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2019年农村义务教育学生营养改善计划中儿童生长迟缓情况及其影响因素

[Growth retardation of children and its influencing factors in the Nutrition Improvement Program for Rural Compulsory Education Students in 2019].

作者信息

Gao T T, Cao W, Yang T T, Xu P P, Xu J, Li L, Gan Q, Pan H, Zhang Q

机构信息

National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention/Key Laboratory of Trace Element Nutrition, National Health Commission of the People's Republic of China, Beijing 100050, China.

National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention/Key Laboratory of Trace Element Nutrition, National Health Commission of the People's Republic of China, Beijing 100050, China National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China.

出版信息

Zhonghua Liu Xing Bing Xue Za Zhi. 2022 Apr 10;43(4):488-495. doi: 10.3760/cma.j.cn112338-20210722-00574.

Abstract

To understand the growth retardation among primary and secondary school students in areas covered by the Nutrition Improvement Program for Rural Compulsory Education Students and its influencing factors to provide evidence for improving the nutrition status of rural students in China. The multi-stage cluster random sampling method selected 1 550 969 primary and secondary school students aged 6-15 years from China's central and western regions. The ratio of male and female students was balanced. The height was measured, and the growth retardation of students was determined according to the Screening Criteria for School-age Children and Adolescents malnutrition (WS/T 456-2014), from the school and county questionnaire survey related factors. The number of cases and percentages described the growth retardation of students, and the test was used for comparison between groups. Binary logistic regression was used to analyze students' growth retardation factors. In 2019, the growth retardation rate of primary and secondary school students in areas covered by the Nutrition Improvement Program for Rural Compulsory Education Students was 5.7% (88 631/1 550 969), the growth retardation rate in the western part (7.1%, 66 167/927 954) was higher than that in the central part (3.7%,19 511/533 973) with difference statistically significant (<0.001). The growth retardation rate of the boys (6.3%,50 665/803 851) were higher than that of girls (5.1%, 37 966/747 118), the difference was statistically significant (<0.001). The growth retardation rate of primary school students in central China was 3.9%(14 914/380 598), higher than that of junior middle school students (3.0%,4 597/153 375, <0.001). In contrast, the growth retardation rate of the western junior high school students (7.2%, 21 494/297 217) were higher than that of elementary school students (7.1%, 44 673/630 737), with a difference statistically significant (all =0.009). Multi-factor logistic regression results showed that, in high income area (=0.829, 95%: 0.816-0.842, <0.001), parents providing part of the meal cost (=0.948, 95%: 0.931-0.965, <0.001), enterprises providing meals (=0.845, 95%: 0.805-0.887, <0.001), schools providing milk (=0.780, 95%: 0.767-0.793, <0.001), health education courses (=0.702, 95%: 0.682-0.723, <0.001) and other local nutrition improvement efforts (=0.739, 95%: 0.720-0.758, <0.001) were negatively correlated with the occurrence of growth retardation, The growth retardation rate of the students was lower. There appeared significant regional, gender, and age differences in the growth retardation rate of primary and middle school students in areas covered by the Nutrition Improvement Program for Rural Compulsory Education Students. Appropriate food supply in schools, health education courses, and parental participation in nutritional improvement was related to children's lower growth retardation rate.

摘要

了解农村义务教育学生营养改善计划覆盖地区中小学生生长迟缓情况及其影响因素,为改善我国农村学生营养状况提供依据。采用多阶段整群随机抽样方法,从我国中西部地区选取1550969名6-15岁中小学生,男女学生比例均衡。测量身高,并根据《学龄儿童青少年营养不良筛查标准》(WS/T 456-2014)判定学生生长迟缓情况,通过学校和县区问卷调查相关因素。用例数和百分比描述学生生长迟缓情况,采用检验进行组间比较。用二元logistic回归分析学生生长迟缓影响因素。2019年,农村义务教育学生营养改善计划覆盖地区中小学生生长迟缓率为5.7%(88631/1550969),西部地区生长迟缓率(7.1%,66167/927954)高于中部地区(3.7%,19511/533973),差异有统计学意义(<0.001)。男生生长迟缓率(6.3%,50665/803851)高于女生(5.1%,37966/747118),差异有统计学意义(<0.001)。中部地区小学生生长迟缓率为3.9%(14914/380598),高于初中生(3.0%,4597/153375,<0.001)。相反,西部地区初中生生长迟缓率(7.2%,21494/297217)高于小学生(7.1%,44673/630737),差异有统计学意义(均=0.009)。多因素logistic回归结果显示,在高收入地区(=0.829,95%:0.816-0.842,<0.001)、家长提供部分餐费(=0.948,95%:0.931-0.965,<0.001)、企业供餐(=0.845,95%:0.805-0.887,<0.001)、学校提供牛奶(=0.780,95%:0.767-0.793,<0.001)、健康教育课程(=0.702,95%:0.682-0.723,<0.001)及其他当地营养改善措施(=0.739,95%:0.720-0.758,<0.001)与生长迟缓发生呈负相关,学生生长迟缓率较低。农村义务教育学生营养改善计划覆盖地区中小学生生长迟缓率存在明显的地区、性别和年龄差异。学校适当的食物供应、健康教育课程以及家长参与营养改善与儿童较低的生长迟缓率有关。

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