留守儿童带养人类型与饮食行为对超重肥胖的影响

Interaction effects between the dietary behaviors and the type of caregivers on their overweight or obesity among left-behind children

目的研究留守儿童带养人类型与饮食行为交互作用与留守儿童超重肥胖的关联,为减少留守儿童超重肥胖的发生提供干预依据和参考。方法于2018年10—12月,分层整群随机抽取江西省上饶市玉山县区7~18岁877名留守儿童,对其带养人类型、饮食行为、健康状况进行问卷调查和身高、体重等项目测试。结果留守儿童超重肥胖的检出率为21.7%(190/877),带养人类型为其他人的留守儿童超重肥胖率为29.8%(158/530),高于带养人为父/母亲者(16.2%,32/198);经常吃西式快餐的留守儿童超重肥胖检出率为59.0%(59/100),高于不经常吃西式快餐者(20.9%,131/628);带养人类型、是否经常吃西式快餐留守儿童超重肥胖检出率差异均有统计学意义(χ^2值分别为15.39,65.06,P值均<0.05)。Logistic回归分析结果显示,留守儿童经常吃西式快餐超重肥胖检出率是不经常吃西式快餐者的5.70倍(95%CI=3.62~8.99)。交互作用分析显示,带养人类型×是否经常吃西式快餐中(父/母×是)呈现正向相乘的交互作用(协同作用),带养人为父/母且经常吃西式快餐留守儿童增加了超重肥胖发生的风险(OR=6.94,95%CI=2.76~17.44)。其交互对比度(ICR)为1.26,归因比(AP)为1.81,交互作用指数(SI)为1.27。结论父/母带养留守儿童经常吃西式快餐与留守儿童超重肥胖关联,二者具有协同作用,极大增加了留守儿童超重肥胖发生的风险。

Objective To explore the association between interaction effects of dietary behaviors and caregivers’s type on overweight or obesity among left-behind children,and to provide a reference for overweight or obesity prevention among the left-behind children.Methods From October to December 2018,877 left-behind children aged 7-18 years were randomly selected from a stratified cluster in county,Shangrao City,Jiangxi Province.Type of caregives,dietary behavior,health status were collected from questionnaires,height,weight were examined.Results The detection rate of overweight and obesity in left-behind children was 21.7%(190/877),and the rate of overweight and obese left-behind children with other foster parents was 29.8%(158/530),higher than the rate of 16.2%(32/198).The detection rate of overweight and obesity of left-behind children who consumed high level of western fast food was 59.0%(59/100).There were significant differences in rate of overweight and obesity by type of caregiver and western food consumption.Regression analysis showed that the detection rate of overweight and obesity of left-behind children who often ate western fast food was 5.70 times(95%CI=3.62-8.99)high than that of those who seldom ate western fast food.Interaction analysis showed that the interaction(synergistic effect)of the type of adopter×whether the adopter often ate western fast food(father or mother×yes)presents a positive multiplying interaction(synergistic effect).Left-behind children under paternal or maternal care together with high western fast food consumption greatly increased the risk of overweight and obesity(OR=6.94,95%CI=2.76-17.44).Conclusion Frequent consumption of western fast food together with one parent stay at home is associated with overweight and obesity of left-behind children.These two factors have a synergistic effect,which greatly increases the risk of overweight and obesity of left-behind children.In other words,their interaction is a major risk factor.