| 高婷婷,曹薇,杨媞媞,徐培培,许娟,李荔,甘倩,潘慧,张倩.2019年“农村义务教育学生营养改善计划”覆盖地区中小学生生长迟缓状况及影响因素分析[J].Chinese journal of Epidemiology,2022,43(4):488-495 |
| 2019年“农村义务教育学生营养改善计划”覆盖地区中小学生生长迟缓状况及影响因素分析 |
| Growth retardation of children and its influencing factors in the Nutrition Improvement Program for Rural Compulsory Education Students in 2019 |
| Received:July 22, 2021 |
| DOI：10.3760/cma.j.cn112338-20210722-00574 |
| KeyWord: 农村学生|生长迟缓|影响因素 |
| English Key Word: Rural students|Growth retardation|Influencing factor |
| FundProject:公共卫生专项任务经费（131031107000180004） |
| Author Name | Affiliation | E-mail | | Gao Tingting | National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention/Key Laboratory of Trace Element Nutrition, National Health Commission of the People's Republic of China, Beijing 100050, China | | | Cao Wei | National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention/Key Laboratory of Trace Element Nutrition, National Health Commission of the People's Republic of China, Beijing 100050, China | | | Yang Titi | National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention/Key Laboratory of Trace Element Nutrition, National Health Commission of the People's Republic of China, Beijing 100050, China | | | Xu Peipei | National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention/Key Laboratory of Trace Element Nutrition, National Health Commission of the People's Republic of China, Beijing 100050, China | | | Xu juan | National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention/Key Laboratory of Trace Element Nutrition, National Health Commission of the People's Republic of China, Beijing 100050, China | | | Li Li | National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention/Key Laboratory of Trace Element Nutrition, National Health Commission of the People's Republic of China, Beijing 100050, China
National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China | | | Gan Qian | National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention/Key Laboratory of Trace Element Nutrition, National Health Commission of the People's Republic of China, Beijing 100050, China | | | Pan Hui | National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention/Key Laboratory of Trace Element Nutrition, National Health Commission of the People's Republic of China, Beijing 100050, China | | | Zhang Qian | National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention/Key Laboratory of Trace Element Nutrition, National Health Commission of the People's Republic of China, Beijing 100050, China | zhangqian7208@163.com |
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| Abstract: |
| 目的 了解我国“农村义务教育学生营养改善计划”覆盖地区中小学生生长迟缓状况及其影响因素，为改善我国农村学生营养状况提供科学依据。方法 采用多阶段整群随机抽样方法，抽取我国“农村义务教育学生营养改善计划”覆盖地区的1 550 969名6~15岁中小学生，男女生比例基本均衡，测量身高，依据《学龄儿童青少年营养不良筛查标准》（WS/T 456-2014）判定学生生长迟缓状况。通过《学校调查表》和《县级调查表》调查相关影响因素。学生生长迟缓情况采用例数和百分率描述，组间比较采用χ2检验。采用二分类logistic回归进行学生生长迟缓影响因素分析。结果 2019年我国“农村义务教育学生营养改善计划”覆盖地区中小学生的生长迟缓率为5.7%（88 631/1 550 969），西部地区生长迟缓率（7.1%，66 167/927 954）高于中部地区（3.7%，19 511/533 973），差异有统计学意义（P<0.001）；男生生长迟缓率（6.3%，50 665/803 851）高于女生（5.1%，37 966/747 118），差异有统计学意义（P<0.001）。中部地区小学生生长迟缓率为3.9%（14 914/380 598），高于初中生（3.0%，4 597/153 375，P<0.001）；而西部地区初中生生长迟缓率（7.2%，21 494/297 217）高于小学生（7.1%，44 673/630 737，P=0.009），差异均有统计学意义。多因素logistic回归分析结果显示，高收入地区（OR=0.829，95%CI：0.816~0.842，P<0.001）、家长承担一部分餐费（OR=0.948，95%CI：0.931~0.965，P<0.001）、企业供餐（OR=0.845，95%CI：0.805~0.887，P<0.001）、学校提供牛奶（OR=0.780，95%CI：0.767~0.793，P<0.001）、开设健康教育课（OR=0.702，95%CI： 0.682~0.723，P<0.001）和当地有其他营养改善活动（OR=0.739，95%CI：0.720~0.758，P<0.001）的学生生长迟缓率较低。结论 我国“农村义务教育学生营养改善计划”覆盖地区中小学生生长迟缓率有明显的地区、性别和年龄差异，学校适宜的食物供应、开设健康教育课，以及家长参与营养改善与儿童较低的生长迟缓率有关。 |
| English Abstract: |
| Objective To understand the growth retardation among primary and secondary school students in areas covered by the Nutrition Improvement Program for Rural Compulsory Education Students and its influencing factors to provide evidence for improving the nutrition status of rural students in China. Methods The multi-stage cluster random sampling method selected 1 550 969 primary and secondary school students aged 6-15 years from China's central and western regions. The ratio of male and female students was balanced. The height was measured, and the growth retardation of students was determined according to the Screening Criteria for School-age Children and Adolescents malnutrition (WS/T 456-2014), from the school and county questionnaire survey related factors. The number of cases and percentages described the growth retardation of students, and the χ2 test was used for comparison between groups. Binary logistic regression was used to analyze students' growth retardation factors. Results In 2019, the growth retardation rate of primary and secondary school students in areas covered by the Nutrition Improvement Program for Rural Compulsory Education Students was 5.7% (88 631/1 550 969), the growth retardation rate in the western part (7.1%, 66 167/927 954) was higher than that in the central part (3.7%,19 511/533 973) with difference statistically significant (P<0.001). The growth retardation rate of the boys (6.3%,50 665/803 851) were higher than that of girls (5.1%, 37 966/747 118), the difference was statistically significant (P<0.001). The growth retardation rate of primary school students in central China was 3.9%(14 914/380 598), higher than that of junior middle school students (3.0%,4 597/153 375, P<0.001). In contrast, the growth retardation rate of the western junior high school students (7.2%, 21 494/297 217) were higher than that of elementary school students (7.1%, 44 673/630 737), with a difference statistically significant (all P=0.009). Multi-factor logistic regression results showed that, in high income area (OR=0.829, 95%CI:0.816-0.842, P<0.001), parents providing part of the meal cost (OR=0.948, 95%CI:0.931-0.965, P<0.001), enterprises providing meals (OR=0.845, 95%CI:0.805-0.887, P<0.001), schools providing milk (OR=0.780, 95%CI:0.767-0.793, P<0.001), health education courses (OR=0.702, 95%CI:0.682-0.723, P<0.001) and other local nutrition improvement efforts (OR=0.739, 95%CI:0.720-0.758, P<0.001) were negatively correlated with the occurrence of growth retardation, The growth retardation rate of the students was lower. Conclusions There appeared significant regional, gender, and age differences in the growth retardation rate of primary and middle school students in areas covered by the Nutrition Improvement Program for Rural Compulsory Education Students. Appropriate food supply in schools, health education courses, and parental participation in nutritional improvement was related to children's lower growth retardation rate. |
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