上海市闵行区中小学校学生午餐综合干预效果评价

胡玉环; 臧嘉捷; 许慧琳; 郭琪; 韩雁; 汤红梅; 应芳佳; 梁好

doi:10.16835/j.cnki.1000-9817.2025053

上海市闵行区中小学校学生午餐综合干预效果评价

doi: 10.16835/j.cnki.1000-9817.2025053

1.
上海市闵行区疾病预防控制中心学校卫生科，201100
2.
上海市疾病预防控制中心危害监控所营养健康科
3.
The Bishop's School

详细信息

作者简介:
胡玉环(1994-)，女，河南信阳人，硕士，主管医师，主要研究方向为学校卫生与儿少卫生

通讯作者:
郭琪，E-mail：qif0713@163.com

利益冲突声明 所有作者声明无利益冲突。
中图分类号: G478 R155.1 R153.2
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- 文章访问数: 100
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- 被引次数: 0
出版历程
- 收稿日期: 2024-10-28
- 修回日期: 2024-12-20
- 网络出版日期: 2025-03-05
- 刊出日期: 2025-02-25

Evaluation of the comprehensive intervention effect on lunch for primary and secondary school students in Minhang District of Shanghai

1.
Department of School Health, Center for Disease Control and Prevention of Shanghai Minhang District, Shanghai (201100), China

摘要

摘要: 目的评价闵行区中小学校学生午餐综合干预效果，为开展学校午餐干预提供理论基础和实践依据。方法于2023年10—12月采用方便抽样方法抽取闵行区中小学校各1所共1 937名小学和初中学生作为调查对象，开展以“减油减盐”为重点的午餐食谱优化和营养宣教的综合干预措施，并进行问卷调查，3个月后评估干预效果，采用χ²检验和Wilcoxon秩和检验对干预前后资料进行比较。结果干预后，中小学校午餐烹调油盐使用量、午餐中蛋白质和脂肪的供应量均有所降低，对能量和其余主要营养素的影响不明显。相比干预前，干预后小学生觉得午餐油腻的比例降低(8.9%，6.2%，χ²=4.35)，中、小学生觉得午餐好吃的比例均降低(33.2%，23.2%;63.9%，53.5%，χ²值分别为26.39，17.52)，初中生觉得食材种类丰富度降低(46.9%，38.3%，χ²=16.05)(P值均＜0.05)。干预后小学生饭菜总剩余率降低(7.4%，4.4%，χ²=5.73)，主要体现在主食的剩余率降低(7.1%，2.4%，χ²=17.39)，而素菜剩余率上升(16.0%，21.2%，χ²=6.01)(P值均＜0.05)；初中生饭菜总剩余率虽无明显变化，但主食剩余率降低(12.9%，5.4%，χ²=33.52)，荤菜和素菜的剩余率上升(11.2%，26.9%;17.5%，33.2%，χ²值分别为74.26，61.88)(P值均＜0.05)。干预后，小学生和初中生的超重率和肥胖率与干预前差异均无统计学意义(χ_小学²值分别为0.11，0.43；χ_初中²值分别为0.01，0.00，P值均>0.05)；干预后，小学生肺活量[1 564(1 269，1 890)mL]和坐位体前屈[11.3(7.6，15.2) cm] 较干预前[1 522(1 259，1 819)mL，10.5(6.3，13.5)cm]均提升(Z值分别为2.20，4.68，P值均 < 0.01)，但初中生干预前后肺活量和坐位体前屈差异均无统计学意义(Z值分别为-0.46，-0.08，P值均>0.05)。结论学校午餐综合干预促进了午餐油盐使用量的大幅下降，提升了菜谱质量，对午餐剩饭情况和学生健康状况有一定程度的积极影响。
- 膳食 /
- 干预性研究 /
- 营养调查 /
- 学生
Abstract: Objective To evaluate the comprehensive intervention effect of lunch for primary and secondary school students in Minhang District, so as to provide a theoretical and practical basis for lunch intervention in school. Methods From October to December 2023, a convenience sampling method was used to select 1 937 students from one primary and secondary school in Minhang District.A comprehensive intervention measure focusing on "reducing oil and salt" for lunch recipe optimization and nutrition education was carried out, and a questionnaire survey was conducted to evaluate the intervention effect three months later. Chi-square test and Wilcoxon rank test were used to compare the data before and after the intervention. Results After intervention, the use of cooking oil and salt, the supply of protein and fat in primary and secondary school lunches were reduced, and had no obvious impact on energy and other major nutrients. After intervention, compared to before intervention, the proportion of primary school students who felt that lunch was greasy decreased (8.9%, 6.2%, χ²=4.35), and the proportion of primary and secondary school students who felt that lunch were delicious decreased significantly (33.2%, 23.2%; 63.9%, 53.5%, χ²=26.39, 17.52) (P < 0.05). Secondary school students also felt reduced variety of food ingredients (46.9%, 38.3%, χ²=16.05, P < 0.05). In addition, after intervention, the total surplus rate of primary school students' meals decreased (7.4%, 4.4%, χ²=5.73), mainly reflected in the decrease of the surplus rate of staple foods (7.1%, 2.4%, χ²=17.39), while the surplus rate of vegetable dishes increased (16.0%, 21.2%, χ²=6.01) (P < 0.05). Although there was no significant change in the total surplus rate of meals for secondary school students, the surplus rate of staple foods decreased (12.9%, 5.4%, χ²=33.52), while the surplus rates of meat and vegetable dishes increased (11.2%, 26.9%; 17.5%, 33.2%, χ²=74.26, 61.88) (P < 0.05). After intervention, there was no statistically significant difference in the overweight and obesity rates of primary school students (χ²=0.11, 0.43) and secondary school students (χ²=0.01, 0.00) compared to before intervention(P>0.05). After intervention, the lung capacity of primary school students [1 564 (1 269, 1 890) mL] and sitting forward flexion [11.3 (7.6, 15.2) cm] increased compared to before intervention [1 522 (1 259, 1 819) mL, 10.5 (6.3, 13.5) cm] (Z=2.20, 4.68, P < 0.01), but there was no statistically significant difference in lung capacity and sitting forward flexion of secondary school students before and after intervention (Z=-0.46, -0.08, P>0.05). Conclusions The comprehensive intervention of school lunch has promoted a significant decrease in the use of oil and salt in lunch and improved the quality of recipes, and has a positive impact on the situation of leftover lunch and the health of students to a certain extent.
- Diet /
- Intervention studies /
- Nutrition surveys /
- Students
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表 1 学校午餐能量和主要营养素供应量及其超过/不足推荐量百分比

Table 1. Energy and the supply of major nutrients and their over/under recommended percentage of school lunch

学段	干预前后	总能量/kcal	蛋白质/g	脂肪/g	碳水化合物/g	钙/mg	铁/mg	锌/mg	维生素A/μg	维生素B1/mg	维生素B2/mg	维生素C/mg
小学	干预前	896(19.5)	36(56.5)	45(114.3)	87^*	138(-48.9)	9.09(97.6)	3.71(37.4)	270(68.8)	0.25(-16.7)	0.37^*	40.16(33.9)
	干预后	719^*	33(43.5)	31(47.6)	75(-7.4)	110(-59.3)	8.07(75.4)	3.89(44.1)	188(17.5)	0.24(-20.0)	0.33^*	37.98(26.6)
初中	干预前	959(6.6)	42(50.0)	39(50.0)	110^*	175(-45.3)	11.00(96.4)	4.18(7.2)	229^*	0.39(-2.5)	0.40^*	60.32(77.4)
	干预后	904(0.4)	41(46.4)	39(50.0)	97(-11.8)	151(-52.8)	8.85(58.0)	4.48(14.9)	271(17.8)	0.32(-20.0)	0.42^*	45.85(34.9)
注：^*供应量在推荐量范围内; ()内数字为超过或不足推荐量百分比/%，其中负值代表不足推荐值，正值代表超过推荐值; 1 kcal=4.18 kJ。

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表 2 不同学段学生干预前后午餐口味和满意度报告率比较

Table 2. Comparison of report rates of student lunch taste and satisfaction by different school stage before and after intervention

学段	干预前后	人数	统计值	午餐口味		午餐满意度
学段	干预前后	人数	统计值	觉得咸	觉得油腻	觉得好吃	食材种类丰富
小学	干预前	783		24(3.1)	70(8.9)	500(63.9)	548(70.0)
	干预后	809		32(4.0)	50(6.2)	433(53.5)	538(66.5)
			χ²值	0.93	4.35	17.52	2.23
			P值	0.34	0.04	< 0.01	0.14
初中	干预前	1 013		137(13.5)	226(22.3)	336(33.2)	475(46.9)
	干预后	1 110		153(13.8)	287(25.9)	257(23.2)	425(38.3)
			χ²值	0.03	3.63	26.39	16.05
			P值	0.86	0.06	< 0.01	< 0.01
注：^*()内数字为报告率/%。

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表 3 不同学段学生干预前后午餐剩余率变化

Table 3. Changes in lunch surplus rate of students in different school stage before and after intervention

学段	干预前后	人数	统计值	主食	荤菜	素菜	总剩余
小学	干预前	619		44(7.1)	79(12.8)	99(16.0)	46(7.4)
	干预后	750		18(2.4)	115(15.3)	159(21.2)	33(4.4)
			χ²值	17.39	1.84	6.01	5.73
			P值	< 0.01	0.17	0.01	0.02
初中	干预前	899		116(12.9)	101(11.2)	157(17.5)	115(12.8)
	干预后	1 024		55(5.4)	275(26.9)	340(33.2)	115(11.2)
			χ²	33.52	74.26	61.88	0.15
			P值	< 0.01	< 0.01	< 0.01	0.70
注：^*()内数字为剩余率/%。

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