北京市城区和郊区学龄儿童膳食行为与血压的关联研究

Dietary habits of school-age children and its associations with blood pressure level in Beijing, China

目的 分析北京市城区和郊区学龄儿童的膳食行为特点,探讨其与血压水平的关联性.方法 按照分层整群随机抽样原则,于2004年采用抽签法在北京市随机抽取了4个城区和3个郊区的29所小学和中学,并以抽中学校所有6～18岁学龄儿童为研究对象,共调查了20 638名学龄儿童,有效人数为19 072名.采用标准方法测量其身高、体重和血压,采用《简短半定量食物频率问卷》进行膳食调查,调查了10种食物组的摄入频率,构建分析膳食行为.采用多元线性回归模型,分析不同膳食行为与儿童血压水平间的关联.结果 城区学龄儿童肥胖率（12.2％,1 218/9 984）高于郊区（6.7％,609/9 088）（Х^2=4.62,P＜0.05）;城区学龄儿童高血压患病率（8.0％,799/9 984）低于郊区（8.9％,809/9 088） （Х^2=167.32,P＜0.05）.城区和郊区学龄儿童舒张压分别为（65.7±8.6）、（67.0±8.7）mmHg（1 mmHg=0.133 kPa）（F=86.44,P＜0.05）,收缩压分别为（103.4±12.2）、（104.3±11.6）mmHg（F=11.33,P＜0.05）.共分析提取了相对均衡饮食、高蛋白饮食、高脂高热量饮食和蔬果饮食等4种膳食行为,其方差贡献率分别为24.7％、14.6％、14.0％、8.9％,共反映原来10种食物组所描述特征的62.2％.多元线性模型分析结果显示,相对均衡饮食与城区学龄儿童舒张压（β＇=-0.026,P＜0.05）,以及郊区学龄儿童收缩压（β＇=-0.050,P＜0.05）和舒张压（β＇=-0.039,P＜0.05）呈负相关;高蛋白饮食与城区学龄儿童收缩压（β＇=-0.018,P＜0.05）和舒张压（β＇=-0.030,P＜0.05）呈负相关.结论 北京市城区和郊区学龄儿童表现不同的饮食特点,相对均衡饮食及高蛋白饮食膳食行为可能降低儿童血压水平,预防高血压的发生.

Objective To study the dietary habits of school-age children in urban and rural districts and their association with blood pressure levels in Beijing,China.Methods A stratified,randomly clustered sampling design was used,29 primary and secondary schools from four urban districts and three rural districts in Beijing were randomly selected in 2004.20 638 children aged 6-18 years old were surveyed,and 19 072 of them provided completed usable data.The weight,height and blood pressure of the subjects were measured according to standard method.10 food-groups＇ information was collected by a semi-quantitative food frequency questionnaire.The relationship between different dietary habits and the blood pressure levels in school children was analyzed by multiple linear regression model.Results The prevalence of obesity among children in urban area（12.2%,1 218/9 984） was higher than that in rural area（6.7%,609/9 088） （Х^2 =4.62,P 〈0.05）,whereas the prevalence of hypertension among children in urban area（8.0%,799/9 984）was lower than that in rural area（8.9%,809/9 088） （Х^2 =167.32,P 〈0.05）.The diastolic blood pressure （DBP） among children was （65.7-± 8.6） mmHg（1 mmHg =0.133 kPa） in urban area and （67.0 ±8.7） mmHg in rural area,respectively （F =86.44,P 〈 0.05）,and the systolic blood pressure （SBP） among children was （103.4 ± 12.2） mmHg in urban area and （104.3 ± 11.6） mmHg in rural area,respectively （F =11.33,P 〈 0.05）.Factor analysis revealed 4 dietary habits labeled prudent habit,protein habit,high-fat and high-calorie habit and vegetables and fruits habit.The 4 dietary habits＇ variance contribution rate respectively was 24.7%,14.6%,14.0%,8.9%,and the 4 dietary habits totally reflect 62.2%characteristics of the 10 food-groups.In urban area,prudent habit was inversely associated with DBP （β＇ =-0.026,P 〈 0.05）,Protein habit was inversely associated with both children＇s SBP（β＇ =-0.018,P 〈0.05） and DBP（β＇=-0.030,P 〈 0.05）.In rural area,prudent habit was associated with children＇s SBP （β＇ =-0.050,P 〈 0.05） and DBP （β＇ =-0.039,P 〈 0.05）.Conclusions The dietary habits of school age children varied by sociodemographic characters in Beijing.The prudent habit and protein habit may decrease the children＇s blood pressure levels.