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Article(id=1241759334078681092, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241759317016252418, articleNumber=null, orderNo=null, doi=10.20043/j.cnki.MPM.202404076, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1712160000000, receivedDateStr=2024-04-04, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1773988096017, onlineDateStr=2026-03-20, pubDate=1727193600000, pubDateStr=2024-09-25, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1773988096017, onlineIssueDateStr=2026-03-20, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1773988096017, creator=13701087609, updateTime=1773988096017, updator=13701087609, issue=Issue{id=1241759317016252418, tenantId=1146029695717560320, journalId=1227665162245664772, year='2024', volume='51', issue='18', pageStart='3265', pageEnd='3456', issueExtLink='null', onlineDate='null', pubDate='null', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1773988091898, creator=13701087609, updateTime=1773991617194, updator=13701087609, preIssue=null, nextIssue=null, ext={EN=IssueExt(id=1241774103024174010, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241759317016252418, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1241774103024174011, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241759317016252418, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null}, startPage=3307, endPage=3313, ext={EN=ArticleExt(id=1241759335320195092, articleId=1241759334078681092, tenantId=1146029695717560320, journalId=1227665162245664772, language=EN, title=Associations on status of sugar-sweetened beverages instake and correlation of cognition and intake behavior among primary and secondary students, columnId=null, journalTitle=Modern Preventive Medicine, columnName=null, runingTitle=null, highlight=null, articleAbstract=
Objective

To understand intake frequency of sugar-sweetened beverages (SSBs) and the consumption habit among primary and secondary students. To explore the relationship of SSBs cognition and behavior，and to provide a basis for reducing students’ intake of SSBs.

Methods

A multi-stage sampling process was employed to select subjects from primary and middle school in Shenzhen. Network questionnaire survey was conducted to collecting information in September and October, 2021. Spearman rank correlations was used to analyze relationships of various types of SSBs consumption frequency. Multivariable linear regression model was used to examine the relationship between SSBs cognition score and consumption frequency score. Hierarchical analysis to explore the interactions.

Results

A total of 16 840 primary and secondary students aged 6 to 18 years old were included. The prevalence of SSBs consumption at least 3 time/week was 58.9%, the grades 1-3, 4-6 and middle school students were 52.3%, 60.3% and 67.6%. Parents (73.3%) were the main buyers of SSBs, convenience stores (73.7%) were the main places and delicious (77.2%) was the major cause of choices. There was a positive correlation between the intake frequency of different types of SSBs (P<0.001). The results of multivariate linear regression showed that the higher the cognition was, the lower the intake frequency of SSBs was (β=0.179, 95%CI：0.155-0.204). There was a multiplicative interaction between the cognitive score of SSBs and the educational level of parents (P<0.00l).

Conclusion

The intake frequency of SSBs was high among primary and middle school students in Shenzhen, and the cognitive level of SSBs was related to the intake frequency and the educational level of parents.

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目的

了解中小学生含糖饮料摄入频次及购买习惯，并探究含糖饮料认知和行为的关系，为减少学生含糖饮料摄入提供依据。

方法

采用多阶段抽样的方法以深圳市中小学生为研究对象，于2021年9至10月通过网络发放问卷收集相关信息。Spearman秩相关分析不同类型含糖饮料摄入频次之间的相关关系，多因素线性回归模型分析含糖饮料认知得分与摄入频次得分之间的关系，分层分析探讨可能存在的交互作用。

结果

共纳入6~18岁中小学生16 840名。含糖饮料总摄入量≥3次/周占比为58.9%，一～三年级、四～六年级和中学生分别为52.3%、60.3%和67.6%。父母(73.3%)为含糖饮料的主要购买人，便利店(73.7%)为主要购买场所，“好喝”(77.2%)是主要选择原因。不同类型的含糖饮料摄入频次之间均具有正相关关系(P<0.001)。多因素线性回归结果显示，含糖饮料认知得分越高者其含糖饮料摄入频次越低(β =0.179，95% CI：0.155~0.204)。含糖饮料认知得分与父母文化水平对学生含糖饮料摄入频次存在相乘交互作用(P<0.001)。

结论

深圳市中小学生含糖饮料摄入频次较高，含糖饮料认知水平与摄入频次以及父母文化水平有关。

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李艳艳，E-mail:
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张双霞(1997—)，女，硕士，公卫医师，研究方向：儿童青少年慢性病防控与营养健康教育

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张双霞(1997—)，女，硕士，公卫医师，研究方向：儿童青少年慢性病防控与营养健康教育

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张双霞(1997—)，女，硕士，公卫医师，研究方向：儿童青少年慢性病防控与营养健康教育

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Advances in Psychological Science, 2020, 28(12): 2052-2063.（In Chinese), articleTitle=Nudging strategies to promote healthy eating behavior, refAbstract=null), Reference(id=1241759377976267043, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241759334078681092, doi=null, pmid=null, pmcid=null, year=2021, volume=42, issue=4, pageStart=506, pageEnd=509, url=null, language=null, rfNumber=[25], rfOrder=38, authorNames=徐玉祥, 江伟康, 赵莉, journalName=中国学校卫生, refType=null, unstructuredReference=徐玉祥，江伟康，赵莉，等．含糖饮料摄入模式与儿童肥胖关联的纵向研究[J]．中国学校卫生，2021，42（4）：506-509．, articleTitle=含糖饮料摄入模式与儿童肥胖关联的纵向研究, refAbstract=null), Reference(id=1241759378139844904, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241759334078681092, doi=null, pmid=null, pmcid=null, year=2021, volume=42, issue=4, pageStart=506, pageEnd=509, url=null, language=null, rfNumber=[25], rfOrder=39, authorNames=Xu YX, Jiang WK, Zhao L, journalName=Chinese Journal of School Health, refType=null, unstructuredReference=Xu YX, Jiang WK, Zhao L, et al. A cohort study on the association between sugar-sweetened beverage intake and childhood obesity using a group-based trajectory model[J]. Chinese Journal of School Health, 2021, 42(4): 506-509.（In Chinese), articleTitle=A cohort study on the association between sugar-sweetened beverage intake and childhood obesity using a group-based trajectory model, refAbstract=null), Reference(id=1241759378299228463, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241759334078681092, doi=null, pmid=null, pmcid=null, year=2021, volume=42, issue=6, pageStart=845, pageEnd=849, url=null, language=null, rfNumber=[26], rfOrder=40, authorNames=王琛琛, 王巍巍, 郑雨虹, journalName=中国学校卫生, refType=null, unstructuredReference=王琛琛，王巍巍，郑雨虹，等．南京市三年级小学生含糖饮料知识知晓及饮用情况[J]．中国学校卫生，2021，42（6）：845-849．, articleTitle=南京市三年级小学生含糖饮料知识知晓及饮用情况, refAbstract=null), Reference(id=1241759378437640501, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241759334078681092, doi=null, pmid=null, pmcid=null, year=2021, volume=42, issue=6, pageStart=845, pageEnd=849, url=null, language=null, rfNumber=[26], rfOrder=41, authorNames=Wang CC, Wang WW, Zheng YH, journalName=Chinese Journal of School Health, refType=null, unstructuredReference=Wang CC, Wang WW,Zheng YH, et al. Sugar-sweetened beverage knowledge and consumption among third-grade primary students in Nanjing[J]. Chinese Journal of School Health, 2021, 42(6): 845-849.（In Chinese), articleTitle=Sugar-sweetened beverage knowledge and consumption among third-grade primary students in Nanjing, refAbstract=null)], funds=[Fund(id=1241759367138185978, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241759334078681092, awardId=KCXFZ20201221173400002, language=CN, fundingSource=深圳市基础研究资助项目(KCXFZ20201221173400002), fundOrder=null, country=null), Fund(id=1241759367385649926, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241759334078681092, awardId=SZXK065, language=CN, fundingSource=深圳医学重点学科建设经费资助(SZXK065), fundOrder=null, country=null)], companyList=[AuthorCompany(id=1241759344967094413, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241759334078681092, xref=null, ext=[AuthorCompanyExt(id=1241759345025814672, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241759334078681092, companyId=1241759344967094413, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=Shenzhen Center for Chronic Disease Control, Shenzhen, Guangdong 518020, China), AuthorCompanyExt(id=1241759345348776088, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241759334078681092, companyId=1241759344967094413, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=深圳市慢性病防治中心，广东 深圳 518020)])], figs=[ArticleFig(id=1241759362050495098, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241759334078681092, language=EN, label=Table 1, caption=

Comparison of consumption frequency of sugar-sweetened beveragesamong primary and secondary students in different grade groups[n(%)]

, figureFileSmall=null, figureFileBig=null, tableContent=
摄入频次(次/周)总体一～三年级四～六年级中学χ2值P值
果蔬饮料30.955<0.001
08 494(50.4)3 522(51.3)2 691(49.0)2 281(50.9)
<15 527(32.8)2 262(32.9)1 861(33.9)1 404(31.3)
1~22 174(12.9)878(12.8)708(12.9)588(13.1)
≥3645(3.8)206(3.0)230(4.2)209(4.7)
碳酸饮料459.482<0.001
08 602(51.1)4 054(59.0)2 650(48.3)1 898(42.3)
<15 712(33.9)2 139(31.1)1 962(35.7)1 611(35.9)
1~22 042(12.1)563(8.2)723(13.2)756(16.9)
≥3484(2.9)112(1.6)155(2.8)217(4.8)
茶饮料895.413<0.001
010 695(63.5)5 089(74.1)3 418(62.3)2 188(48.8)
<14 151(24.6)1 322(19.2)1 472(26.8)1 357(30.3)
1~21 448(8.6)337(4.9)432(7.9)679(15.1)
≥3546(3.2)120(1.7)168(3.1)258(5.8)
乳酸菌饮料111.076<0.001
05 029(29.9)1 805(26.3)1 651(30.1)1 573(35.1)
<15 921(35.2)2 564(37.3)1 881(34.3)1 476(32.9)
1~23 626(21.5)1 584(23.1)1 196(21.8)846(18.9)
≥32 264(13.4)915(13.3)762(13.9)587(13.1)
调制乳饮品21.8640.001
011 780(70.0)4 901(71.4)3 765(68.6)3 114(69.5)
<13 453(20.5)1 366(19.9)1 172(21.3)915(20.4)
1~21 149(6.8)454(6.6)383(7.0)312(7.0)
≥3458(2.7)147(2.1)170(3.1)141(3.1)
现制奶茶584.181<0.001
08 285(49.2)3 964(57.7)2 634(48.0)1 687(37.6)
<16 722(39.9)2 424(35.3)2 293(41.8)2 005(44.7)
1~21 518(9.0)416(6.1)464(8.5)638(14.2)
≥3315(1.9)64(0.9)99(1.8)152(3.4)
植物蛋白和谷物饮料77.254<0.001
011 014(65.4)4 675(68.1)3 542(64.5)2 797(62.4)
<13 837(22.8)1 516(22.1)1 272(23.2)1 049(23.4)
1~21 425(8.5)521(7.6)476(8.7)428(9.5)
≥3564(3.3)156(2.3)200(3.6)208(4.6)
功能饮料582.989<0.001
011 585(68.8)5 340(77.8)3 596(65.5)2 649(59.1)
<13 755(22.3)1 200(17.5)1 353(24.6)1 202(26.8)
1~21 182(7.0)278(4.0)448(8.2)456(10.2)
≥3318(1.9)50(0.7)93(1.7)175(3.9)
咖啡饮料418.349<0.001
015 482(91.9)6 519(94.9)5 156(93.9)3 807(84.9)
<1868(5.2)233(3.4)222(4.0)413(9.2)
1~2309(1.8)65(0.9)68(1.2)176(3.9)
≥3181(1.1)51(0.7)44(0.8)86(1.9)
总含糖饮料279.896<0.001
01 435(8.5)694(10.1)435(7.9)306(6.8)
<11 262(7.5)644(9.4)377(6.9)241(5.4)
1~24 216(25.0)1 940(28.2)1 370(25.0)906(20.2)
≥39 927(58.9)3 590(52.3)3 308(60.3)3 029(67.6)
), ArticleFig(id=1241759362310541960, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241759334078681092, language=CN, label=表1, caption=

不同年级组中小学生含糖饮料摄入频次的比较 [n(%)]

, figureFileSmall=null, figureFileBig=null, tableContent=
摄入频次(次/周)总体一～三年级四～六年级中学χ2值P值
果蔬饮料30.955<0.001
08 494(50.4)3 522(51.3)2 691(49.0)2 281(50.9)
<15 527(32.8)2 262(32.9)1 861(33.9)1 404(31.3)
1~22 174(12.9)878(12.8)708(12.9)588(13.1)
≥3645(3.8)206(3.0)230(4.2)209(4.7)
碳酸饮料459.482<0.001
08 602(51.1)4 054(59.0)2 650(48.3)1 898(42.3)
<15 712(33.9)2 139(31.1)1 962(35.7)1 611(35.9)
1~22 042(12.1)563(8.2)723(13.2)756(16.9)
≥3484(2.9)112(1.6)155(2.8)217(4.8)
茶饮料895.413<0.001
010 695(63.5)5 089(74.1)3 418(62.3)2 188(48.8)
<14 151(24.6)1 322(19.2)1 472(26.8)1 357(30.3)
1~21 448(8.6)337(4.9)432(7.9)679(15.1)
≥3546(3.2)120(1.7)168(3.1)258(5.8)
乳酸菌饮料111.076<0.001
05 029(29.9)1 805(26.3)1 651(30.1)1 573(35.1)
<15 921(35.2)2 564(37.3)1 881(34.3)1 476(32.9)
1~23 626(21.5)1 584(23.1)1 196(21.8)846(18.9)
≥32 264(13.4)915(13.3)762(13.9)587(13.1)
调制乳饮品21.8640.001
011 780(70.0)4 901(71.4)3 765(68.6)3 114(69.5)
<13 453(20.5)1 366(19.9)1 172(21.3)915(20.4)
1~21 149(6.8)454(6.6)383(7.0)312(7.0)
≥3458(2.7)147(2.1)170(3.1)141(3.1)
现制奶茶584.181<0.001
08 285(49.2)3 964(57.7)2 634(48.0)1 687(37.6)
<16 722(39.9)2 424(35.3)2 293(41.8)2 005(44.7)
1~21 518(9.0)416(6.1)464(8.5)638(14.2)
≥3315(1.9)64(0.9)99(1.8)152(3.4)
植物蛋白和谷物饮料77.254<0.001
011 014(65.4)4 675(68.1)3 542(64.5)2 797(62.4)
<13 837(22.8)1 516(22.1)1 272(23.2)1 049(23.4)
1~21 425(8.5)521(7.6)476(8.7)428(9.5)
≥3564(3.3)156(2.3)200(3.6)208(4.6)
功能饮料582.989<0.001
011 585(68.8)5 340(77.8)3 596(65.5)2 649(59.1)
<13 755(22.3)1 200(17.5)1 353(24.6)1 202(26.8)
1~21 182(7.0)278(4.0)448(8.2)456(10.2)
≥3318(1.9)50(0.7)93(1.7)175(3.9)
咖啡饮料418.349<0.001
015 482(91.9)6 519(94.9)5 156(93.9)3 807(84.9)
<1868(5.2)233(3.4)222(4.0)413(9.2)
1~2309(1.8)65(0.9)68(1.2)176(3.9)
≥3181(1.1)51(0.7)44(0.8)86(1.9)
总含糖饮料279.896<0.001
01 435(8.5)694(10.1)435(7.9)306(6.8)
<11 262(7.5)644(9.4)377(6.9)241(5.4)
1~24 216(25.0)1 940(28.2)1 370(25.0)906(20.2)
≥39 927(58.9)3 590(52.3)3 308(60.3)3 029(67.6)
), ArticleFig(id=1241759362583171740, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241759334078681092, language=EN, label=Table 2, caption=

Spearman correlation analysis of sugar-sweetened beverages consumption frequency

, figureFileSmall=null, figureFileBig=null, tableContent=
含糖饮料123456789
11.0000.1730.2430.2440.2430.2550.2880.1780.104
21.0000.3400.1620.2460.3390.1270.3050.160
31.0000.1470.2370.3720.2190.2690.233
41.0000.2950.1640.2170.1350.042
51.0000.2410.3220.1600.116
61.0000.2270.2230.214
71.0000.1460.132
81.0000.206
91.000
), ArticleFig(id=1241759362855801526, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241759334078681092, language=CN, label=表2, caption=

含糖饮料摄入频次之间的Spearman秩相关

, figureFileSmall=null, figureFileBig=null, tableContent=
含糖饮料123456789
11.0000.1730.2430.2440.2430.2550.2880.1780.104
21.0000.3400.1620.2460.3390.1270.3050.160
31.0000.1470.2370.3720.2190.2690.233
41.0000.2950.1640.2170.1350.042
51.0000.2410.3220.1600.116
61.0000.2270.2230.214
71.0000.1460.132
81.0000.206
91.000
), ArticleFig(id=1241759362977436350, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241759334078681092, language=EN, label=Table 3, caption=

Comparison of sugar-sweetened beverages purchase habits of primary and secondary students [n(%)]

, figureFileSmall=null, figureFileBig=null, tableContent=
项目总一～三年级四～六年级中学χ2值P值
饮料购买人
父母12 344(73.3)5 651(82.3)4 128(75.2)2 565(57.2)884.555<0.001
自己6 659(39.5)1 344(19.6)2 215(40.3)3 100(69.2)997.944<0.001
祖父母/外祖父母1 700(10.1)1 064(15.5)471(8.6)165(3.7)437.461<0.001
饮料购买途径
便利店12 419(73.7)4 734(68.9)4 041(73.6)3 644(81.3)214.593<0.001
超市9 663(57.4)4 292(62.5)3 257(59.3)2 114(47.2)273.099<0.001
餐饮店(餐馆/奶茶店等)6 172(36.7)2 096(30.5)2 035(37.1)2 041(45.5)264.111<0.001
网购1 984(11.8)919(13.4)609(11.1)456(10.2)30.551<0.001
外卖1 348(8.0)367(5.3)404(7.4)577(12.9)213.445<0.001
自动售货机1 227(7.3)511(7.4)413(7.5)303(6.8)2.5310.282
娱乐场所(影剧院等)396(2.4)156(2.3)139(2.5)101(2.3)1.1570.561
饮料购买原因
好喝12 995(77.2)5 041(73.4)4 285(78.1)3 669(81.9)113.840<0.001
营养健康3 643(21.6)1 629(23.7)1 167(21.3)847(18.9)37.860<0.001
同学朋友常喝3 394(20.2)1 027(15.0)1 251(22.8)1 116(24.9)201.802<0.001
家人常喝2 080(12.4)1 023(14.9)705(12.8)352(7.9)126.022<0.001
广告宣传/促销1 254(7.4)521(7.6)432(7.9)301(6.7)5.0870.079
), ArticleFig(id=1241759364181201604, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241759334078681092, language=CN, label=表3, caption=

中小学生含糖饮料购买习惯的比较 [n(%)]

, figureFileSmall=null, figureFileBig=null, tableContent=
项目总一～三年级四～六年级中学χ2值P值
饮料购买人
父母12 344(73.3)5 651(82.3)4 128(75.2)2 565(57.2)884.555<0.001
自己6 659(39.5)1 344(19.6)2 215(40.3)3 100(69.2)997.944<0.001
祖父母/外祖父母1 700(10.1)1 064(15.5)471(8.6)165(3.7)437.461<0.001
饮料购买途径
便利店12 419(73.7)4 734(68.9)4 041(73.6)3 644(81.3)214.593<0.001
超市9 663(57.4)4 292(62.5)3 257(59.3)2 114(47.2)273.099<0.001
餐饮店(餐馆/奶茶店等)6 172(36.7)2 096(30.5)2 035(37.1)2 041(45.5)264.111<0.001
网购1 984(11.8)919(13.4)609(11.1)456(10.2)30.551<0.001
外卖1 348(8.0)367(5.3)404(7.4)577(12.9)213.445<0.001
自动售货机1 227(7.3)511(7.4)413(7.5)303(6.8)2.5310.282
娱乐场所(影剧院等)396(2.4)156(2.3)139(2.5)101(2.3)1.1570.561
饮料购买原因
好喝12 995(77.2)5 041(73.4)4 285(78.1)3 669(81.9)113.840<0.001
营养健康3 643(21.6)1 629(23.7)1 167(21.3)847(18.9)37.860<0.001
同学朋友常喝3 394(20.2)1 027(15.0)1 251(22.8)1 116(24.9)201.802<0.001
家人常喝2 080(12.4)1 023(14.9)705(12.8)352(7.9)126.022<0.001
广告宣传/促销1 254(7.4)521(7.6)432(7.9)301(6.7)5.0870.079
), ArticleFig(id=1241759364487385811, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241759334078681092, language=EN, label=Table 4, caption=

Multi-factor linear regression analyses of sugar-sweetened beverages knowledge score and consumption frequency score

, figureFileSmall=null, figureFileBig=null, tableContent=
分层因素n模型1模型2交互项
P值
β值(95% CI)P值β值(95% CI)P值
总体16 8400.287(0.261~0.312)<0.0010.179(0.155~0.204)<0.001
年级
小学12 3580.287(0.258~0.316)<0.0010.189(0.162~0.217)<0.0010.151
中学4 4820.218(0.163~0.272)<0.0010.153(0.101~0.205)<0.001
性别
男8 9750.276(0.241~0.311)<0.0010.173(0.140~0.205)<0.0010.314
女7 8650.275(0.237~0.313)<0.0010.185(0.149~0.222)<0.001
饮料购买人
自己6 6590.229(0.186~0.273)<0.0010.156(0.114~0.198)<0.0010.122
其他人10 1810.282(0.251~0.313)<0.0010.194(0.165~0.223)<0.001
父亲文化水平
大专及以下8 3070.247(0.210~0.285)<0.0010.135(0.100~0.170)<0.001<0.001
本科及以上8 5330.316(0.279~0.354)<0.0010.229(0.194~0.263)<0.001
母亲文化水平
大专及以下9 6280.255(0.220~0.289)<0.0010.145(0.112~0.177)<0.001<0.001
本科及以上7 2120.323(0.282~0.364)<0.0010.233(0.195~0.270)<0.001
), ArticleFig(id=1241759364915204840, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241759334078681092, language=CN, label=表4, caption=

含糖饮料认知得分与摄入频次得分之间的多因素线性回归分析

, figureFileSmall=null, figureFileBig=null, tableContent=
分层因素n模型1模型2交互项
P值
β值(95% CI)P值β值(95% CI)P值
总体16 8400.287(0.261~0.312)<0.0010.179(0.155~0.204)<0.001
年级
小学12 3580.287(0.258~0.316)<0.0010.189(0.162~0.217)<0.0010.151
中学4 4820.218(0.163~0.272)<0.0010.153(0.101~0.205)<0.001
性别
男8 9750.276(0.241~0.311)<0.0010.173(0.140~0.205)<0.0010.314
女7 8650.275(0.237~0.313)<0.0010.185(0.149~0.222)<0.001
饮料购买人
自己6 6590.229(0.186~0.273)<0.0010.156(0.114~0.198)<0.0010.122
其他人10 1810.282(0.251~0.313)<0.0010.194(0.165~0.223)<0.001
父亲文化水平
大专及以下8 3070.247(0.210~0.285)<0.0010.135(0.100~0.170)<0.001<0.001
本科及以上8 5330.316(0.279~0.354)<0.0010.229(0.194~0.263)<0.001
母亲文化水平
大专及以下9 6280.255(0.220~0.289)<0.0010.145(0.112~0.177)<0.001<0.001
本科及以上7 2120.323(0.282~0.364)<0.0010.233(0.195~0.270)<0.001
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中小学生含糖饮料摄入现状及含糖饮料认知与摄入行为的关联
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张双霞 , 李妍 , 熊静帆 , 李艳艳
现代预防医学 | 营养与食品卫生 2024,51(18): 3307-3313
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现代预防医学 | 营养与食品卫生 2024, 51(18): 3307-3313
中小学生含糖饮料摄入现状及含糖饮料认知与摄入行为的关联
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张双霞, 李妍, 熊静帆, 李艳艳
作者信息
  • 深圳市慢性病防治中心，广东 深圳 518020

    • 张双霞(1997—)，女，硕士，公卫医师，研究方向：儿童青少年慢性病防控与营养健康教育

通讯作者:

李艳艳，E-mail:
Associations on status of sugar-sweetened beverages instake and correlation of cognition and intake behavior among primary and secondary students
Shuang-xia ZHANG, Yan LI, Jing-fan XIONG, Yan-yan LI
Affiliations
  • Shenzhen Center for Chronic Disease Control, Shenzhen, Guangdong 518020, China
出版时间: 2024-09-25 doi: 10.20043/j.cnki.MPM.202404076
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摘要
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目的

了解中小学生含糖饮料摄入频次及购买习惯，并探究含糖饮料认知和行为的关系，为减少学生含糖饮料摄入提供依据。

方法

采用多阶段抽样的方法以深圳市中小学生为研究对象，于2021年9至10月通过网络发放问卷收集相关信息。Spearman秩相关分析不同类型含糖饮料摄入频次之间的相关关系，多因素线性回归模型分析含糖饮料认知得分与摄入频次得分之间的关系，分层分析探讨可能存在的交互作用。

结果

共纳入6~18岁中小学生16 840名。含糖饮料总摄入量≥3次/周占比为58.9%，一～三年级、四～六年级和中学生分别为52.3%、60.3%和67.6%。父母(73.3%)为含糖饮料的主要购买人，便利店(73.7%)为主要购买场所，“好喝”(77.2%)是主要选择原因。不同类型的含糖饮料摄入频次之间均具有正相关关系(P<0.001)。多因素线性回归结果显示，含糖饮料认知得分越高者其含糖饮料摄入频次越低(β =0.179，95% CI：0.155~0.204)。含糖饮料认知得分与父母文化水平对学生含糖饮料摄入频次存在相乘交互作用(P<0.001)。

结论

深圳市中小学生含糖饮料摄入频次较高，含糖饮料认知水平与摄入频次以及父母文化水平有关。

中小学生  /  儿童青少年  /  含糖饮料  /  摄入频次  /  认知与行为
Objective

To understand intake frequency of sugar-sweetened beverages (SSBs) and the consumption habit among primary and secondary students. To explore the relationship of SSBs cognition and behavior，and to provide a basis for reducing students’ intake of SSBs.

Methods

A multi-stage sampling process was employed to select subjects from primary and middle school in Shenzhen. Network questionnaire survey was conducted to collecting information in September and October, 2021. Spearman rank correlations was used to analyze relationships of various types of SSBs consumption frequency. Multivariable linear regression model was used to examine the relationship between SSBs cognition score and consumption frequency score. Hierarchical analysis to explore the interactions.

Results

A total of 16 840 primary and secondary students aged 6 to 18 years old were included. The prevalence of SSBs consumption at least 3 time/week was 58.9%, the grades 1-3, 4-6 and middle school students were 52.3%, 60.3% and 67.6%. Parents (73.3%) were the main buyers of SSBs, convenience stores (73.7%) were the main places and delicious (77.2%) was the major cause of choices. There was a positive correlation between the intake frequency of different types of SSBs (P<0.001). The results of multivariate linear regression showed that the higher the cognition was, the lower the intake frequency of SSBs was (β=0.179, 95%CI：0.155-0.204). There was a multiplicative interaction between the cognitive score of SSBs and the educational level of parents (P<0.00l).

Conclusion

The intake frequency of SSBs was high among primary and middle school students in Shenzhen, and the cognitive level of SSBs was related to the intake frequency and the educational level of parents.

Primary and secondary students  /  Children and adolescents  /  Sugar-sweetened beverages (SSBs)  /  Frequency of consumption  /  Cognition and behavior
张双霞, 李妍, 熊静帆, 李艳艳. 中小学生含糖饮料摄入现状及含糖饮料认知与摄入行为的关联. 现代预防医学, 2024 , 51 (18) : 3307 -3313 . DOI: 10.20043/j.cnki.MPM.202404076
Shuang-xia ZHANG, Yan LI, Jing-fan XIONG, Yan-yan LI. Associations on status of sugar-sweetened beverages instake and correlation of cognition and intake behavior among primary and secondary students[J]. Modern Preventive Medicine, 2024 , 51 (18) : 3307 -3313 . DOI: 10.20043/j.cnki.MPM.202404076
正文
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含糖饮料作为饮食中添加糖的主要来源，已被证实过量摄入会增加儿童青少年龋齿、超重肥胖、糖尿病等的发生风险和死亡[1-2]。《中国居民膳食指南（2022）》建议儿童青少年不喝或少喝含糖饮料[3]。然而，我国居民含糖饮料消费率不断增加，平均消费量也在逐年升高，儿童青少年已成为含糖饮料消费的主力军[4]，控制儿童青少年含糖饮料摄入亟待解决。有研究显示，提高儿童青少年对含糖饮料的认知会降低含糖饮料的摄入行为[5-6]，但也有研究指出儿童青少年对含糖饮料的认知水平与其饮料摄入行为无关[7]，甚至知晓含糖饮料健康危害的学生其并未减少含糖饮料的摄入[8]。有关儿童青少年含糖饮料认知和行为的研究结果并不一致，还有待进一步探索。本研究旨评估深圳市6~18岁中小学生含糖饮料认知与饮料摄入现状，探讨含糖饮料认知与摄入频次之间的关系，为有针对性地控制含糖饮料摄入，促进中小学生健康成长提供依据。
1　对象与方法
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1.1　对象与方法
本研究以深圳市6~18岁中小学生为研究对象，采用随机数字表法在深圳市10个行政区属各抽取3所学校，方便抽样法对30所学校的部分学生进行问卷调查，于2021年9至10月完成电子问卷调查。问卷首页为知情同意书，学生选择同意调查后开始问卷填写。调查内容包括学生和家长基本信息，含糖饮料认知和近一月摄入情况，含糖饮料购买习惯，家长行为（含糖饮料饮用情况，储备情况，劝阻或奖励行为）等。含糖饮料摄入频次部分参考了中国居民营养与健康状况监测调查和FFQ问卷[9-10]，本研究中量表的Cronbach α系数为0.724。为保证填写质量，问卷内容设置了填写范围、段落说明以及专人线上指导，以班级为单位发放问卷，每个班级填写问卷不作数量要求。一至三年级学生由学生作答家长辅助（家长先为学生讲解如何操作和问卷问题，后由学生自己作答）完成填写，四年级及以上学生独自完成填写。剔除无效问卷（IP地址为非深圳、年龄>18或<6岁、重复问卷、答题时间<3分钟）1 802份，最终纳入有效问卷共16 840份，有效应答率为90.3%。本调查已通过深圳市慢性病防治中心伦理委员会批准（SZCCC－2021－006－01－PJ）。
1.2　指标定义
含糖饮料指在饮料制作过程中人工添加糖，且含糖量在5%以上的饮料[11]。本研究的含糖饮料包括常见的碳酸饮料、功能饮料、果蔬饮料、茶饮料、咖啡饮料、含乳饮料（乳酸菌饮料、调制乳饮品、现制奶茶）、植物蛋白饮料和谷物饮料。
认知得分赋值方法：共22项关于含糖饮料的知识题，答对1项得1分，答错不得分，分值范围为0~22分，分值越高认知越高。摄入频次分为0次/周（不喝）、<1次/周、1~2次/周、≥3次/周。含糖饮料摄入频次得分赋值方法：0次/周赋3分、<1次/周赋2分、1~2次/周赋1分、≥3次/周赋0分，将9种含糖饮料摄入频次得分相加，分值范围为0~27分，分值越高总摄入频次越低。
1.3　统计分析
运用SPSS 26.0进行统计分析。计量资料采用均数±标准差（）表示，计数资料采用频数和百分比[n,（%）]表示。三个年级组之间含糖饮料摄入频次和购买习惯的比较采用χ2检验，得分的比较采用方差分析。各含糖饮料之间的相关性采用Spearman秩相关分析。含糖饮料认知得分和摄入频次得分之间关系的探讨采用多因素线性回归，并进行分层分析。用相乘模型进行Wald检验，当交互作用P <0.05时，可认为该因素具有效应修饰作用。检验水准α =0.05。
2　结果
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2.1　基本情况
本研究共有16 840人，其中男生8 975（53.7%）人，女生7 865（46.7%）人；一～三年级6 868（40.8%）人，四～六年级5 490（32.6%）人，中学生4 482（26.6%）人。父母亲文化水平为本科及以上有8 533人（50.7%）和7 212人（42.8%）,学生关注配料表和营养标签分别有11 142人（66.2%）和11 144人（66.2%），家长饮用和储存含糖饮料分别有10 640人（63.2%）和10 705人（63.6%），家长奖励含糖饮料和劝阻学生购买/饮用含糖饮料分别有6 671人（39.6%）和15 638人（92.9%）。含糖饮料认知得分为18.0±2.2，一～三年级组、四～六年级组和中学生组得分分别为18.2、17.9和17.7；含糖饮料摄入频次得分为21.8±3.8，各年级组得分分别为22.5、21.7和20.9。
2.2　含糖饮料摄入情况的比较
由表1可知，中小学生摄入咖啡饮料0次/周（不喝）的占比为91.9%，而乳酸菌饮料0次/周的占比仅为29.9%。其余7种含糖饮料摄入频次相似，0次/周占比最大（70.0%~49.2%），<1次/周占比较大（39.9%~20.5%），1~2次/周占比较小（12.9%~6.8%），≥3次/周占比最小（3.8%~1.9%）。含糖饮料总摄入量≥1次/周的占比为83.9%，其中≥3次/周的占比为58.9%。
组间比较结果显示，各种含糖饮料摄入频次在3个年级组之间的差异均具有统计学意义（P<0.001）。中学生摄入乳酸菌饮料0次/周的占比最高，而一～三年级组学生碳酸饮料、茶饮料、现制奶茶、植物蛋白和谷物饮料、功能饮料、咖啡饮料占比最高。3个年级组学生乳酸菌饮料≥3次/周的占比一致，约为13.0%。中学生含糖饮料总摄入量≥3次/周的占比为67.6%，而一～三年级组为52.3%。详见表1。
2.3　含糖饮料摄入频次之间的相关关系
表2结果表明，各含糖饮料之间摄入频次具有相关关系（P值均<0.001）。饮用碳酸饮料者也经常饮用茶饮料（r=0.340）、现制奶茶（r=0.339）和功能饮料（r=0.305）；饮用茶饮料者也经常饮用现制奶茶（r=0.372）和咖啡饮料（r=0.233）；饮用调制乳饮品者也经常饮用乳酸菌饮料（r=0.295）、植物蛋白和谷物饮料（r=0.322）。
2.4　含糖饮料购买习惯
由表3可知，中小学生含糖饮料购买人73.3%为父母，39.5%为自己，10.1%为祖父母/外祖父母。其中，82.3%的一～三年级学生为父母购买，而69.2%的中学生为自己购买。含糖饮料购买场所主要有便利店（73.7%）、超市（57.4%）和餐饮店（36.7%），其中有81.3%的中学生常在便利店购买。相比之下学生选择在自动售货机和娱乐场所购买饮料的人数较少（7.3%和2.4%），各年级之间的比较无统计学差异（P=0.282和0.561）。选择饮用某种饮料的原因有好喝（77.2%）、营养健康（21.6%）和同学朋友常喝（20.2%），其中有81.8%的中学生选择原因为“好喝”。相比之下广告宣传/促销对学生饮料选择的影响偏低（7.4%）,各年级之间的比较无统计学差异（P =0.079）。详见表3。
2.5　含糖饮料认知得分与摄入频次得分的关联性分析和分层分析
以含糖饮料摄入频次得分作为应变量，含糖饮料认知得分作为自变量，在调整了相关因素（学生的年级、性别、饮料购买人、配料表和营养标签关注情况，以及父母文化水平、家长饮用和储存含糖饮料情况、家长奖励含糖饮料和劝阻学生购买/饮用含糖饮料情况）后发现，认知得分与摄入频次得分呈正相关关系，认知越高者，其摄入频次越低（β=0.179，95% CI:0.155~0.204，P <0.001）。
通过分层分析进一步探索含糖饮料认知得分与摄入频次得分的关系是否受到一些潜在因素的影响。经校正后的交互项Wald检验结果显示，含糖饮料认知得分与父母文化水平对摄入频次得分具有相乘交互作用（P <0.001）。详见表4。
3　讨论
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本研究结果中，中小学生含糖饮料总摄入频次为0次/周（不喝）、<1次/周、1~2次/周和≥3次/周的占比分别为8.5%、7.5%、25.0%和58.9%，2010—2013年（中国居民营养与健康状况监测）我国6~17岁学生饮料总摄入频次占比分别为11.3%、3.7%、42.1%和42.9% [9]。相比之下，本研究含糖饮料≥3次/周占比增加了16.0%。这可能是由含乳饮料摄入偏高引起（其余各种含糖饮料摄入频次均比国民营养监测值低）。同年，宝安区30 188名中小学生含乳饮料摄入频次居于首位[12]的调查也进一步说明了本市学生含乳饮料摄入偏高。因乳酸菌等含乳饮料独特的酸甜奶香味，以及某些生产厂家在包装和宣传上误导消费者，容易让购买者认为含乳饮料就是奶及奶制品[13-14]，这可能是含乳饮料受学生群体喜欢的原因。既往研究显示，果蔬饮料一直是我国中小学生最常喝的含糖饮料之一[15-16]，本研究果蔬饮料摄入≥1次/周仅次于乳酸菌饮料，占比为16.7%。2013年我国9省7~18岁学生碳酸饮料摄入≥1次/周占比超过40% [17]，而本研究仅为15.0%。此外，中小学生倾向于选择具有共同特点的含糖饮料。饮用调制乳饮品者经常饮用乳酸菌饮料、植物蛋白和谷物饮料，这几类含糖饮料含有健康元素－乳、益生菌、蛋白质及谷物。饮用茶饮料者经常饮用现制奶茶和咖啡饮料，这三类含糖饮料均具有提神功效。其中，中学生摄入茶饮料≥1次/周占比为20.9%，而一～三年级学生仅为6.6%，这可能与中学生学业增多有关[18]。
从中小学生含糖饮料购买习惯得知，“好喝”（77.2%）是主要选择原因，这与北京九城区中小学生[19]和城市高年级小学生选择原因一致[16]。此外，父母为主要购买人（73.3%），尤其对于小学生。便利店（73.7%）为主要购买场所。由此可见，相比于无味的白水，含糖饮料丰富的味道吸引着学生；父母和便利的购买场所在一定程度给学生含糖饮料的摄入提供了有利条件；加之广东地区人民喜食甜食，这可能也影响着学生的饮用行为。基于此，我们未来的关注点应聚焦于学生能常喝纯奶和白水，按时吃好三餐等来减少市售饮料的吸引。后续的校园营养教育应加强含糖饮料添加成分以及健康危害等相关内容的宣教，从而达到直接和间接影响学生个人的饮用行为。同时也应开展家长营养教育，采用以学校和家庭相结合为基础的干预措施以减少学生含糖饮料的摄入[20]。
儿童青少年时期建立良好的饮食行为习惯尤为重要，这一时期形成的行为往往会持续到成年，从而影响长期的健康状况[21]。而营养知识的提高有助于他们更好饮食行为习惯的养成[22]，同时增加相应的知识储备可能有效改善其含糖饮料饮用习惯[23]。本研究发现中小学生含糖饮料认知与摄入频次有关，认知越高者摄入频次越低。但也有研究发现具有较高认知的儿童其摄入频次也高[7-8]。其原因可能是人们对不健康食物的偏好并不能轻易改变，所以即使可以理性认识到某些食物对健康的危害，也很难从行为上做出改变[24]。此外，学生的饮食行为还与父母的文化水平有关，父母的文化程度越高，学生的营养相关行为越好[25-26]。本研究中小学生含糖饮料摄入频次受到认知与父母文化水平的相乘交互作用，父母学历为本科及以上，其孩子含糖饮料认知得分与频次得分之间的相关性越高。这提示：深圳市未来的校园营养教育应重点关注中小学生含糖饮料的摄入，提高学生对各类含糖饮料的认知。同时，有必要提供家长的健康意识，改善其不良行为，共同创建无含糖饮料家庭环境。中小学生每日应摄入充足的蔬果和奶类，不能用含糖饮料取而代之，忽略添加糖过量导致的健康危害。
总之，本研究中小学生含糖饮料总摄入频次较高，学生还会倾向于选择具有共同特征的饮料。父母、便利的购买场所以及含糖饮料的滋味都影响着学生的摄入行为。含糖饮料认知与摄入频次以及父母文化水平有关。但本研究仍存在一些局限性：随机抽取学校后用方便抽样的方法对学生进行调查，影响样本代表性；虽然在调查前强调了填写的自愿真实原则和填写说明等，但一～三年级学生由家长辅助填写，个别问卷可能会有填写不实的情况；横断面调查结果尚不能提供因果关联，研究结论需要进一步验证。
基金
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  • 深圳市基础研究资助项目(KCXFZ20201221173400002)
  • 深圳医学重点学科建设经费资助(SZXK065)
文献
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2024年第51卷第18期
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doi: 10.20043/j.cnki.MPM.202404076
  • 接收时间：2024-04-04
  • 首发时间：2026-03-20
  • 出版时间：2024-09-25
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  • 收稿日期：2024-04-04
基金
深圳市基础研究资助项目(KCXFZ20201221173400002)
深圳医学重点学科建设经费资助(SZXK065)
作者信息
    深圳市慢性病防治中心，广东 深圳 518020

通讯作者:

李艳艳，E-mail:
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https://castjournals.cast.org.cn/joweb/xdyfyx/CN/10.20043/j.cnki.MPM.202404076
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2种不同金属材料的力学参数
科
Family		 属数
Number of
genus		 种数
Number of
species		 占总种数比例
Percentage of
total species (%)		 属
Genus		 种数
Number of
species		 占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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