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Article(id=1241771809121570983, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241771801366299468, articleNumber=null, orderNo=null, doi=10.20043/j.cnki.MPM.202406400, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1719244800000, receivedDateStr=2024-06-25, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1773991070298, onlineDateStr=2026-03-20, pubDate=1729785600000, pubDateStr=2024-10-25, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1773991070298, onlineIssueDateStr=2026-03-20, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1773991070298, creator=13701087609, updateTime=1773991070298, updator=13701087609, issue=Issue{id=1241771801366299468, tenantId=1146029695717560320, journalId=1227665162245664772, year='2024', volume='51', issue='20', pageStart='3649', pageEnd='3840', issueExtLink='null', onlineDate='null', pubDate='null', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1773991068450, creator=13701087609, updateTime=1773991676896, updator=13701087609, preIssue=null, nextIssue=null, ext={EN=IssueExt(id=1241774353457681403, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241771801366299468, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1241774353457681404, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241771801366299468, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null}, startPage=3702, endPage=3706, ext={EN=ArticleExt(id=1241771810367279289, articleId=1241771809121570983, tenantId=1146029695717560320, journalId=1227665162245664772, language=EN, title=Investigation on added sugar intake among primary school students based on food atlas,Lianyungang, columnId=null, journalTitle=Modern Preventive Medicine, columnName=null, runingTitle=null, highlight=null, articleAbstract=
Objective

To understand the intake of added sugars among primary school students, to analyze the sources and influencing factors of intake, and to propose improvement measures.

Methods

A stratified cluster sampling method was used to select 12,603 primary school students in Lianyungang as the research subjects. A food atlas-based questionnaire was used to investigate the intake of foods with added sugars and calculate daily intake of added sugars.

Results

The median added sugar intake of primary school students was 22.1 g/day, 45.7% of students consumed more than 25 g/day, and 21.7% of students consumed more than 50 g/day. Sugar-sweetened beverages, flavored yogurt, pastries and sweets were the four main sources of added sugar intake among primary school students (accounting for 38.3%, 24.0%, 14.1% and 12.1% respectively). Multiple linear regression analysis showed that boys, higher grade, higher BMI, and less sleep were associated with increased intake of added sugars.

Conclusions

The excessive intake of added sugar by primary school students in Lianyungang was quite prominent. On the one hand, nutrition education should be carried out to publicize the harm of excessive intake of added sugar.On the other hand, it isrecommended to include the added sugar content in the nutrition label to guide teenagers to choose healthy food.

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目的

了解小学生添加糖摄入情况，分析摄入来源和影响因素并提出改善对策。

方法

2023年10月-2024年3月，采用分层整群抽样法选取连云港市12 603名小学生为调查对象，利用基于食物图谱辅助的问卷调查含添加糖食品的摄入情况并计算每日添加糖摄入量。

结果

小学生添加糖摄入量中位数为22.1 g/d，45.7%的学生超过25 g/d，21.7%的学生超过50 g/d。含糖饮料、风味酸奶、糕点和甜食是小学生添加糖摄入的四大主要来源（占比分别为38.3%、24.0%、14,1%和12.1%）。多元线性回归分析显示，男生、高年级、高BMI和睡眠时间少与添加糖摄入增加有关。

结论

连云港市小学生添加糖摄入过量状况较为突出。一方面要开展营养教育活动，宣传添加糖摄入过多存在的危害；同时建议将添加糖含量纳入营养标签管理，指导青少年合理选择健康食品。

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周明，E-mail:
, copyrightStatement=本刊刊出的所有文章不代表中华预防医学会和本刊编委会的观点，除非特别声明。, copyrightOwner=中华预防医学会和四川大学华西公共卫生学院, extLink=null, articleAbsUrl=null, sourceXml=+SNuKQzVKAMrZV1jGhsT3g==, magXml=TnFHQIncpUKr4qf6VK2KfA==, pdfUrl=null, pdf=AIO7kwLrNx+rORLaLcJT4w==, pdfFileSize=1036725, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=lWd+XOqIZLdyu2HDfJlrnQ==, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=12XpLP5AhgNkvrsubcTuWQ==, mapNumber=null, authorCompany=null, fund=null, authors=

王晨曲（1999—），男，硕士在读，研究方向：营养与健康

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王晨曲（1999—），男，硕士在读，研究方向：营养与健康

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王晨曲（1999—），男，硕士在读，研究方向：营养与健康

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Trend of sugar-sweetened beverage consumption and intake of added sugar inChina nine provinces among adults[J]. Journal of Hygiene Research, 2014, 43(1):70-72.(In Chinese), articleTitle=Trend of sugar-sweetened beverage consumption and intake of added sugar inChina nine provinces among adults, refAbstract=null)], funds=null, companyList=[AuthorCompany(id=1241771811680096512, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241771809121570983, xref=null, ext=[AuthorCompanyExt(id=1241771811701068036, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241771809121570983, companyId=1241771811680096512, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=School of Public Health, Nanjing Medical University, Nanjing, Jiangsu 211166, China), AuthorCompanyExt(id=1241771811713650950, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241771809121570983, companyId=1241771811680096512, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=南京医科大学公共卫生学院，江苏 南京 211166)])], figs=[ArticleFig(id=1241771816193167814, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241771809121570983, language=EN, label=Fig.1, caption=Food atlas, figureFileSmall=nkjZgQqoiXK13GJKZct48g==, figureFileBig=lWd+XOqIZLdyu2HDfJlrnQ==, tableContent=null), ArticleFig(id=1241771816436437463, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241771809121570983, language=CN, label=图1, caption=食物图谱示意, figureFileSmall=nkjZgQqoiXK13GJKZct48g==, figureFileBig=lWd+XOqIZLdyu2HDfJlrnQ==, tableContent=null), ArticleFig(id=1241771816730038764, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241771809121570983, language=EN, label=Fig.2, caption=Distribution of sources of added sugar intake among primary school students, figureFileSmall=jBogQGyiSSmDAdhcSpm6Hg==, figureFileBig=qpLGftLUp8uCaTt4Y0yzQA==, tableContent=null), ArticleFig(id=1241771816847479282, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241771809121570983, language=CN, label=图2, caption=小学生添加糖摄入来源分布, figureFileSmall=jBogQGyiSSmDAdhcSpm6Hg==, figureFileBig=qpLGftLUp8uCaTt4Y0yzQA==, tableContent=null), ArticleFig(id=1241771816952336890, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241771809121570983, language=EN, label=Table 1, caption=

Basic characteristics of primary school students (n =12 603)

, figureFileSmall=null, figureFileBig=null, tableContent=
人口学特征男生女生合计
人数百分比(%)人数百分比(%)人数百分比(%)
年级
一年级1 18616.999617.82 18217.3
二年级1 30618.51 08019.42 38618.9
三年级1 26918.199217.82 26117.9
四年级82911.861311.01 44211.5
五年级1 17316.786815.62 04116.2
六年级1 26318.01 02818.42 29118.2
地区
城市4 38062.33 30159.27 68161.0
农村2 64637.72 27640.84 92239.0
BMI
营养不良94313.463811.41 58112.5
正常3 69352.63 60164.67 29457.9
超重1 24417.767612.11 92015.2
肥胖1 14616.366211.91 80814.4
睡眠时长（h/d）
<91 99828.41 68930.33 68729.3
9～104 66366.43 64165.38 30465.8
>103655.22474.46124.9
中高强度身体活动（天/周）
097113.881114.51 78214.1
1～24 14158.93 29159.07 43259.0
3～41 18617.092916.72 11516.8
≥572710.35479.81 27410.1
), ArticleFig(id=1241771817057194504, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241771809121570983, language=CN, label=表1, caption=

小学生基本特征（n =12 603）

, figureFileSmall=null, figureFileBig=null, tableContent=
人口学特征男生女生合计
人数百分比(%)人数百分比(%)人数百分比(%)
年级
一年级1 18616.999617.82 18217.3
二年级1 30618.51 08019.42 38618.9
三年级1 26918.199217.82 26117.9
四年级82911.861311.01 44211.5
五年级1 17316.786815.62 04116.2
六年级1 26318.01 02818.42 29118.2
地区
城市4 38062.33 30159.27 68161.0
农村2 64637.72 27640.84 92239.0
BMI
营养不良94313.463811.41 58112.5
正常3 69352.63 60164.67 29457.9
超重1 24417.767612.11 92015.2
肥胖1 14616.366211.91 80814.4
睡眠时长（h/d）
<91 99828.41 68930.33 68729.3
9～104 66366.43 64165.38 30465.8
>103655.22474.46124.9
中高强度身体活动（天/周）
097113.881114.51 78214.1
1～24 14158.93 29159.07 43259.0
3～41 18617.092916.72 11516.8
≥572710.35479.81 27410.1
), ArticleFig(id=1241771817195606547, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241771809121570983, language=EN, label=Table 2, caption=

Daily intake of added sugars among primary school students

, figureFileSmall=null, figureFileBig=null, tableContent=
人口学特征添加糖摄入量
（g/d）
[M(P25,P75)]		Z/χ2P值添加糖摄入量分布[n(%)]χ2P值
≤25 g>25 g且≤50 g>50 g
性别18.91<0.00124.08<0.001
男22.7(9.7, 44.7)3 688(52.5)1 715(24.4)1 623(23.1)
女20.2(8.5, 40.9)3 151(56.5)1 311(23.5)1 115(20.0)
年级37.45<0.00179.31<0.001
一年级19.9(8.3, 38.5)1 259(57.7)543(24.9)380(17.4)
二年级20.3(9.0, 40.1)1 354(56.8)578(24.2)454(19.0)
三年级21.4(9.3, 43.5)1 236(54.6)537(23.8)488(21.6)
四年级23.0(9.8, 47.2)737(51.1)342(23.7)363(25.2)
五年级22.9(9.8, 46.9)1 055(51.7)481(23.6)505(24.7)
六年级23.6(10.2, 47.4)1 157(50.5)541(23.6)593(25.9)
地区-0.910.36511.950.003
城市21.7(9.5, 42.4)4 178(54.4)1 902(24.8)1 601(20.8)
农村21.3(8.6, 43.8)2 661(54.1)1 123(22.8)1 138(23.1)
BMI6.460.0919.780.134
营养不良19.9(8.9, 40.3)898(56.8)373(23.6)310(19.6)
正常21.0(9.0, 42.3)3 985(54.6)1 769(24.3)1 540(21.1)
超重21.6(9.2, 43.6)1 064(55.4)442(23.0)414(21.6)
肥胖23.6(9.6, 44.8)945(52.3)474(26.2)389(21.5)
睡眠时长（h/d）59.27<0.00157.44<0.001
<924.3(10.7, 47.5)1 834(49.7)912(24.8)941(25.5)
9～1020.2(8.6, 41.0)4 672(56.3)1 972(23.8)1 660(19.9)
>1020.6(7.6, 42.4)333(54.4)141(23.0)138(22.6)
中高强度身体活动（天/周）3.170.36615.800.015
022.5(9.5, 44.9)924(51.9)424(23.8)434(24.3)
1～221.0(9.1, 42.2)4 106(55.2)1 742(23.4)1 584(21.4)
3～421.9(9.4, 42.4)1 149(54.3)540(25.5)426(20/2)
≥522.0(8.5, 44.4)676(53.1)310(24.3)288(22.6)
), ArticleFig(id=1241771817313047069, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241771809121570983, language=CN, label=表2, caption=

小学生每日添加糖摄入情况

, figureFileSmall=null, figureFileBig=null, tableContent=
人口学特征添加糖摄入量
（g/d）
[M(P25,P75)]		Z/χ2P值添加糖摄入量分布[n(%)]χ2P值
≤25 g>25 g且≤50 g>50 g
性别18.91<0.00124.08<0.001
男22.7(9.7, 44.7)3 688(52.5)1 715(24.4)1 623(23.1)
女20.2(8.5, 40.9)3 151(56.5)1 311(23.5)1 115(20.0)
年级37.45<0.00179.31<0.001
一年级19.9(8.3, 38.5)1 259(57.7)543(24.9)380(17.4)
二年级20.3(9.0, 40.1)1 354(56.8)578(24.2)454(19.0)
三年级21.4(9.3, 43.5)1 236(54.6)537(23.8)488(21.6)
四年级23.0(9.8, 47.2)737(51.1)342(23.7)363(25.2)
五年级22.9(9.8, 46.9)1 055(51.7)481(23.6)505(24.7)
六年级23.6(10.2, 47.4)1 157(50.5)541(23.6)593(25.9)
地区-0.910.36511.950.003
城市21.7(9.5, 42.4)4 178(54.4)1 902(24.8)1 601(20.8)
农村21.3(8.6, 43.8)2 661(54.1)1 123(22.8)1 138(23.1)
BMI6.460.0919.780.134
营养不良19.9(8.9, 40.3)898(56.8)373(23.6)310(19.6)
正常21.0(9.0, 42.3)3 985(54.6)1 769(24.3)1 540(21.1)
超重21.6(9.2, 43.6)1 064(55.4)442(23.0)414(21.6)
肥胖23.6(9.6, 44.8)945(52.3)474(26.2)389(21.5)
睡眠时长（h/d）59.27<0.00157.44<0.001
<924.3(10.7, 47.5)1 834(49.7)912(24.8)941(25.5)
9～1020.2(8.6, 41.0)4 672(56.3)1 972(23.8)1 660(19.9)
>1020.6(7.6, 42.4)333(54.4)141(23.0)138(22.6)
中高强度身体活动（天/周）3.170.36615.800.015
022.5(9.5, 44.9)924(51.9)424(23.8)434(24.3)
1～221.0(9.1, 42.2)4 106(55.2)1 742(23.4)1 584(21.4)
3～421.9(9.4, 42.4)1 149(54.3)540(25.5)426(20/2)
≥522.0(8.5, 44.4)676(53.1)310(24.3)288(22.6)
), ArticleFig(id=1241771817401127468, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241771809121570983, language=EN, label=Table 3, caption=

Multiplelinear regression analysis of factors for added sugar intakeamong primary school students

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自变量未标准化系数标准误标准化系数t值P值
性别-2.720.60-0.04-4.55<0.001
年级1.090.170.066.31<0.001
地区0.710.620.011.150.249
BMI0.730.34-0.022.140.032
睡眠时长-3.820.57-0.06-6.68<0.001
中高强度身体活动0.220.370.010.580.561
), ArticleFig(id=1241771817514373681, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241771809121570983, language=CN, label=表3, caption=

小学生添加糖摄入量影响因素的多元线性回归分析

, figureFileSmall=null, figureFileBig=null, tableContent=
自变量未标准化系数标准误标准化系数t值P值
性别-2.720.60-0.04-4.55<0.001
年级1.090.170.066.31<0.001
地区0.710.620.011.150.249
BMI0.730.34-0.022.140.032
睡眠时长-3.820.57-0.06-6.68<0.001
中高强度身体活动0.220.370.010.580.561
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基于食物图谱辅助的连云港市小学生添加糖摄入调查
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王晨曲 , 周明
现代预防医学 | 营养与食品卫生 2024,51(20): 3702-3706
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现代预防医学 | 营养与食品卫生 2024, 51(20): 3702-3706
基于食物图谱辅助的连云港市小学生添加糖摄入调查
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王晨曲, 周明
作者信息
  • 南京医科大学公共卫生学院，江苏 南京 211166

    • 王晨曲（1999—），男，硕士在读，研究方向：营养与健康

通讯作者:

周明，E-mail:
Investigation on added sugar intake among primary school students based on food atlas,Lianyungang
Chen-qu WANG, Ming ZHOU
Affiliations
  • School of Public Health, Nanjing Medical University, Nanjing, Jiangsu 211166, China
出版时间: 2024-10-25 doi: 10.20043/j.cnki.MPM.202406400
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摘要
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目的

了解小学生添加糖摄入情况，分析摄入来源和影响因素并提出改善对策。

方法

2023年10月-2024年3月，采用分层整群抽样法选取连云港市12 603名小学生为调查对象，利用基于食物图谱辅助的问卷调查含添加糖食品的摄入情况并计算每日添加糖摄入量。

结果

小学生添加糖摄入量中位数为22.1 g/d，45.7%的学生超过25 g/d，21.7%的学生超过50 g/d。含糖饮料、风味酸奶、糕点和甜食是小学生添加糖摄入的四大主要来源（占比分别为38.3%、24.0%、14,1%和12.1%）。多元线性回归分析显示，男生、高年级、高BMI和睡眠时间少与添加糖摄入增加有关。

结论

连云港市小学生添加糖摄入过量状况较为突出。一方面要开展营养教育活动，宣传添加糖摄入过多存在的危害；同时建议将添加糖含量纳入营养标签管理，指导青少年合理选择健康食品。

食物图谱  /  小学生  /  添加糖  /  含糖饮料  /  风味酸奶
Objective

To understand the intake of added sugars among primary school students, to analyze the sources and influencing factors of intake, and to propose improvement measures.

Methods

A stratified cluster sampling method was used to select 12,603 primary school students in Lianyungang as the research subjects. A food atlas-based questionnaire was used to investigate the intake of foods with added sugars and calculate daily intake of added sugars.

Results

The median added sugar intake of primary school students was 22.1 g/day, 45.7% of students consumed more than 25 g/day, and 21.7% of students consumed more than 50 g/day. Sugar-sweetened beverages, flavored yogurt, pastries and sweets were the four main sources of added sugar intake among primary school students (accounting for 38.3%, 24.0%, 14.1% and 12.1% respectively). Multiple linear regression analysis showed that boys, higher grade, higher BMI, and less sleep were associated with increased intake of added sugars.

Conclusions

The excessive intake of added sugar by primary school students in Lianyungang was quite prominent. On the one hand, nutrition education should be carried out to publicize the harm of excessive intake of added sugar.On the other hand, it isrecommended to include the added sugar content in the nutrition label to guide teenagers to choose healthy food.

Food atlas  /  Primary school students  /  Added sugars  /  Sugar-sweetened beverages  /  Flavored yogurt
王晨曲, 周明. 基于食物图谱辅助的连云港市小学生添加糖摄入调查. 现代预防医学, 2024 , 51 (20) : 3702 -3706 . DOI: 10.20043/j.cnki.MPM.202406400
Chen-qu WANG, Ming ZHOU. Investigation on added sugar intake among primary school students based on food atlas,Lianyungang[J]. Modern Preventive Medicine, 2024 , 51 (20) : 3702 -3706 . DOI: 10.20043/j.cnki.MPM.202406400
正文
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添加糖，指在食品生产和制备过程中被添加到食品中的糖及糖浆，其具有热量高、营养密度低的特点[1]。研究显示，添加糖摄入过多不仅会影响其他营养素的吸收，还与糖尿病、高血压、抑郁症等多种生理心理疾病的发生密切相关[2]。青少年摄入添加糖过多还会损害认知功能及钙质代谢，影响骨骼生长发育[3]。《中国居民膳食指南（2022）》建议每天添加糖摄入不超过50g，最好控制在25g以下[4]。然而，根据《中国城市居民糖摄入水平及其风险评估报告（摘要）》的数据，我国7～12岁年龄组人群有27.2%糖摄入超过25g，有3.3%超过50g，且摄入量还在逐年增长[5]，需要引起高度重视。既往研究中通常采用24h膳食回顾法或食物频率法调查添加糖摄入量[6-7]。24h膳食回顾法基于回忆，对儿童适用性较差且难以反映长期食物消费状况；食物频率法虽可了解被调查者过去较长时间的饮食情况，但存在食物份额量化不准确的问题。因此，本研究基于食物图谱辅助的调查方式，以期获得更准确、更具代表性的儿童添加糖摄入情况，为进一步精准防控提供科学依据。
1　对象与方法
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1.1　对象
2023年10月—2024年3月，采用分层整群抽样法，在江苏省连云港市城市和农村地区分别抽取3个乡镇，每个乡镇随机选择6所小学，每所小学的各个年级随机抽取1个班，对所抽到班级的全体学生进行调查。6个乡镇共计选取36所学校，12 603名学生。调查以自愿参加为原则，学生和家长均知晓调查内容和方案，并签署了知情同意书。
1.2　方法
1.2.1　调查的基本内容
针对本研究目的初步设计问卷，经咨询专家和小范围预调查后进行修改，确定正式问卷用于调查。问卷内容包括人口学特征和含添加糖食品的摄入情况。人口学特征主要包括性别、年级、地区等信息；含添加糖食品的摄入情况采用食物频率法，调查对象填写过去1年内某类食品的摄入频率，同时依据问卷中的食物图谱估计每次摄入量。
1.2.2　食品种类的纳入
参考国内外有关文献[6,8]，确定食品类别包括含糖饮料、甜食、糕点、风味酸奶和其他含添加糖食品五大类。其中，含糖饮料填写碳酸类、含乳类、茶类、果汁和蔬菜汁类和其他类共5种饮品；甜食填写糖果、巧克力、果冻和冰激凌共4种食品；糕点填写面包、西点蛋糕和其他类糕点共3种食品；其他含添加糖食品填写奶茶、饼干和烹饪用糖。
1.2.3　含添加糖食品的图谱建立
参考《回顾性膳食调查辅助估量食物图谱》建立含添加糖食品的食物图谱[9]，借助食物份量对比、背景刻度坐标和常见物品三个视觉参照体系，帮助被调查者更好地依据记忆中的食物视觉信息估计各种食物的摄入量。见图1。食物图谱建立的具体步骤包括：食品样本选择、食品样本称量与展示和食品图片的拍照记录。
1.2.4　添加糖摄入量的计算和分组
通过中国疾病预防控制中心发布的“食物营养成分查询平台”和相关研究文献[10-11]获得各类食品的添加糖含量，通过以下公式计算调查对象每日添加糖摄入量：
添加糖摄入量（g/d）=食品摄入频率（次/月）× 食品摄入量（g）× 食品添加糖含量（g/100g）÷ 30。
根据《中国居民膳食指南2022》对添加糖摄入量按低、中、高分为三组，分别为：≤25 g/d、>25且≤50 g/d和>50 g/d。
1.2.5　体格测量
由培训合格的调查员进行体格测量工作。调查对象脱鞋站立在体格测量仪底板上，双足并拢，脚跟、骶骨部及两肩胛间紧靠体格测量仪立柱，测量身高至0.1 cm，体重至0.1 kg。
1.3　质量控制
调查开始前对调查员开展统一培训。每日体格测量前由专人对体格测量仪进行校正，测量后对数据进行双录入。问卷采用电子版形式，由选定班级的班主任在班级群内发布，家长和学生共同填写。问卷填写完成后自动提交，由质量管理人员对问卷内容进行核查。
1.4　统计分析
所有数据均采用SPSS 25.0进行统计分析。添加糖摄入量呈偏态分布，采用中位数 [M（P25, P75） ]进行描述。根据数据性质分别采用秩和检验、χ2检验比较组间差异，采用多元线性回归模型分析影响因素，检验水准α=0.05。
2　结果
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2.1　调查对象基本情况
所纳入的12 603名学生中，男生7 026人（55.8%），女生5 577人（44.2%）；城市地区7 681人（60.9%），农村地区4 922人（39.1%）；BMI正常学生8 875人（70.4%），超重及肥胖学生合计3 728人（29.6%）。见表1。
2.2　添加糖摄入来源分析
研究结果显示，小学生添加糖摄入来源从高到底依次为：含糖饮料38.3%、风味酸奶24.0%、糕点14.1%、甜食12.1%、其他含添加糖食品11.5%。按性别划分，男生从含糖饮料和风味酸奶中摄入的糖比女生更多；按地区划分，城市学生从风味酸奶、甜食和其他含添加糖食品中摄入的糖比农村学生更多。上述差异均有统计学意义（P<0.05）。见图2。
2.3　添加糖摄入量和分布
调查对象每日添加糖摄入量中位数为22.1 g，男生和女生分别为22.7 g和20.2 g。一至六年级学生每日添加糖摄入量存在差异，中位数分别为19.9 g、20.3 g、21.4 g、23.0 g、22.9 g和23.6 g。睡眠时长<9 h/d的学生每日添加糖摄入量高于睡眠时长9～10 h/d和>10 h/d的学生，摄入量中位数分别为24.3 g、20.2 g和20.6 g。上述差异均有统计学意义（P <0.05）。见表2。
调查对象每日添加糖摄入量低中高三组的比例分别为54.3%、24.0%和21.7%。性别之间、不同年级学生之间、城市和农村学生之间每日添加糖摄入量的分布不同，上述差异均有统计学意义（P <0.05）。见表2。
2.4　添加糖摄入量影响因素的多元线性回归分析
以性别、年级、地区、BMI指数、睡眠时长和中高强度身体活动频率为自变量，添加糖摄入量为因变量进行多元线性回归分析。结果表明，男生、高年级、高BMI和睡眠时间少与添加糖摄入增加有关。见表3。
3　讨论
收起
本研究中连云港市小学生添加糖摄入量中位数为22.1 g，有45.7%的学生超过25 g/d，21.7%的学生超过50 g/d,各项指标相比2021年发布的《中国城市居民糖摄入水平及其风险评估》中7～12岁年龄组的数据均有所增加[5]。另外，男生添加糖摄入量高于女生，这可能与饮食习惯和对能量的需求有关[6]。高年级学生的添加糖摄入量高于低年级学生，与国内外相关研究结果类似。西班牙的全国性横断面调查研究显示[12],7～12岁儿童平均添加糖摄入量为55.7 g/d，且随年龄增长而增加；Yang等[13]在2021年对长沙市12～14岁青少年游离糖摄入的调查也有类似发现，可能是由于学生群体在食物选择方面还不成熟，且高年级学生较低年级学生在食物选择方面更加自主和独立。此外，睡眠时长<9 h/d的学生添加糖摄入量高于睡眠时长9～10 h/d和>10 h/d的学生，这可能是因为睡眠时间较少的学生需要摄入更多糖分来提振精神[14]。
本研究发现，含糖饮料、风味酸奶、糕点和甜食是小学生添加糖摄入的四大主要来源（占每日添加糖摄入量的88.5%）。价格低廉、口味多样、添加糖含量较高可能是小学生乐于购买含糖饮料且从中摄入添加糖较多的原因[15]。本研究中小学生每日摄入的添加糖有38.3%来自含糖饮料，高于《中国城市居民糖摄入水平及其风险评估》中3～17岁组含糖食品高消费者中的饮料对糖摄入的贡献率（25.5%）[5]。另外，每日含糖饮料摄入量较高的学生，其甜食摄入量也较高，这可能是因为喜欢喝含糖饮料的学生也有吃甜食的习惯[8]，提示想要减少小学生添加糖摄入量需要从改变饮食习惯着手。
风味酸奶在国内以往的研究中较少被涉及，本研究发现其对小学生添加糖摄入的贡献接近四分之一（24.0%）。由于酸奶富含优质蛋白质和钙且易被消化吸收，家长通常并不严格控制孩子对酸奶的摄入量。然而，食品厂商出于改善口感的目的通常会向酸奶中加入糖、香精等风味物质来遮掩酸奶经过发酵后产生的酸味。研究显示[16]，风味改善后的酸奶相比改善前在添加糖含量上高出4%～15%。因此，家长在为孩子购买酸奶时应尽量选择不添加其他风味物质的原味酸奶，减少添加糖摄入。
除含糖饮料和风味酸奶外，居民对于糕点和甜食的摄入也应引起关注。李冬华等[17]研究发现，我国九省成人居民糕点、甜食等含添加糖食品的消费率由1997年的8.9%攀升至2009年的25.4%；任志斌等[8]在对中国11～14岁儿童的调查中发现，70.0%的调查对象在过去一个月内曾经吃过糕点、甜食类食品。本研究中小学生糕点和甜食摄入也较为普遍，对每日添加糖摄入的贡献率合计为26.2%。
本研究的优势在于利用多参照体系的食物图谱，帮助被调查者依据记忆中的食物视觉信息更精准地估计添加糖摄入量；同时基于大样本，可获得更准确的添加糖摄入情况。尽管如此，本研究仍存在一定的局限性。一是采用横断面研究，难以确定添加糖摄入量与影响因素的因果关系；二是人群存在地域性限制，不同地区的饮食习惯存在差异，需要开展多中心研究更准确地了解各地添加糖摄入情况。
本文调查结果显示，连云港市小学生添加糖摄入过量状况较为突出，近半数学生每日添加糖摄入量超过25 g，摄入来源涵盖糕点，甜食，饮料等众多食品。为减少添加糖摄入，相关部门一方面应积极开展营养进校园活动，采用多种方式向学生群体科普营养相关知识，尤其是对添加糖摄入过多存在危害的宣传，提高学生健康意识；另一方面，还应在深入研究其他国家经验的基础上制定、更新符合我国国情的营养标签规范，将添加糖含量纳入标签管理，同时引入食品营养评级机制，指导青少年群体合理选择健康食品。
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2024年第51卷第20期
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doi: 10.20043/j.cnki.MPM.202406400
  • 接收时间：2024-06-25
  • 首发时间：2026-03-20
  • 出版时间：2024-10-25
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    南京医科大学公共卫生学院，江苏 南京 211166

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鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
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