学龄前儿童体力活动模式及其与儿童超重/肥胖的关系

目的 探索学龄前儿童体力活动模式及其与儿童超重/肥胖的相关性,为学龄前儿童体力活动干预提供参考。方法 2017年4-7月,运用自编的学龄前儿童体力活动及影响因素调查问卷,对学龄前儿童日常体力活动情况进行调查,采用因子分析探索学龄前儿童体力活动模式,运用Logistic回归分析体力活动模式与儿童超重/肥胖间的相关性。结果 因子分析抽取了3个公因子分别命名为特长培养模式、托幼机构集体活动模式和家庭户外模式,累计方差贡献率为35.4%。在控制了家庭人口学特征后,特长培养模式因子得分≥P₇₅时,超重/肥胖的风险比因子得分25高(OR=2.633,95%CI:1.066~6.504);家庭户外模式因子得分≥P₇₅时,超重/肥胖的风险比因子得分25低(OR=0.747,95%CI:0.387~0.984)。结论 特长培养模式是学龄前儿童超重/肥胖的危险因素,家庭户外活动模式是超重/肥胖的保护因素。     

上海静安区学龄前儿童超重肥胖及高血压流行现状

目的 了解上海静安区学龄前儿童超重、肥胖及高血压的流行现状,为制定相关干预措施提供依据。方法 以参加2017年上海静安区幼儿园体检的3 608名3~7岁学龄前儿童为研究对象,按照世界卫生组织儿童生长发育标准和中国儿童青少年血压参考标准进行超重肥胖和高血压的调查,采用SPSS 24.0进行统计学分析。结果 上海市静安区3~7岁学龄前儿童超重和肥胖的总检出率分别为9.3%和9.2%,男童肥胖检出率高于女童,6~7岁儿童超重及肥胖检出率高于其余年龄组(P＜0.05),而超重检出率的性别差异无统计学意义(P>0.05)。高血压的总检出率为1.5%,男童高于女童,肥胖儿童高血压检出率显著高于超重及非超重肥胖儿童(P＜0.001),而高血压检出率的年龄差异无统计学意义(P>0.05)。结论 上海市静安区学龄前儿童超重、肥胖检出率较高,相关慢性病的预防应早在学龄前期进行。     

青岛市城区学龄前儿童体格发育及肥胖发生变化分析

目的 了解青岛市城区学龄前儿童近十二年体格发育及肥胖构成变化情况,为学龄前儿童健康管理提供依据。方法 采用分层整群抽样方法,抽取城区13所幼儿园,于2018年3-4月测量评价在园儿童身高、体重与营养状况,统计超重、肥胖检出率,与2006同质人群肥胖流调数据比较分析。结果 与2006年相比,2018年青岛市城区学龄前儿童总体身高变化差异无统计学意义(P>0.05),体重下降(P<0.001,3岁～组除外);2018年青岛市城区学龄前儿童肥胖检出率(7.5%)、超重检出率(15.9%)、生长迟缓检出率(0.2%)均低于2006年(P<0.05)。结论 青岛市2018年学龄前儿童在身高发育正常的前提下,肥胖、超重检出率较2006年呈下降趋势,佐证始于生命早期,基于社区、幼儿园及家庭的、持续开展的儿童综合肥胖防控措施行之有效。     

三代直系亲属超重、肥胖的比较及与学龄前儿童肥胖关系的研究

目的 比较学龄前儿童及其父母、祖父母及外祖父母三代直系亲属之间超重、肥胖发生率的差异,探究直系亲属超重、肥胖与儿童肥胖的关系,为预防和减少学龄前儿童肥胖的发生提供科学依据。方法 2019年5-6月,对南京市雨花台区辖区内幼儿园采用整群分层随机抽样调查方法,共有2 217名3~5岁学龄前儿童作为研究对象,通过问卷调查收集所有研究对象年龄、性别、出生体重及其父母、祖父母及外祖父母年龄、体重、身高等信息,并采用统一标准方法测量儿童的体重、身高,分析直系亲属超重、肥胖与儿童超重、肥胖之间的关系。结果 学龄前儿童超重发生率7.80%、肥胖发生率2.75%。儿童中男性肥胖发生率明显高于女性(3.4% vs. 2.0%, P<0.05);在中年父母辈中,男性的超重及肥胖发生率分别为36.1%、11.1%,均显著高于女性(13.6%、3.3%)(P<0.001),而在祖父母辈,女性的肥胖发生率却显著高于男性(祖父母:10.1% vs. 5.9%,P<0.001;外祖父母:7.5% vs. 6.2%,P<0.05)。经有序Logistic回归模型分析,母亲超重(OR＝1.614,95%CI:1.132~2.301,P<0.01)及父亲肥胖(OR＝2.584,95%CI:1.773~3.765,P<0.001)是导致儿童超重肥胖的独立危险因素;而二代亲属祖父母和外祖父母肥胖与儿童肥胖无显著关系。结论 直系三代亲属中,中年男性的超重、肥胖发生率最高,父母超重、肥胖可导致学龄前儿童肥胖发生风险显著增加。     

广州花都3 373名学龄前儿童单纯性肥胖现状及影响因素分析

目的 了解广州花都学龄前儿童肥胖的检出率及主要影响因素,为预防儿童肥胖提供科学依据。方法 2016年9-10月应用随机整群抽样法,随机抽取广州花都10所幼儿园作为调查对象。收集3 373名2～6岁学龄前儿童身高、体重、生活习惯和父母情况等基本信息,计算肥胖检出率,并对肥胖危险因素进行分析。结果 学龄前儿童肥胖及超重的检出率分别为3.0%和8.7%;儿童肥胖的危险因素有:高出生体重、非母乳喂养、进食速度快、吃饭时看电视或边吃边玩、加餐次数多、祖辈鼓励儿童多吃、祖辈经常用食物奖励儿童、外面吃饭次数多、父母年龄、父母体质量指数高、出生时有异常情况、母亲孕晚期食欲好、家长不重视儿童的体检记录。儿童肥胖的保护因素为睡眠时间长。结论 儿童肥胖更多的与生活方式相关。创造良好的家庭环境,培养儿童良好的饮食习惯和生活习惯,是防止肥胖发生的关键。     

顺义区学龄前儿童超重/肥胖的危险因素Logistic分析

目的 了解北京市顺义区学龄前儿童超重/肥胖的流行特征及其危险因素,为儿童肥胖的预防和临床干预提供科学依据。方法 采取整群分层随机抽样的方式,于2017年9—11月抽取顺义区5所幼儿园共1 238名儿童作为研究对象。采用自行设计的调查问卷方式研究儿童肥胖的危险因素,对相关危险因素进行多因素Logistic回归分析。结果 顺义区学龄前儿童超重/肥胖发生率分别为13.3%、15.2%。学龄前儿童超重/肥胖的危险因素包括:剖宫产(OR=1.333,95%CI:1.032~1.722)、父亲超重/肥胖(OR=1.723,95%CI:1.293~2.295)、母亲超重/肥胖(OR=1.617,95%CI:1.234~2.119)、进食速度快(OR=1.403,95%CI:1.125~1.748)。而平均户外活动时间>2 h(OR=0.649,95%CI:0.549~0.771)是儿童超重/肥胖发生的保护因素。结论 学龄前儿童超重/肥胖是诸多因素共同作用的结果,应制定父母参与的综合防治措施,以减少儿童超重/肥胖的发生。     

饮食行为及饮食习惯对学龄前期儿童超重肥胖的影响

目的 了解苏州市工业园区学龄前期儿童超重肥胖的现状,探讨其中饮食相关因素,提供预防方法。方法 采用随机抽样的方法,在苏州工业园区斜塘街道所属于幼儿园随机抽取5所3～6岁儿童2 034名作为本次研究的调查现场,进行问卷调查和相关体格测量。结果 超重肥胖检出率为16.8%,进食膨化食品次数多(χ2=9.200,P<0.05)、喜欢看食品广告(χ2=13.069,P<0.05),尤其膨化食品和甜饮料广告(P<0.05)、临睡前进食主食和零食、食欲好、吃饭时间短、边看电视边吃零食(P均<0.05)为学龄前儿童超重肥胖的危险因素。结论 为儿童营造健康的饮食环境,培养儿童良好的饮食行为,可有效预防儿童超重肥胖的发生。     

2013—2018年北京市大兴区学龄前期儿童超重及肥胖状况趋势分析

目的 了解北京市大兴地区学龄前期儿童生长发育状况,掌握儿童超重及肥胖相关健康问题现状及变化趋势,为制定促进儿童身心健康适宜的策略提供科学依据。 方法 采用世界卫生组织2006年标准,对儿童超重、肥胖进行评价。 结果 2013—2018年大兴地区学龄前期散居儿童超重肥胖呈逐年下降趋势,超重检出率分别为17.07%、16.58%、16.99%、14.69%、11.12%、11.24%,差异有统计学意义(χ²=430.220,P<0.001),肥胖检出率分别为9.01%、8.75%、8.66%、6.04%、5.44%、5.20%,差异有统计学意义(χ²=167.631,P<0.001);男童超重肥胖检出率高于女童;不同年龄组别男女童超重检出率差异小,5岁儿童肥胖检出率分别为14.73%、12.26%、12.75%、9.72%、10.85%和11.86%,6岁儿童肥胖检出率分别为22.73%、13.95%、21.28%、14.29%、13.30%和14.79%,高于其他组别。 结论 大兴区学龄前儿童保健成效显著,超重肥胖检出率呈下降趋势。但需要进一步加大超重肥胖干预工作力度,5~、6~岁男性儿童是工作的重点;学校应与家庭相结合,采取有效措施。     

南京市栖霞区学龄前儿童单纯性肥胖干预效果分析

目的 分析学龄前儿童单纯性肥胖主要因素,制订有针对性的干预措施。方法 2015年5月选取3 所幼儿园4岁学龄前儿童452名开展健康问卷调查,并实施健康干预,研究干预措施对学龄前儿童超重/肥胖检出率和体质量指数(BMI)的影响。结果 实验组超重/肥胖1年后检出率(14.16%)呈减少趋势,差异无统计学意义(χ²=0.43,P＞0.05)。观察组1年后超重/肥胖检出率(16.37%)呈显著增加趋势,差异有统计学意义(χ²=4.82,P＞0.05)。调查显示母亲超重/肥胖、摄入肉类占比超30%、食量超标、进食速度过快,运动不足等是导致超重/肥胖的重要因素。干预后超重组和肥胖组儿童BMI增长趋势均放缓(t=2.30和2.27,P均<0.05),超重/肥胖儿童生长曲线趋于正常。结论 引发学龄前儿童超重/肥胖是多种因素共同作用的结果,通过有针对性的综合干预,可以有效控制儿童超重/肥胖的发展程度,干预效果的持续性有待进一步研究。     

出生因素和早期喂养方式对6~23月龄婴幼儿超重肥胖的影响

目的 了解湖北省6~23月龄婴幼儿超重肥胖状况及出生因素和早期喂养方式对婴幼儿超重肥胖的影响,为预防及控制儿童超重肥胖提供参考依据。方法 采用PPS抽样方法,调查湖北省贫困地区6县6~23月龄婴幼儿及其看护人,以WHO性别月龄别BMI为超重肥胖的标准。采用χ²检验和Logistic回归模型进行数据分析。结果 共调查婴幼儿2 667人,其中男童1 438人(53.92%),女童1 229人(46.08%);超重209人(7.84%), 肥胖151人(5.66%)。出生时为巨大儿的婴幼儿超重率较高,男童肥胖率高于女童,剖腹产的婴幼儿肥胖率较高,出生后前6个月纯母乳喂养是婴幼儿肥胖的保护因素(P均<0.05)。结论 湖北省贫困地区婴幼儿超重肥胖问题不容忽视,男童、剖腹产出生、出生后前6个月为非纯母乳喂养的婴幼儿发生肥胖的风险较高,需积极关注并采取有效措施进行预防与控制。     

Prevalence of overweight and obesity in Nigerian preschool children

The problem of obesity is taking a worldwide dimension. However, there is paucity of data on obesity in Nigerian children. This study was therefore conducted to determine the prevalence and factors associated with overweight and obesity among Nigerian preschool children. A total of 270 children were recruited from 216 households using multistage cluster sampling technique. The prevalence of overweight and obesity were 13.7% and 5.2% respectively while the prevalence of underweight was 8.5%. Although, there was no statistically significant relationship between exclusive breastfeeding for 6 months, duration of breastfeeding and the prevalence of overweight (P = 0.569, 0.669 respectively), the prevalence of overweight decreases with increase in the duration of breastfeeding. Ninety-nine (36.3%) children were given infant formula feeds with 92 (93.9%) children introduced to infant formula feeds before the age of 6 months. The use of infant formula feeds was significantly associated with reduction in the prevalence of overweight (P = 0.041). No linear relationship was detected in the association between overweight and socioeconomic class. The population shows heterogeneity in their nutritional problem by having mixture of obesity and underweight. There is need for trend of obesity to be monitored so that timely intervention will be taken and associated morbidity and mortality from obesity prevented.     

Breastfeeding and Overweight in European Preschoolers: The ToyBox Study

The benefits of breastfeeding (BF) include risk reduction of later overweight and obesity. We aimed to analyse the association between breastfeeding practices and overweight/obesity among preschool children participating in the ToyBox study. Data from children in the six countries, participating in the ToyBox-study (Belgium, Bulgaria, Germany, Greece, Poland, and Spain) 7554 children/families and their age is 3.5–5.5 years, 51.9% were boys collected cross-sectionally in 2012. The questionnaires included parents’ self-reported data on their weight, height, socio-demographic status, and infant feeding practices. Measurements of preschool children’s weight and height were done by trained researchers using standard protocols and equipment. The ever breastfeeding rate in the total sample was 85.0% (n = 5777). Only 6.3% (n = 428) of the children from the general sample were exclusively breastfed (EBF) for the duration of the first six months. EBF for four to six months was significantly (p < 0.001) less likely among mothers with formal education < 12 years (adjusted Odds Ratio (OR) = 0.61; 95% Confidence interval (CI) 0.44–0.85), smoking throughout pregnancy (adjusted OR = 0.39; 95% CI 0.24–0.62), overweight before pregnancy (adjusted OR = 0.67; 95%CI 0.47–0.95) and ≤25 years old. The median duration of any breastfeeding was five months. The prevalence of exclusive formula feeding during the first five months in the general sample was about 12% (n = 830). The prevalence of overweight and obesity at preschool age was 8.0% (n = 542) and 2.8% (n = 190), respectively. The study did not identify any significant association between breastfeeding practices and obesity in childhood when adjusted for relevant confounding factors (p > 0.05). It is likely that sociodemographic and lifestyle factors associated with breastfeeding practices may have an impact on childhood obesity. The identified lower than desirable rates and duration of breastfeeding practices should prompt enhanced efforts for effective promotion, protection, and support of breastfeeding across Europe, and in particular in regions with low BF rates.     

青岛市城区学龄前儿童肥胖流行趋势研究

目的 了解青岛市城区学龄前儿童肥胖发生现状及近年流行趋势,为有效控制干预提供理论依据。方法 2018年4-6月,方便整群抽取青岛市城区13家中等规模幼儿园,对全体在园儿童进行身高、体重及腰围、臀围测量评价,与2006年同质调查数据比较,研究十二年来学龄前儿童肥胖流行趋势。结果 2018年城区幼儿园3～6岁儿童肥胖检出率为7.51%,较2006年(9.52%)显著下降(χ²=11.218,P=0.001),年均下降16.75%;男童肥胖超出率(10.02%)显著高于女童(4.80%),差异有统计学意义(χ²=42.11,P<0.001);2018年城区3～6岁儿童超重检出率为15.85％,较2006年(18.12%)显著下降(χ²=7.892,P<0.05);肥胖儿童BMI、腰臀比及腰围身高比均显著高于正常体重儿童(P＜0.001)。结论 近十二年青岛市城区学龄前儿童肥胖得到有效控制。儿童超重检出率亦下降,但远高于肥胖检出率,提示需加强学龄前儿童超重防控,以减少其转化为学龄期乃至成年期肥胖。     

绍兴地区3~6岁儿童单纯性肥胖的流行病学调查

目的 了解绍兴地区3~6岁儿童单纯性肥胖的流行特征及其影响因素, 为肥胖儿的早期干预提供科学依据。方法 采用分层整群随机抽样的方法选取本地区17 640 名学龄前儿童作为研究对象, 进行相关的体格测量、评价和问卷调查。结果 17 640名学龄前儿童中, 单纯性肥胖检出率为4.92 %, 男童为5.72%, 女童为4.04%, 差异有统计学意义(χ²=50.111, P<0.01);超重检出率为11.05 %, 男童为10.96%, 女童为11.52%, 无性别差异(χ²=1.703, P>0.05)。经多因素Logistic回归分析显示:出生体重, 纯母乳喂养持续时间, 看电视时间, 母亲BMI, 进食速度, 甜食摄入频率与肥胖的发生关系密切。结论 本地区学龄前儿童肥胖和超重的检出率处于较高水平。应加强对肥胖和超重的学龄前儿童的综合管理和早期干预, 降低肥胖和超重的发生率。     

Characteristics of Overweight and Obesity at Age Two and the Association with Breastfeeding in Hawai’i Women,Infants, and Children (WIC) Participants

Childhood obesity is associated with many adverse health effects during childhood and is linked to an increased risk for obesity in adulthood. The objective of this study was to determine the characteristics of early childhood overweight and obesity and assess the impact of breastfeeding. Data from Hawai’i’s Special Supplemental Nutrition Program for Women, Infants and Children (WIC) were analyzed for children 2 years of age born between 2005 and 2009 and their mothers. Childhood overweight and obesity was examined using a log-binomial regression model to estimate prevalence ratios. In the sample population, 12.5 % of children were overweight and 8.5 % of children were obese. Significant differences in childhood overweight and obesity were seen between breastfeeding duration and other socio-demographic groups. Children who were breastfed for 6 months or more had a lower risk of childhood obesity at age two compared to those who were never breastfed (APR 0.79, 95 % CI 0.69–0.91) with adjustment for child race/ethnicity, maternal age, trimester of prenatal care entry, maternal smoking status, and child birth weight. The prevalence of early childhood overweight and obesity is associated with shorter durations of breastfeeding. Early and continued breastfeeding support and education for mothers in the WIC program that improves duration of breastfeeding may help reduce the risk of early childhood obesity.     

生命早期喂养模式对学龄前儿童蔬菜和水果摄入的影响

目的 了解婴儿期母乳喂养持续时间和纯母乳喂养对学龄前期儿童蔬菜和水果摄入的影响,为婴幼儿喂养指导提供更为有力的科学依据。方法 使用已经进行的儿童肥胖研究的基线调查数据进行分析,数据为通过问卷调查的方式了解儿童婴儿期喂养基本情况和儿童膳食现状,使用Logistic回归模型对可能关联进行验证。结果 在1 189名调查儿童婴儿期,纯母乳喂养持续超过6个月的占17.1%,母乳喂养持续时间超过12个月的占9.6%。纯母乳喂养持续6个月以上的儿童在学龄前期超重肥胖发生率明显低于纯母乳喂养持续时间<6个月的儿童(2.2% &3.7%,P<0.05)。学龄前儿童摄入每周≥6次的水果和蔬菜的频率比例分别为87.5%及67.7%。婴儿期持续母乳喂养12个月及以上儿童在学龄前期摄入蔬菜频率高于母乳喂养持续时间<12个月的儿童(OR=1.251; 95%CI1.115~2.563),纯母乳喂养≥6个月的儿童较纯母乳喂养时间<6个月的儿童在学龄前期摄入蔬菜的频率高,两者存在统计学关联(OR=1.015;95%CI1.002~1.105)。母乳喂养模式与学龄前期儿童摄入水果频率差异无统计学意义(OR=0.882;95%CI0.412~1.514) &(OR=0.657;95%CI0.442~1.019)。结论 长期母乳喂养及纯母乳喂养与学龄前期儿童蔬菜摄入量存在正向关联,但与学龄前期儿童水果摄入无任何关联。生命早期科学喂养方式对于儿童生命后期营养习惯的形成乃至对营养发育的影响都十分重要的,因而社会和家庭对于母乳喂养的认识和支持也需进一步深入和提高。