中国城市学龄儿童超重肥胖流行现状及危险因素分析

Prevalence and risk factors of overweight/obesity among urban school children in five cities

目的了解中国城市学龄儿童超重肥胖流行现状并分析其危险因素。方法于2013年12月-2014年6月,选取石家庄、上海、深圳、兰州、武汉5个城市共3896名小学生进行问卷调查。结果超重肥胖检出率为19.8%,其中超重率为10.6%,肥胖率为9.2%;超重肥胖分布存在年龄、性别、地区差异,男童超重肥胖率(22.8%)高于女童(16.5%)(P<0.01)。校正地域和年龄后,多因素分析结果显示,儿童超重肥胖危险因素:体力活动不足(OR=4.179,95%CI=3.492~5.002)、男童(OR=1.218,95%CI 1.019~1.456)、不爱吃零食(OR=1.346,95%CI=1.047~1.731);而进食速度一般(OR=0.532,95%CI=0.335~0.845)或进食速度慢(OR=0.352,95%CI=0.211~0.586)、不爱吃肉类食物(OR=0.723,95%CI=0.549~0.952)、饮食结构为荤素搭配(OR=0.556,95%CI=0.324~0.965)有助于降低城市儿童超重肥胖发生率。结论以促进儿童体力活动水平、促进健康饮食习惯为目标的干预策略是预防和干预超重肥胖的重点和关键。

Objective To examine the prevalence and influencing factors of overweight/obesity among urban school children in China.Methods A questionnaire survey and physical measurement were conducted among 3 986 children selected with multistage random cluster sampling from elementary schools in five cities （Shijiazhuang,Shanghai,Shenzhen,Lanzhou,and Wuhan） across China during December 2013 to June 2014.Results The overall prevalence of overweight and obesity were 19.8% and the prevalcence of overweight and obesity was 10.6% and 9.2%.There were significant differences in the prevalence of overweight/obesity among the school children in diferent cities,at various ages,and between the school boys and girls （P〈0.05 for all）.The prevalence of obesity in school boys was significantly higher than that in school girls （22.8% vs.16.5%,P〈0.01）.After adjusting for city and age,logistic regression analysis revealed that physical inactivity （odds ratio[OR]=4.179,95% confidence interval[95%CI]：3.492-5.002）,male gender （OR=1.218,95%CI：1.019-1.456）,without snacking habit （OR=1.346,95%CI：1.047-1.731） were risks of overweight/obesity; while taking meals not fast or slowly （OR=0.532,95%CI：0.335-0.845）,taking meals slowly（OR=0.352,95%CI：0.211-0.586）,not liking to have meat products（OR=0.723,95%CI：0.549-0.952）,and with balanced dietary patterns （OR=0.556,95%CI：0.324-0.965）were protective factors for overweight/obesity among the school children.Conclusion Healthy dietary behaviors and being physically active are focal points when making intervention strategies for the prevention of overweight/obesity among urban school children.