上海市青少年饮食行为现状以及抑郁焦虑情绪的影响

  目的  了解上海市青少年饮食行为现状，并探讨情绪对饮食行为的影响，为培养青少年良好的饮食行为提供参考。  方法  采用分层随机整群抽样方法，于2021年5月对上海市3个区10所初中和6所高中的7 456名学生进行问卷调查，调查内容包括一般情况、饮食行为、患者健康问卷(2条目)和广泛性焦虑量表。  结果  上海市青少年过去7 d每天食用含糖饮料、甜食、油炸食品及西式快餐(≥4次/周)的报告率分别为13.26%，16.90%，6.99%，13.01%，每天吃水果、蔬菜、牛奶、早餐的报告率分别为56.96%，73.00%，65.03%，76.11%，不同性别和学段学生间差异均有统计学意义(P值均 < 0.05)。有抑郁或焦虑情绪青少年不良饮食行为的发生率高于无抑郁或焦虑者(P值均 < 0.01)。校正性别、学校、住宿、成绩、零花钱、社会阶层后，抑郁和焦虑情绪增加青少年各种不良饮食行为的发生风险(P值均 < 0.05)。与无焦虑者相比，轻度和中重度焦虑者每天喝≥1次含糖饮料的风险为1.42(95%CI=1.20~1.67)和2.51倍(95%CI=2.09~3.01)，不是每天吃水果的风险为1.30(95%CI=1.16~1.45)和1.28倍(95%CI=1.11~1.47)，不是每天吃蔬菜的风险为1.35(95%CI=1.20~1.52)和1.41倍(95%CI=1.21~1.65)，不是每天喝牛奶的风险为1.29(95%CI=1.15~1.44)和1.20倍(95%CI=1.04~1.39)，不是每天吃早餐的风险为1.75(95%CI=1.54~1.99)和2.97倍(95%CI=2.55~3.46)。  结论  上海市青少年不良饮食行为比例较高，应早期开展饮食行为宣教和干预，并关注青少年负性情绪的发生，以减少不良饮食行为的发生风险。

Prevalence and influence of depression and anxiety on dietary behaviors among adolescents in Shanghai

  Objective  To investigate the prevalence of adolescents' dietary behavior in Shanghai, and to explore emotional influence on dietary behavior.  Methods  A total of 7 456 students from 10 junior and 6 senior high schools in Shanghai were selected to participate in the questionnaire survey with the stratified random cluster sampling method. The survey included general information, eating behavior, PHQ-2 and GAD-7.  Results  During the past week, the proportion of adolescents in Shanghai reported consumption of sugar-sweetened beverages, sweet desserts, frequent fried food and fast food (≥4 times/week) were 13.26%, 16.90%, 6.99% and 13.01%, respectively. The proportion of students reported consumption of fruits, vegetables, milk and breakfast every day were 56.96%, 73.00%, 65.03% and 76.11%, respectively. There were significant differences by sex and educational stages(both P < 0.05). Adolescents with depression or anxiety have a higher incidence of unhealthy eating behaviors than those without depression or anxiety(P < 0.01). After adjusting for gender, school, accommodation, grades, pocket money and social class, depression and anxiety increase the risk of various unhealthy eating behaviors in adolescents(P < 0.05). Compared with those without anxiety, the risks of sugar-sweetened beverages consumption (≥1 time/d) among adolescents with mild and moderate to severe anxiety were 1.42 times (95%CI=1.20-1.67) and 2.51 times (95%CI=2.09-3.01), the risks of insufficient fruits consumption (< 1 time/d) were 1.30 times (95%CI=1.16-1.45) and 1.28 times (95%CI=1.11-1.47), the risks of insufficient vegetable consumption (< 1 time/d) were 1.35 times (95%CI=1.20-1.52) and 1.41 times(95%CI=1.21-1.65), the risks of insufficient milk consumption (< 1 time/d) were 1.29 times (95%CI=1.15-1.44) and 1.20 times(95%CI=1.04-1.39), and the risks of breakfast skipping were 1.75 times (95%CI=1.54-1.99) and 2.97 times (95%CI=2.55-3.46) among adolescents with mild and moderate to severe anxiety.  Conclusion  The proportion of unhealthy eating behaviors among adolescents in Shanghai is still high. Early education and intervention for students' eating behaviors should be carried out, and attention should be paid to the occurrence of adolescents' negative emotions, so as to reduce the risk of unhealthy eating behaviors among adolescents through the promotion of mental health.