小学生零食消费种类与肥胖及代谢异常的关系

Association of snacks consumption with the prevalence of obesity and related metabolic abnormalities among Chinese children

目的了解零食消费种类与儿童肥胖及代谢异常之间的关系,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7 084名,使用问卷调查收集年龄、性别、家庭经济情况和零食消费情况等信息,按照标准程序测量身高、体重、腰围、血压,采集晨起空腹血测定血糖、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。结果常吃"可经常食用"、"适当食用"、"限量食用"3类零食的小学生肥胖检出率(OR值及OR值95%CI)依次为9.3%(参照组)、10.2%(1.09,0.88～1.35)、11.8%(1.25,1.05～1.50),腹型肥胖率依次为13.3%(参照组)、14.8%(1.14,0.95～1.37)、15.8%(1.25,1.07～1.46),高三酰甘油血症检出率依次为3.4%(参照组)、3.9%(1.13,0.81～1.58)、4.6%(1.34,1.02～1.77)。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,肥胖、腹型肥胖、高三酰甘油血症检出率在各组间差异仍有统计学意义。结论经常吃不健康零食会增加儿童患肥胖及代谢异常的风险,选择蔬菜、水果、奶及奶制品、豆及豆制品等食物作为零食有益于健康,对儿童进行营养健康教育具有重要意义。

Objective To investigate the association of snacks consumption with the prevalence of obesity and related metabolic abnormalities among children in China. Methods A total of 7 084 children in grade 2nd to 5th, aged 6 - 13 years were selected to complete the questionnaires from 6 citiesf Harbin, Beijing, Jinan, Shanghai, Chongqing, Guangzhou） , using multistage random sampling in 2009. Height, weight, waist circ- umference, blood pressure, fasting glucose level, total cholesterol （ TC ）, high-density lipoprotein （ HDL ） cholesterol, low-density lipoprotein （LDL） cholesterol and triglycerides （TG） were collected according to the standard procedure. Results The prevalence （ OR, 95% CI） of obesity among children regularly consuming snacks of the ＂Eligible to regular consumption＂ , ＂Moderate to consumption＂ and ＂ Restrained to consumption＂ , was 9. 3% （ref） , 10.2% （ 1.09, 0.88 - 1.35 ）, 11.8% （ 1.25, 1.05 - 1.50 ） , respectively; And the prevalence of abdominal obesity in different snacks category groups was orderly 13.3% （ref）, 14.8% （1.14, 0.95 -1.37）, 15.8% ） 1.25, 1.07 -1.46）, respectively; The prevalence IOR, 95% CI）of metabolic syndrome in different snacks category groups was 3.4% （ ref） , 3.9% （ 1.13, 0.81 - 1.58 ） , 4.6% （ 1.34, 1.02 - 1.77 ） , re- spectively. There was significant difference in the prevalence of obesity, abdominal obesity and hypertfiglyceridemia among children in different snacks category groups, after adjustment for age, gender, birth weight, feeding types after birth within 4 months, parents＂ weight status and educational lev- el, and family income. Conclusion Regular consumption of the restrained snacks can elevate the risk of obesity and related metabolic abnormalities among children. To select snacks such as fresh vegetables and fruits, milk and products, legume and products, as snacks, is healthy for children. It meaningful to instruct nutrition knowledge to the children.