饮食偏好及行为对中小学生超重或肥胖影响的病例对照研究

Study on food preference and dietary behavior to overweight/obesity in school children and adolescents in Guangzhou： a case-control study

目的探讨饮食偏好及行为对中小学生超重或肥胖的影响。方法采用病例对照研究方法，病例为广州市28所中小学中年龄为6～19岁的所有超重或肥胖学生，对照为同校同年级随机抽取的1～2个班中所有体重正常者。饮食偏好和行为采用自编问卷调查，对饮食偏好和行为按由少到多或由不喜欢到喜欢分为4个水平；通过测量身高和体重计算BMI并进行营养状况的分类；采用两分类logistic回归分析筛选中小学生超重或肥胖的影响因素。结果共调查7136人，问卷有效者5755人中超重或肥胖者为1947人，体重正常者2136人。单因素分析超重或肥胖的风险，很喜欢吃蔬菜、水果或糖果及夜宵者是不喜欢者的0．60～0．69倍；对食物挑剔多者是极少挑剔者的0．50倍；而很喜欢吃猪肉、牛羊肉和油炸食物者分别是不喜欢者的1．84、1．30和1．26倍；以及吃饭速度快者是慢者的5．14倍（P值均〈0．05）。在控制年龄、性别、家庭社会经济因素、父母体型后，对蔬菜与夜宵的偏好、挑剔食物以及进食速度4个指标对超重或肥胖的影响依然具有统计学意义。与不喜欢蔬菜或夜宵、不挑剔食物或进食速度慢者相比，喜欢蔬菜或夜宵、挑剔食物、进食速度快者对超重或肥胖影响的比值比（OR）及95％CI分别为0．55（0．42～0．73），0．48（0．35～0．65），0．50（0．39～0．65）和4．32（3．23～5．80）。结论减慢进食速度与多吃蔬菜有利于预防中小学生超重或肥胖。

Objective This study assessed the effect of food preference and dietary behaviors on the risk of overweight or obesity in school children and adolescents aged 6-19 years. Methods All overweight or obese students,with age-and school-matched controls were recruited for this case-control study from 28 elementary and secondary schools in Guangzhou urban districts from October 2006 to April 2007. Weight and height were measured, and body mass index was calculated for the classification of obesity, overweight and underweight. Their food preference and behaviors were assessed using a structured questionnaire completed by their parents. Behavior and food preference were classified into four levels, and the relevant bottom levels were defined as control groups. Logistic regression was used to assess independent determinants of overweight and obesity. Results Among 7136 participants, 1947 cases and 2136 normal weight controls from 5755 students with valid questionnaire data were included in the study. Results from univariate analysis showed that odds ratios for overweight or obesity were 0.60-0.69 in those with most preference （top group） on vegetables, fruits, candy, evening snacks, 0.50 in the students of less food partiality, 1.84,1.30 and 1.26 in those of most preference for pork,beef and deep-flied foods, and 5.14 in students with fastest speed during eating, respectively （all P〈 0.05 ）. Vegetable intake, evening snacks preference, speed during eating and food partiality remained with significant association with overweight and obesity in multivariate analysis after adjusted for age, sex, family socio-economical status and their parents＇ body build. The adjusted odds ratios （ OR ） and 95 % confidence intervals （95 % CI） of the above items became 0.55（0.42-0.73）,0.48（0.35-0.65）,0.50（0.39-0.65）,and 4.32（3.23-5.80） as compared to the relevant lowest categories, respectively. Conclusion Behaviors as eating more vegetables and sloweating might be protective factors against overweight and obesity in school children.