Analysis of the prevalence and risk factors of overweight and obesity in fourth grade students in China
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摘要:
目的 分析中国四年级学生超重/肥胖流行情况，探讨影响学生超重/肥胖的因素。 方法 利用2018年中国教育追踪调查(China education panel survey, CEPS)小学队列数据进行分析，最终纳入分析的四年级学生共29 996人。采用χ2检验比较不同特征学生超重/肥胖率差异，并利用logistic回归分析模型分析影响超重/肥胖的因素。 结果 四年级学生的超重/肥胖率为22.4%，超重率和肥胖率分别为12.3%和10.1%。Logistic回归分析模型分析显示，男生的超重/肥胖率高于女生(OR=2.60, 95% CI: 2.43~2.78, P < 0.001)，分别为29.2%和14.6%；11岁组学生的超重/肥胖率低于10岁组(OR=0.81, 95% CI: 0.76~0.87, P < 0.001)，分别为20.9%和23.8%；在城市学校就读的学生超重/肥胖率高于在农村学校就读的学生(OR=1.45, 95% CI: 1.31~1.60, P < 0.001)，分别为23.7%和15.3%；独生子女的超重/肥胖率高于非独生子女(OR=1.42, 95% CI: 1.33~1.52, P < 0.001)；有体育运动爱好的学生超重/肥胖率低于无体育运动爱好的学生(OR=0.74, 95% CI: 0.69~0.79, P < 0.001)；不吃早饭的频率越高，学生超重/肥胖的风险越大；吃油炸/烧烤/膨化食品的频率越高，学生超重/肥胖的风险越大。 结论 学校应科学指导四年级学生合理搭配膳食，保持健康饮食，促进学生主动增加体育运动时间。应加强对男学生, 城市就读学生, 独生子女等高危人群关注和精准预防。 Abstract:Objective To analyze the prevalence of overweight and obesity and their risk factors among fourth grade students in China. Methods A total of 29 996 students were selected from the fourth grade primary school cohort of China education panel survey (CEPS) in 2018-2019 school year. Chi-square test was used to examine the differences in the prevalence of overweight and obesity among different groups and logistic regression models were used to analyze the factors related to overweight or obesity. Results The prevalence of overweight/obesity among fourth-grade elementary school students was 22.4%. The prevalence of overweight and obesity was 12.3% and 10.1% respectively. Logistic regression analysis indicated that the rate of overweight/obesity among boys was higher than girls (OR=2.60, 95% CI: 2.43-2.78, P < 0.001), with respective rates of 29.2% and 14.6%. The rate of overweight/obesity among students in the 11-year-old group was lower than that in the 10-year-old group (OR=0.81, 95% CI: 0.76-0.87, P < 0.001), with respective rates of 20.9% and 23.8%. The rate of overweight/obesity among students attending urban schools was higher than students attending rural schools (OR=1.45, 95% CI: 1.31-1.60, P < 0.001), with respective rates of 23.7% and 15.3%. The rate of overweight/obesity among only children was higher than non-only children (OR=1.42, 95% CI: 1.33-1.52, P < 0.001). The rate of overweight/obesity among students with a sports hobby was lower than students without a sports hobby (OR=0.74, 95% CI: 0.69-0.79, P < 0.001). Besides, our results found that the higher the frequency of skipping breakfast, the greater the risk of overweight/obesity for students; the higher the frequency of consuming fried/grilled/puffed foods, the greater the risk of overweight/obesity for students. Conclusions Schools should scientifically guide fourth-grade students to reasonably combine meals, maintain a healthy diet, and encourage students to actively increase their sports time. Attention and precise prevention should be strengthened for high-risk groups such as male students, urban students, and only children. -
Key words:
- Fourth grade students /
- Overweight /
- Obesity /
- Sports /
- Healthy diet
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表 1 不同社会人口学特征四年级学生超重及肥胖率情况
Table 1. Prevalence of overweight and obesity among fourth grade students by different demographic characteristics
特征 Characteristic 总人数 Total number of people 超重 Overweight① 肥胖 Obesity① χ2值 value P值 value 个人特征 Personal characteristic 性别 Gender 927.435 < 0.001 男 Male 15 938 2 629(16.5) 2 026(12.7) 女 Female 14 058 1 063(7.6) 991(7.0) 年龄/岁 Age/years 49.640 < 0.001 10 15 318 1 936(12.6) 1 711(11.2) 11 14 678 1 756(12.0) 1 306(8.9) 是否为独生子女 Only child or not 262.816 < 0.001 否 No 20 926 2 311(11.0) 1 838(8.8) 是 Yes 8 774 1 342(15.3) 1 148(13.1) 家庭环境 Family environment 母亲受教育年限 Mother′s years of education 32.444 < 0.001 平均教育年以下 Below average years of education 14 829 1 707(11.5) 1 407(9.5) 平均教育年以上 Above average years of education 14 429 1 892(13.1) 1 538(10.7) 父亲受教育年限 Father′s years of education 15.167 0.001 平均教育年以下 Below average years of education 13 736 1 595(11.6) 1 344(9.8) 平均教育年以上 Above average years of education 15 522 2 004(12.9) 1 601(10.3) 家庭年收入 Annual household income/10 000 yuan 98.279 < 0.001 ≤2 5 988 594(9.9) 488(8.2) ＞2~5 5 287 643(12.2) 544(10.3) ＞5~10 7 083 909(12.8) 807(11.4) >10 7 032 974(13.8) 726(10.3) 学校环境 School environment 是否有室内体育馆 Whether there is an indoor stadium 21.832 < 0.001 无 No 22 615 2 703(12.0) 2 192(9.7) 有 Yes 7 181 955(13.3) 788(11.0) 学校所在地区 School location 161.054 < 0.001 农村 Rural 4 758 411(8.6) 319(6.7) 城市 Urban 25238 3 281(13.0) 2 698(10.7) 生活方式 Life style 体育运动爱好 Sports hobby 45.455 < 0.001 无 No 18 557 2 154(11.6) 2 002(10.8) 有 Yes 11 348 1 527(13.5) 1 006(8.9) 吃早饭情况 Breakfast eating habits 69.557 < 0.001 每天都吃 Eat every day 20 553 2 448(11.9) 1 913(9.3) 偶尔不吃 Occasionally do not eat 4 574 625(13.7) 556(12.2) 有时不吃 Sometimes do not eat 2 732 327(12.0) 301(11.0) 经常不吃 Often do not eat 847 117(13.8) 108(12.8) 几乎不吃 Hardly eat 722 103(14.3) 85(11.8) 吃油炸/烧烤/膨化食品 Eat fried/grilled/puffed food 144.289 < 0.001 从不 Never 5 159 508(9.8) 423(8.2) 很少 Seldom 15 336 1 846(12.0) 1 488(9.7) 有时 Sometimes 7 274 1 008(13.9) 8 22(11.3) 经常 Often 1 285 207(16.1) 168(13.1) 总是 Always 565 79(14.0) 85(15.0) 喝含糖/碳酸饮料 Drink sugary/carbonated beverages 48.557 < 0.001 从不 Never 3 928 432(11.0) 374(9.5) 很少 Seldom 14 322 1 723(12.0) 1 360(9.5) 有时 Sometimes 8 357 1 070(12.8) 887(10.6) 经常 Often 2 032 280(13.8) 237(11.7) 总是 Always 800 105(13.1) 114(14.2) 注：①以人数(占比/%)表示。
Note: ① Number of people (proportion/%).
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表 2 超重/肥胖的多因素logistic回归分析
Table 2. Multivariate logistic regression analysis on risk factors of overweight and obesity
变量 Variable OR值 value (95% CI) sx Wald χ2值 value P值 value 个人特征 Personal characteristic 性别 Gender 女 Female 1.00 男 Male 2.60(2.43~2.78) 0.09 27.52 < 0.001 年龄/岁 Age/years 10 1.00 11 0.81(0.76~0.87) 0.03 -6.38 < 0.001 是否为独生子女 Only child or not 否 No 1.00 是 Yes 1.42(1.33~1.52) 0.05 10.14 < 0.001 家庭年收入 Annual household income/10 000 yuan ≤2 1.00 ＞2~5 1.17(1.06~1.29) 0.06 3.07 0.002 ＞5~10 1.20(1.09~1.32) 0.06 3.80 < 0.001 >10 1.16(1.05~1.29) 0.06 2.88 0.004 学校所在地区 School location 农村 Rural 1.00 城市 Urban 1.45(1.31~1.60) 0.08 7.15 < 0.001 生活方式 Life-style 体育运动爱好 Sports hobby 无 No 1.00 有 Yes 0.74(0.69~0.79) 0.02 -8.95 < 0.001 吃早饭情况 Breakfast eating habits 每天都吃 Eat every day 1.00 偶尔不吃 Occasionally do not eat 1.35(1.24-1.47) 0.06 6.80 < 0.001 有时不吃 Sometimes do not eat 1.25(1.11~1.40) 0.07 3.81 < 0.001 经常不吃 Often do not eat 1.42(1.18~1.71) 0.13 3.76 < 0.001 几乎不吃 Hardly eat 1.41(1.15~1.72) 0.14 3.37 0.001 吃油炸/烧烤/膨化食品 Eat fried/grilled/puffed food 从不 Never 1.00 很少 Seldom 1.22(1.11~1.34) 0.06 3.99 < 0.001 有时 Sometimes 1.35(1.21~1.51) 0.08 5.27 < 0.001 经常 Often 1.55(1.30~1.84) 0.14 4.87 < 0.001 总是 Always 1.50(1.16~1.93) 0.19 3.15 0.002
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