Analysis Of Nutritional Health Of Students In The Compulsory Education Stage In Rural Areas Of Jilin Province

Objective:This study analyzed the monitoring data of students’height,weight and hemoglobin in the pilot areas of the"Nutrition Improvement Program for Rural Compulsory Education Students"（referred to as"NIPRCES"）in Jilin Province from 2014 to 2017.The program revealed the growth parameters and nutritional health status of students who were in the compulsory education stage and living in rural areas of Jilin Province.The trend of students’overweight,obesity,wasting and anemia rate were analyzed to provide scientific based evidence for the formulation of prevention and intervention strategies for malnutrition among students who are living in rural areas.Methods:The study used stratified random cluster sampling method to collect data from three counties in Jilin Province which were selected as pilot monitoring counties for the NIPRCES program.In 2017,an additional county was added and all monitoring counties were divided into routine monitoring counties and key monitoring counties.Base on the food supply patterns（eat at school canteen,made by catering company,self-prepared）for students at each school,the study randomly selected 12 primary and junior high schools from all monitoring areas.In key monitoring counties,2 primary and 2 junior high schools with each type of food supply pattern were selected as key monitoring schools.In each school,1 to 2 classes were randomly selected from Grade1 to Grade 8.Approximately 40 students with equal gender proportion were chose from each grade for physical examinnations and blood test.In all monitoring schools,students were recruited for regular physical examines like height and weight.Andblood samples are also collected for students in key monitoring schools.Data was documented in Excel and analyzed with SPSS24.0 software.Measurement data such as height and weight of students were expressed as mean±standard deviation;independent samples T test and analysis of variance were used to analyze the differences in students’height and weight between different genders,ages and years.Single-sample T test was used to compare the average height and weight of the study population with the average height and weight of children from the 2014 National Physical Fitness Survey.Descriptive analysis used frequency and rate to express the overweight,obesity,wasting and anemia among students,and the trend of detection rates of overweight,obesity,wasting and anemia among students with different demographic factors were analyzed.Results:（1）This study used the monitoring data of students aged 6 to 15 from the NIPRCES program in rural areas of Jilin from 2014 to 2017.From 2014 to 2017,there was a total of 8,455 students in key monitoring counties and 13,088 students in routine monitoring counties in Jilin Province’s NIPRCES area;a total of 2,554 students in key monitoring schools and 18,989 students in routine monitoring schools.From 2014 to 2017,there were 5,659,5,163,4,815,and 5,906 students participating in height and weight monitoring in the monitoring area,respectively.Students participated in blood sample collection between 2014 to 2017 were 698,715,733 and 730,respectively.（2）From 2014 to 2017,the average height of students in the areas of Jilin Province’s NIPRCES increased by 0.6 cm,and the average weight of students increased by 1.0 kg.From 2014 to 2017,the average height of primary school students increased by 0.1cm.The average weight of primary school students increased by 0.8kg.From2014 to 2017,the average height of junior high school students increased by 0.8cm.The average weight of junior high school students increased by 0.7kg.（3）The average height of boys aged 6 to 8 and 13 to 15 were greater than girls with the same age,and the average weight of boys aged 6 to 10 and 13 to 15 were greater than girls with the same age.The average height and weight of students from all age groups in key monitoring counties were greater than students in routine monitoring counties.The average height of students in key monitoring schools was greater than the average height of students in routine monitoring schools in the age groups of 9,10,and 13-15 years old.The average weight of students in key monitoring schools was greater than routine monitoring schools between the age group 10,13 and14.（4）From 2014 to 2017,the overall detection rate of overweight and obesity was14.7%,the detection rate of obesity was 8.8%,the total detection rate of overweight and obesity was 23.5%,and the detection rate of wasting was 5.7%.The overall detection rate of overweight in students increased from 14.3%in 2014 to 15.9%in 2017,which showed an increasing trend(c~2_trend=5.697,P=0.017).The overall obesity rate among students increased from 7.1%in 2014 to 10.3%in 2017,and the detection rate of obesity showed an increasing trend(c~2_trend=39.568,P<0.001).The overall wasting detection rate among students decreased from 6.7%in 2014 to 5.3%in 2017,showing a decreasing trend(c~2_trend=16.421,P<0.001).The detection rate of overweight,obesity and wasting in boys was higher than girls(c~2 _overweight=75.512,P<0.001;c~2_obesity=52.907,P<0.001;c~2_wasting=6.182,P=0.013).The detection rate of obesity and wasting in primary school students was higher than junior high school students(c~2_obesity=234.528,P<0.001;c~2_wasting=9.046,P=0.003).The detection rate of student wasting in key monitoring counties is lower than that in routine monitoring counties（c~2=49.834,P<0.001）.The detection rate of wasting among students in key monitoring schools is lower than that in routine monitoring schools（c~2=24.709,P<0.001）.The difference of overweight,obesity and wasting was statistically significant(c~2_overweight=8.141,P=0.017;c~2_obesity=280.923,P<0.001;c~2_wasting=9.231,P=0.01).（5）From 2014 to 2017,the overall anemia detection rate among students in the rural areas of Jilin Province from the NIPRCES program was 6.2%.Among them,the overall detection rate of anemia in boys was 5.2%,and the detection rate of anemia in girls was 7.4%.The detection rate of anemia in girls was higher than boys（c~2=5.593,P=0.018）.The detection rates of anemia in students monitored from 2014 to 2017 were7.4%,6.9%,3.7%and 7.0%respectively,among which,the detection rates of anemia in boys were 7.7%,5.7%,2.3%and 5.4%respectively,and in girls,7.2%,8.3%,5.3%and 8.7%respectively.The detection rate of anemia in boys showed a decreasing trend.The detection rate of anemia in girls showed a decreasing trend at first and then increased with the increase of ages.The overall anemia detection rate of primary school students was 5.2%,and the anemia detection rate of junior high school students was8.1%.The anemia detection rate of junior high school students was higher than primary school students（c~2=9.248,P=0.002）.The overall anemia detection rates were 6.1%,4.4%and 8.1%in grade 1 to 3 of primary school,grade 4 to 6 of primary school and grade 1 to 3 of junior middle school,respectively.The difference in anemia detection rates was statistically significant（c~2=11.431,P=0.003）.Conclusion:（1）From 2014 to 2017,the average height and weight of primary school students and junior high school students in the rural areas of Jilin Province increased,and growth parameters were conformed to the general rules of growth.（2）From 2014 to 2017,the detection rates of overweight and obesity among students in rural areas of Jilin Province showed an increasing trend.And the detection rate of wasting showed a decreasing trend but was still at a relatively high level.This suggests that in the rural areas of Jilin Province from the NIPRCES program should pay more attention to students’reasonable meals and other aspects while implementing measures such as dietary subsidies to reduce students’overweight and obesity.Moreover,it is necessary to continuously explore more reasonable plans to improve the nutritional health of students,so that the wasting of students gradually tends to be lower.（3）From 2014 to 2017,the detection rate of anemia in boys in the rural areas of Jilin Province showed a decreasing trend,and the detection rate of anemia in girls showed an increasing trend with the increase of age.At the same time,the overall anemia detection rate of students is still at a high level,indicating that the improvement of anemia status of students is still followed up,and more attention should be paid to the anemia status of girls in adolescence and later.