上海市青少年饮食行为现状以及抑郁焦虑情绪的影响

顾文馨; 谭银亮; 陆唯怡; 杜兰朵朵; 朱静芬

doi:10.16835/j.cnki.1000-9817.2022.06.016

上海市青少年饮食行为现状以及抑郁焦虑情绪的影响

doi: 10.16835/j.cnki.1000-9817.2022.06.016

1.
上海交通大学公共卫生学院，上海 200025
2.
上海交通大学中国医院发展研究院

基金项目:

上海市公共卫生三年行动计划 GWV-10.1-XK15

详细信息

作者简介:
顾文馨(2000-)，女，江苏高邮人，在读本科生

通讯作者:
朱静芬，E-mail：zhujingfenjt@163.com

利益冲突声明 所有作者声明无利益冲突。
中图分类号: R153.2 G478 R179
计量
- 文章访问数: 725
- HTML全文浏览量: 328
- PDF下载量: 107
- 被引次数: 0
出版历程
- 收稿日期: 2021-11-15
- 修回日期: 2022-01-29
- 网络出版日期: 2022-06-23
- 刊出日期: 2022-06-25

Prevalence and influence of depression and anxiety on dietary behaviors among adolescents in Shanghai

1.
School of Public Health, Shanghai Jiao Tong University, Shanghai (200025), China

摘要

摘要: 目的了解上海市青少年饮食行为现状，并探讨情绪对饮食行为的影响，为培养青少年良好的饮食行为提供参考。方法采用分层随机整群抽样方法，于2021年5月对上海市3个区10所初中和6所高中的7 456名学生进行问卷调查，调查内容包括一般情况、饮食行为、患者健康问卷(2条目)和广泛性焦虑量表。结果上海市青少年过去7 d每天食用含糖饮料、甜食、油炸食品及西式快餐(≥4次/周)的报告率分别为13.26%，16.90%，6.99%，13.01%，每天吃水果、蔬菜、牛奶、早餐的报告率分别为56.96%，73.00%，65.03%，76.11%，不同性别和学段学生间差异均有统计学意义(P值均 < 0.05)。有抑郁或焦虑情绪青少年不良饮食行为的发生率高于无抑郁或焦虑者(P值均 < 0.01)。校正性别、学校、住宿、成绩、零花钱、社会阶层后，抑郁和焦虑情绪增加青少年各种不良饮食行为的发生风险(P值均 < 0.05)。与无焦虑者相比，轻度和中重度焦虑者每天喝≥1次含糖饮料的风险为1.42(95%CI=1.20~1.67)和2.51倍(95%CI=2.09~3.01)，不是每天吃水果的风险为1.30(95%CI=1.16~1.45)和1.28倍(95%CI=1.11~1.47)，不是每天吃蔬菜的风险为1.35(95%CI=1.20~1.52)和1.41倍(95%CI=1.21~1.65)，不是每天喝牛奶的风险为1.29(95%CI=1.15~1.44)和1.20倍(95%CI=1.04~1.39)，不是每天吃早餐的风险为1.75(95%CI=1.54~1.99)和2.97倍(95%CI=2.55~3.46)。结论上海市青少年不良饮食行为比例较高，应早期开展饮食行为宣教和干预，并关注青少年负性情绪的发生，以减少不良饮食行为的发生风险。
- 饮食习惯 /
- 行为 /
- 情绪 /
- 回归分析 /
- 青少年
Abstract: Objective To investigate the prevalence of adolescents' dietary behavior in Shanghai, and to explore emotional influence on dietary behavior. Methods A total of 7 456 students from 10 junior and 6 senior high schools in Shanghai were selected to participate in the questionnaire survey with the stratified random cluster sampling method. The survey included general information, eating behavior, PHQ-2 and GAD-7. Results During the past week, the proportion of adolescents in Shanghai reported consumption of sugar-sweetened beverages, sweet desserts, frequent fried food and fast food (≥4 times/week) were 13.26%, 16.90%, 6.99% and 13.01%, respectively. The proportion of students reported consumption of fruits, vegetables, milk and breakfast every day were 56.96%, 73.00%, 65.03% and 76.11%, respectively. There were significant differences by sex and educational stages(both P < 0.05). Adolescents with depression or anxiety have a higher incidence of unhealthy eating behaviors than those without depression or anxiety(P < 0.01). After adjusting for gender, school, accommodation, grades, pocket money and social class, depression and anxiety increase the risk of various unhealthy eating behaviors in adolescents(P < 0.05). Compared with those without anxiety, the risks of sugar-sweetened beverages consumption (≥1 time/d) among adolescents with mild and moderate to severe anxiety were 1.42 times (95%CI=1.20-1.67) and 2.51 times (95%CI=2.09-3.01), the risks of insufficient fruits consumption (< 1 time/d) were 1.30 times (95%CI=1.16-1.45) and 1.28 times (95%CI=1.11-1.47), the risks of insufficient vegetable consumption (< 1 time/d) were 1.35 times (95%CI=1.20-1.52) and 1.41 times(95%CI=1.21-1.65), the risks of insufficient milk consumption (< 1 time/d) were 1.29 times (95%CI=1.15-1.44) and 1.20 times(95%CI=1.04-1.39), and the risks of breakfast skipping were 1.75 times (95%CI=1.54-1.99) and 2.97 times (95%CI=2.55-3.46) among adolescents with mild and moderate to severe anxiety. Conclusion The proportion of unhealthy eating behaviors among adolescents in Shanghai is still high. Early education and intervention for students' eating behaviors should be carried out, and attention should be paid to the occurrence of adolescents' negative emotions, so as to reduce the risk of unhealthy eating behaviors among adolescents through the promotion of mental health.
- Food habits /
- Behavior /
- Emotions /
- Regression analysis /
- Adolescent
注释:

1) 利益冲突声明 所有作者声明无利益冲突。

HTML全文

表 1 不同性别和学段青少年饮食行为报告率比较

Table 1. Distribution of dietary behaviors among adolescents of different genders and schools

组别	选项	人数	统计值	不健康饮食				健康饮食
组别	选项	人数	统计值	含糖饮料 ≥1次/d	甜食 ≥1次/d	油炸食品 ≥1次/d	西式快餐 ≥4次/周	水果 ≥1次/d	蔬菜 ≥1次/d	牛奶 ≥1次/d	早餐 7次/周
性别	男	3 846		596(15.50)	604(15.70)	320(8.32)	564(14.66)	2 120(55.12)	2 712(70.51)	2 600(67.60)	2 980(77.48)
	女	3 610		393(10.89)	656(18.17)	201(5.57)	406(11.25)	2 127(58.92)	2 731(75.65)	2 249(62.30)	2 695(74.65)
			χ²值	34.40	8.07	21.71	19.22	10.95	24.92	23.03	8.20
			P值	< 0.01	< 0.01	< 0.01	< 0.01	< 0.01	< 0.01	< 0.01	< 0.01
学段	初中	4 498		529(11.76)	733(16.30)	303(6.74)	478(10.63)	2 830(62.92)	3 405(75.70)	3 194(71.01)	3 550(78.92)
	高中	2 958		460(15.55)	527(17.82)	218(7.37)	492(16.63)	1 417(47.90)	2 038(68.90)	1 655(55.95)	2 125(71.84)
			χ²值	22.28	2.94	1.10	56.88	164.06	41.90	177.97	49.27
			P值	< 0.01	0.09	0.29	< 0.01	< 0.01	< 0.01	< 0.01	< 0.01
注： ()内数字为报告率/%。

下载: 导出CSV

表 2 不同抑郁与焦虑情绪青少年的饮食行为比较

Table 2. Comparison of dietary behaviors among adolescents with different levels of depression and anxiety

组别	选项	人数	统计值	不健康饮食				健康饮食
组别	选项	人数	统计值	含糖饮料 ≥1次/d	甜食 ≥1次/d	油炸食品 ≥1次/d	西式快餐 ≥4次/周	水果 ≥1次/d	蔬菜 ≥1次/d	牛奶 ≥1次/d	早餐 7次/周
抑郁情绪	无	5 970		666(11.16)	873(14.62)	349(5.85)	683(11.44)	3 445(57.71)	4 427(74.15)	3 945(66.08)	4 800(80.40)
	有	1 486		323(21.74)	387(26.04)	172(11.57)	287(19.31)	802(53.97)	1 016(68.37)	904(60.83)	875(58.88)
			χ²值	115.77	110.50	60.08	65.17	6.77	20.19	14.40	303.05
			P值	< 0.01	< 0.01	< 0.01	< 0.01	< 0.01	< 0.01	< 0.01	< 0.01
焦虑情绪	无	4 437		458(10.32)	616(13.88)	246(5.54)	444(10.01)	2 689(60.60)	3 376(76.09)	3 045(68.63)	3 657(82.42)
	轻度	2 014		297(14.75)	373(18.52)	151(7.50)	315(15.64)	1 028(51.04)	1 383(68.67)	1 189(59.04)	1 425(70.75)
	中重度	1 005		234(23.28)	271(26.97)	124(12.34)	211(21.00)	530(52.74)	684(68.06)	615(61.19)	593(59.00)
			χ²值	124.92	105.02	59.30	104.30	60.11	53.07	63.57	290.69
			P值	< 0.01	< 0.01	< 0.01	< 0.01	< 0.01	< 0.01	< 0.01	< 0.01
注： ()内数字为报告率/%。

下载: 导出CSV

参考文献(29)

[1]	MASON T B, DO B, WANG S, et al. Ecological momentary assessment of eating and dietary intake behaviors in children and adolescents: a systematic review of the literature[J]. Appetite, 2020, 144: 104465. doi: 10.1016/j.appet.2019.104465
[2]	周美竹, 吴慧攀, 张婷, 等. 中国青少年饮食行为与心理亚健康的相关性[J]. 中国学校卫生, 2021, 42(1): 13-17. doi: 10.16835/j.cnki.1000-9817.2021.01.004 ZHOU M Z, WU H P, ZHANG T, et al. Correlation between Chinese adolescents' dietary behavior and mental sub-health[J]. Chin J Sch Health, 2021, 42(1): 13-17. doi: 10.16835/j.cnki.1000-9817.2021.01.004
[3]	RONG S, SNETSELAAR L G, XU G, et al. Association of skipping breakfast with cardiovascular and all-cause mortality[J]. J Am Coll Cardiol, 2019, 73(16): 2025-2032. doi: 10.1016/j.jacc.2019.01.065
[4]	OMIWOLE M, RICHARDSON C, HUNIEWICZ P, et al. Review of mindfulness-related interventions to modify eating behaviors in adolescents[J]. Nutrients, 2019, 11(12): 2917. doi: 10.3390/nu11122917
[5]	MIKHAIL M E. Affect dysregulation in context: implications and future directions of experience sampling research on affect regulation models of loss of xontrol eating[J]. Front Psychiatry, 2021, 12: 747854. doi: 10.3389/fpsyt.2021.747854
[6]	VAN MALDEREN E, KEMPS E, CLAES L, et al. A dual-pathway perspective on food choices in adolescents: the role of loss of control over eating[J]. Front Psychol, 2021, 12: 630000. doi: 10.3389/fpsyg.2021.630000
[7]	CDC. Youth Risk Behavior Surveillance System(YRBSS)[EB/OL]. (2013-05-30)[2021-02-20]. https://www.cdc.gov/healthyyouth/data/yrbs/questionnaires.htm.
[8]	臧福运. 压力、抑郁对不同社会阶层青少年吸烟行为的影响[D]. 长沙: 湖南师范大学, 2017. ZANG F Y. The effects of stress and depression on smoking behavior among adolescents in different social class[D]. Changsha: Hunan Normal University, 2017.
[9]	中国营养学会. 中国居民膳食指南2016版[EB/OL]. (2016-06-14)[2021-02-26]. http://dg.cnsoc.org/article/2016b.html. Chinese Nutrition Society. Chinese resident dietary guidelines 2016 edition[EB/OL]. (2016-06-14)[2021-02-26]. http://dg.cnsoc.org/article/2016b.html.
[10]	曲爽笑, 孙力菁, 周月芳, 等. 上海市中学生2015年饮食现况调查[J]. 上海预防医学, 2017, 29(3): 186-188. https://www.cnki.com.cn/Article/CJFDTOTAL-SHYI201703006.htm QU S X, SUN L J, ZHOU Y F, et al. Survey on the diet of middle school students in Shanghai in 2015[J]. Shanghai J Prev Med, 2017, 29(3): 186-188. https://www.cnki.com.cn/Article/CJFDTOTAL-SHYI201703006.htm
[11]	廖娟娟, 郑亚楠, 黄亮明, 等. PHQ-2-C、CES-D和BDI-Ⅱ-C在筛查青少年抑郁障碍中的应用研究[J]. 国际精神病学杂志, 2017, 44(1): 23-25, 36. https://www.cnki.com.cn/Article/CJFDTOTAL-GWYJ201701006.htm LIAO J J, ZHENG Y N, HUANG L M, et al. Study of PHQ-2-C, CES-D and BDI-Ⅱ-C in the application of screening of adolescents with depressive disorder[J]. J Int Psychiatry, 2017, 44(1): 23-25, 36. https://www.cnki.com.cn/Article/CJFDTOTAL-GWYJ201701006.htm
[12]	KROENKE K, SPITZER R L, WILLIAMS J B, et al. The patient health questionnaire somatic, anxiety, and depressive symptom scales: a systematic review[J]. Gen Hosp Psychiatry, 2010, 32(4): 345-359. doi: 10.1016/j.genhosppsych.2010.03.006
[13]	王琦, 陈瑛. 江阴市中小学生不良饮食及相关生活习惯行为调查[J]. 江苏预防医学, 2021, 32(2): 242-244, 253. https://www.cnki.com.cn/Article/CJFDTOTAL-JSYF202102044.htm WANG Q, CHEN Y. Investigation on unhealthy diet and related living habits and behaviors of primary and middle school students in Jiangyin City[J]. Jiangsu Prev Med, 2021, 32(2): 242-244, 253. https://www.cnki.com.cn/Article/CJFDTOTAL-JSYF202102044.htm
[14]	金元, 景素芬, 郑康杰, 等. 宝山区中小学生饮食行为调查[J]. 预防医学, 2021, 33(6): 586-588, 591. https://www.cnki.com.cn/Article/CJFDTOTAL-ZYFX202106012.htm JIN Y, JING S F, ZHENG K J, et al. Investigation of dietary behaviors of primary and middle school students in Baoshan District[J]. Prev Med, 2021, 33(6): 586-588, 591. https://www.cnki.com.cn/Article/CJFDTOTAL-ZYFX202106012.htm
[15]	孙力菁, 陆茜, 周月芳, 等. 上海市青少年饮食相关行为调查及危险因素分析[J]. 教育生物学杂志, 2016, 4(3): 126-129. https://www.cnki.com.cn/Article/CJFDTOTAL-BIOM201603006.htm SUN L J, LU Q, ZHOU Y F, et al. Survey on diet-related behaviors and risk factors of adolescents in Shanghai[J]. J Biol Educ, 2016, 4(3): 126-129. https://www.cnki.com.cn/Article/CJFDTOTAL-BIOM201603006.htm
[16]	何彬洪, 杨陈佳, 陈夏威, 等. 中山市在校青少年饮食相关行为调查分析[J]. 华南预防医学, 2018, 44(2): 111-115. https://www.cnki.com.cn/Article/CJFDTOTAL-GDWF201802005.htm HE B H, YANG C J, CHEN X W, et al. Investigation and analysis of diet-related behaviors of school adolescents in Zhongshan City[J]. South Chin J Prev Med, 2018, 44(2): 111-115. https://www.cnki.com.cn/Article/CJFDTOTAL-GDWF201802005.htm
[17]	BISHOP A, OVERCASH F, MCGUIRE J, et al. Diet and physical activity behaviors among adolescent transgender students: school survey results[J]. J Adolesc Health, 2020, 66(4): 484-490. doi: 10.1016/j.jadohealth.2019.10.026
[18]	施淑燕, 龚艳彬, 柴巍中. 北京市中学生不良饮食行为现状及其影响因素研究[J]. 中国健康教育, 2020, 36(5): 418-422. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGJK202005008.htm SHI S Y, GONG Y B, CHAI W Z. Study on the status quo and influencing factors of bad eating behaviors among middle school students in Beijing[J]. Chin J Health Educ, 2020, 36(5): 418-422. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGJK202005008.htm
[19]	LIPSKY L M, HAYNIE D L, LIU D, et al. Trajectories of eating behaviors in a nationally representative cohort of U.S. adolescents during the transition to young adulthood[J]. Int J Behav Nutr Phys Act, 2015, 12: 138. doi: 10.1186/s12966-015-0298-x
[20]	李凤娟, 孙经, 杨汴生, 等. 河南省中学生饮食行为流行现况及影响因素[J]. 中国学校卫生, 2017, 38(7): 1003-1006. doi: 10.16835/j.cnki.1000-9817.2017.07.013 LI F J, SUN J, YANG B S, et al. The prevalence and influencing factors of eating behavior among middle school students in Henan Province[J]. Chin J Sch Health, 2017, 38(7): 1003-1006. doi: 10.16835/j.cnki.1000-9817.2017.07.013
[21]	GIBSON-SMITH D, BOT M, PAANS N P, et al. The role of obesity measures in the development and persistence of major depressive disorder[J]. J Affect Disord, 2016, 198: 222-229.
[22]	KECK M M, VIVIER H, CASSISI J E, et al. Examining the role of anxiety and depression in dietary choices among college students[J]. Nutrients, 2020, 12(7): 2061.
[23]	FRAYN M, LIVSHITS S, KNÄUPER B. Emotional eating and weight regulation: a qualitative study of compensatory behaviors and concerns[J]. J Eat Disord, 2018, 6: 23.
[24]	刘文俐, 蔡太生, 朱虹, 等. 抑郁、焦虑、压力与青少年情绪性进食的关系: 自我控制的中介作用[J]. 中国临床心理学杂志, 2016, 24(5): 841-843. https://www.cnki.com.cn/Article/CJFDTOTAL-ZLCY201605016.htm LIU W L, CAI T S, ZHU H, et al. The relationship between depression, anxiety, stress and adolescent emotional eating: the mediating role of self-control[J]. Chin J Clin Psychol, 2016, 24(5): 841-843. https://www.cnki.com.cn/Article/CJFDTOTAL-ZLCY201605016.htm
[25]	ZHANG X, HUANG X, XIAO Y, et al. Daily intake of soft drinks is associated with symptoms of anxiety and depression in Chinese adolescents[J]. Public Health Nutr, 2019, 22(14): 2553-2560.
[26]	FAKHOURY M. Revisiting the serotonin hypothesis: implications for major depressive disorders[J]. Mol Neurobiol, 2016, 53(5): 2778-2786.
[27]	ZAHEDI H, DJALALINIA S, SADEGHI O, et al. Breakfast consumption and mental health: a systematic review and Meta-analysis of observational studies[J]. Nutr Neurosci, 2020. DOI: 10.1080/1028415X.2020.1853411.
[28]	ROMERO-MESA J, PELÁEZ-FERNÁNDEZ M A, EXTREMERA N. Emotional intelligence and eating disorders: a systematic review[J]. Eat Weight Disord, 2021, 26(5): 1287-1301.
[29]	PREFIT A B, CÂNDEA D M, SZENTAGOTAI-TǍTAR A. Emotion regulation across eating pathology: a Meta-analysis[J]. Appetite, 2019, 143: 104438.