营养改善计划对义务教育学生营养及健康状况影响的效果评估

发布时间：2018-05-18 20:05

本文选题：营养改善计划 + 中小学生　；参考：《新疆医科大学》2017年硕士论文

【摘要】：目的:了解新疆兵团下属农村义务教育学生营养及健康状况,分析其影响因素并评估营养改善计划实施效果,为改善农村地区学生营养状况提供科学依据和建议。方法:1.采用记账法对中小学生的食物摄入情况进行调查,根据《食物成分表》计算出能量及主要营养素摄入状况,计算人均摄入量并参考2013年膳食营养素参考摄入量(DRIs)同年龄段参考摄入量平均水平计算达标比例。2.按照标准测量方法测量监测学生的身高体重,并参考《2010年中国学生体质与健康调研报告》判定生长迟缓、消瘦及超重肥胖的检出率。3.采用氰化高铁血红蛋白法检测中小学生血红蛋白浓度,按诊断标准计算贫血患病率,并测定血清维生素A和维生素D浓度。数据整理后采用SPSS21.0统计软件分年龄、性别进行描述分析并与2011年基线数据分析比较。结果:1.各学校粮谷类(324.35g)和食用油(22.22g)供给量适宜,蔬菜(269.86g)、禽畜肉(51.31g)、蛋(48.26g)和奶(85.24g)供给量不足,而豆类(17.14g)供给量严重不足,一半以上学校摄入量为0,各学年监测结果与2011年基线数据比较,差异无统计学意义(F=1.23,P0.05)。各学校能量(1995.73kcal)、蛋白质(57.08g)、维生素A(554.87μgRE)、铁(16.55mg)和锌(8.74mg)的供给量适宜,而维生素C(63.47mg)、钙(831.95mg)的供给量不足,将连续4学年监测数据与2011年基线数据进行比较后,差异具有统计学意义(F=353.64,P0.05)。2.所调查学生身高男生8~18岁低于全国平均水平,女生8~14岁低于全国平均水平,男女生均在15~18岁低于新疆平均水平;体重男生13~18岁低于全国及新疆平均水平,女生18~岁低于全国平均水平,14~18岁除16~岁组低于新疆平均水平,且差异均具有统计学意义(P0.05)。3.总生长迟缓率为6.8%,男生(8.1%)高于女生(5.2%)且差异具有统计学意义(?2=95.40,P0.001)。不同年龄比较,在高年龄组(17~18岁)生长迟缓检出率最高(?2=385.26,P0.001)。总消瘦率为6.6%,男生(7.6%)高于女生(5.5%)且差异具有统计学意义(Z=49.40,P0.001)。不同年龄组比较,16~18岁组消瘦率最高且差异具有统计学意义(?2=88.89,P0.001)。不同学年与基线数据比较,营养不良率逐年降低且存在统计学差异。非条件logistics回归分析,性别、年龄、粮谷类、能量、蛋白质为营养不良的影响因素。4.总超重率为9.0%,其中男生10.6%,女生7.2%;总肥胖率为3.5%,男生4.2%,女生2.7%。男女生超重肥胖率比较差异具有统计学意义(Z=153.18,P0.001),不同年龄比较,低年龄组(6~8岁)超重肥胖高发,差异具有统计学意义(?2=153.18,P0.001)。不同学年与基线数据比较,超重肥胖率均无统计学差异。非条件logistics回归分析,性别、食用油类、能量和蛋白质为超重肥胖的影响因素。5.总贫血患病率为14.4%,其中男生14.7%,女生14.1%,男女生贫血检出率比较,差异无统计学意义(?2=0.33,P=0.56)。不同年龄组比较,11~12岁组贫血患病率最高且差异具有统计学意义(?2=57.60,P0.001)。不同学年与基线数据比较,贫血患病率逐年降低。经非条件logistics回归分析,性别、畜禽肉类、维生素A、铁、钙为贫血的影响因素。血清维生素A和维生素D水平测定结果均低于参考值,男女生维生素A水平无性别差异而维生素D水平存在性别差异(t=4.97,P0.001)。结论:1.所监测兵团农村学校义务教育学生膳食结构不合理,营养素摄入不均衡。营养改善计划后食物供给及能量营养素摄入有较大提高,但豆类食物供给量偏低,营养素方面,蛋白质、钙以及铁的供给量需增加。2.所监测对象高年龄组学生的身高、体重未达到全国及新疆平均水平,男生较女生达标程度低。3.男生较于女生更容易发生营养不良及超重肥胖,提示男生是营养监测及改善的重点对象。在年龄方面,高年龄组营养不良高发,低年龄组易发超重肥胖。4.相比于实施营养改善计划之前,学生的营养状况有较大改善,营养不良率明显呈现降低趋势。5.营养改善计划实施后贫血患病率明显降低;血清维生素A和维生素D检测结果远低于参考值,且男女生维生素D水平存在差异。需增加富含维生素A、D食物供给,改善本地区学生营养状况。
[Abstract]:Objective: to understand the nutrition and health status of the students in rural compulsory education in Xinjiang corps, analyze the influencing factors and evaluate the effect of the nutrition improvement program, and provide scientific basis and suggestions for improving the nutritional status of the students in rural areas. Method: 1. the food intake of primary and middle school students is investigated by the accounting method, according to the food composition. Table > calculate the energy and main nutrient intake, calculate the per capita intake and refer to the average level of dietary intake (DRIs) in 2013 and the average age reference intake of.2., measure the height and weight of the students according to the standard measurement method, and take the examination report of the Chinese students' health and health for the year <2010. The detection rate of growth retardation, emaciation and overweight and obesity.3. was used to detect the hemoglobin concentration of primary and middle school students by cyanide hemoglobin method. The prevalence rate of anemia was calculated according to the diagnostic criteria, and the serum vitamin A and vitamin D concentration were measured. After data arrangement, the SPSS21.0 statistical software was used to describe the age, sex and the basis of the 2011 basis. Results: 1. the supply of cereals (324.35g) and edible oil (22.22g) was suitable, the supply of vegetables (269.86g), livestock meat (51.31g), egg (48.26g) and milk (85.24g) was insufficient, while the supply of beans (17.14g) was insufficient, and the intake of more than half of the school was 0. The monitoring results of each school year were not different from the baseline data in 2011. Statistical significance (F=1.23, P0.05). Each school energy (1995.73kcal), protein (57.08g), vitamin A (554.87 u gRE), iron (16.55mg) and zinc (8.74mg) supply is suitable, while vitamin C (63.47mg), calcium (831.95mg) supply is insufficient, the continued 4 school year monitoring data compared with the baseline data in 2011 (F=35), the difference has statistical significance (F=35). 3.64, P0.05) the students' height in.2. was lower than the national average, and the girls' 8~14 years were lower than the national average. The average male and female students were lower than the average level of Xinjiang at the age of 15~18; the weight boys were lower than the national and Xinjiang average, and the girls were lower than the national average in 18~ years, and the 14~18 age group was lower than the average level of Xinjiang, and the age of 14~18 was lower than the average level of Xinjiang. The difference was statistically significant (P0.05).3. total growth retardation rate was 6.8%, boys (8.1%) higher than girls (5.2%) and the difference was statistically significant (2=95.40, P0.001). In the high age group (17~18 years), the growth retardation detection rate was the highest (2= 385.26, P0.001). The total emaciation rate was 6.6%, boys (7.6%) was higher than the girls (5.5%) and the difference was Statistical significance (Z=49.40, P0.001). The rate of emaciation in different age groups was the highest and the difference was statistically significant (2=88.89, P0.001). Compared with baseline data, the rate of malnutrition decreased year by year and there were statistical differences. The non conditional logistics return analysis, sex, age, grain, energy and protein were not nutritious. The total overweight rate of.4. was 9%, including 10.6% for boys and 7.2% for girls; the total obesity rate was 3.5%, boys were 4.2%, and the rate of overweight and obesity in female 2.7%. boys and girls was statistically significant (Z=153.18, P0.001). The difference was statistically significant (2=153.18, P0.001) in different age groups (6~8 years). Compared with baseline data, there was no significant difference in the rate of overweight and obesity. Non conditional logistics regression analysis, sex, edible oil, energy and protein were 14.4% of the prevalence of.5. anemia, among which boys were 14.7%, girls 14.1%, and there was no statistical difference between men and women (? 2=0.33, P=0.56). Compared with the age group, the prevalence rate of anemia in 11~12 group was the highest and the difference was statistically significant (2=57.60, P0.001). The incidence of anemia decreased year by year compared with baseline data. Non conditional logistics regression analysis, sex, livestock meat, vitamin A, iron, calcium were the factors of anemia. Serum vitamin A and vitamin D levels were measured. The results were all lower than the reference value. There was no gender difference in the level of vitamin A between male and female and there was a gender difference between the vitamin D level (t=4.97, P0.001). Conclusion: the dietary structure of the compulsory education students in the 1. rural schools was not reasonable and the nutrient intake was not balanced. The supply of food is low. The supply of nutrients, protein, calcium and iron needs to increase the height of the students in the high age group of.2.. The weight does not reach the national and the average level of the Xinjiang. The boys are less likely to have malnutrition and overweight and obesity compared with the girls, and the boys are lower than the girls' standard of.3.. In terms of age, high age group, high age group, high incidence of malnutrition, low age group and overweight and obese.4., the nutritional status of students improved significantly before implementing the nutrition improvement program, the rate of malnutrition decreased obviously and the prevalence rate of anemia was significantly reduced after the implementation of.5. nutrition improvement program; serum vitamin A and vitamin D were significantly reduced. The results of the D test were far below the reference value, and there were differences in vitamin D levels between male and female students. It was necessary to increase the vitamin A, the supply of D food and improve the nutritional status of the students in the region.
【学位授予单位】：新疆医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R153.2

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