中国西部脱贫地区小学生体重状态和饮食行为干预效果研究

Objective To assess the effect of a comprehensive school-based intervention on weight status and eating behaviors among primary school students in poverty alleviation areas in western China,in order to provide reference for improving the nutritional preoblems of children in impoverished area. Methods Six primary school students in grades 2 - 5 were selected from three poverty alleviation counties in Shaanxi and Sichuan province,and a baseline survey and whole-cluster randomised controlled intervention study were conducted from November 2020 to June 2022,with 18-month malnutrition prevention and control and unhealthy lifestyle behavior improvement in the intervention group and myopia prevention and control education in the control group.A total of 1 160 students were included at baseline and 1 079 were followed up at the end,with 602 and 477 participants in the intervention and control groups,respectively.Physical examination and frequency of eating behavior questionnaires were administered to the students,and mixed-effects models were used to assess the effect of the intervention. Results After the intervention,the risks of overweight/obesity (OR=0.60) and wasting (OR=0.47) in the intervention group were reduced compared with those in the control group(P<0.05).Regional stratified analysis showed that the risk of overweight/obesity (OR=0.54) and wasting (OR=0.31) was reduced in the intervention group in Shaanxi compared with that in the control group (P<0.05).The results of dietary behavior showed that the average weekly frequency of egg (β=0.41),milk (β=0.84) and fruit (β=0.43) intake in the intervention group was higher than that in the control group after the intervention(P<0.05).The results in the two provinces were different,with an increase in the frequency of egg (β=0.36 and 0.54,respectively) and milk (β=0.96 and 0.64,respectively) intake in the intervention group compared with that in the control group in both Shaanxi and Sichuan(P<0.05);the frequency of fried food (β=0.50) and candy (β=0.64) intake increased in the Sichuan intervention group compared with the control group(P<0.05). Conclusions Comprehensive school-based interventions can reduce the risk of obesity and wasting,and improve the weight status and dietary intake of students in rural poverty alleviation areas in China,but there are regional differences in the effectiveness of interventions.