农村留守儿童膳食多样化评价及其影响因素分析

戴一鸣; 丁佳韵; 郭剑秋; 张济明; 张磊; 王铮; 邬春华; 周志俊

doi:10.16835/j.cnki.1000-9817.2021.07.008

农村留守儿童膳食多样化评价及其影响因素分析

doi: 10.16835/j.cnki.1000-9817.2021.07.008

复旦大学公共卫生学院/教育部公共卫生安全重点实验室, 上海 200032

基金项目:

上海市公共卫生三年行动计划重点学科建设项目 GW-V-10.1-XK11

详细信息

作者简介:
戴一鸣(1997-), 男, 江苏盐城人, 在读博士, 主要研究方向为环境因素与健康

丁佳韵(1999-), 女, 山东寿光人, 大学本科, 主要研究方向为环境与儿童健康

通讯作者:
周志俊, E-mail: zjzhou@fudan.edu.cn

戴一鸣与丁佳韵为并列第一作者
中图分类号: R151 R153.2
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- 被引次数: 0
出版历程
- 收稿日期: 2020-11-26
- 修回日期: 2020-12-30
- 网络出版日期: 2021-07-23
- 刊出日期: 2021-07-25

Dietary diversity and determinants among left-behind children in rural area

School of Public Health/Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai (200032), China

摘要

摘要: 目的评价学龄期留守儿童的膳食多样化得分及其影响因素，为指导留守儿童合理膳食提供参考依据。方法 2019年8月对2009年在江苏射阳建立的儿童出生队列中501名9~10岁儿童进行调查，问卷询问儿童留守情况与其他基本信息，24 h膳食回顾法收集膳食资料。根据联合国粮食与农业组织(Food and Agriculture Organization, FAO)的标准计算膳食多样化得分(dietary diversity score, DDS₁₀和DDS)和食物多样性得分(food variety score, FVS)；测量儿童的体格发育指标并评估肥胖情况，应用多变量回归分析留守情况与膳食多样化得分关系及影响因素。结果留守儿童的比例为40.9%，3种膳食多样化得分(DDS₁₀、DDS、FVS)分别为(5.69±1.31)(6.55±1.44)(13.48±4.23)分，均低于非留守儿童(5.99±1.29，6.79±1.40，14.15±4.22)分，留守儿童与非留守儿童的DDS₁₀评分差异有统计学意义(P=0.01)。广义线性模型回归结果显示，性别、被动吸烟、家庭教育水平、家庭年收入、留守情况与膳食多样化得分相关均有统计学意义(P值均 < 0.05)。结论留守儿童的膳食多样化程度较低，膳食多样化与儿童性别、被动吸烟、家庭教育水平和家庭年收入等有关。应注重留守儿童膳食多样化，改善儿童饮食。
- 膳食 /
- 饮食习惯 /
- 回归分析 /
- 儿童 /
- 农村人口
Abstract: Objective To evaluate the status of dietary diversity and determinants among school-age left-behind children. Methods A total of 501 children aged 9-10 years in Sheyang Mini Cohort Study were enrolled from Sheyang City in Jiangsu Province during 2019. A questionnaires survey was administrated to collect left-behind and socioeconomic information. Twenty-four hour dietary recall survey was conducted, dietary diversity score (DDS₁₀ and DDS) and food variety score (FVS) were computed according to Food and Agriculture Organization (FAO). Weight and height of children were measured and sex-and age-standardized body mass index was used to define obesity. Multivariable regression models were preformed to explore the determinants of dietary diversity in school-age left-behind children. Results The proportion of left-behind children was 40.9%. The mean value and standard deviation of three kinds of dietary diversity score (DDS₁₀, DDS, FVS) in left-behind children were (5.69±1.31)(6.55±1.44) and (13.48±4.23), respectively. All of these were lower than that in non-left-behind children (DDS₁₀: 5.99±1.29; DDS: 6.79±1.40; FVS: 14.15±4.22). Significant difference in DDS₁₀ between left-behind and non-left-behind children was observed (P=0.01). The results of multivariable regression demonstrated that gender, passive smoking, family education level and family economic status were related to dietary diversity scores (P < 0.05). Conclusion Dietary diversity in school-age left-behind children was not optimistic and gender, passive smoking, parental education level, family economic status and left-behind situation play a critical role in dietary diversity among these children.
- Diet /
- Food habits /
- Regression analysis /
- Child /
- Rural population
注释:

1) 戴一鸣与丁佳韵为并列第一作者

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表 1 一般特征分布留守儿童与非留守儿童比较

Table 1. Sociodemographic characteristics in left-behind children and non-left-behind children

一般特征	分类	留守儿童(n=205)	非留守儿童(n=296)	χ²值	P值
性别	男	113(55.1)	151(51.0)	0.82	0.37
	女	92(44.9)	145(49.0)
肥胖情况	是	34(16.6)	53(17.9)	0.15	0.70
	否	171(83.4)	243(82.1)
被动吸烟	是	93(45.4)	143(48.3)	0.42	0.52
	否	112(54.6)	153(51.7)
口味偏好	偏清淡	148(72.2)	202(68.2)	1.16	0.56
	轻度油盐	48(23.4)	76(25.7)
	重度油盐	9(4.4)	18(6.1)
家庭教育水平/年	< 9	111(54.1)	140(47.3)	2.27	0.13
	≥9	94(45.9)	156(52.7)
家庭年收入/万元	≤5	74(36.1)	86(29.1)	2.83	0.24
	>5~10	68(33.2)	106(35.8)
	>10	63(30.7)	104(35.1)
抚养人抑郁情况	是	35(17.1)	40(13.5)	1.21	0.27
	否	170(82.9)	256(86.5)
注： ( )内数字为构成比/%。

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表 2 留守与非留守儿童摄入不同种类食物得分人数比例比较

Table 2. Comparison of score proportion of different kinds of food intake among left-behind and non-left-behind children

是否留守	人数	谷物类	富含维生素A的蔬果类	其他水果类	其他蔬菜类	坚果豆类	油脂类	肉类	奶制品类	蛋类
是	205	204(99.5)	91(44.4)	93(45.4)	136(66.3)	63(30.7)	205(100.0)	177(86.3)	73(35.6)	120(58.5)
否	296	296(100.0)	141(47.6)	175(59.1)	208(70.3)	97(32.8)	296(100.0)	260(87.8)	115(38.9)	173(58.4)
合计	501	500(99.8)	232(46.3)	268(53.5)	344(68.7)	160(31.9)	501(100.0)	437(87.2)	188(37.5)	293(58.5)
χ²值		1.45	0.51	9.21	0.87	0.23	-	0.24	0.54	0.00
P值		0.23	0.47	< 0.01	0.35	0.63	-	0.62	0.46	0.98
注：( )内数字为得分率/%。

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表 3 学龄期儿童膳食多样化得分的影响因素线性分析(n=501)

Table 3. Multivariable regression analysis of influencing factors on dietary diversity scores in school-age children(n=501)

自变量	选项	DDS₁₀		DDS		FVS
自变量	选项	β值(β值95%CI)	P值	β值(β值95%CI)	P值	β值(β值95%CI)	P值
性别	男	1.00		1.00		1.00
	女	0.30(0.07~0.53)	0.01	0.30(0.05~0.55)	0.02	0.62(-0.13~1.38)	0.10
年龄/月		0.03(-0.03~0.08)	0.34	0.01(-0.05~0.07)	0.66	-0.01(-0.19~0.17)	0.93
肥胖	否	1.00		1.00		1.00
	是	-0.10(-0.41~0.20)	0.50	-0.21(-0.54~0.12)	0.20	-0.16(-1.14~0.83)	0.76
被动吸烟	否	1.00		1.00		1.00
	是	-0.34(-0.56~-0.12)	0.00	-0.35(-0.60~-0.11)	0.00	-0.85(-1.57~-0.12)	0.02
口味偏好	偏清淡	1.00		1.00		1.00
	轻度油盐	-0.10(-0.36~0.16)	0.43	-0.09(-0.37~0.20)	0.56	-0.81(-1.67~0.04)	0.06
	重度油盐	0.23(-0.27~0.72)	0.37	0.41(-0.13~0.94)	0.14	0.69(-0.93~2.31)	0.40
家庭教育水平/年	< 9	1.00		1.00		1.00
	≥9	0.31(0.08~0.54)	0.01	0.29(0.04~0.53)	0.03	0.91(0.16~1.66)	0.02
家庭年收入/万元	≤5	1.00		1.00		1.00
	>5~10	0.11(-0.17~0.38)	0.46	0.21(-0.09~0.52)	0.17	0.55(-0.36~1.46)	0.24
	>10	0.33(0.05~0.61)	0.01	0.47(0.17~0.78)	0.00	1.09(0.18~2.01)	0.02
抚养人抑郁情况	否	1.00		1.00		1.00
	是	0.04(-0.28~0.35)	0.83	-0.01(-0.35~0.33)	0.94	-0.16(-1.18~0.86)	0.76
留守情况	否	1.00		1.00		1.00
	是	-0.26(-0.48~-0.03)	0.02	-0.19(-0.43~0.16)	0.13	-0.55(-1.28~0.19)	0.15

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表 4 学龄期留守儿童膳食多样化得分的影响因素分析(n=205)

Table 4. Multivariable regression analysis of influencing factors on dietary diversity scores in school-age left-behind children(n=205)

自变量	选项	DDS₁₀		DDS		FVS
自变量	选项	β值(β值95%CI)	P值	β值(β值95%CI)	P值	β值(β值95%CI)	P值
性别	男	1.00		1.00		1.00
	女	0.27(-0.08~0.63)	0.13	0.29(-0.10~0.68)	0.15	0.85(-0.32~2.01)	0.15
年龄/月		0.07(-0.02~0.16)	0.15	0.03(-0.07~0.13)	0.54	-0.03(-0.32~0.27)	0.86
肥胖	否	1.00		1.00		1.00
	是	-0.21(-0.68~0.03)	0.07	-0.38(-0.90~0.14)	0.15	-0.78(-2.32~0.76)	0.32
被动吸烟	否	1.00		1.00		1.00
	是	-0.32(-0.67~0.03)	0.07	-0.42(-0.81~-0.04)	0.03	-0.74(-1.88~0.40)	0.20
口味偏好	偏清淡	1.00		1.00		1.00
	轻度油盐	-0.30(-0.72~0.11)	0.15	-0.37(-0.83~0.08)	0.11	-1.74(-3.08~-0.40)	0.01
	重度油盐	0.72(-0.13~1.57)	0.10	0.92(-0.02~1.85)	0.05	1.37(-1.40~4.14)	0.33
家庭教育水平/年	< 9	1.00		1.00		1.00
	≥9	0.32(-0.05~0.68)	0.09	0.27(-0.13~0.67)	0.19	0.45(-0.74~1.63)	0.46
家庭年收入/万元	≤5	1.00		1.00		1.00
	5~10	0.02(-0.41~0.45)	0.92	0.08(-0.39~0.55)	0.74	0.93(-0.46~2.33)	0.19
	>10	0.34(-0.09~0.78)	0.12	0.45(-0.03~0.93)	0.07	1.33(-0.08~2.74)	0.07
抚养人抑郁情况	否	1.00		1.00		1.00
	是	0.06(-0.41~0.52)	0.81	-0.04(-0.55~0.47)	0.87	0.20(-1.31~1.70)	0.80

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