四年级小学生及其父母减盐减油减糖健康素养与学生超重肥胖的关联

郝颖; 刘丹茹; 陈先献; 任杰; 徐聪; 杜凤军; 郭晓雷; 董静; 马吉祥

doi:10.16835/j.cnki.1000-9817.2025095

四年级小学生及其父母减盐减油减糖健康素养与学生超重肥胖的关联

doi: 10.16835/j.cnki.1000-9817.2025095

郝颖¹,
刘丹茹²,
陈先献²,
任杰²,
徐聪²,
杜凤军³,
郭晓雷²,
董静^2, ,,
马吉祥^4, ,

1.
山东第一医科大学(山东省医学科学院)公共卫生与健康管理学院, 济南 250117
2.
山东省疾病预防控制中心慢性非传染性疾病防制所
3.
山东大学公共卫生学院
4.
山东省慢性病医院

基金项目:

山东省医药卫生科技发展计划项目 202012071231

山东省医药卫生科技发展计划项目 2015WS0280

详细信息

作者简介:
郝颖(2000-), 女, 山东济南人, 在读硕士, 主要研究方向为慢性病预防与控制

通讯作者:
董静, E-mail: freedom.dj1@163.com

马吉祥, E-mail: majix@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 R155.1
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- HTML全文浏览量: 6
- PDF下载量: 0
- 被引次数: 0
出版历程
- 收稿日期: 2024-11-01
- 修回日期: 2024-12-12
- 网络出版日期: 2025-05-08
- 刊出日期: 2025-04-25

Correlation between the health literacy of reducing salt, oil and sugar on overweight and obesity among fourth-grade elementary school students and their parents

1.
School of Public Health and Health Management, Shandong First Medical University (Shandong Academy of Medical Sciences), Jinan(250117), Shandong Province, China

摘要

摘要: 目的分析小学生及其父母减盐、减油、减糖(简称"三减")健康素养对学生超重、肥胖的影响, 为制定肥胖控制措施提供参考依据。方法 2024年3—4月, 采用多阶段整群随机抽样的方法, 在山东省选取6个县24个班级, 共对1 022名四年级小学生和913名学生家长开展问卷调查, 同时对小学生进行体格测量。采用Pearson相关性分析、有序多分类Logistic回归探讨小学生及其父母"三减"健康素养与学生超重、肥胖之间的关联性。结果山东省小学生超重检出率为14.87%, 肥胖检出率为24.66%, 男、女生肥胖检出率(29.46%, 19.76%)差异有统计学意义(χ²=12.93, P<0.01)。除学生减油健康素养得分外, 家长减盐、减油、减糖、综合得分及学生减盐、减糖、综合得分健康素养均与学生超重肥胖呈现负相关关系(r值分别为-0.10, -0.08, -0.07, -0.10, -0.04, -0.07, -0.03, P值均<0.05)。家长减盐、减油、减糖以及综合健康素养得分高的小学生超重肥胖率较低(OR值分别为0.69, 0.69, 0.71, 0.63, P值均<0.05);家长健康素养得分处于高水平时, 学生健康素养处于高、低水平者超重肥胖检出均较低(OR值分别为0.68, 0.57, P值均<0.05)。结论提高父母及儿童的"三减"健康素养, 尤其提高家长健康素养有利于降低儿童超重肥胖发生率。
- 健康教育 /
- 超重 /
- 肥胖症 /
- 回归分析 /
- 学生
Abstract: Objective To analyze the effects of health literacy on overweight and obesity among primary school students and their parents in terms of salt, oil and sugar reduction (referred to as the "three reductions"), so as to provide a theoretical basis for the development of obesity control measures. Methods From March to April 2024, a total of 1 022 fourth-grade primary school students and 913 parents were surveyed in 24 classes in six counties in Shandong Province using multistage cluster random sampling, and physical measurements of primary school students were conducted. Pearson's correlation analysis and ordered multivariate Logistic regression were used to investigate the associations between health literacy of primary school students and their parents with overweight and obesity among children. Results The detection rates of overweight and obesity primary school students in Shandong Province were 14.87% and 24.66%, respectively, with significant sex difference in obesity rate (29.46% for boys and 19.76% for girls) (χ²=12.93, P<0.01). In addition to students' reducing oil scores, parental reducing salt, reducing oil, reducing sugar, comprehensive health literacy scores and students' reducing salt, reducing sugar and comprehensive health literacy scores showed a negative relationship with students' overweight and obesity (r=-0.10, -0.08, -0.07, -0.10, -0.04, -0.07, -0.03, P<0.05). The overweight and obesity rates among primary school students with high parental reducing salt, reducing oil, reducing sugar and composite health literacy scores were lower (OR=0.69, 0.69, 0.71, 0.63, P<0.05); and the overweight and obesity rate among students with high parental and low parental and high and low parental health literacy scores were lower (OR=0.68, 0.57, P<0.05). Conclusion Improving health literacy regarding "three reductions" for parents and children, especially parents, can effectively reduce the risk of childhood overweight and obesity.
- Health education /
- Overweight /
- Obesity /
- Regression analysis /
- Students
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表 1 不同组别小学生超重肥胖检出率比较

Table 1. Comparison of overweight and obesity detection rates among different groups of primary school students

组别	选项	人数	超重			肥胖			超重肥胖
组别	选项	人数	检出人数	χ²值	P值	检出人数	χ²值	P值	检出人数	χ²值	P值
性别	男	516	80(15.50)	0.33	0.57	152(29.46)	12.93	<0.01	232(44.96)	12.27	<0.01
	女	506	72(14.23)			100(19.76)			172(34.25)
是否有意愿选择含盐/钠少的食物	是	615	92(14.96)	0.01	0.92	138(22.44)	4.09	0.04	230(37.40)	2.94	0.09
	否/不知道	407	60(14.74)			114(28.01)			174(42.75)
购买加工食品时是否关注过食品的盐/钠含量	是	604	88(14.57)	0.11	0.74	140(23.18)	1.74	0.19	228(37.75)	1.96	0.16
	否/不知道	418	64(15.31))			112(26.79)			176(42.11
是否要求餐馆少放盐	是	487	72(14.78)	0.01	0.94	101(20.74)	7.69	0.01	173(35.52)	6.25	0.01
	否/不知道	535	80(14.95)			151(28.22)			231(43.18)
购买包装食品时是否关注营养成分表中的脂肪含量	是	696	110(15.80)	1.50	0.22	165(23.71)	1.06	0.30	275(39.51)	0.00	0.99
	否/不知道	326	42(12.88)			87(26.69)			129(39.57)
是否要求餐馆少放油	是	454	69(15.20)	0.07	0.79	105(23.13)	1.03	0.31	174(38.33)	0.50	0.48
	否/不知道	568	83(14.61)			147(25.88)			230(40.49)
每周喝果汁、碳酸饮料频次	0	325	52(16.00)	3.92	0.27	67(20.62)	7.32	0.06	119(36.62)	5.52	0.14
	1~2	592	79(13.34)			160(27.03)			239(40.37)
	3~4	65	12(18.46)			12(18.46)			24(36.92)
	>5	40	9(22.50)			13(32.50)			22(55.00)
每周吃甜食或零食的频次	0	237	42(17.72)	4.13	0.25	56(23.63)	1.15	0.76	98(41.35)	4.00	0.26
	1~2	638	84(13.17)			156(24.45)			240(37.62)
	3~4	108	20(18.52)			31(28.70)			51(47.22)
	>5	39	6(15.38)			9(23.08)			15(38.46)
是否购买过无糖饮料	是	754	117(15.52)	0.94	0.33	176(23.34)	2.68	0.10	293(38.86)	0.54	0.46
	否/不知道	268	35(13.06)			76(28.26)			111(41.42)
学生减盐健康素养得分	高	366	58(15.85)	0.44	0.51	83(22.68)	2.05	0.15	141(38.52)	0.621	0.43
	低	547	78(14.26)			147(26.87)			225(41.13)
学生减油健康素养得分	高	394	60(15.23)	0.06	0.81	106(26.90)	1.078	0.30	166(42.13)	1.21	0.27
	低	519	76(14.64)			124(23.89)			200(38.54)
学生减糖健康素养得分	高	369	63(17.07)	2.32	0.13	81(21.95)	3.45	0.06	144(39.02)	0.29	0.59
	低	544	73(13.42)			149(27.39)			222(40.81)
学生综合健康素养得分	高	461	71(15.40)	0.19	0.67	115(24.95)	0.03	0.86	186(40.35)	0.03	0.87
	低	452	65(14.38)			115(25.44)			180(39.82)
注：()内数字为检出率/%。

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表 2 小学生超重肥胖与学生和家长“三减”健康素养有序多分类Logistic回归分析(n=913)

Table 2. Ordered multicategorical Logistic regression analysis of overweight and obesity in primary school students and the Three-Reduced health literacy of students and parents(n=913)

问卷	健康素养	β值	标准误	Wald χ²值	OR值(95%CI)	P值
学生	减盐	-0.01	0.06	0.06	0.99(0.88~1.11)	0.81
	减油	0.11	0.07	2.60	1.11(0.98~1.26)	0.11
	减糖	-0.11	0.05	4.73	0.90(0.82~0.99)	0.03
	综合	-0.02	0.02	0.99	0.99(0.96~1.01)	0.32
家长	减盐	-0.10	0.04	7.67	0.91(0.84~0.97)	0.01
	减油	-0.16	0.07	5.78	0.85(0.75~0.97)	0.02
	减糖	-0.08	0.05	3.07	0.92(0.84~1.01)	0.08
	综合	-0.06	0.02	8.74	0.94(0.91~0.98)	<0.01

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表 3 家长和学生“三减”健康素养分类变量与学生超重肥胖的关联(n=913)

Table 3. Association between Three-Reduced health literacy categorical variables of parents and students and overweight and obesity(n=913)

问卷	健康素养	β值	标准误	Wald χ²值	OR值(95%CI)	P值
学生	减盐	-0.11	0.14	0.65	0.90(0.69~1.17)	0.42
	减油	0.20	0.13	2.15	1.22(0.94~1.58)	0.14
	减糖	-0.11	0.14	0.61	0.90(0.69~1.17)	0.43
	综合	0.04	0.13	0.08	1.04(0.80~1.34)	0.78
家长	减盐	-0.37	0.14	6.53	0.69(0.52~0.92)	0.01
	减油	-0.37	0.14	7.60	0.69(0.53~0.90)	0.01
	减糖	-0.35	0.15	5.41	0.71(0.53~0.95)	0.02
	综合	-0.46	0.14	11.26	0.63(0.48~0.83)	<0.01

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参考文献(26)

[1]	SMITH J D, FU E, KOBAYASHI M A. Prevention and management of childhood obesity and its psychological and health comorbidities[J]. Annu Rev Clin Psychol, 2020, 16: 351-378. doi: 10.1146/annurev-clinpsy-100219-060201
[2]	武子明. 儿童肥胖与成人胰腺癌风险的关联[D]. 沈阳: 中国医科大学, 2021. WU Z M. Association between childhood obesity and adult pancreatic cancer risk[D]. Shenyang: China Medical University, 2021. (in Chinese)
[3]	WEIHRAUCH-BLüHER S, SCHWARZ P, KLUSMANN J H. Childhood obesity: increased risk for cardiometabolic disease and cancer in adulthood[J]. Metabolism, 2019, 92: 147-152. doi: 10.1016/j.metabol.2018.12.001
[4]	谢竞成, 王惠群, 余慧娴, 等. 贵州省四至九年级学龄儿童营养素养现状及其与体质健康的关系[J]. 中国学校卫生, 2024, 45(5): 649-653. doi: 10.16835/j.cnki.1000-9817.2024145 XIE J C, WANG H J, XU H X, et al. Nutritional literacy of school-age children in grades 4-9 and its relationship with physical health in Guizhou Province[J]. Chin J Sch Health, 2024, 45(5): 649-653. (in Chinese) doi: 10.16835/j.cnki.1000-9817.2024145
[5]	蔡泽敏, 吴肖冰, 卢文龙, 等. 深圳市2019年中学生健康素养水平及影响因素分析[J]. 中国学校卫生, 2022, 43(8): 1152-1155. doi: 10.16835/j.cnki.1000-9817.2022.08.008 CAI Z M, WU X B, LU W L, et al. Analysis of health literacy and associated factors among middle school students in Shenzhen in 2019[J]. Chin J Sch Health, 2022, 43(8): 1152-1155. (in Chinese) doi: 10.16835/j.cnki.1000-9817.2022.08.008
[6]	中华人民共和国国家卫生健康委员会. 学生健康检查技术规范[S]. 北京: 中国国家标准化管理委员会, 2011. National Health Commission of the PRC. TechnicaI standard for physical examination for students[S]. Beijing: Standardization Administration of the PRC, 2011. (in Chinese)
[7]	董静, 刘丹茹, 任杰, 等. 山东省小学生及家长"三减"干预效果评价[J]. 中国慢性病预防与控制, 2023, 31(1): 35-37, 41. DONG J, LIU D R, REN J, et al. Evaluation for intervention effects of Three Reductions among primary school students and their parents in Shandong Province[J]. Chin J Prev Chron Dis, 2023, 31(1): 35-37, 41. (in Chinese)
[8]	张妍, 冯甘雨, 宫伟彦, 等. "三减"知识行为微信端在线调查分析[J]. 中国健康教育, 2019, 35(3): 251-254. ZHANG Y, FENG G Y, GONG W Y, et al. Online survey and analysis of Three Reductions knowledge and behavior through WeChat platform[J]. Chin J Health Educ, 2019, 35(3): 251-254. (in Chinese)
[9]	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: China Standard Press, 2018. (in Chinese)
[10]	杜凤军. 人群减盐干预效果评价研究[D]. 北京: 中国疾病预防控制中心, 2019. DU F J. Evaluation of the effect of salt-reduction intervention in population level[D]. Beijing: Chinese Center for Disease Control and Prevention, 2019. (in Chinese)
[11]	中华人民共和国国家卫生健康委员会. 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. National Health Commission of the PRC. Report on the nutrition and chronic disease status of Chinese residents (2020)[M]. Beijing: People's Medical Publishing House, 2021. (in Chinese).
[12]	韩李臻. 山东省6~12岁儿童超重肥胖现状及影响因素分析[D]. 济南: 山东大学, 2019. HAN L Z. The analysis of overweight and obesity status and influencing factors of children aged 6-12 years in Shandong Province[D]. Jinan: Shandong University, 2019. (in Chinese)
[13]	王小丽, 陈晓云, 陈丽萍, 等. 2018年泰安市城区6~18岁中小学生超重和肥胖的流行病学调查[J]. 中国妇幼健康研究, 2020, 31(12): 1606-1611. WANG X L, CHEN X Y, CHEN L P, et al. Epidemiological survey of overweight and obesity among primary and secondary school students with 6-18 years in Tai'an urban area in 2018[J]. Chin J Woman Child Health Res, 2020, 31(12): 1606-1611. (in Chinese)
[14]	于杰, 隋栋梁, 范子亮, 等. 2014-2018年奎文区少年儿童肥胖超重流行趋势分析[J]. 中国城乡企业卫生, 2019, 34(9): 79-80. YU J, SUI D L, FAN Z L, et al. Trend analysis of obesity overweight prevalence among children and adolescents in Kuiwen District, 2014-2018[J]. Chin J Urban Rural Enterpr, 2019, 34(9): 79-80. (in Chinese)
[15]	王烁, 董彦会, 王政和, 等. 1985-2014年中国7~18岁学生超重与肥胖流行趋势[J]. 中华预防医学杂志, 2017, 51(4): 300-305. WANG S, DONG Y H, WANG Z H, et al. Trends in overweight and obesity among Chinese children of 7-18 years old during 1985-2014[J]. Chin J Prev Med, 2017, 51(4): 300-305. (in Chinese)
[16]	马冠生, 米杰, 马军, 等. 中国儿童肥胖报告[M]. 北京: 人民卫生出版社: 2017. MA G S, MI J, MA J, et al. Report on childhood obesity in China[M]. Beijing: People's Medical Publishing House, 2017. (in Chinese)
[17]	陈睿迪, 苏燕燕, 鹿盼婷, 等. 小学生营养知信行与其超重和肥胖的关系[J]. 疾病预防控制通报, 2021, 36(3): 60-63. CHEN R D, SU Y Y, LU P T, et al. Relationship among nutrition knowledge, attitude and practice of primary school students and their overweight and obesity[J]. Bull Dis Control Prev, 2021, 36(3): 60-63. (in Chinese)
[18]	翟艳丽, 冯向先, 原建慧, 等. 小学生家庭减盐教育前后食盐摄入和血压变化分析[J]. 中国预防医学杂志, 2020, 21(7): 732-736. ZHAI Y L, FENG X X, YUAN J H, et al. Changes of salt intake and blood pressure in elementary school students and their family members after school based salt reduction education program[J]. Chin Prev Med, 2020, 21(7): 732-736. (in Chinese)
[19]	王宏亮, 徐培培, 曹薇, 等. 1982与2012年中国6~17岁儿童膳食烹调油摄入比较分析[J]. 中华疾病控制杂志, 2021, 25(5): 504-508. WANG H L, XU P P, CAO W, et al. Comparative analysis of dietary cooking oil intake of Chinese children aged 6-17 years in 1982 and 2012[J]. Chin J Dis Control Prev, 2021, 25(5): 504-508. (in Chinese)
[20]	贾菡蕊, 姚昕玥, 彭俞婷, 等. 小学生主观不健康饮食态度和行为对其含糖饮料消费频率的影响[J]. 中国食物与营养, 2022, 28(6): 78-83, 88. JIA H R, YAO X Y, PENG Y T, et al. Influence of subjective unhealthy eating attitudes and behaviours on the frequency of consumption of sugary drinks among primary school students[J]. Food Nutr China, 2022, 28(6): 78-83, 88. (in Chinese)
[21]	ZOELLNER J, YOU W, CONNELL C, et al. Health literacy is associated with healthy eating index scores and sugar-sweetened beverage intake: findings from the rural Lower Mississippi Delta[J]. J Am Diet Assoc, 2011, 111(7): 1012-1020. http://europepmc.org/articles/PMC3160591
[22]	蔡豪, 何海蓉, 张娜, 等. 北京市九城区中小学生含糖饮料相关知识和行为调查[J]. 中国食物与营养, 2018, 24(10): 50-54. CAI H, HE H R, ZHANG N, et al. Sugar-sweetened beverages related knowledge and practice among primary and middle school students in nine districts in Beijing City[J]. Food Nutr China, 2018, 24(10): 50-54. (in Chinese)
[23]	孙晗月, 周楠. 家庭环境对儿童体质健康影响的研究进展[J]. 中国妇幼保健, 2024, 39(16): 3229-3232. SUN H Y, ZHOU N. Research progress on the influence of family environment on children's physical health[J]. Matern Child Health Care China, 2024, 39(16): 3229-3232. (in Chinese)
[24]	陈艳琳, 候芳, 杨洁, 等. 深圳市罗湖区儿童家长对学龄前儿童体重感知现状及影响因素分析[J]. 中国妇幼卫生杂志, 2024, 15(4): 26-30. CHEN Y L, HOU F, YANG J, et al. Analysis of the current status and its influencing factors of parents' perception of preschool children's weight in Luohu District[J]. Chin J Women Children Health, 2024, 15(4): 26-30. (in Chinese)
[25]	VON DENEEN K M, WEI Q, TIAN J, et al. Obesity in China: what are the causes?[J]. Curr Pharm Des, 2011, 17(12): 1132-1139.
[26]	王志芳, 张倩, 杨媞媞, 等. 家庭食物环境与儿童青少年超重肥胖关系研究进展[J]. 中国学校卫生, 2023, 44(9): 1436-1440. doi: 10.16835/j.cnki.1000-9817.2023.09.035 WANG Z F, ZHANG Q, YANG T T, et al. Research progress on the relationship between home food environment and overweight and obesity in children and adolescents[J]. Chin J Sch Health, 2023, 44(9): 1436-1440. (in Chinese) doi: 10.16835/j.cnki.1000-9817.2023.09.035