Study on the relationship between sugar-sweetened beverage intake and central obesity in children and adolescents aged 7-17 years from 1997 to 2011 in China
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摘要:
目的 探讨含糖饮料摄入与儿童青少年中心性肥胖的关系。 方法 利用“中国健康与营养调查”项目公开数据库中1997—2011年的横断面调查数据，分析中国7~17岁儿童青少年含糖饮料摄入与中心性肥胖的关系。根据腰围划分为正常组和中心性肥胖前期/中心性肥胖组，采用χ2检验比较不同组间差异，采用多因素Logistic回归分析模型分析含糖饮料对儿童青少年中心性肥胖的影响。 结果 1 916名7~17岁儿童青少年中，含糖饮料摄入频率≥3次/周、1~2次/周、1~3次/月和＜1次/月分别为389人(20.3%)、712人(37.2%)、563人(29.4%)和252人(13.2%)。共计731例(38.2%)发生中心性肥胖前期/中心性肥胖，调整相关混杂因素后，与摄入含糖饮料＜1次/月组相比，≥3次/周组增加68.0%的肥胖风险(95% CI：1.194~2.346，P=0.003)；年龄、性别对含糖饮料摄入频率和中心性肥胖的关系无统计学影响。 结论 含糖饮料摄入频率增高会增加儿童青少年中心性肥胖发生风险。 Abstract:Objective To investgate the relationship between sugar-sweetened beverage intake and central obesity among children and adolescents. Methods We used the cross-sectional survey data from 1997 to 2011 in the open database of the "China Health and Nutrition Survey" project, and this study analyzed the relationship between sugar-sweetened beverage intake and central obesity among Chinese children aged 7-17 years. All participants were divided into normal group and pre-central obesity group/central obesity group by the waist circumference. We used the Chi-square test to compare the differences between different groups, and multivariate Logistic liner regression analysis model was used to analyze the influence of sugary drinks on central obesity in children and adolescents. Results Among 1 916 children aged 7 to 17 years, 389 (20.3%) had more than or equal to 3 times of intake of sugar-sweetened beverages per week, 712 (37.2%) had 1-2 times per week, 563 (29.4%) had 1-3 times per month and 252 (13.2%) had less than once a month group. A total of 731 cases (38.2%) developed pre-central obesity/central obesity. After adjusting for related confounding factors, compared with the group who consumes sugary drinks less than once a month group, the group had more than or equal to 3 times a week increased the risk of obesity by 68.0% (95% CI: 1.194-2.364, P=0.003). Besides, age and gender had no significant effect on the relationship between the frequency of sugar-sweetened beverage intake and central obesity. Conclusion Higher frequency of sugar-beverage intake can increase the risk of central obesity in children and adolescents. -
Key words:
- Children /
- Adolescents /
- Sugary drinks /
- Pre-central obesity /
- Central obesity
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图 1 1997—2011年中国7~17岁儿童青少年不同含糖饮料摄入频率人群占比变化趋势
Figure 1. Changes in different proportion of the frequency of consumption of sugar-sweetened beverages among children and adolescents aged 7-17 years from 1997-2011 in China
图 2 1997—2011年中国7~17岁儿童青少年年龄、性别分层后含糖饮料摄入频率与中心性肥胖的多因素分析a
注：a调整了年龄、性别、城乡、家庭人均年收入、总能量摄入和睡眠充足情况。
Figure 2. Multivariate analysis of the correlation between intake frequency of sugar-sweetened beverages and obesity stratified by age and gender in children and adolescents aged 7-17 years from 1997-2011 in China a
表 1 变量赋值
Table 1. Variable assignment
编码 变量 赋值 备注 Y 中心性肥胖 正常=1，中心性肥胖前期/中心性肥胖组=2 因变量 X1 含糖饮料摄入频率 ＜1次/月=1，1~3次/月=2，1~2次/周=3；≥3次/周=4 自变量 X2 年龄(岁) 7~＜12=1，12~17=2 协变量 X3 性别 男=1，女=2 协变量 X4 城乡 农村=1，城市=2 协变量 X5 家庭人均年收入 低=1，中=2，高=3 协变量 X6 总能量摄入(%) ＜60=1，60~ < 80=2，80~ < 100=3；≥100=4 协变量 X7 睡眠充足情况 否=1，是=2 协变量 
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表 2 1997—2011年中国7~17岁儿童青少年基本特征[n(%)]
Table 2. Basic characteristics of children aged 7-17 years from 1997-2011 in China [n(%)]
特征 合计(N=1 916) 正常组(n=1 185) 中心性肥胖(n=731)a χ2值 P值 年龄(岁) 18.512 ＜0.001 7~＜12 532(27.8) 370(31.2) 162(22.2) 12~17 1 384(72.2) 815(68.8) 569(77.8) 性别 1.349 0.245 男 982(51.3) 595(50.2) 387(52.9) 女 934(48.7) 590(49.8) 344(47.1) 城乡 20.154 ＜0.001 农村 1 279(66.7) 836(70.5) 443(60.7) 城市 637(33.3) 349(28.5) 288(39.3) 家庭人均年收入 9.663 0.008 低 1 213(63.8) 780(66.3) 433(59.6) 中 539(28.3) 315(26.8) 224(30.9) 高 150(7.9) 81(6.9) 69(9.5) 总能量摄入(%) 26.597 ＜0.001 ＜60 1 002(52.5) 670(56.7) 332(45.4) 60~＜80 516(27.0) 304(25.7) 212(29.2) 80~＜100 246(12.9) 133(11.3) 113(15.5) ≥100 146(7.6) 74(6.3) 72(9.9) 睡眠充足情况 1.790 0.181 否 1 493(77.9) 936(79.3) 557(76.7) 是 413(22.1) 244(20.7) 169(23.3) 含糖饮料摄入情况 是否摄入 16.938 0.001 否 252(13.2) 171(14.4) 81(11.1) 是 1 664(86.8) 1 014(85.6) 650(88.9) 摄入频率 ＜1次/月 252(13.2) 171(14.9) 81(11.0) 1~3次/月 563(29.3) 362(30.5) 201(27.5) 1~2次/周 712(37.2) 444(37.5) 268(36.7) ≥3次/周 389(20.3) 208(17.6) 181(24.8) 注：a包含中心性肥胖前期及中心性肥胖。
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表 3 1997—2011年中国含糖饮料摄入与7~17岁儿童青少年中心性肥胖的多因素Logistic线性回归分析模型分析
Table 3. Logistic liner regression analysis of sugary beverage intake and obesity in children and adolescents aged 7-17 years from 1997-2011 in China
含糖饮料摄入 模型1a 模型2b 模型3c OR(95% CI)值 P值 OR(95% CI)值 P值 OR(95% CI)值 P值 ＜1次/月 1.000 1.000 1.000 1~3次/月 1.172(0.855~1.607) 0.324 1.182(0.859~1.625) 0.304 1.158(0.837~1.601) 0.375 1~2次/周 1.274(0.940~1.728) 0.119 1.263(0.929~1.718) 0.137 1.233(0.901~1.688) 0.190 ≥3次/周 1.837(1.319~2.558) < 0.001 1.761(1.260~2.462) 0.001 1.680(1.194~2.364) 0.003 Wald值 14.420 11.699 9.561 P值 < 0.001 0.001 0.002 注：a模型1未调整；b模型2调整了年龄、性别及城乡；c模型3在模型2的基础上调整家庭人均年收入、总能量摄入和睡眠充足情况。
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表 4 1997—2011年中国7~17岁儿童青少年含糖饮料摄入与肥胖的敏感性分析
Table 4. Sensitivity analysis of sugar-sweetened beverage intake and obesity in children and adolescents aged 7-17 years from 1997-2011 in China
含糖饮料摄入 模型1a 模型2b OR(95% CI)值 P值 OR(95% CI)值 P值 ＜1次/月 1.000 1.000 1~3次/月 1.215(0.876~1.686) 0.243 1.200(0.712~2.021) 0.494 1~2次/周 1.316(0.958~1.808) 0.090 1.166(0.706~1.927) 0.548 ≥3次/周 1.832(1.296~2.590) < 0.001 1.829(1.068~3.132) 0.028 注：a调整了年龄、性别、城乡、家庭人均年收入、总能量摄入、睡眠充足情况及招募年份；b调整了年龄、性别、城乡、家庭人均年收入、总能量摄入、睡眠充足情况及经常参加体育活动情况。
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