目的 分析海南省学龄儿童饮奶行为对营养不良的影响,为改善学生营养不良状况提供理论依据。方法 采用分层随机整群抽样的方法,从海南省4个城市和15个县中分别随机抽取1个城市和1个县作为城市和农村调查点,再从2个调查点中随机抽取共10所学校,每所学校按年级分层,从每所学校3~5年级各年级随机抽取3~5个班,采用问卷调查和体格检测收集学生的相关信息。分析该年龄段儿童饮奶行为对营养不良状况的影响。结果 在受检的3 286名8~12岁学龄儿童中营养不良检出率为23.5%(771/3 286),其中生长迟缓检出率为4.0%(132/3 286),轻度消瘦检出率为9.0%(296/3 286),中重度消瘦检出率为11.7%(385/3 286)。92.3%(3 033/3 286)的儿童每周都有饮用牛奶的行为,46.2%每周有5d以上饮用牛奶的行为,11.1%(364/3 286)平均每日饮奶量≥300mL。不同年龄、民族、居住地、选择奶或奶制品作为零食的行为、食用牛奶的频率、平均每日饮奶量与营养不良状况的差异有统计学意义(P＜0.05)。多因素Logistic回归分析结果显示居住在农村的儿童营养不良风险是居住在城市儿童的2.066倍(95%CI:1.742~2.451);而年龄(OR=0.768,95%CI:0.698~0.845)、饮奶频率[1~2d/周(OR=0.413,95%CI:0.305~0.559)、3~4d/周(OR=0.338,95%CI:0.247~0.461)、5~7d/周(OR=0.286,95%CI:0.214~0.383)]、选择奶或奶制品作为零食(OR=0.676,95%CI:0.570~0.801)、平均每日饮奶量≥300mL(OR=0.648,95%CI:0.475~0.883)是营养不良的保护因素(P＜0.05)。结论 海南省学龄儿童营养不良率较高,饮奶行为与营养不良的发生密切相关,建议加强儿童饮奶宣教,增加学生饮奶量和频率,改善饮奶行为。
Abstract
Objective To analyze the influence of milk drinking behavior of school-age children on malnutrition in Hainan Province, so as to provide theoretical basis for improving the malnutrition status of students. Methods Stratified random whole-group sampling was used to randomly select 1 city and 1 county from 4 cities and 15 counties in Hainan Province as urban and rural survey sites, respectively. Then a total of 10 schools were randomly selected from 2 survey sites, each stratified by grade level, and 3 - 5 classes were randomly selected from each grade level from 3 to 5 in each school. Questionnaires and physical tests were used to collect relevant information from students. The effect of milk drinking behavior on malnutrition status of children in this age group was analyzed. Results Among the 3 286 school-age children aged 8 - 12 years, the prevalence of malnutrition was 23.5% (771/3 286), of which the prevalence rates of growth retardation, mild weight loss, moderate and severe weight loss were 4.0% (132/3 286), 9.0% (296/3 286) and 11.7% (385/3 286), respectively. And 92.3% (3 033/3 286) of children drank milk every week, 46.2% drank milk more than 5 days every week, and 11.1% (364/3 286) drank milk ≥ 300mL per day on average. There were significant differences in age, nationality, residence, choice of milk or dairy products as snacks, frequency of milk consumption, average daily milk consumption between students with or without malnutrtion (P<0.05). Multivariate Logistic regression showed that the malnutrition risk of children living in rural areas was 2.066 times higher than that of children living in urban areas (95%CI: 1.742~2.451). Age (OR=0.768, 95%CI: 0.698 - 0.845), higher milk drinking frequency [1 - 2 days/week (OR=0.413, 95%CI: 0.305 - 0.559), 3 - 4 days/week (OR=0.338, 95%CI: 0.247 - 0.461), and 5 - 7 days/week (OR=0.286, 95%CI: 0.214 - 0.383)], choosing milk or dairy products as snacks (OR=0.676, 95%CI:0.570 - 0.801), the average daily milk intake ≥ 300mL (OR=0.648, 95%CI:0.475 - 0.883) were protective factors of malnutrition (P<0.05). Conclusions The malnutrition rate of school age children in Hainan Province is high, and milk drinking behavior is closely related to malnutrition. It is recommended to strengthen the education on milk drinking for children, increase the amount and frequency of milk drinking for students and improve milk drinking behavior.
关键词
饮奶行为 /
营养不良 /
学龄儿童
Key words
milk drinking behavior /
malnutrition /
school-age children
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
参考文献
[1] 王青,吴振茹.1～12岁儿童营养状况及其生长发育的关系[J].公共卫生与预防医学,2021, 32(6): 157-160.
Wang Q,Wu ZR. Relationship between nutritional status and growth and development of children aged 11-12[J]. Journal of Public Health and Preventive Medicine,2021, 32(6):157-160.
[2] 马军.儿童生长发育与营养[J].中国儿童保健杂志,2018,26 (9):932-934.
Ma J. Children's growth, development and nutrition[J]. Chin J Child Health Care,2018, 26(9): 932-934.(in Chinese)
[3] 李立康,戴华,刘玉梅,等.海南省贫困地区中小学生营养不良调查分析[J].实用预防医学,2019, 26(2): 251-253,257.
Li LK, Dai H, Liu YM, et al. Malnutrition among primary and middle school students in poverty areas of Hainan Province[J].Practical Preventive Medicine,2019,26(2): 251-253,257.(in Chinese)
[4] Jaiswal L, Worku M.Recent perspective on cow's milk allergy and dairy nutrition[J].Crit Rev Food Sci Nutr,2022,62(27):7503-7517.
[5] 湖南省疾病预防控制中心,上海市疾病预防控制中心,安徽医科大学公共卫生学院,等. 学生健康检查技术规范(GBT 26343-2010) [S]. 2011: 24.
[6] 中华人民共和国国家卫生和计划生育委员会.学龄儿童青少年营养不良筛查:WS/T 456-2014[S]. 2014.
[7] 中华人民共和国国家卫生和计划生育委员会.学龄儿童青少年超重与肥胖筛查:WS/T 586-2018[S]. 2018.
[8] 杨月欣.《中国食物成分表》标准版[M].6版.北京:北京大学医学出版社.
Yang YX.China Food Composition Tables (standard edition)[M].6th ed.Peking University Medical Press.
[9] Yichao W, Zhenli G. An analysis of the nutritional status of left-behind children in rural China and the impact mechanisms of child malnutrition[J].Children and Youth Services Review, 2020, 119.
[10] 董彦会, 王政和, 杨招庚, 等.2005年至2014年中国7～18岁儿童青少年营养不良流行现状及趋势变化分析[J].北京大学学报(医学版),2017, 49 (3): 424-432.
Dong YH, Wang ZH, Yang ZG, et al. Epidemic status and secular trends of malnutrition among children and adoles-cents aged 7-18 years from 2005 to 2014 in China[J]. Journal of Peking University(Health Sciences), 2017, 49 (3): 424-432.(in Chinese)
[11] 邓竹娟,茆广绪,王毓君,等. 湖南省农村义务教育学龄儿童实施“营养改善计划”后营养状况评价[J].中国当代儿科杂志, 2016, 18 (9): 851-856.
Deng ZJ, Mao GX, Wang YJ, et al. Evaluation of nutritional status of school-age children after implementation of "Nutrition Improvement Program" in rural area in Hunan, China[J]. Chinese Journal of Contemporary Pediatrics, 2016, 18 (9): 851-856.(in Chinese)
[12] Yackobovitch-Gavan M,Phillip M,Gat-Yablonski G.How milk and its proteins affect growth, bone health, and weight[J].Horm Res Paediatr,2017,88 (1):63-69.
[13] Dor C, Stark AH, Dichtiar R, et al.Milk and dairy consumption is positively associated with height in adolescents: Results from the Israeli National Youth Health and Nutrition Survey[J].Eur J Nutr,2022,61(1):429-438.
[14] Grenov B,Michaelsen KF.Growth components of cow's milk: Emphasis on effects in undernourished children[J].Food Nutr Bull,2018,39 (Suppl2):45-53.
[15] 许晓丽,于冬梅,房红芸,等.中国小学生乳类及制品消费情况分析[J].中国食物与营养,2021,27(10): 5-9.
Xu XL, Yu DM, Fang HY, et al. Analysis on the consumption of milk and milk products among primary school students in China[J].Food and Nutrition in China,2021,27(10):5-9.(in Chinese)
[16] 刘玉梅, 吴红, 张帆, 等.海南贫困地区黎族中小学生营养知识状况及影响因素[J].中国学校卫生,2018, 39 (3): 354-356.
Liu YM, Wu H, Zhang F, et al. Nutritional knowledge and influencing factors among Li nationality students in undeveloped areas of Hainan Province[J]. Chinese Journal of School Health, 2018, 39 (3): 354-356.(in Chinese)
基金
中国营养学会-营养科普与传播研究基金项目(CNS-SCP2020-88);2021年海南省研究生创新科研课题(Qhys-2021-374)。
PDF(645 KB)
