目的 探究中国西部贫困地区学龄儿童生长发育和营养状况,及其与社会经济状况(SES)的关系,为贫困地区儿童生长发育与营养状况改善提供建议。方法 依托中国贫困地区学龄儿童营养状况调查及改善研究项目,2020年10—12月纳入陕西和四川两省3个国家级贫困县1 059名学龄儿童及其父母为研究对象。对儿童进行体格测量,并对儿童及其父母进行问卷调查。主成分分析法纳入父/母文化程度、职业和家庭月收入5项指标构建SES作为解释变量。采用混合效应模型分析SES与生长发育(身高、体重、腰围、BMI)和营养状况(生长迟缓、消瘦、超重肥胖、中心性肥胖)的关系。结果 学龄儿童的生长迟缓、消瘦、超重肥胖、肥胖、中心性肥胖率分别为2.8%、7.4%、26.0%、14.4%、24.5%。高SES组比低SES组儿童的腰围、BMI分别高2.50cm(95%CI:1.14～3.86)、0.76kg/m2(95%CI:0.27～1.25),超重肥胖和中心性肥胖风险分别高63%(OR＝1.63, 95%CI:1.12～2.38)、62%(OR=1.62, 95%CI:1.10～2.39)(P<0.05)。结论 西部贫困地区儿童面临双重营养不良的挑战。SES与儿童生长发育的相关指标、超重肥胖和中心性肥胖风险呈正相关。在消除贫困地区儿童消瘦的同时需要遏制肥胖的快速增加,同时重视儿童家庭环境和营养状况的改善。
Abstract
Objective To study growth, development, and nutritional status of school-age children in poor areas of western China, and to analyze their relationship with socioeconomic status (SES), so as to provide recommendations for future work. Methods This study recruited1 059 children and their parents from 3 poverty-stricken counties in Shaanxi and Sichuan provinces, using data collected from the "Study of Nutritional Status and Improvement of School-age Children in Poor Areas of China". Physical measurements were taken, and a questionnaire survey was administered to the children and their parents. Principal component analysis was used to construct SES as explanatory variables, including five indicators of parental education, occupation, and family monthly income. The correaltion of SES and growth (height, weight, waist circumference and BMI) with nutritional status (stunting, wasting, overweight/obesity and central obesity) was analyzed using a mixed-effects model. Results The prevalence of stunting, wasting, overweight/obesity, obesity, and central obesity among school-age children was 2.8%, 7.4%, 26.0%, 14.4%, and 24.5%, respectively. Compared with the low SES group, school-age children with high SES had a higher waist circumference and BMI, increased by 2.50cm (95%CI:1.14 - 3.86) and 0.76kg/m2 (95%CI: 0.27 - 1.25) respectively (P < 0.05). They were also more likely to be overweight/obese and have central obesity, with an increased risk of 63% (OR=1.63, 95%CI:1.12 - 2.38) and 62% (OR=1.62,95%CI:1.10 - 2.39) respectively (P<0.05). Conclusions SES is positively correlated with school-age children's growth indices and the prevalence of overweight and obesity in impoverished areas of western China, where children face the double burden of malnutrition. While efforts are made to eliminate wasting, it is necessary to control the rapid increase in obesity prevalence and focus on improving children's family environment and nutritional status.
关键词
社会经济状况 /
学龄儿童 /
生长发育 /
营养状况 /
贫困地区
Key words
socioeconomic status /
school-age children /
growth and development /
nutritional status /
impoverished areas
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基金
全民营养科研基金(CNS-NNSRG2019-97)
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