中国7~17岁儿童青少年宏量营养素摄入与中心性肥胖的关系

  目的  探讨三大宏量营养素供能比对儿童青少年中心性肥胖前期/中心性肥胖的影响。  方法  本研究采用横断面研究，对象为1997—2011年中国营养与健康调查6轮调查中膳食及腰围数据完整的7~17岁的儿童青少年。根据中国疾病预防控制中心营养与食品安全所的研究标准判定儿童青少年中心性肥胖前期/中心性肥胖。采用多因素Logistic回归分析模型分析宏量营养素供能比与中心性肥胖前期/中心性肥胖的关系。  结果  调整相关混杂因素后，与脂肪供能比 < 25%组相比，≥30%组增加中心性肥胖前期/中心性肥胖风险(OR=1.29, 95% CI: 1.12~1.48)；与蛋白质供能比 < 10%组相比，≥15%组增加中心性肥胖前期/中心性肥胖风险(OR=1.47, 95% CI: 1.19~1.82)；与碳水化合物供能比 < 55%组相比，55%~ < 65%组(OR=0.75, 95% CI: 0.64~0.87)与≥65%组(OR=0.68, 95% CI: 0.58~0.80)都降低了中心性肥胖前期/中心性肥胖风险。男生蛋白质供能比≥15%增加中心性肥胖前期/中心性肥胖的风险与女生相比更大(OR=1.78, 95% CI: 1.31~2.41, 交互作用P=0.012)。   结论  儿童青少年膳食结构中，脂肪和蛋白质供能比越高、碳水化合物供能比越低会增加中心性肥胖前期/中心性肥胖发生风险。

Study on the association between macronutrients intake and abdominal obesity in Chinese children and adolescents aged 7-17 years

  Objective  To explore the effect of macronutrient energy supply ratios on precentral obesity/central obesity in children and adolescents.  Methods  A cross-sectional study was conducted on children and adolescents aged 7-17 year. Dietary and waist circumference data were collected from the six rounds of the China Health and Nutrition Survey (CHNS) during 1997 to 2011. According to the research criteria of National Institute of Nutrition and Food Safety of Chinese Center for Disease Control and Prevention, precentral obesity/central obesity in children and adolescents was determined. Multivariate Logistic regression was used to analyze the relationship between macronutrient energy supply ratios and precentral obesity/central obesity.  Results  After adjusting confounders, the group with more than 30% fat supply increased the risk of precentral obesity/central obesity (OR=1.29, 95% CI: 1.12-1.48) compared with the group with fat energy supply less than 25%. Compared with the protein energy ratio less than 10% group, the ratio greater than or equal to 15% group increased the risk of precentral obesity/central obesity (OR=1.47, 95% CI: 1.19-1.82). The risk ofprecentral obesity/central obesity were both decreased in the 55% to 65% group (OR=0.75, 95% CI: 0.64-0.87) and ratio greater than or equal to 65% group (OR=0.68, 95% CI: 0.58-0.80) compared with the group with a carbohydrate energy supply ratio of less than 55%. The increased risk of precentral obesity/central obesity was greater in boys with protein energy ratio greater than or equal to 15% than in girls (OR=1.78, 95% CI: 1.31-2.41, interaction P=0.011).  Conclusion  Dietary structure of children and adolescents with lower carbohydrate energy ratio and higher fat and protein energy ratio increase the risk of precentral obesity/central obesity.