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目的了解午餐在外就餐与儿童肥胖等代谢疾病发生率之间的关系,为制定相应的干预措施提供依据。方法采用随机整群抽样法,从哈尔滨、北京、济南、上海、重庆、广州6个城市抽取6～13岁小学生7 083名,使用问卷调查收集年龄、性别及家庭经济情况等信息。按照标准程序进行体格检查和血压测量以及空腹血糖、总胆固醇、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇和三酰甘油等指标的测试。结果经常在学校、家里及在外就餐的儿童肥胖率(OR值95%CI)依次为10.1%(参照组),11.2%(1.01,0.84～1.2),11.3%(1.06,0.89～1.34),腹型肥胖的发生率依次为13.5%(参照组),16.1%(1.05,0.89～1.23),17.2%(1.24,1.03～1.51),代谢综合征的发生率依次为0.8%(参照组),1.4%(1.34,0.79～2.26),1.6%(1.71,1.01～3.26)。调整年龄、性别、出生体重、出生4个月内喂养方式、父母文化程度、家庭人均收入等混杂因素后,腹型肥胖、代谢综合征的发生率在各组间差异仍有统计学意义。结论经常在外吃午餐可增加儿童患肥胖及代谢异常的危险;学校午餐可为儿童提供更加均衡的营养摄入,应大力推广学校营养午餐,以保证儿童健康成长。
Objective To understand the relationship between the incidence of metabolic diseases such as lunchtime eating and childhood obesity, and to provide evidence for the corresponding interventions. Methods A total of 7 083 primary school students aged 6 to 13 were selected from 6 cities in Harbin, Beijing, Jinan, Shanghai, Chongqing and Guangzhou using random cluster sampling method. Age, gender and family economic status were collected using questionnaires. Physical examination and blood pressure measurement as well as tests for fasting blood glucose, total cholesterol, low density lipoprotein cholesterol, high density lipoprotein cholesterol, and triglyceride were performed according to standard procedures. Results The prevalence of obesity (OR 95% CI) was 10.1% (control group), 11.2% (1.01,0.84 ~ 1.2) and 11.3% (1.06,0.89 ~ 1.34) in children, The incidence of obesity was 13.5% (reference group), 16.1% (1.05,0.89-1.23), 17.2% (1.24,1.03-1.51), metabolic syndrome was 0.8% (reference group), 1.4 % (1.34,0.79 ~ 2.26), 1.6% (1.71,1.01 ~ 3.26). After adjusting for age, sex, birth weight, feeding pattern, educational level of parents and per capita income of the family within 4 months of birth, the incidence of abdominal obesity and metabolic syndrome still had statistical significance among the groups. Conclusions Eating lunch regularly can increase children’s risk of obesity and metabolic disorders. School lunch can provide more balanced nutrition for children. School lunch should be vigorously promoted to ensure the healthy growth of children.