中国儿童青少年零食消费状况及其与超重肥胖的关联

黄绯绯; 张继国; 李园; 郭春雷; 王惠君

doi:10.16835/j.cnki.1000-9817.2023.09.009

中国儿童青少年零食消费状况及其与超重肥胖的关联

doi: 10.16835/j.cnki.1000-9817.2023.09.009

黄绯绯¹,
张继国¹,
李园²,
郭春雷^3, ,,
王惠君^1, ,

1.
中国疾病预防控制中心营养与健康所/国家卫生健康委微量元素与营养重点实验室，北京 100050
2.
乔治全球健康研究院(澳大利亚)北京代表处
3.
中国学生营养与健康促进会

详细信息

作者简介:
黄绯绯(1987-)，女，北京市人，博士，副研究员，主要研究方向为公共营养与健康

通讯作者:
郭春雷，E-mail: gclwyf@163.com

王惠君，E-mail：wanghj@ninh.chinacdc.cn

利益冲突声明 所有作者声明无利益冲突。
中图分类号: R155.1 R153.2 R723.14
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出版历程
- 收稿日期: 2023-03-23
- 修回日期: 2023-06-14
- 网络出版日期: 2023-09-28
- 刊出日期: 2023-09-25

Snack consumption of children and adolescents in China and its correlation with overweight and obesity

1.
National Institute for Nutrition and Health of Chinese Center for Disease Control and Prevention/Key Laboratory of Trace Elements and Nutrition of the National Health Commission, Beijing (100050), China

摘要

摘要: 目的了解中国儿童青少年零食消费现状及其与超重肥胖的关联，为制定预防和控制中国儿童青少年超重肥胖策略提供依据。方法选取“中国健康与营养调查”项目2018年中国十五省、自治区、直辖市6~17岁儿童青少年共1 882名作为调查对象，采用连续3 d 24 h膳食回顾法调查零食消费状况，通过聚类分析法探索零食消费模式，并利用Logistic回归分析零食消费与超重肥胖的关联。结果儿童青少年零食消费率为60.6%，供能比为2.4%。零食消费特征可分为4个模式，模式1以每天只摄入中等量水果为特征，模式2以每天摄入少量水果和焙烤类为特征，模式3以每天只摄入少量水果为特征，模式4以每天摄入中等量奶类和少量水果为特征。调整能量摄入等相关协变量后，与不吃零食者相比，不同零食消费模式组发生超重肥胖风险的OR值(95%CI)分别为1.56(0.93~2.58)，0.81(0.51~1.24)，1.24(0.94~1.63)，1.00(0.60~1.63)，零食供能比自低至高四分位分组超重肥胖风险的OR值(95%CI)分别为1.17(0.81~1.68)，1.32(0.92~1.89)，1.12(0.77~1.61)，1.00(0.69~1.45)，均无统计学意义(P值均>0.05)。结论中国儿童青少年消费零食比例较高，种类以水果及其制品、奶类及其制品和焙烤类为主，未发现零食消费与超重肥胖的关联。
- 食品 /
- 饮食习惯 /
- 超重 /
- 肥胖症 /
- 回归分析 /
- 儿童 /
- 青少年
Abstract: Objective To understand the current situation of snack consumption among children and adolescents in China and its relationship with overweight and obesity, so as to provide a basis for formulating strategies of preventing and controlling overweight and obesity in children and adolescents in China. Methods A total of 1 882 children and adolescents aged 6-17 years old, choosed from 15 provinces, autonomous regions and municipalities according to China Health and Nutrition Survey in 2018, were selected. Snack consumption was investigated by the 24-hour dietary retrospective method for three consecutive days. The pattern of snack consumption was explored by cluster analysis, and the relationship between snack consumption and overweight and obesity was analyzed by Logistic regression. Results The snack consumption rate was 60.6%, and the percentage of daily energy intake from snacks was 2.4%. Snack consumption characteristics could be divided into four modes. Mode 1 was characterized by daily intake of medium amount of fruit, Mode 2 was characterized by daily intake of small amount of fruit and baked goods, Mode 3 was characterized by daily intake of small amount of fruit, and Mode 4 was characterized by daily intake of medium amount of milk and small amount of fruit. After adjusting the relevant covariates such as energy intake, compared with those who did not eat snacks, the OR(95%CI) values of the risk of overweight and obesity in different snack consumption patterns were 1.56(0.93-2.58), 0.81(0.51-1.24), 1.24(0.94-1.63) and 1.00(0.60-1.63), respectively; the OR(95%CI) values of percentage of daily energy intake from snacks from low to high quartiles were 1.17(0.81-1.68), 1.32(0.92-1.89), 1.12(0.77-1.61) and 1.00(0.69-1.45), respectively. There was no statistically significant difference(P>0.05). Conclusion The proportion of Chinese children and adolescents consuming snacks is relatively high, mainly including fruit and its products, milk and its products and baked goods. No association between snack consumption and overweight and obesity has been found.
- Food /
- Food habits /
- Overweight /
- Obesity /
- Regression analysis /
- Child /
- Adolescent
注释:

1) 利益冲突声明 所有作者声明无利益冲突。

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表 1 不同年龄段城乡儿童青少年各类零食消费率比较

Table 1. Comparison of consumption rate of snacks in different age groups among children in urban and rural areas

组别	人数	统计值	豆类及其制品	蔬菜及其制品	水果及其制品	坚果	肉类及其制品	奶类及其制品	蛋类及其制品
年龄段/岁
6~12	1 406		15(1.1)	32(2.3)	674(47.9)	105(7.5)	41(2.9)	345(24.5)	13(0.9)
13~17	476		7(1.5)	13(2.7)	226(47.5)	36(7.6)	13(2.7)	122(25.6)	5(1.1)
		P值	0.46	0.60	0.87	0.92	1.00	0.67	0.79
城乡
城市	660		7(1.1)	14(2.1)	383(58)	67(10.2)	16(2.4)	226(34.2)	7(1.1)
农村	1 222		15(1.2)	31(2.5)	517(42.3)	74(6.1)	38(3.1)	241(19.7)	11(0.9)
		P值	0.83	0.64	< 0.01	< 0.01	0.47	< 0.01	0.81
合计	1 882		22(1.2)	45(2.4)	900(47.8)	141(7.5)	54(2.9)	467(24.8)	18(1.0)

组别	人数	统计值	水产类	速食食品	焙烤类	饮料	糖果巧克力	冰淇淋	膨化食品
年龄段/岁
6~12	1 406		4(0.3)	45(3.2)	229(16.3)	49(3.5)	91(6.5)	8(0.6)	53(3.8)
13~17	476		1(0.2)	26(5.5)	80(16.8)	28(5.9)	19(4.0)	1(0.2)	30(6.3)
		P值	1.00	0.04	0.78	0.03	0.05	0.46	0.03
城乡
城市	660		1(0.2)	21(3.2)	118(17.9)	28(4.2)	34(5.2)	2(0.3)	36(5.5)
农村	1 222		4(0.3)	50(4.1)	191(15.6)	49(4.0)	76(6.2)	7(0.6)	47(3.8)
		P值	0.66	0.38	0.22	0.81	0.41	0.51	0.13
合计	1 882		5(0.3)	71(3.8)	309(16.4)	77(4.1)	110(5.8)	9(0.5)	83(4.4)
注：()内数字为消费率/%。

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表 2 不同零食模式特征儿童青少年零食消费情况[M(P₂₅, P₇₅)]

Table 2. Characteristics of different snack consumption patterns among children and adolescents[M(P₂₅, P₇₅)]

模式	人数	水果及其制品/(g·d^-1)	奶类及其制品/(g·d^-1)	焙烤类/(g·d^-1)	总能量摄入/(kcal·d^-1)	零食能量摄入/(kcal·d^-1)	零食供能比/%
1	104	207.5(171.6, 250.8)	0(0, 55.6)	0	1 945.9(1 596.9, 2 256.2)	148.9(116.3, 234.4)	8.8(6.2, 12.7)
2	175	62.8(0, 126.9)	0(0, 75.0)	35.0(29.6, 53.3)	1 956.5(1 567.5, 2 397.6)	281.6(204.2, 413.2)	14.8(10.8, 21.4)
3	646	50.0(25.7, 83.3)	0(0, 36.9)	0	1 553.9(1 233.7, 1 920.4)	61.6(34.0, 106.5)	3.9(2.2, 7.7)
4	144	65.4(16.7, 140.0)	166.7(150.0, 220.6)	0	1 693.9(1 369.0, 2 260.9)	192.1(135.0, 284.9)	11.5(7.9, 16.5)

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参考文献(39)

[1]	中华人民共和国国家卫生健康委疾病预防控制局. 中国居民营养与慢性病状况报告(2020年)[M]. 北京: 人民卫生出版社, 2021: 44. Bureau for Disease Control and Prevention of National Health Commission of the PRC. Report on Chinese residents' chronic diseases and nutrition (2020)[M]. Beijing: People's Medical Publishing House, 2021: 44. (in Chinese)
[2]	SERAVALLE G, GRASSI G. Obesity and hypertension[J]. Pharmacol Res, 2017, 122: 1-7. doi: 10.1016/j.phrs.2017.05.013
[3]	BECHARD L J, ROTHPLETZ-PUGLIA P, TOUGER-DECKER R, et al. Influence of obesity on clinical outcomes in hospitalized children: a systematic review[J]. JAMA Pediatr, 2013, 167(5): 476-482. doi: 10.1001/jamapediatrics.2013.13
[4]	杜文雯, 王惠君, 王丹彤, 等. 中国十二省市儿童青少年三餐及零食消费状况研究[J]. 卫生研究, 2016, 45(6): 876-881. doi: 10.19813/j.cnki.weishengyanjiu.2016.06.031 DU W W, WANG H J, WANG D T, et al. Meal and snack consumption among Chinese children and adolescents in twelve provinces[J]. J Hyg Res, 2016, 45(6): 876-881. (in Chinese) doi: 10.19813/j.cnki.weishengyanjiu.2016.06.031
[5]	WANG Z, ZHAI F, ZHANG B, et al. Trends in Chinese snacking behaviors and patterns and the social-demographic role between 1991 and 2009[J]. Asia Pac J Clin Nutr, 2012, 21(2): 253-262.
[6]	于冬梅, 张兵, 赵丽云, 等. 中国3~17岁儿童青少年零食消费状况[J]. 卫生研究, 2008, 37(6): 710-713. doi: 10.3969/j.issn.1000-8020.2008.06.021 YU D M, ZHANG B, ZHAO L Y, et al. Snacks consumption in Chinese children and adolescents at the ages of 3-17 years[J]. J Hyg Res, 2008, 37(6): 710-713. (in Chinese) doi: 10.3969/j.issn.1000-8020.2008.06.021
[7]	李艳红, 吕全军, 王惠君, 等. 中国九省学龄儿童青少年零食消费行为变化趋势分析[J]. 卫生研究, 2008, 37(5): 621-622. doi: 10.3969/j.issn.1000-8020.2008.05.035 LI Y H, LYU Q J, WANG H J, et al. Analysis on the changing trends of snack consumption behavior among school age children and adolescents in nine provinces of China[J]. J Hyg Res, 2008, 37(5): 621-622. (in Chinese) doi: 10.3969/j.issn.1000-8020.2008.05.035
[8]	JOHNSON G H, ANDERSON G H. Snacking definitions: impact on interpretation of the literature and dietary recommendations[J]. Crit Rev Food Sci Nutr, 2010, 50(9): 848-871. doi: 10.1080/10408390903572479
[9]	TAILLIE L S, AFEICHE M C, ELDRIDGE A L, et al. Increased snacking and eating occasions are associated with higher energy intake among Mexican children aged 2-13 years[J]. J Nutr, 2015, 145(11): 2570-2577. doi: 10.3945/jn.115.213165
[10]	LARSON N, STORY M. A review of snacking patterns among children and adolescents: what are the implications of snacking for weight status?[J]. Child Obes, 2013, 9(2): 104-115. doi: 10.1089/chi.2012.0108
[11]	SEBASTIAN R S, CLEVELAND L E, GOLDMAN J D. Effect of snacking frequency on adolescents' dietary intakes and meeting national recommendations[J]. J Adolesc Health, 2008, 42(5): 503-511. doi: 10.1016/j.jadohealth.2007.10.002
[12]	杨月欣, 王光亚, 潘兴昌. 中国食物成分表[M]. 2版. 北京: 北京大学医学出版社, 2009. YANG Y X, WANG G Y, PAN X C. Chinese food composition table[M]. 2th ed. Beijing: Peking University Medical Press, 2009. (in Chinese)
[13]	中国疾病预防控制中心营养与健康所, 中国营养学会. 中国儿童青少年零食指南2018[M]. 北京: 人民卫生出版社, 2018. National Institute for Nutrition and Health of Chinese Center for Disease Control and Prevention, Chinese Nutrition Society. Guidelines on snacks for Chinese children and adolescents 2018[M]. Beijing: People's Medical Publishing House, 2018. (in Chinese)
[14]	中华人民共和国国家卫生和计划生育委员会. 学龄儿童青少年超重与肥胖筛查: WS/T 586—2018[S]. 北京: 中国标准出版社, 2018. National Health and Family Planning Commission of the PRC. Screening for overweight and obesity among school-age children and adolescents: WS/T 586-2018[S]. Beijing: Standards Press of China, 2018. (in Chinese)
[15]	中华人民共和国国家卫生和计划生育委员会. 学龄儿童青少年营养不良筛查: WS/T 456—2014[S]. 北京: 中国标准出版社, 2014. National Health and Family Planning Commission of the PRC. Screening standard for malnutrition of school-age children and adolescents: WS/T 456-2014[S]. Beijing: Standards Press of China, 2014. (in Chinese)
[16]	NJIKE V Y, SMITH T M, SHUVAL O, et al. Snack food, satiety, and weight[J]. Adv Nutr, 2016, 7(5): 866-878. doi: 10.3945/an.115.009340
[17]	MURAKAMI K, LIVINGSTONE M B E. Associations between meal and snack frequency and overweight and abdominal obesity in US children and adolescents from National Health and Nutrition Examination Survey (NHANES) 2003-2012[J]. Br J Nutr, 2016, 115(10): 1819-1829. doi: 10.1017/S0007114516000854
[18]	ROBLIN L. Childhood obesity: food, nutrient, and eating-habit trends and influences[J]. Appl Physiol Nutr Metabol, 2007, 32(4): 635-645. doi: 10.1139/H07-046
[19]	BO S, DE CARLI L, VENCO E, et al. Impact of snacking pattern on overweight and obesity risk in a cohort of 11- to 13-year-old adolescents[J]. J Pediatr Gastroenterol Nutr, 2014, 59(4): 465-471. doi: 10.1097/MPG.0000000000000453
[20]	TRIER C, FONVIG C E, BJSØE C, et al. No influence of sugar, snacks and fast food intake on the degree of obesity or treatment effect in childhood obesity[J]. Pediatr Obes, 2016, 11(6): 506-512. doi: 10.1111/ijpo.12094
[21]	AZADBAKHT L, HAJISHAFIEE M, GOLSHAHI J, et al. Snacking behavior and obesity among female adolescents in Isfahan, Iran[J]. J Am Coll Nutr, 2016, 35(5): 405-412. doi: 10.1080/07315724.2015.1030474
[22]	KEAST D R, NICKLAS T A, O NEIL C E. Snacking is associated with reduced risk of overweight and reduced abdominal obesity in adolescents: national Health and Nutrition Examination Survey (NHANES) 1999-2004[J]. Am J Clin Nutr, 2010, 92(2): 428-435. doi: 10.3945/ajcn.2009.28421
[23]	刘爱玲, 尚现文, 张倩, 等. 小学生零食消费种类与肥胖及代谢异常的关系[J]. 中国学校卫生, 2012, 33(6): 644-647. doi: 10.16835/j.cnki.1000-9817.2012.06.003 LIU A L, SHANG X W, ZHANG Q, et al. Association of snacks consumption with the prevalence of obesity and related metabolic abnormalities among Chinese children[J]. Chin J Sch Health, 2012, 33(6): 644-647. (in Chinese) doi: 10.16835/j.cnki.1000-9817.2012.06.003
[24]	EVANS E W, JACQUES P F, DALLAL G E, et al. The role of eating frequency on relative weight in urban school-age children[J]. Pediatr Obes, 2015, 10(6): 442-447. doi: 10.1111/ijpo.12004
[25]	JODKOWSKA M, OBLACINSKA A, TABAK I, et al. Differences in dietary patterns between overweight and normal-weight adolescents[J]. Med Wieku Rozwoj, 2011, 15(3): 266-273.
[26]	OELLINGRATH I M, SVENDSEN M V, BRANTSAETER A L. Tracking of eating patterns and overweight-a follow-up study of Norwegian schoolchildren from middle childhood to early adolescence[J]. Nutr J, 2011, 10: 106. doi: 10.1186/1475-2891-10-106
[27]	TUCKER W J, JARRETT C L, D'LUGOS A C, et al. Effects of indulgent food snacking, with and without exercise training, on body weight, fat mass, and cardiometabolic risk markers in overweight and obese men[J]. Physiol Rep, 2021, 9(22): e15118.
[28]	VISKAAL-VAN D M, KOK F J, DE GRAAF C. Effects of snack consumption for 8 weeks on energy intake and body weight[J]. Int J Obes (Lond), 2010, 34(2): 319-326. doi: 10.1038/ijo.2009.243
[29]	戎芬. 出生体重与环境因素对儿童青少年超重肥胖影响的队列研究[D]. 上海: 复旦大学, 2012. RONG F. Cohort study on influence of birth weight and environmental factors on overweight and obesity for children and adolescents[D]. Shanghai: Fudan University, 2012. (in Chinese)
[30]	CHAPELOT D. The role of snacking in energy balance: a biobehavioral approach[J]. J Nutr, 2011, 141(1): 158-162. doi: 10.3945/jn.109.114330
[31]	HARTMANN C, SIEGRIST M, VAN DER HORST K. Snack frequency: associations with healthy and unhealthy food choices[J]. Public Health Nutr, 2013, 16(8): 1487-1496. doi: 10.1017/S1368980012003771
[32]	DUFFEY K J, RIVERA J A, POPKIN B M. Snacking is prevalent in Mexico[J]. J Nutr, 2014, 144(11): 1843-1849. doi: 10.3945/jn.114.198192
[33]	YOUNGINER N A, BLAKE C E, DAVISON K K, et al. "What do you think of when I say the word 'snack'?" Towards a cohesive definition among low-income caregivers of preschool-age children[J]. Appetite, 2016, 98: 35-40. doi: 10.1016/j.appet.2015.12.002
[34]	DE CASTRO J M. Genetic influences on daily intake and meal patterns of humans[J]. Physiol Behav, 1993, 53(4): 777-782. doi: 10.1016/0031-9384(93)90188-L
[35]	BERNSTEIN I L, ZIMMERMAN J C, CZEISLER C A, et al. Meal patterns in "free-running" humans[J]. Physiol Behav, 1981, 27(4): 621-623. doi: 10.1016/0031-9384(81)90232-8
[36]	HESS J M, JONNALAGADDA S S, SLAVIN J L. What is a snack, why do we snack, and how can we choose better snacks?A review of the definitions of snacking, motivations to snack, contributions to dietary intake, and recommendations for improvement[J]. Adv Nutr, 2016, 7(3): 466-475. doi: 10.3945/an.115.009571
[37]	GREGORI D, MAFFEIS C. Snacking and obesity: urgency of a definition to explore such a relationship[J]. J Am Diet Assoc, 2007, 107(4): 562-563.
[38]	周瑾, 王颜, 于冬梅, 等. 我国五省一市城乡学龄儿童青少年预包装食品消费现况[EB/OL]. (2021-05-26)[2023-08-15]. https://www.cnsoc.org/acadconfn/6521202051.html. ZHOU J, WANG Y, YU D M, et al. Consumption status of prepackaged food for school-age children and adolescents in urban and rural areas of five provinces and one city in China[EB/OL]. (2021-05-26)[2023-08-15]. https://www.cnsoc.org/acadconfn/6521202051.html. (in Chinese)
[39]	张曼, 闫心语, 李亦斌, 等. 中国城市高年级小学生零食消费现况[J]. 中国学校卫生, 2019, 40(2): 171-174. doi: 10.16835/j.cnki.1000-9817.2019.02.004 ZHANG M, YAN X Y, LI Y B, et al. Snack food consumption among grade four and grade five primary school students in six cities of China[J]. Chin J Sch Health, 2019, 40(2): 171-174. (in Chinese) doi: 10.16835/j.cnki.1000-9817.2019.02.004