中国7~17岁儿童青少年宏量营养素摄入与超重肥胖的关系

  目的  探讨7~17岁儿童青少年宏量营养素摄入与超重肥胖的关系。  方法  1997—2011年基于“中国居民健康与营养调查”的6轮调查数据，纳入膳食及BMI数据完整的7~17岁儿童青少年为研究对象。依照中国肥胖问题工作组制定标准判定超重肥胖，采用Logistic回归分析模型分析宏量营养素摄入与儿童青少年超重肥胖的关系。  结果  最终纳入6 360名研究对象，其中7~＜12岁儿童青少年3 529人(55.5%)，男生3 360人(52.8%)，超重肥胖1 060人(16.7%)。校正相关混杂因素后，与脂肪供能比 < 25%组相比，≥30%组增加20%肥胖风险(OR=1.20, 95% CI:1.03~1.41, P=0.023)；与蛋白质供能比 < 10%组相比，≥15%组增加61%肥胖风险(OR=1.61, 95% CI:1.25~2.04, P < 0.001)；与碳水化合物供能比 < 55%组相比，55%~ < 65%组降低20%肥胖风险(OR=0.80, 95% CI:0.68~0.95, P=0.011)，≥65%组降低21%肥胖风险(OR=0.79, 95% CI:0.66~0.94, P=0.010)；脂肪及蛋白质供能比越高、碳水化合物供能比越低，发生超重肥胖的风险越高(P < 0.05)；男生摄入过量蛋白质更可能发生肥胖(P=0.034)。  结论  儿童青少年摄入过量脂肪和蛋白质可增加超重肥胖发生风险。

Study on the association of macronutrients intake with overweight and obesity among children and adolescents aged 7-17 years in China

  Objective  To analyze the association of macronutrients intake with overweight and obesity among children and adolescents aged 7-17 years in China.  Methods  Children and adolescents aged 7-17 years who participated in China Health and Nutrition Survey from 1997 to 2011 with complete dietary and BMI data were included. Overweight and obesity were judged by experts from the Group of China Obesity Task Force. The Logistic regression method was applied to assess the association of macronutrients intake with overweight and obesity.  Results  A total of 6 360 Chinese children and adolescents were included, including 3 529 (55.5%) aged 7- < 12 years and 3 360 (52.8%) boys. Among them, 1 060 (16.7%) were overweight and obese. After controlling for potential confounders, when compared with fat energy supply ratio < 25%, the risk of overweight and obesity appeared an increase of 20% (OR=1.20, 95% CI: 1.03-1.41, P=0.023) with fat energy supply ratio ≥30%. Compared with protein energy supply ratio < 10%, it increased of 61% (OR=1.61, 95% CI: 1.25-2.04, P < 0.001) with protein energy supply ratio ≥15%. Compared with carbohydrate energy supply ratio < 55%, it decreased of 20% (OR=0.80, 95% CI: 0.68-0.95, P=0.011) and 21% (OR=0.79, 95% CI: 0.66-0.94, P=0.010) with carbohydrate energy supply ratio between 55%- < 65%, ≥65%, respectively. The higher energy supply ratios of fat and protein, and lower carbohydrate energy supply ratio had a stronger association with overweight and obesity (P < 0.05). For overweight and obesity, the association seemed to be stronger among boys with excessive intake of protein (P=0.034).  Conclusion  Excessive intakes of fat and protein may lead to overweight and obesity in children and adolescents.