午餐在外就餐与儿童肥胖及代谢异常的关系

The Association of Lunch Dining Place with the Prevalence of Obesity and Related Chronic Diseases among Children

目的分析午餐在外就餐与儿童肥胖等慢性病发生率之间的关系.为制定相应的干预措施提供依据。方法采用随机整群抽样法从哈尔滨等6城市抽取6-13岁小学生7083名,使用问卷调查收集他们的年龄、性别及家庭经济情况等信息。按照标准程序进行体格检查和血压测量以及空腹血糖、总胆固醇、低密度脂蛋白胆固醇、高密度脂蛋白胆回醇和甘油三酯等指标的测试。结果经常在学校、家里及在外就餐的儿童肥胖率[比值比(0R),95%可信区间(Cl))]依次为10.1%(参照组)、11.2%(1.01,0.84-1.2)、11.3%(1.06,0.89-1.34);腹型肥胖的发生率(OR,95%Cl)在各组间依次为:13.5%(参照组)、16.1%(1.05,0.89-1.23)、17.2%(1.24,1.03-1.51);代谢综合征的发生率(OR,95%C1)依次为:0.8%(参照组)、1.4%(1.34,0.79-2.26)、1.6%(1.71,1.01-3.26)。调整年龄、性别、出生体重、出生4个月内喂养方式、父母文化程度、家庭人均收入等混杂因素后,腹型肥胖、代谢综合征的发生率在各组间仍有显著差异。结论经常在外吃午餐,可增加儿童患肥胖及代谢异常的危险:学校午餐可为儿童提供更加均衡的营养摄入,应大力推广学校营养午餐,以保证儿童健康成长。

Objective To investigate the association of lunch dining place with the prevalence of obesity and related chronic diseases among children.Methods 7083 children grade second to fifth,aged 6-13 years were selected to complete the questionnaires from 6 cities such as Haerbin and so on,using multistage random sampling in 2009.And they were tested for physique and blood biochemistry according to the same standards,Results The prevalence(odds ratio, 95%CI)of obesity among children regularly lunching at school,home,and 'other' place,was 10.1%(ref), 11.2%(OR:1.01(0.84-1.2)),11.3%(OR:1.06(0.89-1.34)),respectively;And the prevalence(odds ratio,95%CI)of abdominal obesity in different groups was orderly 13.5%(ref),16.1%(OR:1.05(0.891.23)),17.2%(OR:1.24(1.03-1.51)),respectively;The prevalence(odds ratio,95%Cl)of metabolic syndrome in different groups was 0.8%(ref),1.4%(OR: 1.34(0.79-2.26))、1.6%(OR:1.71(1.01-3.26)), respectively.There was significant difference in the prevalence of abdominal obesity and metabolic syndrome among children lunching at different places,after adjustment for age, gender,birth weight,feeding types after birth within 4 months,parents' weight status and educational level,and family income.Conclusions Regularly lunching at restaurants or 'other' place elevated the risk of obesity and related chronic diseases among children.Lunching at school provided children not only appropriate nutrition intakes but also low likelihood of diseases risk.Advocating and spreading of school nutritional lunch was very meaningful.