中国7~17岁儿童青少年宏量营养素摄入与超重肥胖的关系

宋玮琦; 南颖; 孙宇; 王劲东; 梁芬; 张文婷; 刘丹; 毛琛

doi:10.16462/j.cnki.zhjbkz.2021.05.006

中国7~17岁儿童青少年宏量营养素摄入与超重肥胖的关系

doi: 10.16462/j.cnki.zhjbkz.2021.05.006

宋玮琦¹,
南颖²,
孙宇¹,
王劲东¹,
梁芬¹,
张文婷¹,
刘丹¹,
毛琛^1, ,

1.
510515 广州，南方医科大学公共卫生学院流行病学系
2.
510515 广州，南方医科大学护理学院

基金项目:

广东省高等学校珠江学者岗位计划资助项目 2019

广东省高水平大学建设计划 G820332010

广东省高水平大学建设计划 G618339167

广东省高水平大学建设计划 G618339164

第五届中国科协青年人才托举工程 2019QNRC001

详细信息

通讯作者:
毛琛，E-mail：maochen9@smu.edu.cn

中图分类号: R153.2
计量
- 文章访问数: 627
- HTML全文浏览量: 324
- PDF下载量: 83
- 被引次数: 0
出版历程
- 收稿日期: 2021-03-16
- 修回日期: 2021-04-26
- 网络出版日期: 2021-06-16
- 刊出日期: 2021-05-10

Study on the association of macronutrients intake with overweight and obesity among children and adolescents aged 7-17 years in China

1.
Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou 510515, China
2.
School of Nursing, Southern Medical University, Guangzhou 510515, China

Funds:

Guangdong Province Universities and Colleges Pearl River Scholar Funded Scheme 2019

The Construction of High-level University of Guangdong G820332010

The Construction of High-level University of Guangdong G618339167

The Construction of High-level University of Guangdong G618339164

Young Elite Scientists Sponsorship Program by CAST 2019QNRC001

More Information

Corresponding author: MAO Chen, E-mail: maochen9@smu.edu.cn

摘要

摘要: 目的探讨7~17岁儿童青少年宏量营养素摄入与超重肥胖的关系。方法 1997—2011年基于“中国居民健康与营养调查”的6轮调查数据，纳入膳食及BMI数据完整的7~17岁儿童青少年为研究对象。依照中国肥胖问题工作组制定标准判定超重肥胖，采用Logistic回归分析模型分析宏量营养素摄入与儿童青少年超重肥胖的关系。结果最终纳入6 360名研究对象，其中7~＜12岁儿童青少年3 529人(55.5%)，男生3 360人(52.8%)，超重肥胖1 060人(16.7%)。校正相关混杂因素后，与脂肪供能比 < 25%组相比，≥30%组增加20%肥胖风险(OR=1.20, 95% CI：1.03~1.41, P=0.023)；与蛋白质供能比 < 10%组相比，≥15%组增加61%肥胖风险(OR=1.61, 95% CI：1.25~2.04, P < 0.001)；与碳水化合物供能比 < 55%组相比，55%~ < 65%组降低20%肥胖风险(OR=0.80, 95% CI：0.68~0.95, P=0.011)，≥65%组降低21%肥胖风险(OR=0.79, 95% CI：0.66~0.94, P=0.010)；脂肪及蛋白质供能比越高、碳水化合物供能比越低，发生超重肥胖的风险越高(P < 0.05)；男生摄入过量蛋白质更可能发生肥胖(P=0.034)。结论儿童青少年摄入过量脂肪和蛋白质可增加超重肥胖发生风险。
- 儿童 /
- 青少年 /
- 宏量营养素 /
- 肥胖
Abstract: Objective To analyze the association of macronutrients intake with overweight and obesity among children and adolescents aged 7-17 years in China. Methods Children and adolescents aged 7-17 years who participated in China Health and Nutrition Survey from 1997 to 2011 with complete dietary and BMI data were included. Overweight and obesity were judged by experts from the Group of China Obesity Task Force. The Logistic regression method was applied to assess the association of macronutrients intake with overweight and obesity. Results A total of 6 360 Chinese children and adolescents were included, including 3 529 (55.5%) aged 7- < 12 years and 3 360 (52.8%) boys. Among them, 1 060 (16.7%) were overweight and obese. After controlling for potential confounders, when compared with fat energy supply ratio < 25%, the risk of overweight and obesity appeared an increase of 20% (OR=1.20, 95% CI: 1.03-1.41, P=0.023) with fat energy supply ratio ≥30%. Compared with protein energy supply ratio < 10%, it increased of 61% (OR=1.61, 95% CI: 1.25-2.04, P < 0.001) with protein energy supply ratio ≥15%. Compared with carbohydrate energy supply ratio < 55%, it decreased of 20% (OR=0.80, 95% CI: 0.68-0.95, P=0.011) and 21% (OR=0.79, 95% CI: 0.66-0.94, P=0.010) with carbohydrate energy supply ratio between 55%- < 65%, ≥65%, respectively. The higher energy supply ratios of fat and protein, and lower carbohydrate energy supply ratio had a stronger association with overweight and obesity (P < 0.05). For overweight and obesity, the association seemed to be stronger among boys with excessive intake of protein (P=0.034). Conclusion Excessive intakes of fat and protein may lead to overweight and obesity in children and adolescents.
- Children /
- Adolescents /
- Macronutrients /
- Obesity

HTML全文

图 1 1997—2011年7~17岁儿童青少年摄入宏量营养素、总能量与超重肥胖的人群比例变化趋势

Figure 1. Overweight, obesity and macronutrients intake, total energy intake among Chinese children and adolescents aged 7-17 years, 1997-2011 trends

下载: 全尺寸图片幻灯片

图 2 按年龄、性别分层对宏量营养素摄入量与超重肥胖的多因素Logistic回归分析模型

Figure 2. Multiple Logistic regression analysis on the association of macronutrients intake with overweight and obesity in groups stratified by age and sex

下载: 全尺寸图片幻灯片

表 1 6 360名7~17岁儿童青少年基本特征[n(%)]

Table 1. The demographic characteristics of 6 360 children and adolescents [n(%)]

变量	非超重肥胖组	超重肥胖组	合计	χ²值	P值	变量	非超重肥胖组	超重肥胖组	合计	χ²值	P值
年龄(岁)				23.323	< 0.001	摄入总能量/RNI(%)				17.514	< 0.001
7~＜12	2 869(54.1)	660(62.3)	3 529(55.5)			< 80	2 564(48.4)	458(43.2)	3 022(47.5)
12~17	2 431(45.9)	400(37.7)	2 831(44.5)			80~ < 100	1 523(28.7)	298(28.1)	1 821(28.6)
性别				20.698	< 0.001	≥100	1 213(22.9)	304(28.7)	1 517(23.9)
男	2 732(51.5)	628(59.2)	3 360(52.8)			经常参加体育活动				0.736	0.834
女	2 568(48.5)	432(40.8)	3 000(47.2)			是	4 019(75.8)	800(75.5)	4 819(75.8)
城乡				20.533	< 0.001	否	1 281(24.2)	260(24.5)	1 541(24.2)
城市	1 569(29.6)	389(36.7)	1 958(30.8)			脂肪供能比(%)				28.870	< 0.001
农村	3 731(70.4)	671(63.3)	4 402(69.2)			< 25	2 309(43.6)	378(35.7)	2 687(42.2)
家庭人均年收入				32.292	< 0.001	25~ < 30	883(16.6)	170(16.0)	1 053(16.6)
低	1 649(31.1)	267(25.2)	1 916(30.1)			≥30	2 108(39.8)	512(48.3)	2 620(41.2)
中	2 694(50.8)	529(49.9)	3 223(50.7)			蛋白质供能比(%)				43.462	< 0.001
高	957(18.1)	264(24.9)	1 221(19.2)	109.800		< 10	975(18.4)	146(13.8)	1 121(17.6)
父母肥胖					< 0.001	10~ < 15	3 566(67.3)	683(64.4)	4 249(66.8)
否	4 248(80.2)	677(63.9)	4 925(77.4)			≥15	759(14.3)	231(21.8)	990(15.6)
是	1 052(19.8)	383(36.1)	1 435(22.6)			碳水化合物供能比(%)				40.364	< 0.001
母亲文化程度				64.046	< 0.001	< 55	1 749(33.0)	454(42.8)	2 203(34.6)
小学及以下	2 314(43.7)	364(34.3)	2 678(42.1)			55~ < 65	1 618(30.5)	299(28.2)	1 917(30.2)
初中	1 918(36.2)	362(34.2)	2 280(35.8)			≥65	1 933(36.5)	307(29.0)	2 240(35.2)
高中及以上	1 068(20.1)	334(31.5)	1 402(22.1)

下载: 导出CSV

表 2 宏量营养素摄入与超重肥胖的多因素Logistic回归分析模型

Table 2. Multiple Logistic regression analysis on the association of macronutrients intake with overweight and obesity

变量	人数/超重肥胖数	模型1^a		模型2^b		模型3^c
变量	人数/超重肥胖数	OR(95% CI)值	P值	OR(95% CI)值	P值	OR(95% CI)值	P值
脂肪供能比(%)
< 25	2 687/378	1.00		1.00		1.00
25~ < 30	1 053/170	1.18(0.96~1.43)	0.107	1.18(0.96~1.43)	0.109	1.07(0.87~1.31)	0.520
≥30	2 620/512	1.48(1.28~1.72)	< 0.001	1.47(1.27~1.70)	< 0.001	1.20(1.03~1.41)	0.023
蛋白质供能比(%)
< 10	1 121/146	1.00		1.00		1.00
10~ < 15	4 249/683	1.28(1.06~1.55)	0.012	1.28(1.06~1.47)	0.012	1.17(0.96~1.43)	0.121
≥15	990/231	2.03(1.62~2.56)	< 0.001	2.01(1.60~2.53)	< 0.001	1.61(1.25~2.04)	< 0.001
碳水化合物供能比(%)
< 55	2 203/454	1.00		1.00		1.00
55~ < 65	1 917/299	0.71(0.61~0.84)	< 0.001	0.71(0.61~0.84)	< 0.001	0.80(0.68~0.95)	0.011
≥65	2 240/307	0.61(0.52~0.72)	< 0.001	0.62(0.53~0.72)	< 0.001	0.79(0.66~0.94)	0.010
注：^a模型1未校正任何因素；^b模型2校正了年龄、性别、城乡；^c模型3：进一步校正家庭人均年收入、父母肥胖、母亲教育程度、摄入总能量/RNI和经常参加体育活动。

下载: 导出CSV

表 3 校正招募年份、排除协变量数据缺失后的宏量营养素摄入量与超重肥胖的多因素Logistic回归分析模型

Table 3. Multiple Logistic regression analysis on the association of macronutrients intake with overweight and obesity additionally adjusting for time of recruitment and after excluding participants with missing data on covariate

变量	校正招募年份		排除协变量缺失
变量	OR(95% CI)^a值	P值	OR(95% CI)^a值	P值
脂肪供能比(%)
< 25	1.00		1.00
25~ < 30	1.06(0.86~1.30)	0.575	1.13(0.88~1.44)	0.346
≥30	1.19(1.01~1.40)	0.036	1.23(1.01~1.51)	0.040
蛋白质供能比(%)
< 10	1.00		1.00
10~ < 15	1.17(0.96~1.43)	0.118	1.41(1.08~1.86)	0.012
≥15	1.59(1.24~2.03)	< 0.001	2.04(1.48~2.81)	< 0.001
碳水化合物供能比(%)
< 55	1.00		1.00
55~ < 65	0.81(0.68~0.96)	0.015	0.79(0.64~0.97)	0.024
≥65	0.80(0.67~0.96)	0.018	0.74(0.59~0.93)	0.009
注：^a校正了年龄、性别、城乡、家庭人均年收入、父母肥胖、母亲教育程度、摄入总能量/RNI和经常参加体育活动。

下载: 导出CSV

参考文献(41)

[1]	Han JC, Lawlor DA, Kimm SYS. Childhood obesity[J]. The Lancet, 2010, 375(9727): 1737-1748. DOI: 10.1016/S0140-6736(10)60171-7.
[2]	国务院办公厅. 国务院办公厅关于印发国民营养计划(2017—2030年)的通知[EB/OL]. (2017-06-30)[2021-03-05]. http://www.gov.cn/zhengce/content/2017-07/13/content_5210134.htm. General Office of the State Council. Notice of the General Office of the State Council on issuing the national nutrition plan (2017-2030)[EB/OL]. (2017-06-30)[2021-03-15]. http://www.gov.cn/zhengce/content/2017-07/13/content_5210134.htm.
[3]	国务院新闻办公室. 中国居民营养与慢性病状况报告(2020年)[EB/OL]. (2020-12-23)[2021-03-05]. http://www.scio.gov.cn/xwfbh/xwbfbh/wqfbh/42311/44583/index.htm#2, 2020-12-23. The Information Office of the State Council. Report on Chinese residents' chronic diseases and nutrition 2020[EB/OL]. (2020-12-23)[2021-03-05]. http://www.scio.gov.cn/xwfbh/xwbfbh/wqfbh/42311/44583/index.htm#2, 2020-12-23.
[4]	Segovia-Siapco G, Khayef G, Pribis P, et al. Animal protein intake is associated with general adiposity in adolescents: the teen food and development study[J]. Nutrients, 2019, 12(1): 110. DOI: 10.3390/nu12010110.
[5]	Wycherley TP, Moran LJ, Clifton PM, et al. Effects of energy-restricted high-protein, low-fat compared with standard-protein, low-fat diets: a meta-analysis of randomized controlled trials[J]. Am J Clin Nutr, 2012, 96(6): 1281-1298. DOI: 10.3945/ajcn.112.044321.
[6]	Vergnaud AC, Norat T, Mouw T, et al. Macronutrient composition of the diet and prospective weight change in participants of the EPIC-PANACEA study[J]. PLoS One, 2013, 8(3): e57300. DOI: 10.1371/journal.pone.0057300.
[7]	Song S, Shim JE. Trends in dietary intake of total fat and fatty acids among Korean adolescents from 2007 to 2017[J]. Nutrients, 2019, 11(12): 3073. DOI: 10.3390/nu11123073.
[8]	赵丽云, 刘素, 于冬梅, 等. 我国居民膳食营养状况与《中国食物与营养发展纲要(2014—2020年)》相关目标的比较分析[J]. 中国食物与营养, 2015, 21(8): 5-7. DOI: 10.3969/j.issn.1006-9577.2015.08.001. Zhao LY, Liu S, Yu DM, et al. Comparative analysis of dietary nutrition status of Chinese residents and related targets of Chinese food and nutrition development program (2014-2020)[J]. Food and Nutrition in China, 2015, 21(8): 5-7. DOI: 10.3969/j.issn.1006-9577.2015.08.001.
[9]	Zhu Z, Yang X, Fang Y, et al. Trends and disparities of energy intake and macronutrient composition in China: a series of national surveys, 1982-2012[J]. Nutrients, 2020, 12(8): 2168. DOI: 10.3390/nu12082168.
[10]	Wang L, Wang H, Zhang B, et al. Elevated fat intake increases body weight and the risk of overweight and obesity among Chinese adults: 1991-2015 trends[J]. Nutrients, 2020, 12(11): 3272. DOI: 10.3390/nu12113272.
[11]	Zhao J, Sun J, Su C. Gender differences in the relationship between dietary energy and macronutrients intake and body weight outcomes in Chinese adults[J]. Nutr J, 2020, 19(1): 45. DOI: 10.1186/s12937-020-00564-6.
[12]	张琪, 潘晓群, 杨婕, 等. 中国成年女性能量及宏量营养素摄入与超重肥胖关系的研究[J]. 中华疾病控制杂志, 2014, 18(4): 296-300. https://www.cnki.com.cn/Article/CJFDTOTAL-JBKZ201404007.htm Zhang Q, Pan XQ, Yang J, et al. Study on the associations of energy and macronutrients intake with overweight and obesity in Chinese female adults[J]. Chin J Dis Control Prev, 2014, 18(4): 296-300. https://www.cnki.com.cn/Article/CJFDTOTAL-JBKZ201404007.htm
[13]	Zhang B, Zhai FY, Du SF, et al. The China Health and Nutrition Survey, 1989-2011[J]. Obes Rev, 2014, 15 Suppl 1(1): 2-7. DOI: 10.1111/obr.12119.
[14]	"中国健康与营养调查"项目组. 1989-2009年中国九省区居民膳食营养素摄入状况及变化趋势(一)健康与营养调查项目总体方案[J]. 营养学报, 2011, 33(3): 234-236. https://www.cnki.com.cn/Article/CJFDTOTAL-YYXX201103014.htm "The China Health and Nutrition Survey" research team. The trends of nutrients intake of Chinese residents in nine provinces from 1989 to 2009 (I)"The China Health and Nutrition Survey" project design[J]. Acta Nutnmenta Sinica, 2011, 33(3): 234-236. https://www.cnki.com.cn/Article/CJFDTOTAL-YYXX201103014.htm
[15]	中国疾病预防控制中心营养与食品安全所, 湖北省疾病预防控制中心, 首都儿科研究所, 等. WS/T 424-2013人群健康监测人体测量方法[S]. 北京: 中华人民共和国卫生部, 2013. Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Hubei Provincial Center for Disease Control and Prevention, Children's Hospital Affiliated to Capital Institute of Pediatrics, et al. WS/T 424-2013 Anthropometric measurements method in health surveillance[S]. Beijing: Ministry of Health of the People's Republic of China, 2013.
[16]	中国肥胖问题工作组. 中国学龄儿童青少年超重、肥胖筛查体重指数值分类标准[J]. 中华流行病学杂志, 2004, 25(2): 97-102. DOI: 10.3760/j.issn:0254-6450.2004.02.003. Group of China Obeisty Task Force, Body mass index referrence norm for screening overweight and obesity in Chinese children and adolescents[J]. Chin J Epidemiol, 2004, 25(2): 97-102. DOI: 10.3760/j.issn:0254-6450.2004.02.003.
[17]	中国营养学会. 中国居民膳食营养素参考摄入量[J]. 营养学报, 2001, 23(3): 193-196. doi: 10.3321/j.issn:0512-7955.2001.03.001 Chinese Society for Nutrition, Chinese dietary reference intakes[J]. Acta Nutrimenta Sinica, 2001, 23(3): 193-196. doi: 10.3321/j.issn:0512-7955.2001.03.001
[18]	Emmett PM, Jones LR. Diet, growth, and obesity development throughout childhood in the Avon Longitudinal study of parents and children[J]. Nutr Rev, 2015, 73(Suppl 3): 175-206. DOI: 10.1093/nutrit/nuv054.
[19]	Gupta N, Goel K, Shah P, et al. Childhood obesity in developing countries: epidemiology, determinants, and prevention[J]. Endocr Rev, 2012, 33(1): 48-70. DOI: 10.1210/er.2010-0028.
[20]	中华人民共和国国家卫生和计划生育委员会. WS/T 428—2013成人体重判定[S]. 北京: 中国标准出版社, 2013. National Health and Family Planning Commission of the People's Republic of China. WS/T 428—2013 Criteria of weight for adults[S]. Beijing: Standards Press of China, 2013.
[21]	Rubin DB. Missing Data, Imputation, and the bootstrap: comment[J]. J Am Stat Assoc, 1994, 89(426): 475-478. DOI: 10.1080/01621459.1994.10476768.
[22]	Jia P, Xue H, Zhang J, et al. Time trend and demographic and geographic disparities in childhood obesity prevalence in China-evidence from twenty yars of longitudinal data[J]. Int J Environ Res Public Health, 2017, 14(4): 369. DOI: 10.3390/ijerph14040369.
[23]	Tudor-Locke C, Ainsworth BE, Adair LS, et al. Physical activity and inactivity in Chinese school-aged youth: the China Health and Nutrition Survey[J]. Int J Obes Relat Metab Disord, 2003, 27(9): 1093-1099. DOI: 10.1038/sj.ijo.0802377.
[24]	苏畅, 王惠君, 王志宏, 等. 中国9省区1991—2009年7~17岁儿童青少年膳食脂肪和胆固醇摄入状况及变化趋势[J]. 中华流行病学杂志, 2012, 33(12): 1208-1212. DOI: 10.3760/cma.j.issn.0254-6450.2012.12.002. Su C, Wang HJ, Wang ZH, et al. Current status and trends of both dietary fat and cholesteroI intake among Chinese children and adolescents aged 7 to 17 years old in 9 provinces of China, from 1991 to 2009[J]. Chin J Epidemiol, 2012, 33(12): 1208-1212. DOI: 10.3760/cma.j.issn.0254-6450.2012.12.002.
[25]	Al-Jawaldeh A, Taktouk M, Nasreddine L. Food consumption patterns and nutrient intakes of children and adolescents in the Eastern Mediterranean Region: a call for policy action[J]. Nutrients, 2020, 12(11): 3345. DOI: 10.3390/nu12113345.
[26]	Hooper L, Abdelhamid A, Bunn D, et al. Effects of total fat intake on body weight[J]. Cochrane Database Syst Rev, 2015, 8(8): CD011834. DOI: 10.1002/14651858.CD011834.
[27]	Costa CS, Del-Ponte B, Assunção MCF, et al. Consumption of ultra-processed foods and body fat during childhood and adolescence: a systematic review[J]. Public Health Nutr, 2018, 21(1): 148-159. DOI: 10.1017/S1368980017001331.
[28]	Zhen S, Ma Y, Zhao Z, 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.
[29]	Poti JM, Duffey KJ, Popkin BM. The association of fast food consumption with poor dietary outcomes and obesity among children: is it the fast food or the remainder of the diet?[J]. Am J Clin Nutr, 2014, 99(1): 162-171. DOI: 10.3945/ajcn.113.071928.
[30]	Naja F, Hwalla N, Itani L, et al. A Western dietary pattern is associated with overweight and obesity in a national sample of Lebanese adolescents (13-19 years): a cross-sectional study[J]. Br J Nutr, 2015, 114(11): 1909-1919. DOI: 10.1017/S0007114515003657.
[31]	Ambrosini GL, Emmett PM, Northstone K, et al. Tracking a dietary pattern associated with increased adiposity in childhood and adolescence[J]. Obesity (Silver Spring), 2014, 22(2): 458-465. DOI: 10.1002/oby.20542.
[32]	Bujnowski D, Xun P, Daviglus ML, et al. Longitudinal association between animal and vegetable protein intake and obesity among men in the United States: the Chicago Western Electric Study[J]. J Am Diet Assoc, 2011, 111(8): 1150-1155. e1. DOI: 10.1016/j.jada.2011.05.002.
[33]	Alkerwi A, Sauvageot N, Buckley JD, et al. The potential impact of animal protein intake on global and abdominal obesity: evidence from the Observation of Cardiovascular Risk Factors in Luxembourg (ORISCAV-LUX) study[J]. Public Health Nutr, 2015, 18(10): 1831-1838. DOI: 10.1017/S1368980014002596.
[34]	Lin Y, Bolca S, Vandevijvere S, et al. Plant and animal protein intake and its association with overweight and obesity among the Belgian population[J]. Br J Nutr, 2011, 105(7): 1106-1116. DOI: 10.1017/S0007114510004642.
[35]	Min S, Bai Jf, Seale J, et al. Demographics, societal aging, and meat consumption in China[J]. J Integr Agric, 2015, 14(6): 995-1007. DOI: 10.1016/S2095-3119(14)60984-9.
[36]	Wang Z, Zhang B, Zhai F, et al. Fatty and lean red meat consumption in China: Differential association with Chinese abdominal obesity[J]. Nutr Metab Cardiovasc Dis, 2014, 24(8): 869-876. DOI: 10.1016/j.numecd.2014.03.002.
[37]	Zhang J, Hayden K, Jackson R, et al. Association of red and processed meat consumption with cardiovascular morbidity and mortality in participants with and without obesity: a prospective cohort study[J]. Clin Nutr, 2020, S0261-5614(20): 30705-30706 DOI: 10.1016/j.clnu.2020.12.030.
[38]	Hoppe C, Udam TR, Lauritzen L, et al. Animal protein intake, serum insulin-like growth factor I, and growth in healthy 2.5-y-old Danish children[J]. Am J Clin Nutr, 2004, 80(2): 447-452. DOI: 10.1093/ajcn/80.2.447.
[39]	Voortman T, van den Hooven EH, Tielemans MJ, et al. Protein intake in early childhood and cardiometabolic health at school age: the Generation R Study[J]. Eur J Nutr, 2016, 55(6): 2117-2127. DOI: 10.1007/s00394-015-1026-7.
[40]	Ambrosini GL, Emmett PM, Northstone K, et al. Identification of a dietary pattern prospectively associated with increased adiposity during childhood and adolescence[J]. Int J Obes (Lond), 2012, 36(10): 1299-1305. DOI: 10.1038/ijo.2012.127.
[41]	Maffeis C, Schutz Y, Grezzani A, et al. Meal-induced thermogenesis and obesity: is a fat meal a risk factor for fat gain in children?[J]. J Clin Endocrinol Metab, 2001, 86(1): 214-219. DOI: 10.1210/jcem.86.1.7132.