膳食水果摄入量与儿童超重肥胖的关系

Relationship between dietary fruit intake and overweight and obesity in children

目的 探讨儿童水果摄入量与超重肥胖患病风险的关系,为儿童肥胖的防控提供流行病学依据。方法 于2014年9—11月在重庆市采用分层整群抽样的方法,选取重庆农村1个县的2所小学共6 369名6~12岁儿童进行体格检查和问卷调查,并于2019年3—5月对基线一至二年级的儿童(1 814名)进行随访,分析比较不同水果摄入量与儿童超重肥胖患病率的关系。结果 将基线调查的6 369名儿童按照水果摄入量百分位数分为3个组Q1(P66.7,水果摄入量>214.3 g/d)。基线调查,Q2组的儿童体重、体质量指数(BMI)更低,Q1组儿童的超重肥胖患病率最高(32.03%);按照性别分组后,Q2组男童的超重肥胖患病率最低(31.94%)(P值均<0.05)。随访调查,3组儿童身高、体重、BMI的变化差异均无统计学意义(P值均>0.05),但Q2组的儿童肥胖患病率最低,为5.07%(P<0.05)。与Q2组的儿童比较,基线调查Q1组的儿童患肥胖的风险增加(OR=1.41,95%CI=1.10~1.81,P<0.05),随访调查Q3组的儿童患肥胖的风险增加(RR=1.83,95%CI=1.21~2.75,P<0.05)。结论 水果摄入量较高或较低均可能是儿童超重肥胖的危险因素。儿童适当摄入水果,可以预防肥胖的发生。

Objective To explore the relationship between fruit intake and the risk of overweight with obesity in children,so as to provide references for the prevention of childhood obesity.Methods From September to November 2014,a stratified cluster sampling method was used to select 6369 children aged 6-12 from two elementary schools of a country in rural Chongqing for physical examinations and questionnaire surveys,and 1814 children in grades 1-2 at baseline were followed up from March to May 2019.The relationship between fruit intake and the prevalence of overweight and obesity was analyzed.Results According to the percentile of fruit intake,the 6369 children at baseline were assigned to three groups:Q1(<P33.3,fruit intake<100 g/d),Q2(P33.3-P66.7,fruit intake:100-214.3 g/d),and Q3(>P66.7,fruit intake>214.3 g/d).For the baseline survey results,children in the Q2 group had a lower weight and Body Mass Index(BMI)(P<0.05);the prevalence of overweight and obesity among children in the Q1 group was the highest(32.03%),and the prevalence of overweight and obesity among boys in the Q2 group was the lowest(31.94%)after gender stratification(P<0.05).The follow-up survey results showed no significant differences between the three groups in terms of changes in height,weight,and BMI(P>0.05);but the prevalence of obesity among youth in the Q2 group was the lowest(5.07%,P<0.05).Compared with youth in the Q2 group,the risk of obesity was higher among those in the Q1 group at baseline survey(OR=1.41,95%CI=1.10-1.81,P<0.05),and was higher among those in the Q3 group at follow-up survey(RR=1.83,95%CI=1.21-2.75,P<0.05).Conclusion Deviating from moderate fruit intake may increase the likelihood of overweight and obesity in children,and it is recommended that children are encouraged to consume fruits as part of a well-balanced diet to prevent the occurrence of obesity.