中国西部贫困地区小学生营养与饮食行为现状及相关性

Status and associations of nutritional and dietary behaviors of school-age children in poor areas of western China

目的了解中国西部贫困地区学生营养与饮食行为现状及其关联,为中学生营养不良持续改善策略提供参考。方法2020年10—12月对陕西和四川共3个贫困县1887名小学生进行体格测量和饮食行为问卷调查,采用混合效应模型分析营养状况与饮食行为的相关性。结果1887名学生生长迟缓、消瘦、超重肥胖、中心型肥胖检出率分别为1.8%,6.6%,27.7%,24.5%,省份间差异均有统计学意义(χ^(2)值分别为94.76,46.05,109.96,80.50,P值均<0.05)。陕西、四川学生超重肥胖检出率分别为32.8%,4.9%;生长迟缓和消瘦检出率陕西为0.4%,4.7%,四川为8.1%,14.7%。1160名学生饮食行为分析结果显示每天吃早餐、蛋、奶等的学生比例偏低;关联分析结果显示,每天吃早餐与学生超重肥胖风险呈负相关(OR=0.26,P<0.05),每周食用外卖和在食堂就餐2~6次与学龄儿童消瘦均呈正相关(OR值分别为2.51,2.82,P值均<0.05)。结论中国西部贫困地区小学生存在营养不足和营养过剩并存情况,且呈现地区差异。应采取针对性措施改善学生营养状况。

Objective To investigate the status of nutrition and dietary behaviors and their associations in school-age children in poor areas of western China,to provide clues for sustainable improvement strategies of malnutrition among primary school students in rural revitalization.Methods A total of 1887 school-age students from 3 poverty-stricken counties in Shaanxi and Sichuan provinces were investigated by physical examination and questionnaire survey during October to December in 2020.Mixed-effects model was used to analyze associations between nutritional status and dietary behaviors.Results The prevalence of stunting,wasting,overweight and obesity,and central obesity among 1887 students were 1.8%,6.6%,27.7%,24.5%,respectively,and the differences between two provinces were statistically significant(χ^(2)=94.76,46.05,109.96,80.50,P<0.05).The prevalence of overweight and obesity of students in Shaanxi and Sichuan were 32.8%and 4.9%,respectively.The prevalence of stunting and wasting were 0.4%and 4.7%in Shaanxi,and 8.1%and 14.7%in Sichuan,respectively.Among 1160 students with complete dietary data,the proportions of students who ate breakfast,eggs,and milk daily were low,and eating breakfast daily was negatively associated with overweight and obesity(OR=0.26,P<0.05),and eating out and eating in canteen were positively associated with wasting(OR=2.51,2.82,P<0.05).Conclusion School-age children in poor areas of western China are facing double burden of malnutrition,and there are significant regional differences.Future targeted interventions should be made to improve these students’nutritional status.