重庆市城市农村儿童肥胖发病率及相关因素的分析

Analysis on childhood obesity incidences between urban and rural in Chongqing and its related factors

摘要:

目的：了解重庆地区儿童肥胖发病率及肥胖相关因素的城乡差异。方法：按照整群抽样方法，抽取重庆市86所城乡中小学校共77 411名学龄儿童，测量身高、体质量，并计算体质指数（body mass index，BMI）。按照分层整群抽样方法再从中抽取2所城市学校和3所农村学校共4 400名儿童行肥胖影响因素问卷调查，按照BMI法判定肥胖，将肥胖儿童和正常儿童设为肥胖组和对照组，对儿童肥胖相关因素进行多因素logistic回归分析，并比较肥胖危险因素城乡差异。结果：（1）重庆地区学龄儿童总体肥胖率8.23%，城市9.70%，农村5.32%，城市高于农村（P<0.000 1）。（2）肥胖相关因素logistic回归分析结果显示，共13个因素与城市儿童肥胖相关，其中出生体质量，肉食、油炸食品、饮料、零食摄入频率，母亲吸烟及肥胖家族史是危险因素，母乳喂养、蔬菜摄入频率及补充维生素是保护因素；共8个因素与农村儿童肥胖相关，其中出生体质量、油炸食品、奶制品、零食摄入频率，父母BMI是危险因素，母乳喂养是保护因素。（3）城市儿童肉食、油炸食品、奶制品摄入频率高于农村，母亲吸烟比例高于农村，家族肥胖史比例高于农村，母乳喂养率低于农村（P<0.05）。结论：重庆地区儿童肥胖率城市高于农村，引起差异的主要因素为母亲吸烟、母孕期营养、6月龄前喂养方式、儿童青少年生活方式及肥胖家族史。控制儿童肥胖城市重点应倡导母孕期戒烟，加强母乳喂养，控制儿童肉食、油炸食品、含糖饮料、零食摄入；农村儿童肥胖率虽低于城市，但增速大于城市，应改善儿童饮食方式，控制油炸食品、奶制品、零食摄入，预防儿童肥胖。

Abstract:

Objective：To study the incidences of childhood obesity between urban and rural area in Chongqing and its related factors. Methods：According to the cluster sampling method，a total of 77 411 school-age children aged 6 to 18 years from Chongqing urban and rural area were enrolled. Height，weight and body mass index（BMI） were measured. According to the method of stratified cluster sampling，4 400 children from 2 urban schools and 3 rural schools were extracted to fill obesity influencing factors questionnaires. Children were divided into obese group and control group according to BMI，childhood obesity related multivariate Logistic regression analysis was made and differences of obesity risk factors between urban and rural were compared. Results：（1）Overall obesity inci－dences among school-age children in Chongqing were 8.23%，9.70% in urban and 5.32% in rural areas（P<0.000 1）. （2）Obesity re－lated factors logistic regression analysis demonstrated that birth weight，meat，fried food，beverage，snack intake frequency，maternal smoking and family history of obesity were risk factors for childhood obesity in urban area；breastfeeding，vegetable intake frequency and vitamin supplements were protective factors. At the same time，birth weight，fried foods，milk products，snack intake frequency，parents BMI were risk factors for childhood obesity in rural area；breastfeeding was protective factor. （3）Urban children ate more meat，fried foods and milk product than rural children；family obesity history rate was higher while breastfeeding rate was lower in urban children than in rural children（P<0.05）. Conclusions：Childhood obesity incidence of urban area is higher than that of rural area in Chongqing and the influencing factors are maternal nutrition during pregnancy，maternal smoking，feeding mode，way of life and family history of obesity. To control childhood obesity in urban，we should focus on advocating smoking cessation during pregnancy，raising breast feeding rate and controlling meat，fried food，sugary drinks，snack intake of children. Childhood obesity incidence is lower in rural area than in urban area，but the growth rate is higher in rural area than in urban area；measures should be taken to im－prove children’s dietary patterns and control fried foods，milk products and snack intake to avoid recommitting the same error of ur－ban children.