海南省696名小学生饮奶行为及其对骨密度的影响

钟成望; 杨斌; 冯棋琴; 赵婵娟; 郭静悦; 张滔; 程秋云; 张帆

doi:10.16835/j.cnki.1000-9817.2023.11.008

海南省696名小学生饮奶行为及其对骨密度的影响

doi: 10.16835/j.cnki.1000-9817.2023.11.008

1.
海南医学院公共卫生与全健康国际学院营养与食品卫生学教研室, 海口 571199
2.
海南省疾病预防控制中心食品安全风险监测评估所
3.
海南医学院公共卫生与全健康国际学院卫生统计学教研室

基金项目:

中国营养学会-营养科普与传播研究基金项目 CNS-SCP2020-88

2021年海南省普通高等学校研究生创新科研课题 HYYS2021B17

详细信息

作者简介:
钟成望(1997-)，男，海南儋州人，在读硕士，主要研究方向为营养与健康

通讯作者:
张帆，E-mail：zhangfan@hainmc.edu.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 R726.8
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- 被引次数: 0
出版历程
- 收稿日期: 2023-05-04
- 修回日期: 2023-08-04
- 网络出版日期: 2023-11-27
- 刊出日期: 2023-11-25

Milk consumption behavior and its impact on bone mineral density among 696 pupils in Hainan Province

1.
Department of Nutrition and Food Hygiene, International School of Public Health and One Health, Hainan Medical University, Haikou (571199), Hainan Province, China

摘要

摘要: 目的了解海南省小学生的饮奶行为及其骨密度水平，并探究骨密度与饮奶行为的相关性，为促进儿童青少年骨骼的健康发育提供科学依据。方法于2021年11月，采用分层整群随机抽样方法，分别从海南省三亚市和白沙县抽取三至五年级696名小学生进行调查，包括人口学特征、奶及奶制品的摄入情况、不良饮食行为、身体活动和睡眠情况，采用双能X线骨密度测量仪测量学生右侧前臂远端1/3处的骨密度。采用t检验比较不同饮奶行为小学生的骨密度，采用多元线性回归分析饮奶量与骨密度的相关性。结果有25.3%小学生每日饮奶，13.9%小学生日均饮奶量≥300 g。小学生右侧前臂远端1/3处的骨密度平均为(0.237±0.041)g/cm²。每日饮奶组的小学生骨密度大于非每日饮奶组[(0.250±0.037)(0.204±0.034)g/cm²；t=15.00，P < 0.01]，日均饮奶量≥300 g的小学生骨密度大于日均饮奶量 < 300 g的学生[(0.284±0.036)(0.229±0.037)g/cm²；t=13.48，P < 0.01]。多元线性回归分析显示，小学生日均饮奶量与骨密度呈正相关(β=0.020，t=21.46，P < 0.01)。结论小学生饮奶状况不佳，饮奶行为对骨密度有积极影响。应进行有效的饮奶干预促进儿童骨骼发育。
- 饮食习惯 /
- 骨密度 /
- 回归分析 /
- 学生
Abstract: Objective To investigate the milk-drinking behavior and bone mineral density level of pupils in Hainan Province, and to explore the correlation between bone mineral density and milk-drinking behavior, in order to provide scientific basis for promoting the healthy development of bones in children and adolescents. Methods In November 2021, a cross-sectional survey including demographic characteristics, milk intake, unhealthy eating behavior, physical activity and sleep was conducted among 696 students from grades 3 to 5 in Sanya and Baisha, Hainan by stratified cluster random sampling, and bone mineral density at the distal 1/3 of the right forearm was measured by dual-energy X-ray absorptiometry. t-test was used to compare the differences in bone mineral density among different milk-drinking behaviors of pupils, and multiple linear regression was used to analyze the correlation between milk consumption and bone mineral density. Results About 25.3% students consumed milk daily and 13.9% consumed ≥300 g of milk daily. The mean bone mineral density at the distal 1/3 of the right forearm was (0.237±0.041)g/cm². The bone mineral density was greater in the group with daily milk intake than in the group without daily milk intake [(0.250±0.037)(0.204±0.034)g/cm², t=15.00, P < 0.01], and the bone mineral density was greater in the group with daily average milk intake ≥300 g than in the group with daily average milk intake < 300 g [(0.284±0.036)(0.229±0.037)g/cm², t=13.48, P < 0.01]. Multiple linear regression analysis showed that daily average milk intake was positively correlated with bone mineral density, with a correlation coefficient (β=0.020, t=21.46, P < 0.01). Conclusion Milk consumption among pupils is inadequate, and milk-drinking behavior has a positive impact on bone mineral density, so effective milk-drinking intervention should be carried out to promote children's bone development.
- Food habits /
- Bone density /
- Regression analysis /
- Students
注释:

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表 1 不同人口学特征小学生饮奶现况单因素分析

Table 1. Univariate analysis of milk consumption among pupils with different demographic characteristics

人口学指标	选项	人数	每日饮奶			日均饮奶量≥300 g
人口学指标	选项	人数	报告人数	χ²/χ_趋势²值	P值	报告人数	χ²/χ_趋势²值	P值
地区	三亚市	354	101(28.5)	4.01	0.04	61(17.2)	6.52	0.01
	白沙县	342	75(21.9)			36(10.5)
性别	男	363	98(27.0)	1.17	0.28	52(14.3)	0.10	0.76
	女	333	78(23.4)			45(13.5)
年龄/岁	8	128	27(21.1)	3.48	0.48	15(11.7)	1.71	0.79
	9	239	65(27.2)			38(15.9)
	10	219	52(23.7)			30(13.7)
	11	110	32(29.1)			14(12.7)
家庭年收入/万元	< 2.0	240	44(18.3)	14.63^*	< 0.01	20(8.3)	11.82^*	< 0.01
	2.0~3.9	265	66(24.9)			39(14.7)
	4.0~5.9	102	34(33.3)			19(18.6)
	≥6.0	89	32(36.0)			19(21.3)
父母最高学历	小学及以下	147	27(18.4)	12.93^*	< 0.01	14(9.5)	16.53^*	< 0.01
	初中	291	67(23.0)			26(8.9)
	高中或中专	150	43(28.7)			32(21.3)
	大专或职大	67	22(32.8)			16(23.9)
	大学及以上	41	17(41.5)			9(22.0)
注： ()内数字为报告率/%；*为χ²趋势值。

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表 2 小学生骨密度现况及单因素分析(x±s，g/cm²)

Table 2. Bone mineral density of pupils and univariate analysis (x±s, g/cm²)

变量	选项	人数	骨密度	t/F值	P值	变量	选项	人数	骨密度	t/F值	P值
地区	三亚市	354	0.240±0.039	1.74	0.08	经常喝碳酸饮料	是	216	0.219±0.041	-7.84	< 0.01
	白沙县	342	0.234±0.044				否	480	0.245±0.039
性别	男	363	0.240±0.040	1.90	0.06	经常喝含糖饮料	是	353	0.232±0.044	-3.53	< 0.01
	女	333	0.233±0.039				否	343	0.243±0.037
年龄/岁	8	128	0.235±0.040	-0.85	0.47	中高强度运动	是	176	0.266±0.041	11.75	< 0.01
	9	239	0.236±0.041			≥1 h/d	否	520	0.227±0.037
	10	219	0.237±0.041			户外活动≥2 h/d	是	292	0.247±0.037	5.48	< 0.01
	11	110	0.243±0.044				否	404	0.230±0.043
家庭年收入/万元	< 2.0	240	0.226±0.038	-12.04	< 0.01	久坐时间 < 1 h/d	是	215	0.246±0.035	7.98	< 0.01
	2.0~3.9	265	0.238±0.039				否	481	0.217±0.048
	4.0~5.9	102	0.249±0.042			屏幕时间 < 2 h/d	是	340	0.241±0.042	2.91	< 0.01
	≥6.0	89	0.251±0.048				否	356	0.232±0.040
父母最高学历	小学及以下	147	0.219±0.035	-15.35	< 0.01	睡眠时间≥10 h/d	是	225	0.243±0.044	2.61	0.01
	初中	291	0.235±0.040				否	471	0.234±0.040
	高中或中专	150	0.251±0.037			每日饮奶	是	176	0.250±0.037	15.00	< 0.01
	大专或职大	67	0.252±0.046				否	520	0.204±0.034
	大学及以上	41	0.245±0.053			日均饮奶量/g	≥300	97	0.284±0.036	13.48	< 0.01
经常不吃早餐	是	263	0.230±0.038	-5.19	< 0.01		< 300	599	0.229±0.037
	否	433	0.249±0.045			经常吃零食	是	438	0.235±0.039	-1.77	0.08
							否	258	0.241±0.045

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参考文献(25)

[1]	吴斌, 白峰华, 林明侠, 等. 青少年跟骨骨密度与骨矿脂肪肌肉含量的关系[J]. 中国学校卫生, 2019, 40(9): 1360-1362. doi: 10.16835/j.cnki.1000-9817.2019.09.022 WU B, BAI F H, LIN M X, et al. The relationship between calcaneal bone mineral density and bone mineral, fat and muscle content in adolescents[J]. Chin J Sch Health, 2019, 40(9): 1360-1362. (in Chinese) doi: 10.16835/j.cnki.1000-9817.2019.09.022
[2]	沈朝霞, 潘圆圆, 黄荣, 等. 儿童骨密度与骨代谢相关因素的临床研究[J]. 中国儿童保健杂志, 2020, 28(2): 144-147, 160. https://www.cnki.com.cn/Article/CJFDTOTAL-ERTO202002011.htm SHEN Z X, PAN Y Y, HUANG R, et al. Clinical study of relationship between bone mineral density and related of bone metabolism in children[J]. Chin J Child Health Care, 2020, 28(2): 144-147, 160. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-ERTO202002011.htm
[3]	RATAJCZAK A, ZAWADA A, RYCHTER A, et al. Milk and dairy products: good or bad for human bone?Practical dietary recommendations for the prevention and management of osteoporosis[J]. Nutrients, 2021, 13(4): 1329. doi: 10.3390/nu13041329
[4]	潘丽莉, 赵显峰, 来伟旗, 等. 饮用学生奶对浙江省小学生生长发育和骨密度的影响[J]. 卫生研究, 2010, 39(5): 555-556. https://www.cnki.com.cn/Article/CJFDTOTAL-WSYJ201005008.htm PAN L L, ZHAO X F, LAI W Q, et al. Effects of drinking school milk on growth and bone mineral density of primary school students in Zhejiang Province[J]. J Hyg Res, 2010, 39(5): 555-556. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-WSYJ201005008.htm
[5]	袁兆康, 文小桐. 中国青少年健康危险行为研究设计与流行现状[J]. 中国学校卫生, 2019, 40(4): 638-640. doi: 10.16835/j.cnki.1000-9817.2019.04.046 YUAN Z K, WEN X T. Research design and prevalence of adolescent health risk behaviors in China[J]. Chin J Sch Health, 2019, 40(4): 638-640. (in Chinese) doi: 10.16835/j.cnki.1000-9817.2019.04.046
[6]	张帆, 张倩, 潘慧, 等. 学生营养改善计划地区2012和2013年不同供餐模式学校能量营养素供应情况比较[J]. 中国学校卫生, 2016, 37(5): 667-669, 673. doi: 10.16835/j.cnki.1000-9817.2016.05.009 ZHANG F, ZHANG Q, PAN H, et al. Comparison of dietary nutrients of nutrition improvement program for rural compulsory education students between different catering models[J]. Chin J Sch Health, 2016, 37(5): 667-669, 673. (in Chinese) doi: 10.16835/j.cnki.1000-9817.2016.05.009
[7]	杨月欣, 王光亚, 何梅, 等. 中国食物成分表[M]. 北京: 北京大学医学出版社, 2018. YANG Y X, WANG G Y, HE M, et al. Chinese food composition table[M]. Beijing: Peking University Medical Press, 2018. (in Chinese)
[8]	张娜, 朱文丽, 张曼, 等. 《中国学龄儿童膳食指南(2022)》解读[J]. 中国学校卫生, 2022, 43(6): 805-808. doi: 10.16835/j.cnki.1000-9817.2022.06.002 ZHANG N, ZHU W L, ZHANG M, et al. Interpretation on Dietary Guidelines for Chinese School-aged Children[J]. Chin J Sch Health, 2022, 43(6): 805-808. (in Chinese) doi: 10.16835/j.cnki.1000-9817.2022.06.002
[9]	李红飞, 陈靖敏, 黄丽华, 等. 中国青少年不良饮食行为及影响因素分析[J]. 现代预防医学, 2022, 49(18): 3344-3350. https://www.cnki.com.cn/Article/CJFDTOTAL-XDYF202218015.htm LI H F, CHEN J M, HUANG L H, et al. Unhealthy dietary behaviors and influencing factors among Chinese adolescents[J]. Mod Prev Med, 2022, 49(18): 3344-3350. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-XDYF202218015.htm
[10]	《中国人群身体活动指南》编写委员会. 中国人群身体活动指南(2021)[J]. 中华预防医学杂志, 2022, 56(1): 7-8. https://www.cnki.com.cn/Article/CJFDTOTAL-YASY202204028.htm Composing and Editorial Board of Physical Activity Guidelines for Chinese. Physical activity guidelines for Chinese(2021)[J]. Chin J Prev Med, 2022, 56(1): 7-8. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-YASY202204028.htm
[11]	中华人民共和国卫生部. 中小学生一日学习时间卫生要求: GB/T 17223—2012[S]. 北京: 中国标准出版社, 2012. Ministry of Health of the PRC. One day study time hygiene requirements for elementary and secondary students: GB/T 17223-2012[S]. Beijing: Standards Press of China, 2012. (in Chinese)
[12]	程晓光, 袁慧书, 程敬亮, 等. 骨质疏松的影像学与骨密度诊断专家共识[J]. 中国骨与关节杂志, 2020, 9: 666-673. https://www.cnki.com.cn/Article/CJFDTOTAL-GZGL202009011.htm CHENG X G, YUAN H S, CHENG J L, et al. Consensus on imaging and bone mineral density diagnosis of osteoporosis[J]. Chin J Bone Joint, 2020, 9: 666-673. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-GZGL202009011.htm
[13]	张金, 张田, 孙慧慧, 等. 学龄期肥胖儿童骨密度水平及影响因素研究[J]. 中国儿童保健杂志, 2020, 28(11): 1271-1275. https://www.cnki.com.cn/Article/CJFDTOTAL-ERTO202011025.htm ZHANG J, ZHANG T, SUN H H, et al. Study on bone mineral density level and its influencing factors in obese school-age children[J]. Child Health Care China J, 2020, 28(11): 1271-1275. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-ERTO202011025.htm
[14]	骆彦霏, 王超群, 王小娜, 等. 海口市112例少年儿童骨密度及影响因素分析[J]. 中国骨质疏松杂志, 2014, 20(7): 804-806. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGZS201407018.htm LUO Y F, WANG C Q, WANG X N, et al. Study of the bone mineral density in 112 children and adolescents in Haikou and the influencing factors[J]. Chin J Osteopor, 2014, 20(7): 804-806. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-ZGZS201407018.htm
[15]	李静. 银川市学龄儿童青少年骨密度发育特征及其与维生素D的关系[D]. 银川: 宁夏医科大学, 2018. LI J. Analysis of bone mineral density and its correlation with vitamin D among children and adolescents in Yinchuan[D]. Yinchuan: Ningxia Medical University, 2018. (in Chinese)
[16]	DOLAN E, SALE C. Protein and bone health across the lifespan[J]. Proc Nutr Soc, 2019, 78(1): 45-55.
[17]	冯棋琴, 叶志萍, 董春波, 等. 海南省贫困地区9~16岁学生维生素D水平及影响因素[J]. 中华骨质疏松和骨矿盐疾病杂志, 2021, 14(6): 615-620. https://www.cnki.com.cn/Article/CJFDTOTAL-GUSS202106013.htm FENG Q Q, YE Z P, DONG C B, et al. Vitamin D levels and influencing factors among students aged 9-16 years in poor areas of Hainan Province[J]. Chin J Osteop Bone Miner Res, 2021, 14(6): 615-620. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-GUSS202106013.htm
[18]	冯棋琴, 王松, 王会琴, 等. 海南省琼中县中小学生营养知识和行为调查[J]. 基层医学论坛, 2015, 19(10): 1395-1397. https://www.cnki.com.cn/Article/CJFDTOTAL-YXLT201510072.htm FENG Q Q, WANG S, WANG H Q, et al. Investigation on nutrition knowledge and dietary behavior of primary and middle-school students in Qiongzhong Country of Hainan Province[J]. Med Forum, 2015, 19(10): 1395-1397. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-YXLT201510072.htm
[19]	唐咏梅, 杨猛, 刘英莉, 等. 学龄儿童骨密度水平及其膳食影响因素[J]. 中国学校卫生, 2013, 34(6): 706-708. http://www.cjsh.org.cn/article/id/zgxxws201306023 TANG Y M, YANG M, LIU Y L, et al. Effect of dietary on bone density among school-age children[J]. Chin J Sch Health, 2013, 34(6): 706-708. (in Chinese) http://www.cjsh.org.cn/article/id/zgxxws201306023
[20]	罗仁惠, 谢奇, 郭秋云, 等. 海南省2005与2015年12岁儿童口腔健康状况及行为变化[J]. 中国学校卫生, 2020, 41(10): 1552-1554. doi: 10.16835/j.cnki.1000-9817.2020.10.029 LUO R H, XIE Q, GUO Q Y, et al. Changes in oral health status and oral health behavior among 12-year-old children in Hainan Province during 2005-2015[J]. Chin J Sch Health, 2020, 41(10): 1552-1554. (in Chinese) doi: 10.16835/j.cnki.1000-9817.2020.10.029
[21]	卢琼妹. 学龄期儿童预防保健对儿童生长发育的作用分析[J]. 蚌埠医学院学报, 2017, 42(9): 1238-1242. https://www.cnki.com.cn/Article/CJFDTOTAL-BANG201709028.htm LU Q M. Effect of health care on the growth and development of school-age children[J]. J Bengbu Med Coll, 2017, 42(9): 1238-1242. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-BANG201709028.htm
[22]	周月婵, 胡余明, 马征, 等. 长期饮用学生奶与儿童骨密度的关系[J]. 卫生研究, 2011, 40(1): 65-67. https://www.cnki.com.cn/Article/CJFDTOTAL-WSYJ201101015.htm ZHOU Y C, HU Y M, MA Z, et al. Relation of long-term consumption of school milk to bone density in children[J]. J Hyg Res, 2011, 40(1): 65-67. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-WSYJ201101015.htm
[23]	KIM S, KIM W, KANG M. Effect of milk and milk products consumption on physical growth and bone mineral density in Korean adolescents[J]. Nutr Res Pract, 2013, 7(4): 309-314.
[24]	杜文雯, 王惠君, 王志宏, 等. 中国九省区1991—2006年7~17岁儿童青少年饮奶状况及变化趋势[J]. 中华流行病学杂志, 2010, 31(12): 1349-1352. DU W W, WANG H J, WANG Z H, et al. Trend of milk consumption among Chinese children and adolescents aged 7 to 17 years old in 9 provinces from 1991 to 2006[J]. Chin J Epidemiol, 2010, 31(12): 1349-1352. (in Chinese)
[25]	史佳, 房红芸, 于冬梅, 等. 中国6~17岁儿童青少年奶制品摄入状况分析[J]. 中国食物与营养, 2022, 28(6): 26-30. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGWY202206005.htm SHI J, FANG H Y, YU D M, et al. Consumption status of Dairy products in Chinese children and adolescents aged 6-17[J]. Food Nutr China, 2022, 28(6): 26-30. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-ZGWY202206005.htm