膳食炎症指数与一年级小学生肥胖风险的关联

孙倩; 张刘荣; 翟光富; 朱煜典; 鲁芬; 屈光波

doi:10.16835/j.cnki.1000-9817.2025017

膳食炎症指数与一年级小学生肥胖风险的关联

doi: 10.16835/j.cnki.1000-9817.2025017

1.
马鞍山市疾病预防控制中心食品营养与学校卫生科，安徽 243000
2.
安徽医科大学公共卫生学院

基金项目:

安徽省教育厅重点项目 2022AH050664

详细信息

作者简介:
孙倩(1986-)，女，江苏东海人，硕士，主管医师，主要研究方向为食品营养与学校卫生

通讯作者:
屈光波，E-mail: m17356519870@163.com

利益冲突声明 所有作者声明无利益冲突。
中图分类号: R179 R723.14 R153.2
计量
- 文章访问数: 79
- HTML全文浏览量: 36
- PDF下载量: 12
- 被引次数: 0
出版历程
- 收稿日期: 2024-11-07
- 修回日期: 2024-12-05
- 网络出版日期: 2025-01-25
- 刊出日期: 2025-01-25

Association between dietary inflammation index and obesity risk in first-grade primary school students

1.
Department of Food Nutrition and School Health, Ma'anshan Center for Disease Control and Prevention, Ma'anshan (243000), Anhui Province, China

摘要

摘要: 目的探讨膳食炎症指数(DII)与一年级小学生肥胖患病风险之间的关联，为儿童肥胖预防和干预提供科学依据。方法 2024年4—6月，采用多阶段整群抽样与方便抽样相结合的方法选取马鞍山市儿童青少年健康成长队列中基线调查的4 059名小学一年级学生作为研究对象。通过半定量食物频率问卷收集儿童饮食信息，计算每位学生的DII评分，按DII四分位数分为Q1、Q2、Q3和Q4组。采用统一的身高体重计测量学生的身高和体重，依据《学龄儿童青少年超重与肥胖筛查》(WS/T 586—2018)判断儿童是否肥胖。采用Logistic回归分析探讨DII评分与学生肥胖风险之间的关系，并进行性别分层分析。结果检出肥胖学生895名，检出率为22.0%。Logistic回归分析结果显示，调整协变量后，与DII中Q1组的学生相比，Q3和Q4组的学生肥胖风险增加(Q3:OR=1.43，95%CI=1.12~1.82；Q4:OR=4.14，95%CI=3.32~5.16，P值均 < 0.05)；按照性别分层分析，调整协变量后，DII中Q4组，男生(OR=4.83，95%CI=3.61~6.46)的肥胖风险高于女生(OR=3.46，95%CI=2.45~4.90)(P值均＜0.01)。限制性立方样条分析显示，DII评分与学生肥胖风险之间呈现“J型”剂量反应关系(P < 0.01)。结论 DII评分较高可能与儿童肥胖风险的增加有关，在儿童中提倡抗炎饮食可预防和减少肥胖的发生。
- 膳食炎症指数 /
- 肥胖症 /
- 回归分析 /
- 学生
Abstract: Objective To explore the association between the dietary inflammation index (DII) and the risk of obesity in the first-grade primary school students, so as to provide a scientific evidence for the prevention and intervention of childhood obesity. Methods From April to June 2024, a method combining multi-stage cluster sampling and convenience sampling was used to select 4 059 first-grade students from the Ma'anshan Children and Adolescents Health Growth Cohort as study participants. Dietary information was collected through Semi-quantitative Food Frequency Questionnaire, and each student's DII score was calculated. The students were categorized into four groups (Q1, Q2, Q3, Q4) by their DII quartiles. Height and weight were measured using unified electronic height-weight machines, and obesity was diagnosed according to the Screening for Overweight and Obesity in School-age Children and Adolescents (WS/T 586-2018). Logistic regression was employed to investigate the relationship between DII scores and the risk of obesity among students, with gender stratification. Results A total of 895 obese children were identified, with an obesity rate of 22.0%. After adjusting for covariates, compared to students in the DII Q1 group, students in the Q3 and Q4 groups had increased risks of obesity (Q3: OR=1.43, 95%CI=1.12-1.82; Q4: OR=4.14, 95%CI=3.32-5.16, P < 0.05). Gender stratified analysis revealed that, after adjusting for covariates, boys in the DII Q4 group (OR=4.83, 95%CI=3.61-6.46, P < 0.01) had a higher obesity risk than girls in the same group (OR=3.46, 95%CI=2.45-4.90, P < 0.01). Restricted cubic spline analysis showed a "J-shaped" dose-response relationship between DII scores and obesity risk among students (P < 0.01). Conclusion Higher DII scores may be associated with an increased risk of obesity in the first-grade primary school students. It is recommended to promote anti-inflammatory diets in children to prevent and reduce the incidence of obesity.
- Dietary inflammatory index /
- Obesity /
- Regression analysis /
- Students
注释:

1) 利益冲突声明 所有作者声明无利益冲突。

HTML全文

图 1 DII与一年级小学生肥胖关联的剂量-反应关系

Figure 1. Dose-response relationship between DII and the obesity of the first-grade primary school students

下载: 全尺寸图片幻灯片

表 1 不同人口学特征一年级小学生肥胖检出率比较

Table 1. Comparison of obesity detection rates in the first-grade primary school students with different demographic charcteristics

人口学指标	选项	人数	肥胖检出人数	χ²值	P值
性别	男	2 173	556(25.6)	34.04	＜0.01
	女	1 886	339(18.0)
是否独生子女	否	2 643	551(20.8)	6.37	0.01
	是	1 416	344(24.3)
父亲文化程度	小学及以下	112	23(20.5)	3.23	0.52
	初中	1 362	285(20.9)
	高中/中专	948	226(23.8)
	大专/本科	1 534	336(21.9)
	研究生及以上	103	25(24.3)
母亲文化程度	小学及以下	222	40(18.0)	7.51	0.11
	初中	1 429	300(21.0)
	高中/中专	766	175(22.8)
	大专/本科	1 584	372(23.5)
	研究生及以上	58	8(13.8)
父亲职业	务工	849	174(20.5)	6.93	0.23
	务农	69	14(20.3)
	机关事业单位	511	117(22.9)
	经商/服务业/运输	1 009	249(24.7)
	家务/待业	25	4(16.0)
	其他	1 596	337(21.1)
母亲职业	务工	602	122(20.3)	12.32	0.03
	务农	64	15(23.4)
	机关事业单位	474	107(22.6)
	经商/服务业/运输	657	176(26.8)
	家务/待业	706	139(19.7)
	其他	1 556	336(21.6)
父亲是否肥胖	否	3 511	734(20.9)	19.80	＜0.01
	是	548	161(29.4)
母亲是否肥胖	否	3 750	800(21.3)	14.71	＜0.01
	是	309	95(30.7)
家庭平均	< 3 000	143	27(18.9)	4.96	0.17
月收入/元	3 000~5 000	731	153(20.9)
	>5 000~10 000	1 738	369(21.2)
	>10 000	1 447	346(23.9)
父母婚姻状况	初婚	3 759	826(22.0)	0.17	0.98
	再婚	143	33(23.1)
	离异	144	33(22.9)
	丧偶	13	3(23.1)
DII评分分组	Q1	1 021	146(14.3)	245.30	＜0.01
	Q2	1 018	159(15.6)
	Q3	1 007	190(18.9)
	Q4	1 013	400(39.5)
注： ()内数字为检出率/%。

下载: 导出CSV

表 2 不同性别一年级小学生DII与肥胖关联的Logistic回归分析

Table 2. Logistic regression analysis of the association between dietary inflammatory index and obesity in the first-grade primary school students by gender

性别	自变量	模型1		模型2
性别	自变量	OR值(95%CI)	P值	OR值(95%CI)	P值
男	Q1	1.00		1.00
(n=2 173)	Q2	1.10(0.80~1.51)	0.55	1.10(0.80~1.53)	0.55
	Q3	1.59(1.17~2.16)	＜0.01	1.60(1.17~2.19)	＜0.01
	Q4	4.68(3.53~6.22)	＜0.01	4.83(3.61~6.46)	＜0.01
女	Q1	1.00		1.00
(n=1 886)	Q2	1.13(0.77~1.65)	0.54	1.14(0.78~1.68)	0.49
	Q3	1.17(0.81~1.71)	0.41	1.21(0.83~1.79)	0.32
	Q4	3.17(2.26~4.44)	＜0.01	3.46(2.45~4.90)	＜0.01
注：模型1未调整，模型2调整年龄、是否独生子女、出生体重、父母文化程度、父母职业、父母是否肥胖、父母婚姻状况、家庭平均月收入。

下载: 导出CSV

参考文献(32)

[1]	LEE E Y, YOON K H. Epidemic obesity in children and adolescents: risk factors and prevention[J]. Front Med, 2018, 12(6): 658-666. doi: 10.1007/s11684-018-0640-1
[2]	董彦会, 陈力, 刘婕妤, 等. 1985—2019年中国7~18岁儿童青少年超重与肥胖的流行趋势及预测研究[J]. 中华预防医学杂志, 2023, 57(4): 461-469. DONG Y H, CEHN L, LIU J Y, et al. Epidemiology and prediction of overweight and obesity among children and adolescents aged 7-18 years in China from 1985 to 2019[J]. Chin J Prev Med, 2023, 57(4): 461-469. (in Chinese)
[3]	中华人民共和国国务院新闻办公室. 中国居民营养与慢性病状况报告(2020年)[J]. 营养学报, 2020, 42(6): 521. The State Council Information Office of the PRC. Report on the nutrition and chronic disease status of Chinese residents (2020)[J]. J Nutr, 2020, 42(6): 521. (in Chinese)
[4]	UNICEF. The State of the World's Children 2019: children, food and nutrition-growing well in a changing world[R]. New York: UNICEF, 2019.
[5]	BAGHERI S, ZOLGHADRI S, STANEK A. Beneficial effects of anti-inflammatory diet in modulating gut microbiota and controlling obesity[J]. Nutrients, 2022, 14(19): 3985. doi: 10.3390/nu14193985
[6]	GROSSO G, LAUDISIO D, FRIAS-TORAL E, et al. Anti-inflammatory nutrients and obesity-associated metabolic-inflammation: state of the art and future direction[J]. Nutrients, 2022, 14(6): 1137. doi: 10.3390/nu14061137
[7]	HESS J M, STEPHENSEN C B, KRATZ M, et al. Exploring the links between diet and inflammation: dairy foods as case studies[J]. Adv Nutr, 2021, 12: 1S-13S. doi: 10.1093/advances/nmab108
[8]	FARLEY G, RIGGS D W, BHATNAGAR A, et al. Omega-3 polyunsaturated fatty acids modify the inverse association between systemic inflammation and cardiovascular fitness[J]. Clin Nutr, 2021, 40(6): 4097-4105. doi: 10.1016/j.clnu.2021.02.006
[9]	SHIVAKOTI R, BIGGS M L, DJOUSSÉ L, et al. Intake and sources of dietary fiber, inflammation, and cardiovascular disease in older US adults[J]. JAMA Netw Open, 2022, 5(3): e225012. doi: 10.1001/jamanetworkopen.2022.5012
[10]	MARX W, VERONESE N, KELLY J T, et al. The dietary inflammatory index and human health: an umbrella review of Meta-analyses of observational studies[J]. Adv Nutr, 2021, 12(5): 1681-1690. doi: 10.1093/advances/nmab037
[11]	SHIVAPPA N, STECK S E, HURLEY T G, et al. Designing and developing a literature-derived, population-based dietary in ammatory index[J]. Public Health Nutr, 2014, 17(8): 1689-1696. doi: 10.1017/S1368980013002115
[12]	SHI J, LIANG Z, ZHANG X, et al. Association of physical activity and dietary inflammatory index with overweight/obesity in US adults: NHANES 2007-2018[J]. Environ Health Prev Med, 2023, 28: 40. doi: 10.1265/ehpm.23-00016
[13]	SABER N, HOSSEINZADEH M, SHAB-BIDAR S, et al. Empirical dietary inflammatory index and lifestyle inflammation score relationship with obesity: a population-based cross-sectional study[J]. Food Sci Nutr, 2023, 11(11): 7341-7351. doi: 10.1002/fsn3.3660
[14]	WANG Y B, SHIVAPPA N, HÉBERT J R, et al. Association between dietary inflammatory index, dietary patterns, plant-based dietary index and the risk of obesity[J]. Nutrients, 2021, 13(5): 1536. doi: 10.3390/nu13051536
[15]	OLIVEIRA T M S, BRESSAN J, PIMENTA A M, et al. Dietary inflammatory index and prevalence of overweight and obesity in Brazilian graduates from the cohort of universities of Minas Gerais (CUME project)[J]. Nutrition, 2020, 71: 110635. doi: 10.1016/j.nut.2019.110635
[16]	MUHAMMAD H F L, VAN BAAK M A, MARIMAN E C, et al. Dietary inflammatory index score and its association with body weight, blood pressure, lipid profile, and leptin in Indonesian adults[J]. Nutrients, 2019, 11(1): 148. doi: 10.3390/nu11010148
[17]	KENEL JOVANOVIĈ G, MRAKOVCIC-SUTIC I, PAVIĈIĈ ŽEŽELJ S, et al. The efficacy of an energy-restricted anti-inflammatory diet for the management of obesity in younger adults[J]. Nutrients, 2020, 12(11): 3583. doi: 10.3390/nu12113583
[18]	刘丹. 营养、家庭经济因素与儿童期及成年后肥胖关系的研究[D]. 北京: 中国疾病预防控制中心, 2019. LIU D. Study on the relationship between nutrition, family economic factors and childhood, adult obesity[D]. Beijing: Chinese Center for Disease Control and Prevention, 2019. (in Chinese)
[19]	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 in school-aged children and adolescents: WS/T 586-2018[S]. Beijing: Standards Press of China, 2018. (in Chinese)
[20]	中国肥胖问题工作组. 中国成人超重和肥胖症预防与控制指南(节录)[J]. 营养学报, 2004, 26(1): 1-4. Chinese Obesity Problem Work Group. Guidelines for the prevention and control of overweight and obesity in Chinese adults (excerpt)[J]. J Nutr, 2004, 26(1): 1-4. (in Chinese)
[21]	RAMALLAL R, TOLEDO E, MARTÍNEZ J A, et al. Inflammatory potential of diet, weight gain, and incidence of overweight/obesity: the SUN cohort[J]. Obesity (Silver Spring), 2017, 25(6): 997-1005. doi: 10.1002/oby.21833
[22]	FARHANGI M A, VAJDI M. The association between dietary inflammatory index and risk of central obesity in adults: an updated systematic review and Meta-analysis[J]. Int J Vitam Nutr Res, 2020, 90(5/6): 535-552.
[23]	ZHANG L, PENG H, WANG Y, et al. Association of dietary inflammatory index with obesity among children and adolescents in the United States NHANES cohort: a population-based study[J]. Ital J Pediatr, 2024, 50(1): 14. doi: 10.1186/s13052-024-01586-0
[24]	HAJI-HOSSEINI-GAZESTANI N, KESHAVARZ S A, HOSSEINI-ESFAHANI F, et al. The association of dietary inflammatory index and obesity phenotypes in women[J]. Food Health, 2020, 3(3): 19-24.
[25]	KARIMBEIKI R, ALIPOOR E, YASERI M, et al. Association between the dietary inflammatory index and obesity in otherwise healthy adults: role of age and sex[J]. Int J Clin Pract, 2021, 75(10): e14567.
[26]	MA X, NAN F, LIANG H, et al. Excessive intake of sugar: an accomplice of inflammation[J]. Front Immunol, 2022, 13: 988481. doi: 10.3389/fimmu.2022.988481
[27]	SHI H, SCHWEREN L J S, TER HORST R, et al. Low-grade inflammation as mediator between diet and behavioral disinhibition: a UK biobank study[J]. Brain Behav Immun, 2022, 106: 100-110. doi: 10.1016/j.bbi.2022.07.165
[28]	KEEWAN E, NARASIMHULU C A, ROHR M, et al. Are fried foods unhealthy? The dietary peroxidized fatty acid, 13-HPODE, induces intestinal inflammation in vitro and in vivo[J]. Antioxidants, 2020, 9(10): 926. doi: 10.3390/antiox9100926
[29]	MAZZOCCHI A, LEONE L, AGOSTONI C, et al. The secrets of the mediterranean diet. Does[only] olive oil matter?[J]. Nutrients, 2019, 11(12): 2941. doi: 10.3390/nu11122941
[30]	DELEDDA A, ANNUNZIATA G, TENORE G C, et al. Diet-derived antioxidants and their role in inflammation, obesity and gut microbiota modulation[J]. Antioxidants, 2021, 10(5): 708. doi: 10.3390/antiox10050708
[31]	JOHN H S, DOUCET É, POWER K A. Dietary pulses as a means to improve the gut microbiome, inflammation, and appetite control in obesity[J]. Obes Rev, 2023, 24(9): e13598. doi: 10.1111/obr.13598
[32]	KAWAI T, AUTIERI M V, SCALIA R. Adipose tissue inflammation and metabolic dysfunction in obesity[J]. Am J Physiol Cell Physiol, 2021, 320(3): C375-C391. doi: 10.1152/ajpcell.00379.2020