Changes of the dietary intake of vegetable and fruit among Chinese children aged 6-17 in 1982 and 2012
-
摘要:
目的 分析1982年与2012年我国6~17岁儿童蔬菜水果摄入量及其变化特征。 方法 以1982年全国营养调查18 237名与2012年中国居民营养与健康状况监测中的5 819名6~17岁儿童为对象,分别用称重记账法与3 d 24 h膳食调查法收集儿童食物摄入情况,分析并比较两个年份学龄儿童的蔬菜与水果摄入量及达到WHO推荐摄入量的情况。 结果 学龄儿童蔬菜摄入量从1982年的300.4 g下降到2012年的185.8 g(Z=45.9, P<0.001);学龄儿童水果摄入量由1982年的28.2 g增加到2012年的45.9 g(Z=36.8, P<0.001)。学龄儿童蔬菜水果总摄入量达到WHO推荐量80%及以上的比例由1982年的42.2%下降到2012年的21.6%(χ2 =809.9, P<0.001)。1982年和2012年,男生蔬菜摄入量均高于女生,且随年龄增长而升高;水果摄入量均为城市儿童高于农村儿童。 结论 2012年与1982年相比,我国6~17岁儿童蔬菜摄入量下降较多,水果摄入量有所增加,2012年与1982年儿童蔬菜与水果摄入量均不足,建议采取综合干预措施提高儿童蔬菜与水果的消费,促进其健康成长。 Abstract:Objective To analyze the change characteristics of fruits and vegetables intake among Chinese children aged 6-17 years in 1982 and 2012. Methods 18 237 and 5 819 children aged 6-17 years old from the 1982 China Nutrition Survey and China Nutrition and Health Surveillance (2010-2012) were recruited respectively. Three consecutive 24-hour recalls method and weight records method were used to collect the food intake among children. The intakes of vegetables and fruits of children and the proportion reaching WHO recommended intake were analyzed and compared in the two years. Results From 1982 to 2012, Children' s vegetable intake dropped from 300.4 g to 185.8 g (Z=45.9, P < 0.001); the fruit intake of children increased from 28.2 g to 45.9 g (Z=36.8, P < 0.001), the proportion of children reaching 80% of the WHO recommended amount of total intake of fruits and vegetables decreased from 42.2% to 21.6% (χ2 =809.9, P < 0.001). In each year, boys' vegetable intake was higher than girls', and children's vegetable intake gradually increased with ages, fruit intake of urban children was higher than that of rural children. Conclusions Compared with 1982, the vegetable intake of Chinese children aged 6 to 17 years decreased significantly, and the intake of fruits increased in 2012. The intake of vegetables and fruits of children was insufficient in each year. Comprehensive intervention should be urgently needed to effectively promote fruit and vegetable consumption of children. -
Key words:
- Children /
- Vegetable /
- Fruit /
- Dietary intake /
- Diet survey
-
表 1 1982年与2012年调查对象的样本构成情况
Table 1. Sample size of school-aged children in 1982 and 2012
分组 1982年 2012年 N % N % 地区 城市 2 455 13.5 2 385 41.0 农村 15 782 86.5 3 434 59.0 性别 男生 9 257 50.8 3 092 53.1 女生 8 980 49.2 2 727 46.9 年龄组(岁) 6~<9 3 929 21.5 1 741 29.9 9~<12 4 568 25.1 1 748 30.0 12~<15 5 252 28.8 1 404 24.1 15~17 4 488 24.6 926 16.0 合计 18 237 100.0 5 819 100.0 表 2 1982年和2012年不同特征学龄儿童蔬菜摄入量比较(g)
Table 2. Comparison of intake of vegetables by area, gender and age group in 1982 and 2012 (g)
组别 1982年 2012年 2012年与1982年比较 x sx Z/χ2值 P值 x sx Z/χ2值 P值 差值 Z值 P值 地区 1.7 0.095 8.5 < 0.001 城市 300.5 182.3 194.1 132.1 -106.4 25.0 < 0.001 农村 300.4 217.4 178.2 115.4 -122.2 39.0 < 0.001 性别 4.7 < 0.001 1.9 0.064 男生 307.4 216.1 190.4 128.9 -117.0 33.3 < 0.001 女生 293.0 209.6 180.5 116.3 -112.5 31.7 < 0.001 年龄组(岁) 707.0 < 0.001 263.3 < 0.001 6~<9 239.0 169.4 146.1 104.7 -92.9 22.9 < 0.001 9~<12 285.1 201.4 173.9 117.6 -111.3 23.8 < 0.001 12~<15 316.7 216.7 195.5 122.9 -121.1 21.4 < 0.001 15~17 354.9 237.8 217.1 147.5 -137.8 18.7 < 0.001 合计 300.4 213.0 185.8 123.2 -114.6 45.9 < 0.001 表 3 1982年和2012年不同特征组学龄儿童水果的摄入量比较(g)
Table 3. Comparison of intake of fruits by area, gender and age group in 1982 and 2012 (g)
组别 1982年 2012年 2012年与1982年比较 x sx Z/χ2值 P值 x sx Z/χ2值 P值 差值 Z值 P值 地区 24.9 < 0.001 13.4 < 0.001 城市 38.6 118.7 48.6 89.5 10.1 12.9 < 0.001 农村 26.8 120.6 43.5 110.0 16.6 25.9 < 0.001 性别 0.9 0.358 2.1 0.037 男生 29.1 125.8 43.0 105.9 13.9 25.5 < 0.001 女生 27.2 114.6 49.3 98.4 22.1 26.6 < 0.001 年龄组(岁) 1.8 0.620 11.0 0.012 6~<9 23.6 96.6 38.9 104.0 15.3 17.7 < 0.001 9~<12 28.2 117.4 51.2 93.2 23.0 20.9 < 0.001 12~<15 28.5 122.1 51.0 102.1 22.5 19.7 < 0.001 15~17 32.1 138.7 43.6 115.4 11.5 13.4 < 0.001 合计 28.2 120.4 45.9 102.5 17.7 36.8 < 0.001 表 4 1982年和2012年不同组别学龄儿童蔬菜水果总摄入量达到WHO推荐量不同水平的比例(%)
Table 4. Proportion of WHO recommended amount of vegetables and fruit by area, gender and age group in 1982 and 2012(%)
组别 1982年 2012年 2012年与1982年比较 < 50 50~<80 80~<100 ≥100 χ2值a P值 < 50 50~<80 80~<100 ≥100% χ2值a P值 χ2值a P值 地区 0.1 0.756 77.7 < 0.001 城市 24.1 33.9 15.4 26.6 44.5 28.2 11.8 15.5 115.8 < 0.001 农村 31.6 26.1 13.8 28.5 58.0 24.4 8.0 9.6 732.2 < 0.001 性别 12.8 < 0.001 4.1 0.043 男生 29.4 27.0 14.0 29.6 52.0 25.4 9.7 12.9 431.8 < 0.001 女生 31.7 27.4 14.1 26.8 53.0 26.6 9.4 11.0 382.6 < 0.001 年龄组(岁) 525.7 < 0.001 130.2 < 0.001 6~<9 41.8 29.1 11.7 17.4 64.0 22.7 6.9 6.4 165.4 < 0.001 9~<12 31.4 29.6 13.9 25.1 52.9 26.1 9.6 11.4 180.4 < 0.001 12~<15 27.5 26.4 15.3 30.8 45.3 27.2 12.0 15.5 157.0 < 0.001 15~17 23.5 23.9 14.8 37.8 41.1 29.9 11.0 18.0 172.4 < 0.001 合计 30.6 27.2 14.0 28.2 - - 52.5 25.9 9.6 12.0 - - 809.9 < 0.001 注:χ2值a:均为比较组别间达到WHO推荐量≥80%的构成比的差异。 -
[1] 孙长颢. 营养与食品卫生学[M]. 第8版. 北京: 人民卫生出版社. 2017.Sun Changhao. Nutritioon and Food Hygiene[M]. 8th edition. Beijing: People's Medical Publishing House, 2017. [2] Collese TS, Nascimento-Ferreira MV, de Moraes ACF, et al. Role of fruits and vegetables in adolescent cardiovascular health: a systematic review[J]. Nutr Rev. 2017, 75(5): 339-349. DOI: 10.1093/nutrit/nux002. [3] Zhen SH, Ma YA, Zhao ZY, et al. Dietary pattern is associated with obesity in Chinese children and adolescents: data from China Health and Nutrition Survey (CHNS)[J]. Nutr J. 2018, 17(1): 68. DOI: 10.1186/s12937-018-0372-8. [4] Miller V, Mente A, Dehghall M, et al. Fruit, vegetable, and legume intake, and cardiovascular disease and deaths in 18 countries(PURE): a prospective cohort study[J]. Lancet, 2017, 390(10107): 2037-2049. DOI: 10.1016/S0140-6736(17)32253-5. [5] Aune D, Keum N, Giovannucci E, et al. Dietary intake and blood concentrations of antioxidants and the risk of cardiovascular disease, total cancer, and all-cause mortality: a systematic review and dose-response meta-analysis of prospective studies[J]. Am J clin Nutr, 2018, 108(5): 1069-1091. DOI: 10.1093/ajcn/nqy097. [6] Borgi L, Muraki I, Satija A, et al. Fruit and vegetable consumption and the incidence of hypertension in three prospective cohort studies[J]. Hypertension, 2016, 67(2): 288-293. DOI: 10.1161/HYPERTENSIONAHA.115.06497. [7] Herforth A, Arimond M, Alvarez-sanchez C, et al. A global review of food-based dietary guidelines[J]. Adv Nutr, 2019, 10(4): 590-605. DOI: 10.1093/advances/nmy130. [8] Al Ani MF, Al Subhi LK, Bose S. Consumption of fruits and vegetables among adolescents: a multi-national comparison of eleven countries in the Eastern Mediterranean Region[J]. Br J Nutr, 2016, 115(6): 1092-1099. DOI: 10.1017/S0007114515005371. [9] Yngve A, Wolf A, Poortvliet E, et al. Fruit and vegetable intake in a sample of 11-year-old children in 9 European countries: the Pro Children Cross-Sectional Survey[J]. Ann Nutr Metab, 2005, 49(4): 236-245. DOI: 10.1159/000087247. [10] Mihrshahi S, Myton R, Partridge SR, et al. Sustained low consumption of fruit and vegetables in Australian children: Findings from the Australian National Health Surveys[J]. Health Promot J Austr, 2019, 30(1): 83-87. DOI: 10.1002/hpja.201. [11] Hong SA, Piaseu N. Prevalence and determinants of sufficient fruit and vegetable consumption among primary school children in Nakhon Pathom, Thailand[J]. Nutr Res Pract, 2017, 11(2): 130-138. DOI: 10.4162/nrp.2017.11.2.130. [12] 国家统计局. 年度数据: 国内生产总值[EB/OL]. (2018-12-19)[2021-03-16]. http://data.stats.gov.cn/search.htm?s=GDP.National Bureau of Statistics. Annual data: GDP[EB/OL]. (2018-12-19)[2021-03-16]. http://data.stats.gov.cn/search.htm?s=GDP. 2018-12-19. [13] 国家统计局. 年度数据: 农村居民家庭平均每人纯收入[EB/OL]. (2018-12-19)[2021-03-16]. http://data.stats.gov.cn/search.htm?s=%E7%BA%AF%E6%94%B6%E5%85%A5.National Bureau of Statistics. Average net income per capita of rural households[EB/OL]. (2018-12-19)[2021-03-16].http://data.stats.gov.cn/search.htm?s=%E7%BA%AF%E6%94%B6%E5%85%A5. 2018-12-19. [14] 翟凤英, 王惠君, 王志宏, 等. 中国居民膳食营养状况的变迁及政策建议[J]. 中国食物与营养, 2006, (5): 4-6. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGWY200605001.htmZai FY, Wang HJ, Wang ZH, et al. Trend of Dietary and Nutritional Status among Chinese Residents and Policy Suggestions[J]. Food Nutr China, 2006, (5): 4-6. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGWY200605001.htm [15] 中国预防医学中心卫生研究所. 1982年全国营养调查总结[M]. 北京: 中国预防医学中心卫生研究所, 1985: 7-8.Institute of Health, China Preventive Medicine Center. Summary of National Nutrition Survey in 1982[M]. Beijing: Institute of Health, China Preventive Medicine Center, 1985: 7-8. [16] 赵丽云, 马冠生, 朴建华, 等. 2010-2012中国居民营养与健康状况监测总体方案[J]. 中华预防医学杂志, 2016, 50(3): 204-207. DOI: 10.3760/cma.j.issn.0253-9624.2016.03.002.Zhao LY, Ma GS, Piao JH, et al. Scheme of the 2010-2012 Chinese nutrition and health surveillance[J]. Chin J Prev Med, 2016, 5(3): 204-207. DOI: 10.3760/cma.j.issn.0253-9624.2016.03.002. [17] 杨月欣, 王光亚, 潘兴昌. 中国食物成分表[M]. 北京: 北京大学医学出版社, 2009: 1-191.Yang YX, Wang GY, Pan XC. China Food Composition[M]. Beijing: Peking University Medical Press, 2009: 1-191. [18] WHO. Diet, nutrition, and the prevention of chronic disease[R]. Report of a joint WHO/FAO expert consultation, 2003 Technical Report Series 916.Geneva: WHO, 2003. [19] 国务院人口普查办公室, 国家统计局人口统计司. 中国1982年人口普查资料[M]. 北京: 中国统计出版社, 1982: 284-315.Census Office of the State Council, Department of Demographic Statistics, National Bureau of Statistics. China's 1982 Census[M]. Beijing: China Statistics Press, 1982: 284-315. [20] 国务院人口普查办公室, 国家统计局人口和就业统计司. 中国2010年人口普查资料[EB/OL]. (2010-11-01)[2021-03-16]. http://www.stats.gov.cn/tjsj/pcsj/rkpc/6rp/left.htm.Census Office of the State Council, Department of Demographic Statistics, National Bureau of Statistics[EB/OL]. (2010-11-01)[2021-03-16]. http://www.stats.gov.cn/tjsj/pcsj/rkpc/6rp/left.htm. [21] 马冠生, 胡小琪, 杜玉侠. 中国学龄儿童青少年营养与健康状况调查报告[M]. 北京: 中国人口出版社, 2005: 6.Ma GS, Hu XQ, Du YX. A survey report on nutrition and health of Chinese school-age children and adolescents[M]. Beijing: China Population Press, 2005: 6. [22] 李丽, 欧阳一非, 王惠君, 等. 中国15省儿童青少年蔬菜和水果摄入状况[J]. 中国健康教育, 2020, 36(1): 3-7. DOI: 10.16168/j.cnki.issn.1002-9982.2020.01.001.Li L, Ouyang YF, Wang HJ, et al. Status of fruit and vegetable intake among children and adolescents in 15 provinces of China[J]. Chinese Journal of Health Education, 2020, 36(1): 3-7. DOI: 10.16168/j.cnki.issn.1002-9982.2020.01.001. [23] 王志宏, 张兵, 王惠君, 等. 中国9省(区)199l—2009年6—17岁儿童青少年蔬菜水果摄人变化趋势及其社会经济因素的影响[J]. 中华流行病学杂志, 2013, 34(9): 863-868. DOI: 10.3760/cmad.issn.0254-6450.2013.09.002.Wang ZH, Zhang B, Wang HJ, et al. Trend in vegetable and fruit intake among Chinese children and adolescents aged 6 to 17 years from 1991 to 2009 and related socio-demographic factors[J]. Chin J Epidemiol, 2013, 34(9): 863-868. DOI: 10.3760/cmad.issn.0254-6450.2013.09.002. [24] 杨洋, 邸信, 吕晓华. 我国居民膳食变迁与慢性病问题—基于宏观数据的分析[J]. 中国社会医学杂志, 2016, 33(2): 31-33. DOI: 10.3969/j.issn.1673-5625.2016.02.009.Yang Y, Di X, Lv XH. Study on Diet Changes and Population Health in China : Based on Analysis of Macro Data[J]. Chinese Journal of Social Medicine, 2016, 33(2): 31-33. DOI: 10.3969/j.issn.1673-5625.2016.02.009. [25] Lien N, Lytle LA, Klepp KI. Stability in consumption of fruit, vegetables, and sugary foods in a cohort from age 14 to age 21[J]. Prevent Med, 2001, 33(3): 217-226. DOI: 10.1006/pmed.2001.0874. [26] te Velde SJ, Twisk JW, Brug J. Tracking of fruit and vegetable consumption from adolescence into adulthood and its longitudinal association with overweight[J]. Br J Nutr, 2007, 98(2): 431-438. DOI: 10.1017/S0007114507721451. [27] Vik FN, Heslien KEP, Van LW, et al. Effect of a free healthy school meal on fruit, vegetables and unhealthy snacks intake in Norwegian 10 to 12-year-old children[J]. BMC Public Health, 2020, 20(1): 1369. DOI: 10.1186/s12889-020-09470-2. [28] Sharps M, Robinson E. Encouraging children to eat more fruit and vegetables: Health vs. descriptive social norm-based messages[J]. Appetite, 2016, 100: 18-25. DOI: 10.1016/j.appet.2016.01.031.