学龄前儿童含糖饮料摄入与情绪行为问题的关联

周信; 王磊; 彭磊; 陈佳; 张雷; 陶芳标; 金武; 姚庆兵; 孙蕾

doi:10.16835/j.cnki.1000-9817.2022.01.015

学龄前儿童含糖饮料摄入与情绪行为问题的关联

doi: 10.16835/j.cnki.1000-9817.2022.01.015

周信¹,
王磊²,
彭磊³,
陈佳⁴,
张雷²,
陶芳标⁵,
金武¹,
姚庆兵¹,
孙蕾^1, ,

1.
江苏省扬州市疾病预防控制中心，225100
2.
扬州市妇幼保健院儿童保健科
3.
徐州市妇幼保健计划生育服务中心
4.
镇江市妇幼保健院儿童保健科
5.
安徽医科大学公共卫生学院儿少卫生与妇幼保健学系/出生人口健康教育部重点实验室/人口健康与优生安徽省重点实验室

详细信息

作者简介:
周信(1974-)，男，江苏扬州人，大学本科，检验师，主要研究方向为公共卫生

通讯作者:
孙蕾，E-mail：lethe630@163.com

利益冲突声明 所有作者声明无利益冲突。
中图分类号: R179 R844.1
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出版历程
- 收稿日期: 2021-08-09
- 修回日期: 2021-10-14
- 刊出日期: 2022-01-25

Associations between sugar-sweetened beverage intake and emotional and behavioral problems in preschoolers

1.
Yangzhou Center for Disease Control and Prevention, Yangzhou (225100), Jiangsu Province, China

摘要

摘要: 目的探讨学龄前儿童含糖饮料(sugar-sweetened beverages, SSBs)摄入情况及其与行为问题的关联，为儿童行为问题预防提供参考依据。方法于2017年10—11月选择长江中下游流域的扬州、徐州、镇江3座城市, 采取随机整群抽样的方法选取7 634名3~6岁学龄前儿童为研究对象，通过对父母或监护人进行问卷调查获得儿童SSBs消费情况，采用《长处与困难问卷》(SDQ)评估儿童情绪和行为问题，采用多元Logistics回归模型分析不同SSBs摄入频率与儿童行为问题的关联。结果调查的学龄前儿童中，SSBs摄入 < 1、1和≥2次/d分别为5 509(72.2%)、830(10.9%)和1 295名(16.9%)。调整年龄、性别、体质量指数(BMI)、家庭经济状况、父母受教育程度、视屏时间、睡眠时长和体力活动时间等混杂因素后，SSBs摄入1次/d与男童多动障碍(OR=1.26，95%CI=1.01~1.57)、SDQ困难(OR=1.44，95%CI=1.14~1.82)风险增加有关，与女童情绪症状(OR=1.34，95%CI=1.02~1.76)、品行问题(OR=1.53，95%CI=1.18~2.00)、多动障碍(OR=1.79，95%CI=1.42~2.27)和亲社会行为(OR=1.48，95%CI=1.14~1.91)风险增加均有关。SSBs摄入≥2次/d仅与男童情绪症状(OR=1.28，95%CI=1.02~1.59)和SDQ困难(OR=1.30，95%CI=1.07~1.58)风险增加有关(P值均 < 0.05)。结论 SSBs摄入与学龄前儿童行为问题风险增加有关且存在性别差异，但未见显著剂量—反应关系。未来需更多纵向研究深入探讨SSBs摄入与学龄前儿童行为问题的关联及其潜在生理机制。
- 碳水化合物 /
- 饮料 /
- 摄食行为 /
- 情绪 /
- 行为 /
- 儿童, 学龄前
Abstract: Objective To explore the consumption of sugar-sweetened beverages (SSBs) and its association with behavioral problems in Chinese preschool children, and to provide a scientific basis for the prevention of behavioral problems of children. Methods A total of 7 634 children aged 3-6 years were chosen from kindergartens in 3 cities (Yangzhou, Xuzhou, Zhenjiang) in the lower reaches of Yangtze River using method of cluster sampling during October to November in 2017. Parental or guardian questionnaires were used to obtain information regarding child consumption of SSBs. The Strengths and Difficulties Questionnaire (SDQ) was used to assess children's emotional and behavioral problems. Multivariate Logistic regression model was used to explore the association between different SSBs intake frequency and children's behavioral problems. Results A total of 5 509(72.2%) consumed SSBs less than once a day, 830(10.9%) reported SSBs consumption once a day, and 1 295(16.9%) had 2 times or more intake of sugar-sweetened beverages per day. After adjusting for confounding factors including age, sex, BMI, family financial status, parental education, screen time, sleep duration, and physical activities duration, multiple Logistic regression model revealed that intake of SSBs once a day was associated with an increased risk of hyperactivity disorder (OR=1.26, 95%CI=1.01-1.57) and SDQ total difficulties (OR=1.44, 95%CI=1.14-1.82) in boys and with an increased risk of emotional symptoms (OR=1.34, 95%CI=1.02-1.76), conduct problems (OR=1.53, 95%CI=1.18-2.00), hyperactivity disorder (OR=1.79, 95%CI=1.42-2.27) and prosocial behavior (OR=1.48, 95%CI=1.14-1.91) in girls. Intake of SSBs≥2 times per day was associated with an increased risk of emotional symptoms (OR=1.28, 95%CI=1.02-1.59) and SDQ difficulties (OR=1.30, 95%CI=1.07-1.58) in boys and not with behavioral problems in girls. Conclusion Sex differences are observed with respect to the association between SSBs intake and behavioral problems in preschoolers, but no significant dose-response relationship was observed. More longitudinal studies are needed to further explore the association between SSBs intake and behavioral problems in preschool children as well as the underlying physiological mechanisms in future.
- Carbohydrates /
- Beverages /
- Feeding behavior /
- Emotions /
- Behavior /
- Child, preschool
注释:

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表 1 不同组别儿童含糖饮料摄入频率分布比较

Table 1. Comparison of daily frequency distribution of sugary drinks in children in different groups

组别	选项	人数	< 1次/d	1次/d	≥2次/d	χ²值	P值
性别	男	3 999	2 863(71.6)	431(10.8)	705(17.6)	2.64	>0.05
	女	3 635	2 646(72.8)	399(11.0)	590(16.2)
家庭经济状况	较差	231	149(64.5)	30(13.0)	52(22.5)	7.34	>0.05
	中等	6 027	4 367(72.4)	648(10.8)	1 012(16.8)
	较好	1 376	993(72.1)	152(10.9)	231(17.0)
母亲教育程度	初中及以下	577	356(61.7)	70(12.1)	151(26.2)	86.96	< 0.01
	高中或中专	1 666	1 126(67.6)	198(11.9)	342(20.5)
	大专	1 762	1 272(72.2)	189(10.7)	301(17.1)
	本科及以上	3 629	2 755(75.9)	373(10.3)	501(13.8)
父亲教育程度	初中及以下	457	280(61.3)	55(12.0)	122(26.7)	85.15	< 0.01
	高中或中专	1 624	1 104(68.0)	190(11.7)	330(20.3)
	大专	1 759	1 235(70.2)	216(12.3)	308(17.5)
	本科及以上	3 794	2 890(76.2)	369(9.7)	535(14.1)
每日视屏时间/h	< 2	5 267	4 022(76.3)	519(9.9)	726(13.8)	158.94	< 0.01
	≥2	2 367	1 487(62.8)	311(13.2)	569(24.0)
每日睡眠时长/h	< 10	1 195	833(69.7)	141(11.8)	221(18.5)	4.26	>0.05
	≥10	6 439	4 676(72.6)	689(10.7)	1 074(16.7)
每日体力活动	< 1	1918	1 494(77.9)	183(9.5)	241(12.6)	45.04	< 0.01
时间/h	≥1	5 716	4 015(70.3)	647(11.3)	1 054(81.4)
注：()内数字为构成比/%。

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表 2 含糖饮料摄入频率与学龄前儿童情绪与行为问题关联的Logistic回归分析[OR值(OR值95%CI)]

Table 2. Logistic regression model of the association of sugar-sweetened beverages consumption with behavioral problems in preschool children[OR(OR 95%CI)]

自变量	男童(n=3 999)		女童(n=3 635)		合计(n=7 634)
自变量	1次/d	≥2次/d	1次/d	≥2次/d	1次/d	≥2次/d
情绪症状	1.27(0.97~1.66)	1.28(1.02~1.59)^*	1.34(1.02~1.76)^*	1.19(0.94~1.51)	1.31(1.08~1.58)^*	1.23(1.05~1.45)^*
品行问题	1.00(0.77~1.28)	1.09(0.89~1.34)	1.53(1.18~2.00)^**	1.19(0.93~1.51)	1.21(1.01~1.46)^*	1.13(0.97~1.32)
多动障碍	1.26(1.01~1.57)^*	1.09(0.91~1.31)	1.79(1.42~2.27)^**	1.23(0.99~1.53)	1.48(1.26~1.74)^**	1.15(1.00~1.32)
同伴交往	1.15(0.93~1.41)	1.18(1.00~1.40)^*	0.92(0.74~1.15)	1.18(0.98~1.42)	1.04(0.89~1.20)	1.19(1.05~1.35)^*
亲社会行为	1.00(0.79~1.27)	1.16(0.96~1.40)	1.48(1.14~1.91)^**	1.22(0.97~1.54)	1.19(1.00~1.42)	1.19(1.03~1.38)^*
SDQ困难	1.44(1.14~1.82)^**	1.30(1.07~1.58)^*	1.27(0.96~1.67)	1.25(0.99~1.58)	1.37(1.15~1.63)^**	1.28(1.10~1.49)^**
注：P < 0.05，*P < 0.01。

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