上海市浦东新区中小学生超重和肥胖现况及其膳食影响因素
Prevalence and dietary influencing factors of overweight and obesity in primary and secondary school students in Pudong New Area of Shanghai
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摘要:
目的 了解上海市浦东新区中小学生超重和肥胖现况及其影响因素，为制定超重和肥胖的防治策略提供参考依据。
方法 采用多阶段分层随机抽样法选择研究对象。第一阶段采用按规模大小成比例的概率抽样方法在浦东新区抽取3所小学、4所初中、2所高中，第二阶段采用简单随机抽样法从各年级抽取1个班级，第三阶段采用简单随机抽样法从每班抽取18名学生（男女各半）。实际完成调查609名中小学学生，先后开展基本情况调查、"3天24小时"膳食调查和体格检查，并对可能引起超重和肥胖的人口学、膳食、身体活动等相关因素进行单因素和多因素logistic回归分析。
结果 浦东新区中小学生总体超重率为13.96%，肥胖率为11.82%，男生肥胖率（14.85%）高于女生（8.82%）（P < 0.05）。多因素logistic回归分析显示，年龄增长（OR=0.86）、女性（OR=0.47）和蛋白质摄入过量（OR=0.32）、维生素B2摄入不足（OR=0.42）、锌摄入不足（OR=0.46）（均相对于适量摄入）可能是学生罹患超重和肥胖的保护性因素；初中阶段（相对于小学）（OR=2.43）、父亲文化程度为大专/职校（相对于小学及以下）（OR=2.96）和蔬菜类摄入不足（OR=1.61）、视黄醇摄入不足（OR=1.89）、维生素E摄入不足（OR=1.89）（均相对于适量摄入）可能是学生罹患超重和肥胖的危险因素。
结论 浦东新区中小学生超重、肥胖检出率较高，与年龄、性别、家长文化程度和蔬菜摄入不足等膳食因素密切相关。
Abstract:Objective To investigate the prevalence and influencing factors of overweight and obesity among primary and secondary school students in Pudong New Area of Shanghai, and provide a scientific basis for preventing overweight and obesity in students.
Methods A multi-stage stratified random sampling was conducted. In the first stage, three primary schools, four middle schools, and two high schools were selected by probability proportionate to size (PPS) sampling method. In the second stage, one classroom from each grade of the selected schools was selected by simple random sampling method. In the third stage, 18 students (half male and half female) from each classroom were selected by simple random sampling method. A total of 609 students completed the investigation including a survey collecting general information, 3-day 24-hour dietary recall, and physical examination. Single-factor and multiple logistic regression models were established to evaluate selected demographic, dietary, and physical activity-related factors potentially associated with overweight and obesity.
Results The overall prevalence rate of overweight among the selected students in Pudong New Area was 13.96%; the overall prevalence rate of obesity was 11.82%, and boys (14.85%) had a higher obesity rate than girls (8.82%) (P < 0.05). The multiple logistic regression analysis results showed that older age (OR=0.86), female (OR=0.47), excessive intake of protein (OR=0.32), and insufficient vs. adequate intakes of vitamin B2 (OR=0.42) or zinc (OR=0.46) were associated with not reporting overweight or obesity; middle school students (vs. primary school students, OR=2.43), fathers with college/vocational school education (vs. fathers with education level of primary school and below, OR=2.96), and students with inadequate vs. adequate intakes of vegetable (OR=1.61), retinol (OR=1.89), or vitamin E (OR=1.89) were associated with reporting overweight or obesity.
Conclusion Overweight and obesity are prevalent among primary and secondary school students in Pudong New Area of Shanghai, and are associated with age, gender, parental educational level, and diet such as inadequate intake of vegetable.
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