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Article(id=1324078029349192504, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1324077868950631142, articleNumber=null, orderNo=null, doi=10.20043/j.cnki.MPM.202509089, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1756915200000, receivedDateStr=2025-09-04, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1793614402377, onlineDateStr=2026-11-02, pubDate=1771948800000, pubDateStr=2026-02-25, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793614402377, onlineIssueDateStr=2026-11-02, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793614402377, creator=13701087609, updateTime=1793614402377, updator=13701087609, issue=Issue{id=1324077868950631142, tenantId=1146029695717560320, journalId=1227665162245664772, year='2026', volume='53', issue='4', pageStart='577', pageEnd='768', issueExtLink='null', onlineDate='null', pubDate='1771948800000', pubDateStr='2026-02-25', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=0, createTime=1793614364134, creator='13701087609', updateTime=1793614446224, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1324078213328142371, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1324077868950631142, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1324078213332336676, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1324077868950631142, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=637, endPage=643, ext={EN=ArticleExt(id=1324078029592462137, articleId=1324078029349192504, tenantId=1146029695717560320, journalId=1227665162245664772, language=EN, title=Association between nutritional health knowledge and dietary patterns among childbearing-age women，Hunan-mediated effect analysis based on eating out and breakfast frequency, columnId=1228016568949474136, journalTitle=Modern Preventive Medicine, columnName=Child and Adolescent health, Maternal and Child Health, runingTitle=null, highlight=null, articleAbstract=
Objective

To investigate the impact of nutritional health knowledge levels on dietary patterns among childbearing-age women, to analyze the mediating role of eating out and breakfast consumption frequency, and to provide evidence-based references for formulating nutritional intervention strategies.

Methods

A total of 1 340 reproductive-age women aged 18-49 years from 10 districts/counties in Hunan Province were selected as research subjects from the 2022-2023 National Survey on Residents’ Nutritional and Health Knowledge Awareness. Data on basic information, nutritional and health knowledge, and dietary consumption were collected. Factor analysis was used to extract dietary patterns, Logistic regression to examine the association between knowledge levels and dietary patterns, and structural equation modeling with Bootstrap method to test mediating effects.

Results

Among women of childbearing age in Hunan Province, the nutrition and health knowledge awareness rate was 25.9%, 29.8% eating out ≥1 day/week, and 26.6% having breakfast <7 days/week. Four dietary patterns were identified: high-energy, fruit-dairy-seafood, poultry-egg-bean, and whole grain-vegetable. Logistic regression showed that the level of nutrition and health knowledge was negatively correlated with high-energy dietary pattern (OR=0.428, 95% CI:0.319-0.575) and positively correlated with whole grain-vegetable dietary pattern (OR=1.513, 95% CI:1.142-2.005). Mediator effect analysis showed the total effect of knowledge on high-energy pattern was -0.493(-0.616--0.370), direct effect was -0.278(-0.382--0.174), mediating effects of eating out and breakfast consumption frequency were -0.180(-0.250--0.117) and -0.035(-0.057--0.016), accounting for 43.6% of total effect; total effect on whole grain-vegetable pattern was 0.132(0.007-0.256), direct effect was 0.108(-0.017-0.232), mediating effect of breakfast frequency was 0.024(0.008-0.047), accounting for 18.2% of total effect.

Conclusion

Eating out and breakfast consumption frequency mediate the relationship between childbearing-age women’s nutritional health knowledge level and high-energy dietary patterns, and whole-grain vegetable dietary patterns.

, authors=Yun-feng PAN, Qiang WANG, Jia-hao XIONG, authorsList=Yun-feng PAN, Qiang WANG, Jia-hao XIONG, authorCompany=null, correspAuthors=Jia-hao XIONG, authorNote=null, correspAuthorsNote=null, copyrightStatement=null, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1324078030548763454, articleId=1324078029349192504, tenantId=1146029695717560320, journalId=1227665162245664772, language=CN, title=湖南省育龄妇女营养健康知识水平与膳食模式的关联——基于在外就餐与早餐频次的中介效应分析, columnId=1228016570031604578, journalTitle=现代预防医学, columnName=儿少卫生与妇幼保健, runingTitle=null, highlight=null, articleAbstract=
目的

探讨育龄妇女营养健康知识水平对膳食模式的影响，分析在外就餐与早餐食用频次的中介作用，为制定营养干预策略提供参考依据。

方法

在2022—2023年中国居民营养健康知识知晓率调查项目中，选取湖南省10个区/县1 340名18~49岁育龄妇女作为研究对象，收集基本信息、营养健康知识及膳食消费数据。通过因子分析提取膳食模式，采用logistic回归分析营养健康知识水平与膳食模式的关联，结构方程模型和Bootstrap法分析中介效应。

结果

湖南省育龄妇女营养健康知识知晓率为25.9%，在外就餐≥1天/周者占29.8%、早餐食用频次<7天/周者占26.6%。因子分析提取出高能量、水果奶水产类、畜禽蛋豆类、粗粮蔬菜类4种膳食模式。logistic回归显示：营养健康知识水平与高能量膳食模式呈负相关（OR=0.428, 95% CI:0.319~0.575, P<0.001），与粗粮蔬菜类膳食模式呈正相关（OR=1.513, 95% CI:1.142~2.005, P=0.004）。中介效应分析显示：营养健康知识水平对高能量膳食模式的总效应为-0.493（-0.616~-0.370），直接效应为-0.278（-0.382~-0.174），在外就餐和早餐食用频次的中介效应分别为-0.180（-0.250~-0.117）和-0.035（-0.057~-0.016），两者合计占总效应的43.6%；营养健康知识水平对粗粮蔬菜类膳食模式总效应为0.132（0.007~0.256），直接效应为0.108（-0.017~0.232），早餐食用频次的中介效应为0.024（0.008~0.047），占总效应18.2%。

结论

在外就餐与早餐频次在育龄妇女营养健康知识水平与高能量和粗粮蔬菜类膳食模式之间存在中介效应。

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潘云凤（1998—），女，硕士，医师，研究方向：公共营养

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熊家豪，E-mail:
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BMC Public Health, 2023, 23(1): 1132., articleTitle=High nutrition literacy linked with low frequency of take-out food consumption in Chinese college students, refAbstract=null), Reference(id=1324078042041156484, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078029349192504, doi=null, pmid=null, pmcid=null, year=2018, volume=15, issue=2, pageStart=164, pageEnd=166, url=null, language=null, rfNumber=[23], rfOrder=32, authorNames=龙君, journalName=湖南师范大学学报:医学版, refType=null, unstructuredReference=龙君．禁食早餐对肥胖人群血糖及血脂,胰岛素敏感性,食欲相关激素及炎性因子的影响[J]．湖南师范大学学报:医学版，2018，15（2）：164-166．, articleTitle=禁食早餐对肥胖人群血糖及血脂,胰岛素敏感性,食欲相关激素及炎性因子的影响, refAbstract=null), Reference(id=1324078042108265349, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078029349192504, doi=null, pmid=null, pmcid=null, year=2018, volume=15, issue=2, pageStart=164, pageEnd=166, url=null, language=null, rfNumber=[23], rfOrder=33, authorNames=Long J, journalName=Journal of Hunan Normal University(Medical Science), refType=null, unstructuredReference=Long J. The effect of breakfast skipping on body weight, metabolic index, appetite and inflammation index of obese adults[J]. Journal of Hunan Normal University(Medical Science), 2018, 15(2): 164-166. (In Chinese), articleTitle=The effect of breakfast skipping on body weight, metabolic index, appetite and inflammation index of obese adults, refAbstract=null), Reference(id=1324078042196345734, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078029349192504, doi=null, pmid=null, pmcid=null, year=2023, volume=37, issue=4, pageStart=21, pageEnd=24, url=null, language=null, rfNumber=[24], rfOrder=34, authorNames=雷新英, 倪春晓, 陈济丽, journalName=中国初级卫生保健, refType=null, unstructuredReference=雷新英，倪春晓，陈济丽，等．云和县合理膳食行动对社区居民营养知识及饮食行为的影响[J]．中国初级卫生保健，2023，37（4）：21-24．, articleTitle=云和县合理膳食行动对社区居民营养知识及饮食行为的影响, refAbstract=null), Reference(id=1324078042280231815, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078029349192504, doi=null, pmid=null, pmcid=null, year=2023, volume=37, issue=4, pageStart=21, pageEnd=24, url=null, language=null, rfNumber=[24], rfOrder=35, authorNames=Lei XY, Ni CX, Chen JL, journalName=Chinese Primary Health Care, refType=null, unstructuredReference=Lei XY, Ni CX, Chen JL, et al. Effects of reasonable Diet action on nutrition knowledge and eating behavior of community residents in Yunhe county[J]. Chinese Primary Health Care, 2023, 37(4): 21-24. (In Chinese), articleTitle=Effects of reasonable Diet action on nutrition knowledge and eating behavior of community residents in Yunhe county, refAbstract=null), Reference(id=1324078042343146376, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078029349192504, doi=null, pmid=null, pmcid=null, year=2024, volume=30, issue=4, pageStart=5, pageEnd=10, url=null, language=null, rfNumber=[25], rfOrder=36, authorNames=毕小艺, 曹秋野, 王瑛瑶, journalName=中国食物与营养, refType=null, unstructuredReference=毕小艺，曹秋野，王瑛瑶，等．我国城市成年居民早餐食物种类调查[J]．中国食物与营养，2024，30（4）：5-10．, articleTitle=我国城市成年居民早餐食物种类调查, refAbstract=null), Reference(id=1324078042410255241, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078029349192504, doi=null, pmid=null, pmcid=null, year=2024, volume=30, issue=4, pageStart=5, pageEnd=10, url=null, language=null, rfNumber=[25], rfOrder=37, authorNames=Bi XY, Cao QY, Wang YY, journalName=Food and Nutrition in China, refType=null, unstructuredReference=Bi XY, Cao QY, Wang YY, et al. A survey on breakfast food types of urban adults in China[J]. Food and Nutrition in China, 2024, 30(4): 5-10. (In Chinese), articleTitle=A survey on breakfast food types of urban adults in China, refAbstract=null)], funds=[Fund(id=1324078035321881443, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078029349192504, awardId=QHJJ2023014, language=CN, fundingSource=湖南省疾病预防控制中心‘青荷’青年培育基金项目(QHJJ2023014), fundOrder=null, country=null)], companyList=[AuthorCompany(id=1324078030800421695, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078029349192504, xref=null, ext=[AuthorCompanyExt(id=1324078030808810304, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078029349192504, companyId=1324078030800421695, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=Institute of Nutrition, Food Health, and Child and Adolescent Health, Hunan Provincial Center for Disease Control and Prevention(Hunan Academy of Preventive Medicine), Changsha, Hunan 410153, China), AuthorCompanyExt(id=1324078030821393217, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078029349192504, companyId=1324078030800421695, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=湖南省疾病预防控制中心（湖南省预防医学科学院）营养食品健康与儿少卫生所，湖南 长沙 410153)])], figs=[ArticleFig(id=1324078034277499739, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078029349192504, language=EN, label=Fig.1, caption=Path coefficient plots for frequency of eating out/ordering takeout, frequency of breakfast consumption, nutritional knowledge and meal patterns, figureFileSmall=YoSGtcj9gfInV5nnloZFew==, figureFileBig=Fu/9fe9vjXBdLWdJYQJlJw==, tableContent=null), ArticleFig(id=1324078034365580124, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078029349192504, language=CN, label=图1, caption=在外就餐频次、早餐食用频次、营养健康知识与膳食模式的路径系数图

注：X为是否知晓营养健康知识、M1为在外就餐频次、M2为早餐食用频次、Y1为高能量膳食模式、Y2为粗粮蔬菜类膳食模式；***代表P<0.001；ns代表P>0.05。

, figureFileSmall=YoSGtcj9gfInV5nnloZFew==, figureFileBig=Fu/9fe9vjXBdLWdJYQJlJw==, tableContent=null), ArticleFig(id=1324078034701124445, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078029349192504, language=EN, label=Tablle 1, caption=

Factor loadings for different dietary patterns

, figureFileSmall=null, figureFileBig=null, tableContent=
食物类别因子载荷值
高能量膳食模式水果奶水产类膳食模式畜禽蛋豆类膳食模式粗粮蔬菜类膳食模式
全谷物/粗杂粮0.1580.0090.1000.881
水果0.0490.7810.1080.219
蔬菜-0.2030.4600.0570.498
奶及奶制品0.2980.7670.163-0.148
水产品0.4000.5020.3850.053
蛋类0.1120.3100.6830.116
畜禽肉类0.1110.0260.8410.062
加工肉类0.7670.1090.162-0.011
大豆及其制品0.4820.1330.551-0.018
坚果类0.6290.3460.280-0.098
油炸食品类0.8590.0970.0740.034
含糖饮料0.7830.0450.1380.092
酒类0.7980.0470.0800.022
), ArticleFig(id=1324078034785010526, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078029349192504, language=CN, label=表1, caption=

不同膳食模式的因子载荷值

, figureFileSmall=null, figureFileBig=null, tableContent=
食物类别因子载荷值
高能量膳食模式水果奶水产类膳食模式畜禽蛋豆类膳食模式粗粮蔬菜类膳食模式
全谷物/粗杂粮0.1580.0090.1000.881
水果0.0490.7810.1080.219
蔬菜-0.2030.4600.0570.498
奶及奶制品0.2980.7670.163-0.148
水产品0.4000.5020.3850.053
蛋类0.1120.3100.6830.116
畜禽肉类0.1110.0260.8410.062
加工肉类0.7670.1090.162-0.011
大豆及其制品0.4820.1330.551-0.018
坚果类0.6290.3460.280-0.098
油炸食品类0.8590.0970.0740.034
含糖饮料0.7830.0450.1380.092
酒类0.7980.0470.0800.022
), ArticleFig(id=1324078034915033951, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078029349192504, language=EN, label=Table 2, caption=

Binary logistic regression (OR (95% CI)) of different dietary patterns of women of childbearing age in hunan province

, figureFileSmall=null, figureFileBig=null, tableContent=
变量高能量膳食模式水果奶水产类膳食模式畜禽蛋豆类膳食模式粗粮蔬菜类膳食模式
居住地
城市（参照）----
农村0.732(0.527~1.018)0.697(0.515~0.942)a0.784(0.580~1.060)2.362(1.734~3.217)c
年龄组0.868(0.732~1.031)0.931(0.794~1.092)0.901(0.769~1.056)1.057(0.899~1.243)
婚姻状况
未婚(参照）----
有配偶0.902(0.596~1.365)1.728(1.169~2.557)a1.324(0.899~1.95)1.301(0.871~1.945)
离异1.050(0.391~2.817)0.58(0.218~1.542)1.431(0.579~3.535)0.555(0.198~1.557)
丧偶0.662(0.088~4.978)0.753(0.079~7.181)2.439(0.376~15.826)3.558(0.374~33.892)
文化程度0.995(0.864~1.147)1.011(0.886~1.154)0.964(0.846~1.099)0.967(0.846~1.106)
工作单位
医疗卫生机构0.946(0.637~1.403)0.970(0.673~1.399)1.35(0.937~1.944)0.516(0.353~0.754)b
其他健康相关产业2.015(0.787~5.159)1.846(0.723~4.714)0.955(0.403~2.267)0.638(0.26~1.568)
教育相关行业0.745(0.455~1.222)1.357(0.858~2.146)0.929(0.593~1.456)0.447(0.277~0.723)b
农副产品加工业、食品制造业1.572(0.624~3.957)1.195(0.54~2.644)0.499(0.224~1.113)1.2(0.545~2.644)
餐饮业和食品批发零售业0.773(0.401~1.491)0.762(0.428~1.357)0.574(0.318~1.036)0.942(0.524~1.693)
农林牧渔业0.941(0.683~1.298)0.692(0.513~0.931)a0.783(0.583~1.052)0.756(0.56~1.022)
其他(参照）----
家庭人均年收入0.983(0.860~1.123)1.002(0.884~1.136)0.879(0.776~0.995)a0.949(0.835~1.078)
BMI1.049(0.873~1.259)0.885(0.747~1.049)0.800(0.676~0.948)a0.956(0.804~1.136)
是否患慢性病
是(参照）----
否0.678(0.410~1.122)1.025(0.651~1.613)0.860(0.548~1.349)1.043(0.656~1.657)
不清楚1.244(0.848~1.824)0.801(0.562~1.142)1.378(0.968~1.962)0.937(0.651~1.349)
营养健康知识
不知晓(参照）----
知晓0.428(0.319~0.575)c1.272(0.97~1.668)0.914(0.698~1.197)1.513(1.142~2.005)b
早餐食用频次0.762(0.695~0.837)c1.004(0.929~1.085)1.115(1.029~1.208)b1.184(1.090~1.285)c
在外就餐频次1.481(1.354~1.619)c1.132(1.056~1.213)c1.122(1.047~1.202)b1.061(0.989~1.139)
), ArticleFig(id=1324078035019891552, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078029349192504, language=CN, label=表2, caption=

湖南省育龄妇女不同膳食模式的二元logistic回归（OR值(95% CI)）

, figureFileSmall=null, figureFileBig=null, tableContent=
变量高能量膳食模式水果奶水产类膳食模式畜禽蛋豆类膳食模式粗粮蔬菜类膳食模式
居住地
城市（参照）----
农村0.732(0.527~1.018)0.697(0.515~0.942)a0.784(0.580~1.060)2.362(1.734~3.217)c
年龄组0.868(0.732~1.031)0.931(0.794~1.092)0.901(0.769~1.056)1.057(0.899~1.243)
婚姻状况
未婚(参照）----
有配偶0.902(0.596~1.365)1.728(1.169~2.557)a1.324(0.899~1.95)1.301(0.871~1.945)
离异1.050(0.391~2.817)0.58(0.218~1.542)1.431(0.579~3.535)0.555(0.198~1.557)
丧偶0.662(0.088~4.978)0.753(0.079~7.181)2.439(0.376~15.826)3.558(0.374~33.892)
文化程度0.995(0.864~1.147)1.011(0.886~1.154)0.964(0.846~1.099)0.967(0.846~1.106)
工作单位
医疗卫生机构0.946(0.637~1.403)0.970(0.673~1.399)1.35(0.937~1.944)0.516(0.353~0.754)b
其他健康相关产业2.015(0.787~5.159)1.846(0.723~4.714)0.955(0.403~2.267)0.638(0.26~1.568)
教育相关行业0.745(0.455~1.222)1.357(0.858~2.146)0.929(0.593~1.456)0.447(0.277~0.723)b
农副产品加工业、食品制造业1.572(0.624~3.957)1.195(0.54~2.644)0.499(0.224~1.113)1.2(0.545~2.644)
餐饮业和食品批发零售业0.773(0.401~1.491)0.762(0.428~1.357)0.574(0.318~1.036)0.942(0.524~1.693)
农林牧渔业0.941(0.683~1.298)0.692(0.513~0.931)a0.783(0.583~1.052)0.756(0.56~1.022)
其他(参照）----
家庭人均年收入0.983(0.860~1.123)1.002(0.884~1.136)0.879(0.776~0.995)a0.949(0.835~1.078)
BMI1.049(0.873~1.259)0.885(0.747~1.049)0.800(0.676~0.948)a0.956(0.804~1.136)
是否患慢性病
是(参照）----
否0.678(0.410~1.122)1.025(0.651~1.613)0.860(0.548~1.349)1.043(0.656~1.657)
不清楚1.244(0.848~1.824)0.801(0.562~1.142)1.378(0.968~1.962)0.937(0.651~1.349)
营养健康知识
不知晓(参照）----
知晓0.428(0.319~0.575)c1.272(0.97~1.668)0.914(0.698~1.197)1.513(1.142~2.005)b
早餐食用频次0.762(0.695~0.837)c1.004(0.929~1.085)1.115(1.029~1.208)b1.184(1.090~1.285)c
在外就餐频次1.481(1.354~1.619)c1.132(1.056~1.213)c1.122(1.047~1.202)b1.061(0.989~1.139)
), ArticleFig(id=1324078035103777633, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078029349192504, language=EN, label=Table 3, caption=

Mediation effect analysis of eating out frequency and breakfast consumption frequency among women of childbearing age in Hunan province

, figureFileSmall=null, figureFileBig=null, tableContent=
EffectBoot SEBoot LLCIBoot ULCI效应占比
营养健康知识→高能量膳食模式
总效应-0.4930.063-0.616-0.370100.0%
直接效应-0.2780.053-0.382-0.17456.4%
总中介效应-0.2150.036-0.288-0.14843.6%
中介效应1a-0.1800.034-0.250-0.11736.5%
中介效应2b-0.0350.011-0.057-0.0167.1%
营养健康知识→粗粮蔬菜类膳食模式
总效应0.1320.0630.0070.256100.0%
直接效应0.1080.063-0.0170.23281.8%
中介效应c0.0240.0100.0080.04718.2%
), ArticleFig(id=1324078035183469410, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078029349192504, language=CN, label=表3, caption=

湖南省育龄妇女在外就餐频次与早餐食用频次的中介效应分析

, figureFileSmall=null, figureFileBig=null, tableContent=
EffectBoot SEBoot LLCIBoot ULCI效应占比
营养健康知识→高能量膳食模式
总效应-0.4930.063-0.616-0.370100.0%
直接效应-0.2780.053-0.382-0.17456.4%
总中介效应-0.2150.036-0.288-0.14843.6%
中介效应1a-0.1800.034-0.250-0.11736.5%
中介效应2b-0.0350.011-0.057-0.0167.1%
营养健康知识→粗粮蔬菜类膳食模式
总效应0.1320.0630.0070.256100.0%
直接效应0.1080.063-0.0170.23281.8%
中介效应c0.0240.0100.0080.04718.2%
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湖南省育龄妇女营养健康知识水平与膳食模式的关联——基于在外就餐与早餐频次的中介效应分析
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潘云凤 , 汪强 , 熊家豪
现代预防医学 | 儿少卫生与妇幼保健 2026,53(4): 637-643
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现代预防医学 |儿少卫生与妇幼保健 2026 , 53 (4) : 637 -643
湖南省育龄妇女营养健康知识水平与膳食模式的关联——基于在外就餐与早餐频次的中介效应分析
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潘云凤, 汪强, 熊家豪
作者信息
  • 湖南省疾病预防控制中心（湖南省预防医学科学院）营养食品健康与儿少卫生所，湖南 长沙 410153
通讯作者:
熊家豪，E-mail:
作者简介:

潘云凤（1998—），女，硕士，医师，研究方向：公共营养

Association between nutritional health knowledge and dietary patterns among childbearing-age women，Hunan-mediated effect analysis based on eating out and breakfast frequency
Yun-feng PAN, Qiang WANG, Jia-hao XIONG
Affiliations
  • Institute of Nutrition, Food Health, and Child and Adolescent Health, Hunan Provincial Center for Disease Control and Prevention(Hunan Academy of Preventive Medicine), Changsha, Hunan 410153, China
出版时间: 2026-02-25 doi: 10.20043/j.cnki.MPM.202509089
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摘要
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目的

探讨育龄妇女营养健康知识水平对膳食模式的影响，分析在外就餐与早餐食用频次的中介作用，为制定营养干预策略提供参考依据。

方法

在2022—2023年中国居民营养健康知识知晓率调查项目中，选取湖南省10个区/县1 340名18~49岁育龄妇女作为研究对象，收集基本信息、营养健康知识及膳食消费数据。通过因子分析提取膳食模式，采用logistic回归分析营养健康知识水平与膳食模式的关联，结构方程模型和Bootstrap法分析中介效应。

结果

湖南省育龄妇女营养健康知识知晓率为25.9%，在外就餐≥1天/周者占29.8%、早餐食用频次<7天/周者占26.6%。因子分析提取出高能量、水果奶水产类、畜禽蛋豆类、粗粮蔬菜类4种膳食模式。logistic回归显示：营养健康知识水平与高能量膳食模式呈负相关（OR=0.428, 95% CI:0.319~0.575, P<0.001），与粗粮蔬菜类膳食模式呈正相关（OR=1.513, 95% CI:1.142~2.005, P=0.004）。中介效应分析显示：营养健康知识水平对高能量膳食模式的总效应为-0.493（-0.616~-0.370），直接效应为-0.278（-0.382~-0.174），在外就餐和早餐食用频次的中介效应分别为-0.180（-0.250~-0.117）和-0.035（-0.057~-0.016），两者合计占总效应的43.6%；营养健康知识水平对粗粮蔬菜类膳食模式总效应为0.132（0.007~0.256），直接效应为0.108（-0.017~0.232），早餐食用频次的中介效应为0.024（0.008~0.047），占总效应18.2%。

结论

在外就餐与早餐频次在育龄妇女营养健康知识水平与高能量和粗粮蔬菜类膳食模式之间存在中介效应。

营养健康知识  /  膳食模式  /  在外就餐  /  早餐食用频次  /  中介效应
Objective

To investigate the impact of nutritional health knowledge levels on dietary patterns among childbearing-age women, to analyze the mediating role of eating out and breakfast consumption frequency, and to provide evidence-based references for formulating nutritional intervention strategies.

Methods

A total of 1 340 reproductive-age women aged 18-49 years from 10 districts/counties in Hunan Province were selected as research subjects from the 2022-2023 National Survey on Residents’ Nutritional and Health Knowledge Awareness. Data on basic information, nutritional and health knowledge, and dietary consumption were collected. Factor analysis was used to extract dietary patterns, Logistic regression to examine the association between knowledge levels and dietary patterns, and structural equation modeling with Bootstrap method to test mediating effects.

Results

Among women of childbearing age in Hunan Province, the nutrition and health knowledge awareness rate was 25.9%, 29.8% eating out ≥1 day/week, and 26.6% having breakfast <7 days/week. Four dietary patterns were identified: high-energy, fruit-dairy-seafood, poultry-egg-bean, and whole grain-vegetable. Logistic regression showed that the level of nutrition and health knowledge was negatively correlated with high-energy dietary pattern (OR=0.428, 95% CI:0.319-0.575) and positively correlated with whole grain-vegetable dietary pattern (OR=1.513, 95% CI:1.142-2.005). Mediator effect analysis showed the total effect of knowledge on high-energy pattern was -0.493(-0.616--0.370), direct effect was -0.278(-0.382--0.174), mediating effects of eating out and breakfast consumption frequency were -0.180(-0.250--0.117) and -0.035(-0.057--0.016), accounting for 43.6% of total effect; total effect on whole grain-vegetable pattern was 0.132(0.007-0.256), direct effect was 0.108(-0.017-0.232), mediating effect of breakfast frequency was 0.024(0.008-0.047), accounting for 18.2% of total effect.

Conclusion

Eating out and breakfast consumption frequency mediate the relationship between childbearing-age women’s nutritional health knowledge level and high-energy dietary patterns, and whole-grain vegetable dietary patterns.

Nutritional health knowledge  /  Dietary patterns  /  Eating out  /  Breakfast frequency  /  Mediating effect
潘云凤, 汪强, 熊家豪. 湖南省育龄妇女营养健康知识水平与膳食模式的关联——基于在外就餐与早餐频次的中介效应分析. 现代预防医学, 2026 , 53 (4) : 637 -643 . DOI: 10.20043/j.cnki.MPM.202509089
Yun-feng PAN, Qiang WANG, Jia-hao XIONG. Association between nutritional health knowledge and dietary patterns among childbearing-age women，Hunan-mediated effect analysis based on eating out and breakfast frequency[J]. Modern Preventive Medicine, 2026 , 53 (4) : 637 -643 . DOI: 10.20043/j.cnki.MPM.202509089
正文
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膳食模式是评价膳食质量的综合指标，与多种健康结局密切相关[1]。营养健康知识作为健康饮食行为的内在驱动力，被认为是助力合理膳食的可干预变量[2]。育龄妇女作为“健康中国”战略及“生命早期1 000天”健康干预的核心人群，其营养状况不仅关乎自身健康，更影响妊娠结局及子代生长发育[3-4]。因此，探讨该群体营养健康知识向健康膳食转化的路径，具有重要的理论与实践意义。
既往研究显示，营养健康知识水平与饮食行为存在显著关联，知识水平较高者更倾向于减少外出就餐频率[5]，保持规律进食早餐习惯[6]和选择更健康的膳食模式[2]。同时，频繁在外就餐与能量、脂肪、钠摄入过量密切相关[7-8]；规律进食早餐则与整体膳食结构均衡、微量营养素摄入充足显著相关[9]，提示在外就餐与进食早餐不规律可能对居民膳食模式产生不利影响[10-11]。因此，本研究旨在探索育龄妇女营养健康知识水平与膳食模式的关联，分析在外就餐频次与早餐食用频次的中介作用，探讨“营养健康知识—饮食行为—膳食模式”作用路径，为针对该群体制定营养干预策略提供参考。
1　对象与方法
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1.1　数据来源与研究对象
本研究数据来源于“2022—2023年中国居民营养健康知识知晓率调查项目”，项目已通过中国疾病预防控制中心营养与健康所伦理委员会审查（伦理号：2022-037）。2022年11月—2023年4月，采用多阶段分层整群随机抽样，按城乡比例及人口密度在湖南省抽取10个区/县作为调查点，每个调查点420人，年龄组满足18~34岁、35~49岁、50~64岁人数各占34.5%、33.3%、32.2%，实际共调查4 212人。本研究选取其中1 340名18~49岁育龄妇女为研究对象。纳入标准：湖南省常住居民（居住时间≥6月），年龄18~49岁，自愿参与并签署知情同意。排除标准：患有严重的躯体疾病或精神疾病无法完成问卷调查者。
1.2　调查内容与方法
采用全国统一编制的调查问卷开展现场调查，该问卷信效度良好，Cronbach α系数为0.847，分半信度为0.860，各知识维度与总分相关系数在0.542~0.839之间[12]。调查内容：（1）基本情况（性别、年龄、居住地等）；（2）营养健康知识（膳食推荐、食物特点、营养与疾病、食物选择、食品安全5个维度），总分100分。得分≥75分，为知晓营养健康知识[12]；（3）食物消费频次：采用半定量食物频率问卷调查13类食物消费情况，应答选项为“每天、5~6天/周、3~4天/周、1~2天/周、1~3天/月、<1天/月”，分别编码为6至1；（4）在外就餐、早餐食用频次：通过条目“通常情况下，您在外就餐/点外卖的频次是多少？”和“通常情况下，您食用早餐的频次是多少？”询问调查对象在外就餐/点外卖和食用早餐食用频次，应答选项同食物消费频次，编码为6至1。
1.3　数据处理与分析
调查前省级工作组按统一方案培训各调查点质控员及调查员并严格执行指定抽样方法。调查阶段采用面对面询问方式进行调查，问卷完成后当场自查审核，省市县三级质控员进行抽查复核。调查结束后，采用Epidata 3.1录入数据并进行逻辑检验。使用SPSS 26.0进行统计分析，计量资料以均数±标准差（）表示，计数资料以频数和百分比n（%）表示。采用主成分分析对13类食物摄入频率降维（KMO=0.881，巴特利特球形检验P<0.001），最大方差法旋转后选取特征根≥0.8的膳食模式分析并依据因子载荷和组合特点命名。logistic回归分析膳食模式与营养健康知识关联性时，按因子得分P50将膳食模式划分为低分组与高分组，得分越高表明越倾向于该膳食模式。探讨营养健康知识与在外就餐及早餐食用频次的关联时，采用一般线性回归模型分析。
1.4　中介效应分析
（1）变量设定：自变量为营养健康知识水平（知晓=1，不知晓=0）；中介变量为在外就餐频次和早餐食用频次（编码1~6，分值越高频次越高）；因变量为各膳食模式因子分析得分；依据既往研究，将居住地、年龄、文化程度、工作单位、婚姻状况、家庭人均年收入、身体质量指数（Body Mass Index, BMI）及是否患慢性病作为混杂因素。（2）模型构建：构建“营养健康知识→中介变量→膳食模式”中介路径模型，路径假设包括：①直接路径：营养健康知识对膳食模式的直接影响；②间接路径1：营养健康知识→在外就餐频次→膳食模式；③间接路径2：营养健康知识→早餐食用频次→膳食模式。（3）分析与检验：采用SPSS宏程序Process中的model4进行中介效应分析[13]。总效应为直接效应与各间接效应之和；直接效应为排除中介变量后营养健康知识对膳食模式的独立影响；各路径间接效应值为路径系数乘积；中介效应占比为某一中介路径效应占总效应的百分比。若路径95% CI不包含0则该路径中介效应显著，检验水准α=0.05。
2　结果
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2.1　基本人口学特征
本研究共纳入1 340名育龄妇女，平均年龄35.4±7.9岁。其中，农村居民占57.8%（n=775）；有配偶占84.9%（n=1 138）；文化程度在小学及以下、初中、高中/中专/技校、大专/职大、本科及以上的分别为6.1%（n=82）、34.6%（n=464）、21.3%（n=286）、25.1%（n=336）、12.9%（n=172）；医疗卫生行业占15.6%（n=209），农林牧渔业占25.4%（n=340），教育行业占7.3%（n=98）；家庭人均年收入<20 000元、20 001~40 000元、40 001~60 000元、60 001~80 000元、>80 000元分别占38.1%（n=510）、35.4%（n=475）、16.1%（n=216）、4.8%（n=64）、5.6%（n=75）；超重肥胖者占30%（n=402）、体重正常者占63.1%（n=845）、体重过低者占6.9%（n=93）；自报患慢病者占6.9%（n=93）。
2.2　营养健康知识现状、食物消费行为及膳食模式
湖南省育龄妇女营养健康知识知晓率为25.9%（n=347），早餐食用频次<7天/周的比例为26.6%，在外就餐≥1天/周的比例为29.8%。
logistic回归显示：农村育龄妇女知晓率低于城市（OR=0.669, 95% CI:0.481~0.929, P=0.017）；文化程度、家庭人均年收入越高知晓率越高（OR=1.204, 95% CI:1.032~1.404, P=0.018；OR=1.155, 95% CI: 1.007~1.325, P=0.039）；医疗卫生机构从业者知晓率高于其他行业（OR＝2.751, 95% CI: 1.886~4.013, P<0.001）。
因子分析共提取出4种膳食模式，累计解释总方差64.7%。其中，高能量膳食模式以油炸食品（0.859）、含糖饮料（0.783）、酒（0.798）和加工肉类（0.767）等高油、高糖、高能量食物为特征；水果奶水产类膳食模式以水果（0.781）、奶（0.767）和水产品（0.502）摄入为主；畜禽蛋豆类膳食模式以畜禽肉（0.841）、蛋类（0.683）和大豆及其制品（0.551）等蛋白类食物为主；粗粮蔬菜膳食模式则以全谷物（0.881）和蔬菜（0.498）的消费为主，详见表1。
2.3　营养健康知识与膳食模式的关联及中介效应分析
不同膳食模式的影响因素分析显示（见表2）：营养健康知识水平与高能量膳食模式呈负相关（OR=0.428, 95% CI: 0.319~0.575, P<0.001），与粗粮蔬菜类膳食模式呈正相关（OR=1.513, 95% CI: 1.142~2.005, P=0.004）；早餐食用频次与高能量膳食模式呈负相关（OR=0.762, 95% CI: 0.695~0.837, P<0.001），与畜禽蛋豆类膳食模式（OR=1.115, 95% CI: 1.029~1.208, P=0.008）及粗粮蔬菜类膳食模式（OR=1.184, 95% CI: 1.090~1.285, P<0.001）呈正相关；在外就餐频次与高能量膳食模式（OR=1.481, 95% CI：1.354~1.619，P<0.001）、水果奶水产类膳食模式（OR=1.132, 95% CI: 1.056~1.213, P<0.001）及畜禽蛋豆类膳食模式（OR=1.122, 95% CI: 1.047~1.202, P=0.001）均呈正相关。一般线性回归模型显示：营养健康知识与早餐食用频次呈正相关（β=0.396, 95% CI: 0.206~0.586, P<0.001）与在外就餐频次呈负相关（β=-0.660, 95% CI: -0.874 ~ -0.445, P<0.001）。
中介效应分析显示（见图1、表3）：营养健康知识对高能量膳食模式总效应为-0.493（-0.616~-0.370），直接效应为-0.278（-0.382~-0.174），总中介效应为- 0.215（-0.288~-0.148），占总效应值的43.6%，其中在外就餐频次介导-0.180（-0.250~-0.117）（占36.5%），早餐食用频次介导-0.035（-0.057~-0.016）（占7.1%），Bootstrap 95% CI均不包含0，上述作用有统计学意义；营养健康知识对粗粮蔬菜类膳食模式总效应为0.132（0.007~0.256），直接效应为0.108（-0.017~0.232），早餐食用频次的中介效应为0.024（0.008~0.047），占18.2%。其中，总效应与中介效应的效应值Bootstrap 95% CI不包含0，总体作用及中介作用有统计学意义。
3　讨论
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我国育龄妇女膳食结构呈西方化趋势，高能量、高脂肪食物摄入增加，不仅增加肥胖、糖尿病等慢性病发生风险，也对母婴健康构成潜在威胁[3-4]。本研究系统探讨营养健康知识水平、膳食模式及在外就餐与早餐食用频次的关联机制，为育龄妇女营养干预提供靶点。
本研究发现，湖南省育龄妇女营养健康知识知晓率为25.9%，高于本省成年居民[14]，低于安徽省成年居民[15]，营养健康知识水平仍需进一步提升。农村地区、低文化程度、低收入及非医疗卫生行业的育龄妇女知晓率较低，提示需加强上述重点人群的营养教育。本研究发现湖南省育龄妇女在外就餐率低于其他研究，规律进食早餐率高于其他研究，这可能与地区及调查方式不同有关[16-17]。此外，研究发现育龄妇女营养健康知识水平与高能量膳食模式呈负相关，与粗粮蔬菜类膳食模式呈正相关，这与既往研究一致。既往研究显示，营养健康知识较高者可显著增加粗粮、蔬果摄入，降低含糖饮料、油炸食品、西式快餐类食物摄入[18-19]。而且，营养健康知识水平越高，育龄妇女膳食质量得分越高，说明较高的营养健康知识水平有助于育龄妇女做出更健康的食物选择[20]。但营养健康知识对水果奶水产类、畜禽蛋豆类膳食模式的影响无统计学意义，这可能受食物价格、便利性、供应环境等非认知因素制约[20]，提示未来需收集更多潜在变量，建立精细化结构方程模型，剖析知识到行为转化的复杂机制。
本研究显示，减少在外就餐频次是高营养健康知识水平抑制高能量膳食模式的中介因素。杨云淇[21]等人的研究发现在外就餐与成年人口味偏好密切相关，在外就餐次数较高的女性其口味偏咸、甜、辣的风险更高，且多项研究发现在外就餐与能量、脂肪和钠摄入过量相关[6-7]。因此，营养健康知识水平较高的育龄妇女可能更了解部分在外就餐存在的健康问题，进而主动降低在外就餐频次，从而改善其膳食模式[22]。这提示在外就餐可能是促进营养健康知识向健康饮食模式转化的关键环节。此外，增加早餐食用频次是高营养健康知识水平抑制高能量膳食模式、促进粗粮蔬菜类膳食模式的中介因素。既往研究显示，不吃早餐与肥胖、心血管疾病、高血压等多种疾病相关，易引发能量补偿效应，使机体酪酪肽、胃饥饿素等食欲相关激素发生变化，导致食欲上升和饱腹感延迟[23]。因此，营养健康知识较高者可能通过规律进食早餐避免因饥饿导致的代偿性高能量膳食[24]。此外，早餐食用频次是营养健康知识与粗粮蔬菜类膳食模式的中介因素，这可能与早餐食物选择特点有关，燕麦、全麦面包、生菜等粗粮和蔬菜是便捷的早餐食物选项，规律的早餐习惯提升了此类食物的摄入频率[25]。但早餐食用频次的中介效应仅占总效应的18.2%，表明早餐食用频次是营养健康知识影响粗粮蔬菜类膳食模式的“部分中介”，并非唯一路径。上述结果提示，应强化育龄妇女对在外就餐营养特点和早餐重要性的认知，并应进一步推动营养健康餐厅/食堂建设，优化食物供给环境，促进更健康的膳食选择。
本研究分析了在外就餐与早餐食用频次在育龄妇女营养健康知识知晓率和膳食模式之间的中介作用，具有一定创新性。但仍存在局限性，一是横断面设计虽能揭示变量关联，但无法验证因果关系；二是样本仅涵盖湖南省育龄妇女，外推性有限；三是未收集食物价格、供应环境等变量且食物信息采用回顾性调查，可能存在回忆偏倚。未来，可通过队列研究进一步验证因果，扩大样本覆盖范围提升结果代表性，纳入食物价格、供应环境、社会支持等多维变量，深入解析“知识-行为”转化机制，探索育龄妇女膳食干预措施。
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  • 湖南省疾病预防控制中心‘青荷’青年培育基金项目(QHJJ2023014)
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2026年第53卷第4期
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doi: 10.20043/j.cnki.MPM.202509089
  • 接收时间：2025-09-04
  • 首发时间：2026-11-02
  • 出版时间：2026-02-25
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  • 收稿日期：2025-09-04
基金
湖南省疾病预防控制中心‘青荷’青年培育基金项目(QHJJ2023014)
作者信息
    湖南省疾病预防控制中心（湖南省预防医学科学院）营养食品健康与儿少卫生所，湖南 长沙 410153

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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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