伊朗东北部儿童代表性样本中儿童肥胖的膳食预测因素

目的：伊朗儿童的肥胖患病率不断升高。这项研究旨在评价伊朗东北部城市Neishabour的儿童代表性样本中肥胖的某些膳食决定因素。方法：在这项病例对照研究中，病例组为114名在校学生，年龄6~12岁，体重指数（BMI）≥第95个百分位（根据伊朗儿童的参考值），而对照组为102名年龄和性别匹配的非肥胖同班同学。由受过训练的营养师在儿童在场的情况下与母亲面谈，进行两次24 h膳食回顾调查，收集了营养摄入数据；使用食物频率问卷调查了零食摄入模式；使用SPSS软件（第16版）进行了单因素和多因素logistic回归分析。结果：单因素logistic回归分析显示，总能量、蛋白质、碳水化合物、脂肪（包括饱和脂肪、单不饱和脂肪和多不饱和脂肪）和膳食纤维是学生肥胖的正向预测因素；玉米膨化食品、碳酸饮料、薯片、快餐食品和巧克力的摄入频率的粗估比值比（OR）有统计学意义。多因素logistic回归分析显示，肥胖与能量摄入量（OR = 2.489，95%CI：1.667~3.716）、玉米膨化食品摄入频率（OR=1.122，95%CI：1.007~1.250）及薯片摄入频率（OR=1.143，95%CI：1.024~1.276）显著相关；而膳食纤维摄入量（OR=0.909，95%CI：0.835~0.988）和天然果汁摄入量（OR= 0.601，95%CI：0.368~0.983）是预防肥胖的保护因素。结论：该研究结果证实了不健康饮食对儿童肥胖的作用，尤其是高热量零食。应鼓励儿童养成健康的饮食习惯，如摄入高纤维食物。

Dietary predictors of childhood obesity in a representative sample of children in north east of Iran

Objective The prevalence of obesity is increasing in Iranian youngsters.This study aimed to assess some dietary determinants of obesity in a representative sample of children in Neishabour,a city in northeastern,Iran.Methods This case-control study was conducted among 114 school students,aged 6-12 years,with a body mass index(BMI) ≥95th(based on percentile of Iranian children) as the case group and 102 age-and gender-matched controls,who were selected from their non-obese classmates.Nutrient intake data were collected by trained nutritionists by using two 24hour-dietary recalls through maternal interviews in the presence of their child.A food frequency questionnaire was used for detecting the snack consumption patterns.Statistical analysis was done using univariate and multivariate logistic regression(MLR) by SPSS version 16.Results In univariate logistic regression,total energy,protein,carbohydrate,fat(including saturated,mono-and poly-unsaturated fat),and dietary fiber were the positive predictors of obesity in studied children.The estimated crude ORs for frequency of corn-based extruded snacks,carbonated beverages,potato chips,fast foods,and chocolate consumption were statistically significant.After MLR analysis,the association of obesity remained significant with energy intake(OR = 2.489,95% CI: 1.667-3.716),frequency of corn-based extruded snacks(OR = 1.122,95% CI: 1.007-1.250),and potato chips(OR = 1.143,95% CI: 1.024-1.276).The MLR analysis showed that dietary fiber(OR =0.601,95%CI: 0.368-0.983) and natural fruit juice intake(OR = 0.909,95% CI: 0.835-0.988) were protective factors against obesity.Conclusions The findings serve to confirm the role of an unhealthy diet,notably caloriedense snacks,in childhood obesity.Healthy dietary habits,such as the consumption of high-fiber foods,should be encouraged among children.