Malnutrition among primary and secondary school students from 2008 to 2021 in Zhejiang Province
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摘要:
目的 了解2008—2021年浙江省中小学生营养不良的流行特征及趋势变化,为开展针对儿童青少年营养不良的干预提供科学依据。 方法 基于学生常见病和健康影响因素监测与干预项目,于2008,2014,2021年采用分层整群随机抽样方法,从浙江省抽取9~17岁中小学生共81 228名进行问卷调查和体格检查,采用《学龄儿童青少年营养不良筛查》判定营养不良。非正态性数据采用Kruskal-Wallis秩和检验、分类数据采用χ2检验进行差异性分析,不同年份营养不良的检出率趋势分析采用趋势χ2检验。 结果 2008,2014和2021年中小学生营养不良、生长迟缓、轻度消瘦、中重度消瘦检出率分别为12.0%,6.6%,6.0%;1.2%,0.5%,0.3%;6.0%,3.9%,3.6%;4.7%,2.2%,2.2%,总体均呈下降趋势(χ趋势2值分别为532.73,181.43,161.24,240.38,P值均 < 0.01)。各年份男生营养不良和轻度消瘦检出率(13.7%,7.6%;7.5%,5.0%;7.1%,4.5%)均高于女生(10.3%,4.4%;5.5%,2.7%;4.8%,2.5%)(χ2值分别为54.45,88.67;47.04,81.07;85.28,98.81;P值均 < 0.01);城区和郊县中小学生营养不良检出率差距逐渐缩小(12.5%,11.6%;6.9%,6.3%;6.0%,6.0%),在2021年差异无统计学意义(χ2=0.01,P>0.05)。浙江省中小学生营养不良以轻度消瘦为主(56.0%);与2008年相比,2014和2021年营养不良检出率随年龄的增长呈平稳上升趋势(χ趋势2值分别为44.52,11.78,P值均 < 0.01)。 结论 2008—2021年间浙江省中小学生营养不良检出率呈逐年下降趋势,且随着年龄增加呈平稳上升趋势,其中男生营养不良检出率更高。应根据不同年龄、性别和生长发育阶段的饮食模式制定相关政策,减少中小学生营养不良的发生。 Abstract:Objective To describe the prevalence characteristics and trend of malnutrition among primary and secondary school students in Zhejiang Province from 2008 to 2021, so as to provide scientific references for targeted interventions on malnutrition among children and adolescents. Methods Based on the National Student Common Diseases and Health Influencing Factors Surveillance Project, 81 228 primary and middle school students aged 9-17 from Zhejiang Province were recruited for a questionnaire in 2008, 2014 and 2021, with stratified cluster random sampling method. Malnutrition was determined by Screening for Malnutrition in School aged Children and Adolescents. The Kruskal-Wallis test was used for non-normally distributed data, and the Chi-square test was used for categorical data. A trend Chi-square test analyzed detection rates across different years. Results The prevalence rates of malnutrition, stunting, mild wasting, and moderate to severe wasting among primary and secondary school students in 2008, 2014 and 2021 were 12.0%, 6.6%, 6.0%; 1.2%, 0.5%, 0.3%; 6.0%, 3.9%, 3.6%; and 4.7%, 2.2%, 2.2%, with an overall declining trend (χtrend2=532.73, 181.43, 161.24, 240.38, P < 0.05). The prevalence rates of malnutrition and mild wasting in each year were higher in boys (13.7%, 7.6%; 7.5%, 5.0%; 7.1%, 4.5%) than in girls (10.3%, 4.4%; 5.5%, 2.7%; 4.8%, 2.5%) (χ2=54.45, 88.67; 47.04, 81.07; 85.28, 98.81; P < 0.01). The difference in malnutrition prevalence between urban and rural areas gradually narrowed (12.5%, 11.6%; 6.9%, 6.3%; 6.0%, 6.0%), with no statistically significant difference in 2021 (χ2=0.01, P>0.05). Malnutrition among primary and secondary school students was primarily characterized by mild wasting (56.0%) in Zhejiang Province. Compared to 2008, the prevalence of malnutrition in 2014 and 2021 showed a steady upward trend with increasing age in Zhejiang Province(χtrends2=44.52, 11.78, P < 0.01). Conclusions The prevalence of malnutrition among primary and secondary school students aged 9 to 17 years in Zhejiang Province decreases by year from 2008 to 2021. However, the prevalence increase steadily with age, and boys have a higher prevalence of malnutrition. Policies should be developed age-, gender-, and growth-appropriate dietary patterns to reduce malnutrition among primary and secondary school students. -
Key words:
- Malnutrition /
- Emaciation /
- Growth retardation /
- Child /
- Adolescent
1) 利益冲突声明 所有作者声明无利益冲突。 -
表 1 浙江省2008—2021年中小学生性别年龄城乡分布比较
Table 1. Comparison of gender, age and urban-rural distribution of primary and secondary school students in Zhejiang Province from 2008 to 2021
年份 人数 性别 年龄/岁 城乡 男 女 9 10~12 13~15 16~17 城区 郊县 2008 19 535 9 822(50.3) 9 713(49.7) 1 504(7.7) 4 643(23.8) 7 450(38.1) 5 938(30.4) 8 104(41.5) 11 431(58.5) 2014 26 668 13 969(52.4) 12 699(47.6) 1 967(7.4) 6 282(23.6) 10 563(39.6) 7 856(29.5) 10 719(40.2) 15 949(59.8) 2021 35 025 18 344(52.4) 16 681(47.6) 4 038(11.5) 11 886(33.9) 11 532(32.9) 7 569(21.6) 21 410(61.1) 13 615(38.9) χ2值 26.16 1 827.00 3 320.30 P值 <0.01 <0.01 <0.01 注: ()内数字为构成比/%。 表 2 浙江省2008—2021年不同组别中小学生营养不良检出率比较
Table 2. Comparison of detection rates of malnutrition among primary and secondary school students in different groups in Zhejiang Province from 2008 to 2021
组别 选项 统计值 2008年 2014年 2021年 人数 生长迟缓 轻度消瘦 中重度消瘦 营养不良 人数 生长迟缓 轻度消瘦 中重度消瘦 营养不良 人数 生长迟缓 轻度消瘦 中重度消瘦 营养不良 性别 男 9 822 128(1.3) 750(7.6) 467(4.8) 1 345(13.7) 13 969 60(0.4) 692(5.0) 302(2.2) 1 054(7.5) 18 344 45(0.2) 824(4.5) 434(2.4) 1 303(7.1) 女 9 713 107(1.1) 429(4.4) 460(4.7) 996(10.3) 12 699 65(0.5) 347(2.7) 281(2.2) 693(5.5) 16 681 45(0.3) 420(2.5) 328(2.0) 793(4.8) χ2值 1.50 88.67 0.00 54.45 0.80 81.07 0.06 47.04 0.12 98.81 6.37 85.28 P值 0.22 <0.01 0.98 <0.01 0.37 <0.01 0.81 <0.01 0.73 <0.01 0.01 <0.01 年龄/岁 9 1 504 31(2.1) 56(3.7) 85(5.7) 172(11.4) 1 967 8(0.4) 48(2.4) 52(2.6) 108(5.5) 4 038 11(0.3) 130(3.2) 122(3.0) 263(6.5) 10~12 4 643 69(1.5) 272(5.9) 267(5.8) 608(13.1) 6 282 29(0.5) 187(3.0) 119(1.9) 335(5.3) 11 886 27(0.2) 361(3.0) 241(2.0) 629(5.3) 13~15 7 450 75(1.0) 480(6.4) 331(4.4) 886(11.9) 10 563 32(0.3) 421(4.0) 216(2.0) 669(6.3) 11 532 21(0.2) 442(3.8) 203(1.8) 666(5.8) 16~17 5 938 60(1.0) 371(6.2) 244(4.1) 675(11.4) 7 856 56(0.7) 383(4.9) 196(2.5) 635(8.1) 7 569 31(0.4) 311(4.1) 196(2.6) 538(7.1) χ2值 16.72 17.09 19.94 8.06 16.43 45.66 8.92 49.68 9.85 20.01 30.23 30.02 P值 <0.01 <0.01 <0.01 0.05 <0.01 <0.01 0.03 <0.01 0.02 <0.01 <0.01 <0.01 城乡 城区 8 104 101(1.2) 492(6.1) 424(5.2) 1 017(12.5) 10 719 51(0.5) 444(4.1) 246(2.3) 741(6.9) 21 410 47(0.2) 774(3.6) 463(2.2) 1 284(6.0) 郊县 11 431 134(1.2) 687(6.0) 503(4.4) 1 324(11.6) 15 949 74(0.5) 595(3.7) 337(2.1) 1 006(6.3) 13 615 43(0.3) 470(3.5) 299(2.2) 812(6.0) χ2值 0.17 0.02 7.07 4.11 0.00 2.80 0.91 3.74 2.65 0.60 0.03 0.01 P值 0.69 0.88 0.01 0.04 0.96 0.09 0.34 0.05 0.10 0.44 0.86 0.92 注:()内数字为检出率/%。 -
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