周蔚, 夏蒨, 李香亭, 臧嘉捷. 上海成年居民膳食模式与超重/肥胖和中心型肥胖的关系[J]. 环境与职业医学, 2020, 37(9): 846-852. DOI: 10.13213/j.cnki.jeom.2020.20197
引用本文: 周蔚, 夏蒨, 李香亭, 臧嘉捷. 上海成年居民膳食模式与超重/肥胖和中心型肥胖的关系[J]. 环境与职业医学, 2020, 37(9): 846-852. DOI: 10.13213/j.cnki.jeom.2020.20197
ZHOU Wei, XIA Qian, LI Xiang-ting, ZANG Jia-jie. Dietary patterns and their associations with overweight/obesity and central obesity among adult residents in Shanghai[J]. Journal of Environmental and Occupational Medicine, 2020, 37(9): 846-852. DOI: 10.13213/j.cnki.jeom.2020.20197
Citation: ZHOU Wei, XIA Qian, LI Xiang-ting, ZANG Jia-jie. Dietary patterns and their associations with overweight/obesity and central obesity among adult residents in Shanghai[J]. Journal of Environmental and Occupational Medicine, 2020, 37(9): 846-852. DOI: 10.13213/j.cnki.jeom.2020.20197

上海成年居民膳食模式与超重/肥胖和中心型肥胖的关系

Dietary patterns and their associations with overweight/obesity and central obesity among adult residents in Shanghai

  • 摘要: 背景

    目前超重和肥胖在全世界流行,膳食是其重要影响因素之一。膳食模式是对整体膳食进行分析,较单一食物或营养素对肥胖发生的危险更具预测意义。

    目的

    分析上海市成年居民膳食模式,并探讨其与超重/肥胖、中心型肥胖的关系。

    方法

    2015年,上海在全市6个区开展"中国健康与营养调查(China Health and Nutrition Survey,CHNS)"监测项目,采用多阶段分层与人口成比例的整群随机抽样方法,对1 045名18岁及以上成年人开展问卷调查、体格检查和3 d 24 h膳食调查。依据第六次全国人口普查数据,对超重/肥胖检出率进行标化,采用因子分析法对居民膳食模式进行分析;将膳食模式得分按三分位数由低到高依次分为T1、T2、T3三个水平,利用logistic回归法分析膳食模式与超重/肥胖、中心型肥胖的关系。

    结果

    本次调查上海市成年居民超重/肥胖和中心型肥胖的检出率分别为52.0%和43.4%,标化检出率分别为44.1%和35.3%,男性、≥ 60岁老年人、居住地为郊区、小学及以下教育程度、中/重劳动强度、已婚人群超重/肥胖检出率较高,分别为57.2%、59.0%、59.9%、60.9%、63.2%、53.3%;≥ 60岁老年人、小学及以下教育程度、中/重劳动强度、已婚人群的中心型肥胖检出率较高,分别为49.4%、51.9%、54.7%、44.9%。因子分析法提取5种膳食模式,其累计贡献率为46.51%,分别为蔬果肉类模式、水果奶类模式、调味品酒类模式、谷薯禽肉模式和豆类模式。男性能量,蛋白质、脂肪摄入量及蛋白质、碳水化合物供能比在5种膳食模式T3组中的差异有统计学意义(均P < 0.05),而女性能量,蛋白质、脂肪、碳水化合物摄入量及蛋白质、碳水化合物供能比在5种膳食模式T3组中的差异有统计学意义(均P < 0.05)。调整混杂因素后,经logistic回归分析显示:蔬果肉类模式与男性中心型肥胖的发生呈正相关(T2:T1,OR=1.719,95%CI:1.072~2.756),水果奶类模式与女性中心型肥胖的发生呈负相关(T3:T1,OR=0.569,95%CI:0.347~0.933),豆类模式与女性中心型肥胖的发生呈负相关(T2:T1,OR=0.599,95%CI:0.387~0.928)。

    结论

    上海市成年居民超重/肥胖和中心型肥胖检出率高,膳食模式多样化,蔬果肉类模式的男性中心型肥胖的检出率较高,而水果奶类模式和豆类模式的女性中心型肥胖的检出率较低。

     

    Abstract: Background

    Overweight and obesity are prevalent worldwide, and diet is an important impact factor of overweight and obesity. Dietary patterns characterize how foods and nutrients are consumed in combinations, and are more predictive in analysis of the relationship of diet with obesity than individual foods or nutrients.

    Objective

    This study is designed to identify dietary patterns and explore their associations with overweight/obesity and central obesity among adult residents in Shanghai.

    Methods

    The socio-demographic characteristics, dietary intakes, and height and weight were retrieved from 1045 adults aged 18 years and over who participated the "China Health and Nutrition Survey 2015 (CHNS)" in six districts of Shanghai. The participants were selected by multi-stage stratified cluster random sampling method with probability proportional to size. The overweight/obesity prevalence was standardized to the sixth national population census data. Factor analysis was used to explore the dietary patterns. Dietary pattern scores were divided into three groups (T1, T2, and T3, form low to high) by tertiles, and logistic regression analysis was performed to evaluate the association of dietary patterns with overweight/obesity and central obesity.

    Results

    The prevalence rates of overweight/obesity and central obesity were 52.0% and 43.4% respectively. The standardized prevalence rates were 44.1% and 35.3% respectively. Men, the elderly ≥ 60 years, suburban residents, residents with primary school or below education or moderate/high labor intensity, and married residents had higher prevalence rates of overweight/obesity (57.2%, 59.0%, 59.9%, 60.9%, 63.2%, and 53.3%), respectively. The elderly ≥ 60 years, residents with primary school or below education or moderate/high labor intensity, and married residents had higher prevalence rates of central obesity (49.4%, 51.9%, 54.7%, and 44.9%), respectively. We identified five dietary patterns by factor analysis, explaining 46.51% of the diet variation:"vegetable, fruit, and meat", "fruit and dairy", "condiment and alcohol", "grain, tuber, and poultry", and "soybean" patterns respectively. For male, there were significant differences in the intakes of energy, protein, fat, and the proportions of energy intake from protein and carbohydrate among the T3 groups of the five dietary patterns (all P < 0.05). For female, there were significant differences in the intakes of energy, protein, fat, and carbohydrate, and the proportions of energy intake from protein and carbohydrate among the T3 groups of the five dietary patterns (all P < 0.05). After being adjusted for potential confounders, the results of logistic regression analysis showed that the "vegetable, fruit, and meat" pattern was positively correlated with central obesity in male (T2:T1, OR=1.719, 95%CI:1.072-2.756), the "fruit and dairy" pattern was negatively correlated with central obesity in female (T3:T1, OR=0.569, 95%CI:0.347-0.933), and the "soybean" pattern was negatively correlated with central obesity in female (T2:T1, OR=0.599, 95%CI:0.387-0.928).

    Conclusion

    The prevalence rates of overweight/obesity and central obesity are high, and the dietary patterns of adult residents in Shanghai are diversified. "Vegetable, fruit, and meat" pattern may be the risk factor of central obesity in male, "fruit and dairy" and "soybean" patterns may be the protective factors of central obesity in female.

     

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