| ObjectiveTo analyze the physical growth status and the prevalence of dietary behavior problems of children aged 3?6 years in five cities in 2020,and to explore the relationship between children's nutritional status and dietary behavior,so as to provide theoretical basis for improving children's nutritional status,correcting incorrect dietary and feeding behaviors,and developing dietary behavior evaluation and intervention tools suitable for children in China.MethodsSubjectsThis study is a part of the basic resources survey project of the Ministry of Science and Technology of the People's Republic of China "Nutrition and Health System Survey and Application Project for Chinese Children Aged 0?18".Using the method of multi-stage cluster random sampling,two kindergartens of 3?6 years old in Tonghua City of Jilin Province,Nanchang City of Jiangxi Province,Changsha City of Hunan Province,Kunming City of Yunnan Province,and Weinan City of Shanxi Province were selected.The total sample size was 1741.MethodsFrom July 2019 to December 2020,data of physical growth,nutritional status and dietary behavior of children aged 3?6 years old in five cities were obtained from physical examination,laboratory test and questionnaire survey.The indexes of physical growth include height,sitting height and weight.The evaluation indexes of children's nutritional status include low weight,growth retardation,emaciation,overweight,obesity and anemia.The dietary behavior in this paper includes two parts:Children's dietary behavior and caregiver's feeding behavior.Using factor analysis to extract common factors of dietary behavior classification,children's dietary behavior problems and caregiver feeding behavior problems were divided into four dietary behavior and four feeding behavior dimensions.By using the quantitative scoring method,the scores of each dietary behavior dimension were divided into Q1(lower quartile),Q2(median)and Q3(upper quartile)according to the percentile.The group with dietary behavior dimension score more than Q3 was defined as the group with dietary behavior problems of this dimension,and the group with dietary behavior dimension score more than Q1 and less than Q3 was defined as the group without dietary behavior problems of this dimension,the group with the score of eating behavior dimension less than Q1 was defined as the group without eating behavior problem.SPSS 23.0 software was used to analyze chi square test and binomial logistic regression analysis were used to explore the relationship between nutritional status and dietary behavior of children aged 3?6 years.P<0.05 showed that the difference was statistically significant.Results1.The average height and weight of boys and girls aged 3-6 in five urban areas exceeded the WHO reference standard for growth and development of children under 7 years old,and the differences were statistically significant(P<0.05).The difference between the height of 4.5?and 5.5?6.0 years old boys and who reference standard was the largest,exceeding 3.5cm;The difference between the height of 5.5?6.0 years old girls and who reference standard was the largest,exceeding 2.5cm;The difference between the weight of 5.5?6.0 years old children and who reference standard was the largest,which was more than 2.4kg for boys and 1.5kg for girls.Compared with the physical development survey of children in nine cities in 2015,except that the average height and weight of boys in 4.5?years old group and the average weight of boys in 5.5?6.0 years old group were slightly higher than those of children of the same age group in nine cities,the height and weight of boys and girls in other age groups were lower than or equal to those in nine cities,And the difference was statistically significant(P<0.05).2.This study found that the low weight rate of 3?6 years old children in five cities was 0.52%.The low weight rate of 3?years old group(1.57%)was higher than that of 4?years old group and 5?6 years old group.The growth retardation rate of children was 1.09%.The growth retardation rate of 3?years old group(2.27%)was higher than that of 4?years old group and 5?6 years old group.The weight loss rate of children was 1.03%.The overweight rate of children was 3.04%.The overweight rate of boys(4.10%)was significantly higher than that of girls(1.97%).The obesity rate of children was 0.92%.The obesity rate of only child group(1.45%)was higher than that of non only child group(0.36%).The prevalence of anemia in children was 4.31%.The incidence of anemia in cesarean section group(5.46%)was higher than that in vaginal delivery group(3.27%).The incidence of anemia in housework group(6.40%)was higher than that in production or service industry and institution group.3.The prevalence of dietary behavior problems is different in different age groups.The main dietary behavior problems of children aged 3?years old,4?years old and 5?6 years old were that they often only ate their favorite food(the prevalence rates were 40.73%,47.04%and 43.79%,respectively),and often refused to try the food they didn't like(the prevalence rates were 40.56%,39.50%and 42.16%,respectively).Compared with the 3?years old and 4?years old children,the proportion of children in the 5?6 years old group eating with chopsticks or spoons,choosing food by themselves and eating at the same table with adults increased.4.The prevalence of feeding behavior problems of caregivers in different age groups is different.The main feeding behavior problems of 3?years old,4?years old and 5?6 years old children caregivers were food selection and cooking,seldom asking for children's opinions(prevalence rate was 37.94%,28.19%and 23.69%,respectively),and often letting children eat as much as possible(prevalence rate was 22.55%,24.06%and 27.45%,respectively).Compared with 3-years old and 4?years old children,the proportion of children in 5?6 years old group who do not need caregivers to feed,and who put forward opinions on food selection and cooking has increased.5.In the study of the relationship between children's nutritional status and dietary behavior,logistic regression analysis showed that dietary restriction(OR=4.720,95%CI:1.406?15.841)was a risk factor for growth retardation,bad eating habits(OR=3.644,95%CI:1.006?13.339)was a risk factor for weight loss,bad eating habits(OR=1.503,95%CI:1.003?3.026)and lack of encouraging healthy diet(OR=2.322,95%CI:1.014?5.315)were risk factors for overweight,forced feeding(OR=1.961,95%CI:1.074?3.582)was a risk factor for anemia in children.Conclusion1.The average height,sitting height and weight of children aged 3?6 in five urban areas of China increased with age,and the average height and weight of boys and girls in this age group were all higher than the WHO reference standard for the growth and development of children under 7 years old;The average height and weight of boys and girls in most age groups were lower than or equal to the physical development standard of children in nine cities in 2015.2.Growth retardation and overweight are the main nutritional problems of 3?6 years old children in five cities of China.Therefore,scientific feeding guidance should be strengthened to help children establish good eating habits and actively improve their malnutrition.3.The prevalence of dietary and feeding behavior problems among 3?6 years old children and their caregivers in five cities of China is high.It is not only necessary to change children's dietary behavior and promote their good eating habits,but also to strengthen their feeding knowledge and improve their nutrition and health literacy.4.Bad eating habits,forced feeding,lack of encouraging healthy diet and dietary behavior restriction are the main factors affecting the nutritional status of children aged 3?6 in five cities.Caregivers should provide children with a good dining atmosphere,increase the types of food,pay attention to cooking methods,and respect children's subjective eating intention. |
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