经济欠发达地区农村中小学生营养状况分析

目的了解广东省经济欠发达地区农村中小学生营养状况及影响因素，为制定营养健康教育干预措施提供依据。方法采用多阶段随机抽样方法从韶关南雄市、茂名化州市和肇庆怀集县农村分别抽取中小学校各2所，共调查6所中学和6所小学。通过体检测量身高、体重和腰围，计算身体质量指数（BMI），根据BMI判断中小学生的营养状况。通过问卷调查获取中小学生营养知识和饮食行为习惯情况。采用单因素logistic回归和多因素logistic回归方法分析中小学生营养不良的影响因素。结果本次共调查中小学生1853人，男生941人，女生912人。初中生932人，小学生921人。中小学生营养不良、超重和肥胖发生率分别为26．3％（487／1853）、3．2％（59／1853）和0．9％（17／1853）。女生营养不良比例（28．1％）高于男生（24．5％），差异有统计学意义（P〈0．05）。多因素logistic回归分析结果表明，营养知识知晓率〉160％（OR=0．950）为中小学生营养不良发生的保护性因素，小学生（OR=1．451）、家庭小孩数量3个及以上（OR=1．326）、留守儿童（OR=1．321）、经常不吃早餐（OR=1．405）为中小学生营养不良发生的危险因素。结论广东省经济欠发达地区农村中小学生营养不良率高，营养不良与家庭环境、营养认知和饮食习惯相关，应开展针对性的健康教育和行为干预，以改善中小学生营养状况。

Nutritional status of primary and middle school students in underdeveloped rural areas

Objective To understand the nutritional status and influencing factors of the primary and middle school students in underdeveloped rural areas in Guangdong Province. Methods Using multi- stage cluster random sampling, students were selected from 6 secondary and 6 primary schools in Nanxiong, Huazhou, and Huaiji counties to measure their height, weight, and waistline. The body mass index （BMI） was calculated to evaluate their nutritional status. Questionnaire survey about nutrition knowledge and eat- ing behavior were conducted. The univariate logistic regression and multivariate logistic regression analysis method were used to analyze influencing factors. Results A total of 1 853 primary and secondary students were investigated （941 boys and 912 gifts） in the primary and middle school students in underdeveloped rural areas in Guangdong. Of them, 932 were junior high school students and 921 primary school students. The prevalenees of malnutrition, overweight, and obesity were 26.3% （487/1 853 ）, 3.2% （59/1 853 ）, and 0.9% （ 17/1 853 ）, respectively. The prevalence of malnutrition in female students （ 28.1% ） was higher than that in male students （24.5%） ,with statistically significant difference （P 〈0.05）. The re- sults of the multivariate logistic regression showed that the nutrition awareness rate in primary and secondary students （ I〉 60% , OR = 0. 950 ） was protective factor of malnutrition. Primary school students （ OR = 1.451 ）, three children or more in a family （ OR = 1. 326 ）, left-behind children （ OR = 1. 321 ）and often not eating breakfast （ OR = 1. 405 ） were risk factors of malnutrition. Conclusion The prevalence of malnutrition was high in the primary and middle school students in underdeveloped rural areas. Malnutrition was associated with the family environment, nutrition knowledge and eating habit. The health education and behavior intervention should be taken to improve nutrition level for rural primary and middle school students.