged 9-18 years[J]. Br J Nutr,2011,106(5):742-751.
[17]MIHRSHAHI S,DRAYTON B A,BAUMAN A E,et al. Associationsbetween childhood overweight,obesity,abdominal obesity and obeso-genic behaviors and practices in Australian homes[J]. BMC PublicHealth,2017,18(1):44.
[18]AHADI Z,QORBANI M,KELISHADI R,et al. Association betweenbreakfast intake with anthropometric measurements,blood pressureand food consumption behaviors among Iranian children and adoles-cents:the CASPIAN-IV study[J]. Public Health,2015,129(6):740-747.
[19]宋逸,张芯,马军,等.2010年中国中小学生超重与肥胖的行为影响因素[J].中华预防医学杂志,2012,46(9):789-895.
[20]石锦鸿,职心乐,席薇,等.天津市2014年儿童青少年超重肥胖现状及影响因素[J].中国学校卫生,2016,37(8):1130-1135.
[21]VEIGA G V,DIAS P C,ANJOS L A. A comparison of distributioncurves of body mass index from Brazil and the United States for assess-ing overweight and obesity in Brazilian adolescents[J]. Pan Am JPublic Health,2001,10(2):79-85.
[22]STETTLER N,TERSHAKOVEC A M,ZEMEL B S,et al. Early riskfactors increased adiposity:a cohort study of African subjects followedfrom birth to young adulthood[J]. Am J Clin Nutr,2000,72(11):378-383.
[23]O’LOUGHLIN J,PARADIS G,GRAY-DONALD K,et al. One-andtwo-year predictors of weight gain among elementary school children inmultiethnic,low income,inner-city neighbourhoods[J]. Am J Epide-miol,2000,152(8):739-746.
[24]BAYGI F,QORBANI M,DOROSTY A R,et al.伊朗东北部儿童代表性样本中儿童肥胖的膳食预测因素[J].中国当代儿科杂志,2013,15(7):501-508.
[25]ELGAR F J,ROBERTS C,MOORE L,et al. Sedentary behaviour,physical activity and weight problems in adolescents in Wales[J].Public Health,2005,119(6):518-524.
[26]World Health Organization. Global recommendations on physical activ-ity for health[R]. Geneva:WHO,2010:16-45.
[27]宋逸,张芯,杨土保,等.2010年全国中小学生体育锻炼行为现状及原因分析[J].北京大学学报(医学版),2012,44(3):347-354.
[28]PEARSON N,BIDDLE S J H. Sedentary behavior and dietary intakein children,adolescents,and adults:a systematic review[J]. Am JPrev Med,2011,41(2):178-88.
[29]JACKSON S L,CUNNINGHAM S A. The stability of children’sweight status over time,and the role of television,physical activity,and diet in elementary school[J]. Prev Med,2017,100(4):229-234.
[30]CAMPAGNOLO P D,VITOLO M R,GAMA C M,et al. Prevalenceof overweight and associated factors in southern Brazilian adolescents[J]. Public Health,2008,122(5):509-515.
[31]JACKSON J A,SMIT E,BRANSCUM A,et al. The family home en-vironment,food insecurity,and body mass index in rural children[J]. Health Educ Behav,2017,44(4):648-657.
[32]MARINS V M R,ALMEIDA R M V R,PEREIRA R A,et al. Fac-tors associated with overweight and central body fat in the city of Riode Janeiro:results of a two-stage random sampling survey[J]. PublicHealth,2001,115(3):1-7.
[2]国家体育总局.2014年全国学生体质健康调研结果[J].中国学校卫生,2015,36(12):Ⅳ.
[3]王烁,董彦会,王政和,等.1985~2014年中国7~18岁学生超重与肥胖流行趋势[J].中华预防医学杂志,2017,51(4):300-305.
[4]王向军,杨漾,吴艳强,等.上海市7~18岁学生1985-2014年的超重和肥胖流行趋势[J].中国循证儿科杂志,2017,12(2):126-130.
[5]REILLY J J,METHVEN E,MCDOWELL Z C,et al. Health conse-quences of obesity[J]. Arch Dis Child,2003,88(9):748-752.
[6]BAYGI F,DOROSTY A R,KELISHADI R,et al. Determinants ofchildhood obesity in representative sample of children in North East ofIran[J]. Cholesterol,2012,2012(4):1-5.
[7]中国学生体质与健康调研组.2014年中国学生体质与健康调研报告[M].北京:高等教育出版社,2016:4-49.
[8]中华人民共和国国家卫生和计划生育委员会.学龄儿童青少年营养不良筛查WS/T 456—2014[S].北京,2014:1-7.
[9]中国肥胖问题工作组.中国学龄儿童青少年超重、肥胖筛查体重指数值分类标准[J].中华流行病学杂志,2004,25(2):97-102.
[10]NAM G E,HAN K,KIM D H,et al. Sleep duration is associatedwith body fat and muscle mass and waist-to-height ratio beyond con-ventional obesity parameters in Korean adolescent boys[J]. J SleepRes,2017,26(4):444-452.
[11]周婷,王婉宜,孙晓蒙,等.中国7~18岁儿童青少年超重肥胖危险因素Meta分析[J].中国公共卫生,2016,32(10):1444-1448.
[12]WU J,WU H,WANG J,et al. Associations between sleep durationand overweight/obesity:results from 66817 Chinese adolescents[J].Sci Rep,2015,5(11):16686.
[13]DWYER J T,EVANS M,STONE E J,et al. Adolescents’eatingpatterns influence their nutrient intakes[J]. J Am Diet Assoc,2001,101(7):798-802.
[14]YEOH Y J,SHIM J E,CHUNG S J. Factors associated with skippingbreakfast in Korean children:analysis of data from the 2001 NationalHealth and Nutrition Survey[J]. Korean J Commun Nutr,2008,13(1):62-68.
[15]SMITH K J,GALL S L,MCNAUGHTON S A,et al. Skipping break-fast:longitudinal associations with cardiometabolic risk factors in thechildhood determinants of adult health study[J]. Am J Clin Nutr,2010,92(6):1316-1325.
[16]SO H,NELSON E,LI A M,et al. Breakfast frequency inversely as-sociated with BMI and body fatness in Hong Kong Chinese childrenaged 9-18 years[J]. Br J Nutr,2011,106(5):742-751.
[17]MIHRSHAHI S,DRAYTON B A,BAUMAN A E,et al. Associationsbetween childhood overweight,obesity,abdominal obesity and obeso-genic behaviors and practices in Australian homes[J]. BMC PublicHealth,2017,18(1):44.
[18]AHADI Z,QORBANI M,KELISHADI R,et al. Association betweenbreakfast intake with anthropometric measurements,blood pressureand food consumption behaviors among Iranian children and adoles-cents:the CASPIAN-IV study[J]. Public Health,2015,129(6):740-747.
[19]宋逸,张芯,马军,等.2010年中国中小学生超重与肥胖的行为影响因素[J].中华预防医学杂志,2012,46(9):789-895.
[20]石锦鸿,职心乐,席薇,等.天津市2014年儿童青少年超重肥胖现状及影响因素[J].中国学校卫生,2016,37(8):1130-1135.
[21]VEIGA G V,DIAS P C,ANJOS L A. A comparison of distributioncurves of body mass index from Brazil and the United States for assess-ing overweight and obesity in Brazilian adolescents[J]. Pan Am JPublic Health,2001,10(2):79-85.
[22]STETTLER N,TERSHAKOVEC A M,ZEMEL B S,et al. Early riskfactors increased adiposity:a cohort study of African subjects followedfrom birth to young adulthood[J]. Am J Clin Nutr,2000,72(11):378-383.
[23]O’LOUGHLIN J,PARADIS G,GRAY-DONALD K,et al. One-andtwo-year predictors of weight gain among elementary school children inmultiethnic,low income,inner-city neighbourhoods[J]. Am J Epide-miol,2000,152(8):739-746.
[24]BAYGI F,QORBANI M,DOROSTY A R,et al.伊朗东北部儿童代表性样本中儿童肥胖的膳食预测因素[J].中国当代儿科杂志,2013,15(7):501-508.
[25]ELGAR F J,ROBERTS C,MOORE L,et al. Sedentary behaviour,physical activity and weight problems in adolescents in Wales[J].Public Health,2005,119(6):518-524.
[26]World Health Organization. Global recommendations on physical activ-ity for health[R]. Geneva:WHO,2010:16-45.
[27]宋逸,张芯,杨土保,等.2010年全国中小学生体育锻炼行为现状及原因分析[J].北京大学学报(医学版),2012,44(3):347-354.
[28]PEARSON N,BIDDLE S J H. Sedentary behavior and dietary intakein children,adolescents,and adults:a systematic review[J]. Am JPrev Med,2011,41(2):178-88.
[29]JACKSON S L,CUNNINGHAM S A. The stability of children’sweight status over time,and the role of television,physical activity,and diet in elementary school[J]. Prev Med,2017,100(4):229-234.
[30]CAMPAGNOLO P D,VITOLO M R,GAMA C M,et al. Prevalenceof overweight and associated factors in southern Brazilian adolescents[J]. Public Health,2008,122(5):509-515.
[31]JACKSON J A,SMIT E,BRANSCUM A,et al. The family home en-vironment,food insecurity,and body mass index in rural children[J]. Health Educ Behav,2017,44(4):648-657.
[32]MARINS V M R,ALMEIDA R M V R,PEREIRA R A,et al. Fac-tors associated with overweight and central body fat in the city of Riode Janeiro:results of a two-stage random sampling survey[J]. PublicHealth,2001,115(3):1-7.