小学生午餐在外就餐与肥胖及代谢异常的关系

Association of lunch dining place with the prevalence of obesity and related chronic diseases among children

目的了解午餐在外就餐与儿童肥胖等代谢疾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、北京、济南、上海、重庆、广州6个城市抽取6～13岁小学生7 083名,使用问卷调查收集年龄、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、高密度脂蛋白胆固醇和三酰甘油等指标的测试。结果经常在学校、家里及在外就餐的儿童肥胖率(OR值95%CI)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差异仍有统计学意义。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 investigate the association of lunch dining place with the prevalence of obesity and related chronic diseases among children. Methods 7 083 children grade second to fifth, aged 6 - 13 years were selected to complete the questionnaires from 6 cities such as Harbin Beijing, Jinan, Shanghai, Chongqing, Guangzhou and so on, using multistage random sampling in 2009. And they were tested for physique and blood biochemistry according to the same standards. Results The prevalence （ OR, 95 % CI）of obesity among children regularly lunching at school, home, and ＂other＂ place, was 10.1% （ref） , 11.2% （1.01,0.84-1.2） , 11.3% （1.06, 0.89 -1.34） , respectively; And the prevalence of ab- dominal obesity in different groups was orderly 13.5 % （ ref）, 16.1% （ 1.05, 0. 89 - 1.23 ）, 17.2% （ 1.24, 1.03 - 1.51 ）, respectively; The prevalence of metabolic syndrome in different groups was 0.8% （ refl, 1.4% （ 1.34, 0.79 - 2.261）, 1.6% （ 1.71, 1.01 - 3.26 ）, respectively. There was significant difference in the prevalence of abdominal obesity and metabolic syndrome among children lunching at different places after ad- justment for age, gender, birth weight, feeding types after birth within 4 months, parents＂ weight status and educational level, and family income. Conclusion Regularly lunching at restaurants or ＂other＂ place elevated the risk of obesity and related chronic diseases among children. Lunching at school provided children not only appropriate nutrition intakes but also low likelihood of diseases risk. Advocating and spreading of school nutritional lunch is very meaningful.