北京市学龄前儿童单纯性肥胖影响因素研究

目的分析影响学龄前儿童肥胖的主要因素,为采取干预措施提供理论依据。方法采用方便样本整群抽样方法,对北京市五所幼儿园中2~7岁儿童的家长共计400名进行问卷调查和访谈。定性访谈结果采用关键词提取,进行归纳分析。根据中国学龄前儿童生长发育标准体质指数(body mass index,BMI)≥85%为超重或肥胖]判断是否超重或肥胖;将人口学特征,家庭因素及饮食和运动行为作为自变量进行多因素Logistic回归分析。结果儿童超重或肥胖的独立危险因素包括:儿童高出生体重(≥4 000g)(OR=31.55;95%CI:1.78~4.17,P0.001);母亲选择剖宫产(OR=4.89;95%CI:1.42~16.89,P=0.01);混合喂养(OR=25.90;95%CI:3.07~218.39,P0.001),人工喂养(OR=11.15;95%CI:1.686~73.7121,P=0.01)。保护因素包括:父亲的受教育程度高(OR=0.32;95%CI:0.12~0.89,P=0.03)、每天吃粗粮的次数多(OR=0.43;95%CI:0.21~0,87,P=0.02)、家人一起吃饭的次数多(OR=0.86;95%CI:0.75~0.98,P=0.02)。结论学龄前儿童肥胖的危险因素与父母受教育程度、对肥胖的认知及儿童的饮食运动行为有关。

Correlation of child obesity in Beijing preschool children

Objective To identify major factors of child obesity in preschool children for providing target factors for intervention. Methods Parents of preschool children,kindergarten teachers and kindergarten principals were chosen through convenience sampling for focus group interview or deep personal interview.Questionnaires were distributed to a total of 400 parents of 2 to 7 year-old children from five kindergartens in Beijing urban and rural areas.Information of qualitative interviews was obtained and summarized with keyword extraction.Overweight or obesity was determined by reference norm for screening obesity in Chinese preschool children body mass index(BMI)≥the 85^th percentile was defined as overweight or obesity].Multivariate Logistic regression analysis was used to identify potential correlates. Results Overweight and obesity rates were 16.5% and 28.0%,respectively.Multivariate Logistic regression analysis found:1) risk factors:high birth weight (≥4 000 g)(OR=31.55;95%CI:1.78~4.17,P＜0.001),caesarean birth (OR=4.89;95%CI:1.42~16.89,P=0.01),breastfeeding and formula feeding (OR=25.90;95%CI:3.07~218.39,P＜0.001)and rare breastfeeding (OR=11.15;95%CI:1.686~73.7121,P=0.01),compared with exclusive breastfeeding;2) Protective factors:fathers'higher education(OR=0.32;95%CI:0.12~0.89,P=0.03),eating coarse grain frequently (OR=0.43;95%CI:0.21~0,87,P=0.02),and eating at home frequently (OR=0.86;95%CI:0.75~0.98,P=0.02). Conclusions Perinatal factors,family environment,birth and feeding conditions and children's diet and exercise behaviors are correlations of child obesity.With increasingly high incidence of overweight and obesity among Chinese preschool children,early intervention measures should be taken for reducing the incidence and development of overweight and obesity among preschool children.