上海市嘉定区中学生饮食行为评分轨迹与焦虑抑郁症状的纵向关联

童敏; 刘欣欣; 张琴; 井光壮; 朱琰泓; 史慧静

doi:10.16835/j.cnki.1000-9817.2024331

上海市嘉定区中学生饮食行为评分轨迹与焦虑抑郁症状的纵向关联

doi: 10.16835/j.cnki.1000-9817.2024331

童敏¹,
刘欣欣²,
张琴²,
井光壮¹,
朱琰泓^2, ,,
史慧静^1, ,

1.
复旦大学公共卫生学院妇幼与儿少卫生教研室，上海 200032
2.
上海市嘉定区疾病预防控制中心学校卫生与眼病防治科

基金项目:

上海市第六轮加强公共卫生体系建设三年行动计划重点学科建设项目 GWVI-11.1-32

复旦大学公共卫生学院-嘉定区卫生健康委公共卫生高质量发展重点学科、重点专项 GWGZLXK-2023-04

详细信息

作者简介:
童敏(1999-)，女，安徽安庆人，在读硕士，主要研究方向为儿少卫生与妇幼保健学

通讯作者:
朱琰泓，E-mail: shhtzyh@163.com

史慧静，E-mail: hjshi@fudan.edu.cn

利益冲突声明 所有作者声明无利益冲突。
中图分类号: R179 R155.1 G444
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- 文章访问数: 7
- HTML全文浏览量: 7
- PDF下载量: 2
- 被引次数: 0
出版历程
- 收稿日期: 2024-07-22
- 修回日期: 2024-09-23
- 网络出版日期: 2025-06-07
- 刊出日期: 2025-05-25

Longitudinal association of dietary behavior scores trajectories with anxiety and depression symptoms among middle school students in Jiading District, Shanghai

1.
Department of Maternal, Child and Adolescent Health, School of Public Health, Fudan University, Shanghai (200032), China

摘要

摘要: 目的分析上海市嘉定区中学生饮食行为在2021—2023年内变化轨迹，纵向验证其与焦虑抑郁症状之间的关联，为促进青少年心理健康提供科学依据。方法数据源于上海市嘉定区学生常见病和健康影响因素监测与干预项目。选取2021—2023年至少参与2次调查的1 217名初、高中学生为研究对象，构建组基轨迹模型识别其饮食行为评分轨迹，分别采用修正Poisson回归和Logistic回归分析不同饮食行为评分轨迹对焦虑抑郁症状的影响及其与抑郁评分变化水平的关联。结果中学生饮食行为评分轨迹可分为“持续健康饮食行为”(9.5%)、“持续相对不健康饮食行为”(85.0%)和“持续非常不健康饮食行为”(5.5%)3组。自感学习成绩较差、父母文化水平在高中及以下的中学生，其饮食行为评分轨迹中持续健康饮食行为组占比低于其他组学生(χ²值分别为12.87，8.69，6.50，P值均＜0.05)。与持续健康饮食行为组相比，持续非常不健康饮食行为组的中学生出现焦虑症状的可能性升高(aRR=3.04，95%CI=1.15~8.02)；持续相对不健康饮食行为组和持续非常不健康饮食行为组均增加抑郁症状的检出风险(aRR值分别为1.80，2.45)，并与抑郁症状评分增加均呈正相关(aOR值分别为1.70，2.24)(P值均＜0.05)。结论中学生饮食行为在2021—2023年间变化不大，且持续不健康饮食行为最为常见。不健康饮食行为与焦虑抑郁症状的检出风险及抑郁症状评分增加呈正相关。
- 饮食习惯 /
- 焦虑 /
- 抑郁 /
- 精神卫生 /
- 回归分析 /
- 学生
Abstract: Objective To analyze the trajectory of dietary behaviors among middle school students in Jiading District, Shanghai, from 2021 to 2023, and longitudinally verify their association with anxiety and depression symptoms, aiming to provide scientific evidence for promoting the mental health of adolescents. Methods The data were sourced from the National Monitoring and Intervention Project on Common Diseases and Health Impact Factors of students in Jiading District, Shanghai. A total of 1 217 middle school students who participated in at least two surveys from 2021 to 2023 were selected as the research objects, and group-based trajectory model was constructed to identify their dietary behavior scores trajectories. Modified Poisson regression was used to investigate the impact of dietary behavior scores trajectories on anxiety and depression, while Logistic regression was employed to explore the association between trajectories and changes in depression score levels. Results The dietary behavior scores trajectories of middle school students were divided into three groups: Persistent Healthy Dietary Behavior (9.5%), Persistent Relatively Unhealthy Dietary Behavior (85.0%), and Persistent Very Unhealthy Dietary Behavior (5.5%). Students who perceived their academic performance as poor and whose parents had a cultural level of high school or below had a significantly lower proportion in the Persistent Healthy Dietary Behavior group compared to students with other characteristics (χ²=12.87, 8.69, 6.50, P < 0.05). Compared with the Persistent Healthy Dietary Behavior group, the risk of anxiety symptoms in middle school students in the Persistent Very Unhealthy Dietary Behavior group was significantly increased (aRR=3.04, 95%CI=1.15-8.02); Persistent Relatively Unhealthy Dietary Behavior and Persistent Very Unhealthy Dietary Behavior increased the risk of depressive symptoms (aRR=1.80, 2.45, respectively), and were positively correlated with the increase in depression scores (aOR=1.70, 2.24) (P < 0.05). Conclusions The dietary behavior of middle school students have not changed significantly in the past three years, with persistent unhealthy dietary behavior being the most common. Unhealthy dietary behaviors are positively correlated with the risk of anxiety and depressive symptoms and an increase in depression scores.
- Food habits /
- Anxiety /
- Depression /
- Mental health /
- Regression analysis /
- Students
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 不同人口学特征中学生饮食行为评分轨迹分布

Table 1. Comparison of dietary behavior scores trajectories among middle school students with different demographoc characteristics

人口学指标	人数	持续健康饮食行为	持续相对不健康饮食行为	持续非常不健康饮食行为	χ²值	P值
性别
男	745	59(7.92)	643(86.31)	43(5.77)	5.37	0.07
女	472	56(11.86)	392(83.05)	24(5.09)
自感学习成绩
较好	504	61(12.10)	416(82.54)	27(5.35)	12.87	0.01
一般	441	37(8.39)	386(87.53)	18(4.08)
较差	272	17(6.25)	233(85.66)	22(8.09)
住校
是	112	6(5.36)	97(86.61)	9(8.03)	3.66	0.16
否	1 105	109(9.86)	938(84.89)	58(5.25)
自感家庭经济
较好	448	37(8.26)	391(87.28)	20(4.46)	4.26	0.37
一般	690	71(10.29)	579(83.91)	40(5.80)
较差	79	7(8.86)	65(82.28)	7(8.86)
父亲文化水平
高中及以下	470	40(8.51)	393(83.62)	37(7.87)	8.69	0.01
大专及以上	747	75(10.04)	642(85.94)	30(4.02)
母亲文化水平
高中及以下	487	38(7.80)	414(85.01)	35(7.19)	6.50	0.04
大专及以上	730	77(10.55)	621(85.07)	32(4.38)
注： ()内数字为构成比/%。

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表 2 中学生饮食行为评分轨迹对焦虑抑郁症状影响的修正Poisson回归分析

Table 2. Modified Poisson regression analysis of the impact of dietary behavior scores trajectories on anxiety and depression symptoms among middle school students

组别	人数	焦虑症状^a				抑郁症状^b
组别	人数	检出人数	检出率/%	χ²值	aRR值(95%CI)	检出人数	检出率/%	χ²值	aRR值(95%CI)
持续健康饮食行为	66	6	9.09	6.29^*	1.00	10	15.15	11.67^**	1.00
持续相对不健康饮食行为	633	64	10.11		1.26(0.57~2.76)	171	27.01		1.80(1.09~2.98)^*
持续非常不健康饮食行为	34	8	23.53		3.04(1.15~8.02)^*	16	47.06		2.45(1.34~4.48)^**
注： ^a调整2023年调查时年龄、性别、自感学习成绩、自感家庭经济、父母文化水平；^b在^a调整的协变量基础上添加调整基线时抑郁症状；^P＜0.05，^*P＜0.01。

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