中国儿童青少年饮食行为对身高影响的多水平分析

Influence of diet behaviors on height among children and adolescents in China: a multiple level analysis

目的:基于身高增长划分儿童青少年不同生长期,并探索饮食行为在不同生长期对身高的影响。方法:利用2010年全国学生体质与健康调研数据,采用中国肥胖工作组2003年制定的筛查超重、肥胖标准和《中国6～19岁学龄儿童青少年分年龄BMI筛查消瘦界值范围》筛选体重正常7～18岁儿童青少年,整理身高及饮食行为指标,利用系统聚类分析划分儿童青少年不同生长期,构建多水平模型分析饮食行为在不同生长期对身高的影响。结果:基于身高增长将男、女生生长期均划为4期,男生为突增前期(7～10岁)、突增期(11～12岁)、突增后期(13～14岁)和稳定期(15～18岁);女生为快速增长期(7～10岁)、增长期(11～12岁)、增长后期(13～15岁)和稳定期(16～18岁)。男女生各生长期城市学生身高均高于农村学生(P<0.01),且城乡差异随生长期呈抛物线趋势,在男生突增期和女生增长期差异最为突出分别为3.31 cm和3.15 cm;在男生突增前期和女生快速增长期早餐对身高生长有促进作用(增长系数分别为0.40 cm和0.57 cm,P<0.01);在男、女生各生长期(除女生稳定期)牛奶对身高均有促进作用(P<0.01),且随生长期呈逐渐下降趋势,男生突增前期和女生快速增长期促进作用最强分别为0.91 cm和0.94 cm;在男、女生生长早、中期鸡蛋均有利于身高的生长(P<0.01),且随生长期有增强趋势;早餐、牛奶和鸡蛋对身高的影响具有交互作用(P<0.01),且随生长期呈下降趋势。结论:早餐、牛奶在儿童青少年生长发育早期更有利于促进其身高生长,鸡蛋对身高促进作用随生长期逐渐增强。

Objective：To categorize gowth and development stages among children and adolescents based on height, and to explore the influences of diet behaviors on height during diffrerent growth and development stages. Methods： Children and adolescents （7 to 18 years） with normal weights were selected using ＂Reference Norm for Screening Overweight and Obesity in Chinese Child and Adolescent＂ set up by WGOC in 2003 and ＂Reference Norm for Screening Underweight in Chinese Child and Adolescent ＂ from the ＂2010 National Physical Fitness and Health Surveillance＂ data, and the variables of height and diet behaviors sorted. The gorwth and development stages were categorized using the hierachical cluster analysis, and the multilevel model was used to analyze influences of diet behaviors on height at different growth and development stages. Results： Basis on height, there were 4 growth and development stages among the children and adolescents. In the boys, growth and development stages included Pre-GSS （growth spurt stage, GSS） including 7 to 10 years, GSS （11 to 12 years）, Post-GSS （13 to 14 years）, and growth stability stage （15 to 18 years） ; in the girls, the stages included the fast velocity GS （growth stage, GS） including 7 to l0 years, GS （11 to 12 years）, Post-GS （13 to 15 years）, and growth stability stage （16 to 18 years）. The results of the multilevel model showed that the students＇ height in the urban areas were higher than in the rural areas （P 〈0.01 ） , and the trend of difference between the urban and rural areas with the different growth stages was a parabola shape, the highest differences were 3.36 cm and 3.23 cm in the GSS and the fast velocity GS, respectively. There were significant influences of breakfast on height during the Pre-GSS and the fast velocity GS （P 〈 0.01 ）, and increased 0.40 cm and 0.57 cm, respectively. Excluding the stablilty growth stage in the girls, drinking milk increased signifi- cantly height during the different growth stages （ P 〈 0.01 ）, and the inereases were gradual downtrend with the growth stages, the highest increase was 0.91 em and 0.94 em in Pre-GSS and the fast veloeity GS, respectively. Eating eggs increased significantly height during all the growth stages （P 〈 0.01 ）, and the increases were the gradual uptrend with different growth stages. There were interaction effects among breakfast, drinking milk and eating eggs during the different growth stages, which was the gradual downtrend. Conclusion： Breakfast and drinking milk are conducive to growth during early adolescence, and the effect of eating eggs on growth is gradual uptrend with different growth stages.