Relationship between myopia and frequency of high energy food intake among adolescents in Nantong
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摘要:
目的 了解南通市青少年近视发生率及其相关因素,分析食物摄入与青少年近视发生的相关关系,为青少年近视防控提供参考。 方法 采用分层整群随机抽样,选取南通市13所学校,以班级为单位抽取3 437名学生开展健康监测和问卷调查,收集学生社会人口学特征和饮食相关信息。 结果 青少年近视检出2 522名,近视率73.4%,城区青少年近视检出率(74.1%)高于郊区(72.4%),且城区的女生近视率(78.2%)高于郊区(73.6%)。多因素Logistic回归分析显示,城区青少年高能食物摄入频次与近视呈正相关(OR=1.50,P < 0.01),在调整年龄、父母近视、参加课外学习班、户外课间活动等因素后,高能食物摄入频次与近视相关性仍有统计学意义(OR=1.29,P=0.03);郊区青少年高能食物摄入频次与近视呈正相关(OR=1.35,P=0.02),在调整了年龄、父母近视、户外课间活动等因素后发现,高能食物摄入频次与近视发生相关性无统计学意义(P=0.60)。 结论 南通市青少年近视发生与高能食物摄入频次呈正相关。家长、学校及社会应关注青少年近视及高能饮食模式问题,注意引导青少年合理的饮食习惯,多角度防控青少年近视。 Abstract:Objective To investigate the incidence of juvenile myopia and associated factors in Nantong, to analyze the relationship between food intake and juvenile myopia, so as to provide a reference for preventing and controlling myopia of adolescents. Methods Stratified cluster random sampling was used to select 13 schools in Nantong. A total of 3 437 students were selected for health monitoring and questionnaire survey, and the students' sociodemographic characteristics and diet related information were collected. Results The prevalence of myopia was 73.4%(n=2 522). The myopia rate of urban teenagers(74.1%) was higher than that in suburbs(72.4%), and the myopia rate of urban girls (78.2%)was higher than that of suburban girls(73.6%). Multivariate Logistic regression analysis showed that there was a significant positive correlation between the frequency of high-energy food intake and myopia among urban adolescents (OR=1.50, P < 0.01). After adjusting for covariates, e.g. age, parental myopia, participation in extracurricular classes, outdoor inter-class activities, the frequency of high-energy food intake was significantly positively associated with myopia (OR=1.29, P=0.03). Frequency of high-energy food intake was significantly positively correlated with myopia of suburban adolescents (OR=1.35, P=0.02). The association disappeared after adjusting for above-ment ioned covariates (P=0.60). Conclusion There are differences in the main risk factors affecting the incidence of myopia between urban and suburban adolescents in Nantong. Parents, schools and the society should pay attention to adolescent myopia and high-energy diet mode, pay attention to guide their reasonable eating habits, and prevent and control adolescent myopia from multiple angles. -
Key words:
- Myopia /
- Feeding behavior /
- Food habits /
- Regression analysis /
- Adolescent
1) 利益冲突声明 所有作者声明无利益冲突。 -
表 1 不同组别城郊青少年近视率比较
Table 1. Comparison of the myopia rates of different groups of adolescents in urban and suburban areas
组别 选项 城区 郊区 人数 近视人数 χ2值 P值 人数 近视人数 χ2值 P值 性别 男 1 049 738(70.4) 15.84 < 0.01 796 569(71.5) 0.81 0.38 女 944 738(78.2) 648 477(73.6) 年龄/岁 < 13 645 383(59.4) 120.83 < 0.01 628 373(59.4) 110.11 < 0.01 13~14 395 293(74.2) 422 323(76.5) >14 953 800(83.9) 394 350(88.8) 是否做眼保健操 不做 55 44(80.0) 1.04 0.31 30 25(83.3) 1.82 0.18 做 1 938 1 432(73.9) 1 414 1 021(72.2) 父母近视 均不近视 994 698(70.2) 16.25 < 0.01 584 381(65.2) 37.15 < 0.01 父亲近视 354 278(78.5) 258 184(71.3) 母亲近视 350 266(76.0) 297 225(75.8) 均近视 295 234(79.3) 305 256(83.9) 每日户外活动时间/h < 2 1 332 1 003(75.3) 3.22 0.07 994 730(73.4) 1.61 0.20 ≥2 661 473(71.6) 450 316(70.2) 体力活动 低等组 234 181(77.4) 10.36 0.01 185 141(76.2) 14.58 < 0.01 中等组 1 482 1 111(75.0) 942 702(74.5) 高等组 277 184(66.4) 317 203(64.0) 每日用眼后休息/h < 0.5 824 582(70.6) 8.60 0.01 606 407(67.2) 15.53 < 0.01 0.5~ < 2 916 701(76.5) 647 488(75.4) ≥2 253 193(76.3) 191 151(79.1) 每日睡眠情况/h < 8 1 013 824(81.3) 56.88 < 0.01 797 635(80.7) 58.95 < 0.01 ≥8 980 652(66.5) 657 411(62.6) 每日课后作业时长/h < 1 289 199(68.9) 4.76 0.04 308 226(73.4) 0.17 0.72 ≥1 1 704 1 277(74.9) 1 136 820(72.2) 课间活动区域 教学楼 1 723 1 313(76.2) 30.46 < 0.01 1 173 868(74.0) 7.62 0.01 户外 270 163(60.4) 271 178(65.7) 参加课外学习班 否 425 291(68.5) 8.78 < 0.01 235 160(68.1) 2.66 0.11 是 1 568 1 185(75.6) 1 209 886(73.3) 高能食物摄入频次 低 513 346(67.4) 15.72 < 0.01 436 297(68.1) 5.83 0.02 高 1 480 1 130(76.4) 1 008 749(74.3) 低能食物摄入频次 低 935 736(78.7) 19.89 < 0.01 479 335(69.9) 2.24 0.13 高 1 058 740(69.9) 965 711(73.7) 注: ()内数字为检出率/%。 表 2 城区青少年近视与食物摄入频次关系的多因素Logistic回归分析(n=1 993)
Table 2. Multivariate Logistic regression analysis in the association of myopia and frequency of food intake in urban adolescents (n=1 993)
自变量 组别 β值 标准误 Wald χ2值 P值 OR值(OR值95%CI) 模型1 高能食物摄入频次 高 0.41 0.11 12.95 < 0.01 1.50(1.20~1.88) 低能食物摄入频次 高 -0.44 0.11 17.25 < 0.01 0.65(0.53~0.79) 模型2 高能食物摄入频次 高 0.26 0.12 4.59 0.03 1.29(1.02~1.64) 低能食物摄入频次 高 -0.13 0.12 1.12 0.29 0.88(0.70~1.11) 性别 女 0.42 0.11 13.96 < 0.01 1.52(1.22~1.89) 年龄/岁 < 13 -1.20 0.15 61.13 < 0.01 0.30(0.22~0.41) 13~14 -0.47 0.16 9.00 < 0.01 0.62(0.46~0.85) 父母近视 父亲近视 0.67 0.16 18.06 < 0.01 1.96(1.44~2.66) 母亲近视 0.39 0.15 6.39 0.01 1.47(1.09~1.99) 均近视 0.74 0.18 17.77 < 0.01 2.09(1.48~2.95) 每日用眼后休息/h < 0.5 -0.01 0.18 < 0.01 0.96 0.99(0.70~1.41) 0.5~ < 2 0.05 0.18 0.06 0.80 1.05(0.74~1.49) 每日睡眠情况/h < 8 0.18 0.13 1.86 0.17 1.19(0.93~1.54) 课间活动区域 户外 -0.43 0.15 8.34 < 0.01 0.65(0.49~0.87) 体力活动 低等组 0.06 0.22 0.07 0.79 1.06(0.69~1.63) 中等组 0.17 0.15 1.25 0.26 1.19(0.88~1.60) 参加课外学习班 是 0.27 0.13 4.16 0.04 1.31(1.01~1.70) 每日课后作业时长/h < 1 -0.10 0.15 0.48 0.49 1.11(0.83~1.30) 注:模型1未调整其他变量;模型2调整了性别、年龄、父母近视、用眼后休息、睡眠、课间活动区域、体力活动、参加课外学习班等变量。 表 3 郊区青少年近视与食物摄入频次关系的多因素Logistic回归分析(n=1 444)
Table 3. Multivariate Logistic regression analysis in the association of myopia and frequency of food intake in suburban adolescents (n=1 444)
自变量 组别 β值 标准误 Wald χ2值 P值 OR值(OR值95%CI) 模型1 高能食物摄入频次 高 0.30 0.13 5.81 0.02 1.35(1.06~1.73) 模型2 高能食物摄入频次 高 0.07 0.14 0.28 0.60 1.08(0.82~1.41) 年龄/岁 < 13 -1.71 0.23 57.39 < 0.01 0.18(0.12~0.28) 13~14 -0.82 0.21 15.98 < 0.01 0.44(0.30~0.66) 父母近视 父亲近视 0.50 0.17 8.07 0.01 1.64(1.17~2.31) 母亲近视 0.77 0.17 20.04 < 0.01 2.17(1.55~3.05) 均近视 1.32 0.19 47.76 < 0.01 3.74(2.57~5.43) 每日用眼后休息/h < 0.5 -0.25 0.22 1.34 0.25 0.78(0.51~1.19) 0.5~ < 2 -0.05 0.22 0.05 0.82 0.95(0.62~1.45) 每日睡眠情况/h < 8 0.11 0.16 0.45 0.50 1.12(0.81~1.53) 课间活动区域 户外 0.06 0.16 0.16 0.69 1.07(0.78~1.45) 体力活动 低等组 0.20 0.23 0.74 0.39 1.22(0.78~1.90) 中等组 0.39 0.15 6.57 0.01 1.47(1.10~1.97) 注:模型1未调整其他变量;模型2调整了年龄、父母近视、用眼后休息、睡眠、课间活动区域、体力活动等变量。 -
[1] 教育部. 教育部等八部门关于印发《综合防控儿童青少年近视实施方案》的通知[A/OL]. (2018-08-30)[2021-11-06]. http://www.moe.gov.cn/srcsite/A17/moe_943/s3285/201808/t20180830_346672.html.Ministry of Education of the PRC. Notice of the Ministry of Education and other eight departments on the issuance of the "Implementation Plan for the Comprehensive Prevention and Control of Myopia in Children and Adolescents"[A/OL]. (2018-08-30) [2021-11-06]. http://www.moe.gov.cn/srcsite/A17/moe_943/s3285/201808/t20180830_346672.html. [2] HARRINGTON S C, STACK J, O'DWVER V. Risk factors associated with myopia in schoolchildren in Ireland[J]. Br J Ophthalmol, 2019, 103(12): 1803-1809. https://pubmed.ncbi.nlm.nih.gov/30745305/ [3] CHUA S Y, SABANAYAGAM C, TAN C S, et al. Diet and risk of myopia in three-year-old Singapore children: the GUSTO cohort[J]. Clin Exp Optom, 2018, 101(5): 692-699. doi: 10.1111/cxo.12677 [4] 吴泽勇, 陈哲, 杨亚新, 等. 新疆阿克苏地区6~11岁儿童近视状况及影响因素分析[J]. 中华全科医学, 2020, 18(8): 1320-1323. https://www.cnki.com.cn/Article/CJFDTOTAL-SYQY202008022.htmWU Z Y, CHEN Z, YANG Y X, et al. Analysis of myopia and influencing factors in children aged 6-11 in Aksu area of Xinjiang[J]. Chin J Gen Pract, 2020, 18(8): 1320-1323. https://www.cnki.com.cn/Article/CJFDTOTAL-SYQY202008022.htm [5] 李宏, 丁俊杰, 顾鑫, 等. 青少年近视与生活饮食习惯的调查[J]. 黑龙江医药科学, 2020, 43(6): 175-178. doi: 10.3969/j.issn.1008-0104.2020.06.082LI H, DING J J, GU X, et al. A survey of juvenile myopia and dietary habits[J]. Heilongjiang Med Pharmacy, 2020, 43(6): 175-178. doi: 10.3969/j.issn.1008-0104.2020.06.082 [6] 黄玮浩, 陆爽, 杨舒仪, 等. 广州市城区中学生视屏时间与饮食行为关联性[J]. 中国学校卫生, 2020, 41(4): 528-530, 534. doi: 10.16835/j.cnki.1000-9817.2020.04.013HUANG W H, LU S, YANG S Y, et al. Association between screen time and dietary behaviors among urban middle school students in Guangzhou[J]. Chin J Sch Health, 2020, 41(4): 528-530, 534. doi: 10.16835/j.cnki.1000-9817.2020.04.013 [7] EGGERSDORFER M, WYSS A. Carotenoids in human nutrition and health[J]. Arch Biochem Biophys, 2018, 652(15): 18-26. https://pubmed.ncbi.nlm.nih.gov/29885291/ [8] LONDON D S, BEEZHOLD B. A phytochemical-rich diet may explain the absence of age-related decline in visual acuity of Amazonian hunter-gatherers in Ecuador[J]. Nutr Res, 2015, 35(2): 107-117. doi: 10.1016/j.nutres.2014.12.007 [9] BERTICAT C, MAMOUNI S, CIAIS A, et al. Probability of myopia in children with high refined carbohydrates consumption in France[J]. BMC Ophthalmol, 2020, 20(1): 337. doi: 10.1186/s12886-020-01602-x [10] 国家卫生健康委办公厅. 国家卫生健康委办公厅关于印发儿童青少年近视防控适宜技术指南的通知[A/OL]. (2019-10-15)[2021-11-06]. http://www.nhc.gov.cn/jkj/s5898bm/201910/c475e0bd2de444379402f157523f03fe.shtml.General Office of the National Health Commission of the PRC. Notice of the General Office of the National Health Commission on Printing and Distributing Appropriate Technical Guidelines for the Prevention and Control of Myopia in Children and Adolescents[A/OL]. (2019-10-15)[2021-11-06]. http://www.nhc.gov.cn/jkj/s5898bm/201910/c475e0bd2de444379402f157523f03fe.shtml. [11] 樊萌语, 吕筠, 何平平. 国际体力活动问卷中体力活动水平的计算方法[J]. 中华流行病学杂志, 2014, 35(8): 961-964.FAN M Y, LYU Y, HE P P. Chinese guidelines for data processing and analysis concerning the International Physical Activity Questionnaire[J]. Chin J Epidemiol, 2014, 35(8): 961-964. [12] 教育部. 教育部: 2020年全国儿童青少年总体近视率较2019年小幅上升[EB/OL]. (2021-05-11)[2021-11-06]. http://www.moe.gov.cn/jyb_xwfb/xw_fbh/moe_2606/2021/tqh_0511/mtbd/202105/t20210511_530851.html.Ministry of Education of the PRC. Ministry of Education of the PRC: the overall myopia rate of children and adolescents nationwide in 2020 will increase slightly compared with 2019[EB/OL]. (2021-05-11)[2021-11-06]. http://www.moe.gov.cn/jyb_xwfb/xw_fbh/moe_2606/2021/tqh_0511/mtbd/202105/t20210511_530851.html. [13] 高青, 刘懿卿, 叶茜雯, 等. 辽宁省四至六年级小学生近视现况及其影响因素[J]. 中国学校卫生, 2020, 41(6): 929-931. doi: 10.16835/j.cnki.1000-9817.2020.06.035GAO Q, LIU Y Q, YE Q W, et al. Myopia and its influencing factors among grade 4-6 pupils in Liaoning Province[J]. Chin J Sch Health, 2020, 41(6): 929-931. doi: 10.16835/j.cnki.1000-9817.2020.06.035 [14] 范奕, 陈婷, 陈福辉, 等. 江西省儿童青少年近视流行现状及影响因素[J]. 中国学校卫生, 2020, 41(9): 1413-1416. doi: 10.16835/j.cnki.1000-9817.2020.09.038FAN Y, CHEN T, CHEN F H, et al. The prevalence and influencing factors of myopia in children and adolescents, Jiangxi[J]. Chin J Sch Health, 2020, 41(9): 1413-1416. doi: 10.16835/j.cnki.1000-9817.2020.09.038 [15] 谌丁艳, 李晓恒, 周丽, 等. 深圳市中小学生近视影响因素分析[J]. 中国学校卫生, 2020, 41(4): 583-587. doi: 10.16835/j.cnki.1000-9817.2020.04.027CHEN D Y, LI X H, ZHOU L, et al. Influencing factors of myopia among primary and secondary school students in Shenzhen[J]. Chin J Sch Health, 2020, 41(4): 583-587. doi: 10.16835/j.cnki.1000-9817.2020.04.027 [16] 曾叶纯, 冯晴. 某市高校大学生膳食营养与近视的相关性分析[J]. 中国食物与营养, 2015, 21(11): 86-89. doi: 10.3969/j.issn.1006-9577.2015.11.022ZENG Y C, FENG Q. Correlation analysis between dietary nutrition and myopia among college students[J]. Food Nutr China, 2015, 21(11): 86-89. doi: 10.3969/j.issn.1006-9577.2015.11.022 [17] KOSAKA S, SUDA K, GUNAWAN B, et al. Urban-rural difference in the determinants of dietary and energy intake patterns: a case study in West Java, Indonesia[J]. PLoS One, 2018, 13(5): e0197626. doi: 10.1371/journal.pone.0197626 [18] JI Z, WANG D, ALISON E, et al. Urban-rural disparities in energy intake and contribution of fat and animal source foods in chinese children aged 4-17 years[J]. Nutrients, 2017, 9(5): 526. doi: 10.3390/nu9050526 [19] 郭宝福, 李小成, 金迪, 等. 南京市城乡居民膳食结构及营养素摄入状况分析[J]. 营养学报, 2019, 41(4): 321-326. https://www.cnki.com.cn/Article/CJFDTOTAL-YYXX201904008.htmGUO B F, LI X C, JIN D, et al. Dietary pattern and nutrients intake of urban and rural residents in Nanjing[J]. Acta Nutr Sin, 2019, 41(4): 321-326. https://www.cnki.com.cn/Article/CJFDTOTAL-YYXX201904008.htm [20] 中华医学会眼科学分会斜视与小儿眼科学组. 中国儿童睫状肌麻痹验光及安全用药专家共识[J]. 中华眼科杂志, 2019, 55(1): 7-12. doi: 10.3760/cma.j.issn.0412-4081.2019.01.003Strabismus and Pediatric Ophthalmology Group, Ophthalmology Branch, Chinese Medical Association. Expert consensus on optometry and safe drug use in children with cycloplegia in China[J]. Chin J Ophthalmol, 2019, 55(1): 7-12. doi: 10.3760/cma.j.issn.0412-4081.2019.01.003 [21] LIU D, JU H, YANG Z Y, et al. Food frequency questionnaire for Chinese children aged 12-17 years: validity and reliability[J]. Biomed Environ Sci, 2019, 32(7): 486-495. https://pubmed.ncbi.nlm.nih.gov/31331433/ -

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