伊朗东北部儿童代表性样本中儿童肥胖的膳食预测因素

Dietary predictors of childhood obesity in a representative sample of children in north east of Iran

摘要:

目的：伊朗儿童的肥胖患病率不断升高。这项研究旨在评价伊朗东北部城市Neishabour的儿童代表性样本中肥胖的某些膳食决定因素。方法：在这项病例对照研究中，病例组为114名在校学生，年龄6~12岁，体重指数（BMI）≥第95个百分位（根据伊朗儿童的参考值），而对照组为102名年龄和性别匹配的非肥胖同班同学。由受过训练的营养师在儿童在场的情况下与母亲面谈，进行两次24 h膳食回顾调查，收集了营养摄入数据；使用食物频率问卷调查了零食摄入模式；使用SPSS软件（第16版）进行了单因素和多因素logistic回归分析。结果：单因素logistic回归分析显示，总能量、蛋白质、碳水化合物、脂肪（包括饱和脂肪、单不饱和脂肪和多不饱和脂肪）和膳食纤维是学生肥胖的正向预测因素；玉米膨化食品、碳酸饮料、薯片、快餐食品和巧克力的摄入频率的粗估比值比（OR）有统计学意义。多因素logistic回归分析显示，肥胖与能量摄入量（OR = 2.489，95%CI：1.667~3.716）、玉米膨化食品摄入频率（OR=1.122，95%CI：1.007~1.250）及薯片摄入频率（OR=1.143，95%CI：1.024~1.276）显著相关；而膳食纤维摄入量（OR=0.909，95%CI：0.835~0.988）和天然果汁摄入量（OR= 0.601，95%CI：0.368~0.983）是预防肥胖的保护因素。结论：该研究结果证实了不健康饮食对儿童肥胖的作用，尤其是高热量零食。应鼓励儿童养成健康的饮食习惯，如摄入高纤维食物。

Abstract:

OBJECTIVE: The prevalence of obesity is increasing in Iranian youngsters. This study aimed to assess some dietary determinants of obesity in a representative sample of children in Neishabour, a city in northeastern, Iran. METHODS: This case-control study was conducted among 114 school students, aged 6-12 years, with a body mass index (BMI) ≥95th (based on percentile of Iranian children) as the case group and 102 age- and gender-matched controls, who were selected from their non-obese classmates. Nutrient intake data were collected by trained nutritionists by using two 24-hour-dietary recalls through maternal interviews in the presence of their child. A food frequency questionnaire was used for detecting the snack consumption patterns. Statistical analysis was done using univariate and multivariate logistic regression (MLR) by SPSS version 16. RESULTS: In univariate logistic regression, total energy, protein, carbohydrate, fat (including saturated, mono- and poly-unsaturated fat), and dietary fiber were the positive predictors of obesity in studied children. The estimated crude ORs for frequency of corn-based extruded snacks, carbonated beverages, potato chips, fast foods, and chocolate consumption were statistically significant. After MLR analysis, the association of obesity remained significant with energy intake (OR=2.489, 95%CI: 1.667-3.716), frequency of corn-based extruded snacks (OR=1.122, 95%CI: 1.007-1.250), and potato chips (OR=1.143, 95%CI:1.024-1.276). The MLR analysis showed that dietary fiber (OR=0.601, 95%CI: 0.368-0.983) and natural fruit juice intake (OR=0.909, 95%CI: 0.835-0.988) were protective factors against obesity. CONCLUSIONS: The findings serve to confirm the role of an unhealthy diet, notably calorie-dense snacks, in childhood obesity. Healthy dietary habits, such as the consumption of high-fiber foods, should be encouraged among children.