Sasaki Kemal, Hirasawa Akiko, Yamazaki Yoshihisa, Ishikawa Midori
Child Health Center, Aichi Children's Health and Medical Center.
Department of Food and Health Sciences, Jissen Women's University.
Nihon Koshu Eisei Zasshi. 2021 Jan 30;68(1):12-22. doi: 10.11236/jph.20-009. Epub 2020 Dec 19.
Objectives In Japan, medical questionnaires on diet and lifestyle are administered during health checkups for children. Since the rate of health checkup participation is high, the information obtained from these questionnaires can be used for regional diagnoses. In this study, we evaluated the relationship between sweet snack eating habits (SSEHs) and lifestyle habits in toddlers using data from the questionnaires.Methods This study was conducted across 35 municipalities in Aichi Prefecture, Japan, where individual toddlers can be tracked at medical examinations at the age of 1 year 6 months (18 m) and 3 years (36 m). The subjects were 18,251 toddlers (9,393 boys [51.5%]) who participated in the health checkup in the same municipalities at 18 m in 2013 and 36 m in 2014-2015. Subjects were divided into four categories based on their SSEHs at 18 m and 36 m: N-N (no SSEH at either 18 m or 36 m); Y-N (no SSEH at 36 m only); N-Y (no SSEH at 18 m only); Y-Y (SSEH at both 18 m and 36 m). Other lifestyle habits were divided into two levels: good habits and bad habits. A multinomial logistic regression analysis was performed using the SSEH category as the dependent variable and lifestyle as the independent variable. The control groups were the Y-Y category and bad habit for the dependent and independent variables, respectively.Results The proportions of N-N, Y-N, N-Y, and Y-Y subjects were 27.7%, 8.6%, 24.1%, and 39.6%, respectively. At 18 m, 48.2% toddlers had an SSEH, which increased to 63.7% at 36 m. Most toddlers (82.2%) had a habit of sweet snacking at 18 m and habitually consumed sweet snacks at 36 m. The absence of nursing at bedtime at 18 m was positively associated with the N-N group (odds ratio [99% confidence interval]=1.25 [1.11-1.41]) and the Y-N group (1.28 [1.07-1.52]); however, no association was found with the N-Y group (0.99 [0.88-1.11]). Parental finish polishing at 18 m tended to show a positive association only with the N-N group (1.10 [0.99-1.23]).Conclusion Nearly half of toddlers had SSEHs by 18 m, and most of them continued to have the habit at 36 m. Oral hygiene behavior at 18 m was associated with SSEHs of toddlers up to 36 m. A regional diagnosis using the results of the health checkup for children is useful for identifying factors related to health problems.
目的 在日本，儿童健康检查期间会进行饮食和生活方式方面的医学问卷调查。由于健康检查参与率很高，从这些问卷中获得的信息可用于区域诊断。在本研究中，我们利用问卷数据评估了幼儿甜零食饮食习惯（SSEH）与生活方式习惯之间的关系。
方法 本研究在日本爱知县的35个市町村开展，在这些地方，个体幼儿在1岁6个月（18个月）和3岁（36个月）体检时可被追踪。研究对象为2013年18个月时和2014 - 2015年36个月时在同一市町村参加健康检查的18251名幼儿（9393名男孩[51.5%]）。根据幼儿在18个月和36个月时的SSEH将其分为四类：N - N（18个月和36个月时均无SSEH）；Y - N（仅36个月时无SSEH）；N - Y（仅18个月时无SSEH）；Y - Y（18个月和36个月时均有SSEH）。其他生活方式习惯分为两个水平：好习惯和坏习惯。以SSEH类别为因变量、生活方式为自变量进行多项逻辑回归分析。对照组分别为因变量的Y - Y类别和自变量的坏习惯。
结果 N - N、Y - N、N - Y和Y - Y类别的幼儿比例分别为27.7%、8.6%、24.1%和39.6%。18个月时，48.2%的幼儿有SSEH，36个月时增至63.7%。大多数幼儿（82.2%）在18个月时有甜零食习惯且在36个月时习惯性食用甜零食。18个月时睡前不喂奶与N - N组（优势比[99%置信区间]=1.25[1.11 - 1.41]）和Y - N组（1.28[1.07 - 1.52]）呈正相关；然而，与N - Y组未发现关联（0.99[0.88 - 1.11]）。18个月时父母完成刷牙往往仅与N - N组呈正相关（1.10[0.99 - 1.23]）。
结论 到18个月时，近一半的幼儿有SSEH，其中大多数在36个月时仍保持该习惯。18个月时的口腔卫生行为与幼儿直至36个月时的SSEH有关。利用儿童健康检查结果进行区域诊断有助于识别与健康问题相关的因素。
