【摘要】：目的:本研究旨在通過(guò)分析飲食行為、生活方式及主要慢性病相關(guān)流行病學(xué)調(diào)查數(shù)據(jù),掌握天津居民營(yíng)養(yǎng)與健康狀況,并探討和評(píng)估主要慢性病影響因素水平,為深入開(kāi)展全民健康生活方式行動(dòng)工作及政府部門(mén)制定我市營(yíng)養(yǎng)與健康狀況相關(guān)政策提供依據(jù)。方法:2010-2012年連續(xù)三年分別以河西區(qū)、北辰區(qū)及靜海區(qū)作為城區(qū)、郊區(qū)及農(nóng)村監(jiān)測(cè)點(diǎn)開(kāi)展調(diào)查工作,采用多階段整群隨機(jī)抽樣方法,從3個(gè)監(jiān)測(cè)點(diǎn)中分別抽取6個(gè)居委會(huì)/村委會(huì),每個(gè)居委會(huì)/村委會(huì)中隨機(jī)抽取75戶,戶中所有常住家庭成員共計(jì)4028人參與調(diào)查。內(nèi)容包括詢問(wèn)調(diào)查、膳食調(diào)查、醫(yī)學(xué)體檢和實(shí)驗(yàn)室檢測(cè)。運(yùn)用SPSS18.0軟件,按照數(shù)據(jù)分布特點(diǎn),采用χ2檢驗(yàn)、t檢驗(yàn)、非條件logistic回歸等統(tǒng)計(jì)方法進(jìn)行分析。結(jié)果:與《中國(guó)居民膳食指南(2016)》中各類食物推薦攝入量相比,天津居民總體膳食結(jié)構(gòu)中畜禽類、蛋類攝入量符合標(biāo)準(zhǔn)。水果、魚(yú)蝦、奶、豆類及堅(jiān)果攝入量明顯偏低。谷薯雜豆類、烹調(diào)油攝入量稍高于推薦量,烹調(diào)用食鹽攝入量為10.81g,幾乎達(dá)到了推薦量的兩倍。經(jīng)常鍛煉率僅為15.5%,男性高于女性,兒童青少年(6~17歲)經(jīng)常鍛煉率及鍛煉時(shí)間均為最高,其他各年齡組鍛煉率和鍛煉時(shí)間隨年齡增長(zhǎng)呈升高趨勢(shì)。平均每天閑暇靜坐活動(dòng)時(shí)間3.04小時(shí),糖尿病和血脂異�；颊叩撵o坐時(shí)間均明顯超過(guò)正常人群。睡眠不足的比例為35.6%,男性高于女性,兒童青少年組明顯高于其他年齡組。中年人群現(xiàn)在吸煙率最高,為35.4%;女性標(biāo)化吸煙率達(dá)到9.0%,遠(yuǎn)高于2010年全國(guó)成年女性吸煙率(2.4%),被動(dòng)吸煙率隨年齡增長(zhǎng)逐漸減少,其中青少年組最高,達(dá)到57.0%�，F(xiàn)在飲酒率為32.2%,且隨年齡增長(zhǎng)而升高,45~59歲組最高(38.7%),但60歲及以上組開(kāi)始下降為27.3%,男性(55.9%)明顯高于女性(12.6%)。標(biāo)化超重率由2002年的39.1%下降到37.2%。標(biāo)化肥胖率為29.0%,較2002年(20.6%)有明顯增長(zhǎng)。中心性肥胖標(biāo)化患病率達(dá)到64.3%,隨年齡增長(zhǎng)而增加;青年組男性高于女性,老年組女性高于男性。高血壓標(biāo)化患病率為34.9%,比2002年的39.3%有所下降,男性(44.3%)高于女性(35.7%),患病率隨年齡增加而上升,且發(fā)病年齡趨于年輕化。糖尿病標(biāo)化患病率為12.0%,比2002年增長(zhǎng)了2.7%,且隨年齡增加而上升,老年組最高,達(dá)到25.0%。血脂異常標(biāo)化患病率為27.2%,2002年為26.2%,小幅上升1.0%,男性高于女性。經(jīng)二分類logistic回歸分析結(jié)果顯示:TC(升高)、TG(升高)、油脂攝入(30g/標(biāo)準(zhǔn)人日)等是超重/肥胖的危險(xiǎn)因素,而HDL-C升高有保護(hù)作用;年齡(中老年)、家族史、性別(男性)、TC(升高)、TG(邊緣升高)、吸煙、睡眠不足等因素是高血壓的危險(xiǎn)因素,地區(qū)(郊區(qū)相對(duì)于城區(qū))、經(jīng)濟(jì)收入(中等)則對(duì)高血壓有保護(hù)作用;家族史、地區(qū)(郊區(qū)相對(duì)于城區(qū))、年齡(中老年)、TC(升高)、TG(升高)、高血壓、睡眠不足、久坐、BMI(肥胖)、中心型肥胖等因素是糖尿病的危險(xiǎn)因素;男性、超重、肥胖、糖尿病、久坐是血脂異常的危險(xiǎn)因素,而鍛煉是其保護(hù)因素。結(jié)論:2010-2012年天津居民食物消費(fèi)種類廣泛,但蔬菜、水果、奶、豆類及堅(jiān)果攝入量偏低,食鹽、油脂攝入量均超過(guò)推薦量。居民閑暇時(shí)間經(jīng)常鍛煉率偏低,老年人經(jīng)常鍛煉率和鍛煉時(shí)間均高于中年人和青年人,兒童青少年組睡眠不足比例明顯高于其他年齡組。女性煙草使用遠(yuǎn)高于全國(guó)同期水平,青少年組被動(dòng)吸煙率最高。中年組男性現(xiàn)在吸煙率和飲酒率均處在全市最高水平。慢性病患病方面,超重、高血壓患病率與2002年相比有所下降,而肥胖、糖尿病、血脂異常患病率則不同程度增長(zhǎng)。年齡(中老年)、性別(男性)、油脂攝入超標(biāo)、吸煙、久坐等分別為一種或多種慢性病危險(xiǎn)因素。慢性病防治應(yīng)從改變不良生活方式開(kāi)始,加強(qiáng)“合理膳食、適量運(yùn)動(dòng)、戒煙限酒”的主題健康促進(jìn),降低慢性病的發(fā)病率和由此帶來(lái)的疾病負(fù)擔(dān)。
[Abstract]:Objective: The purpose of this study was to understand the nutritional and health status of Tianjin residents by analyzing the epidemiological data of dietary behavior, lifestyle and major chronic diseases, and to explore and evaluate the influencing factors of major chronic diseases, so as to carry out the action of healthy lifestyle for all and formulate the nutritional and health status of Tianjin by government departments. Methods: For three consecutive years from 2010 to 2012, Hexi District, Beichen District and Jinghai District were selected as urban, suburban and rural monitoring points to carry out the investigation. Six neighborhood committees/village committees were selected from three monitoring points by multi-stage cluster random sampling method, and 75 households were randomly selected from each neighborhood committee/village committee. A total of 4028 permanent family members participated in the survey, including questionnaires, dietary surveys, medical examinations and laboratory tests. According to the distribution characteristics of the data, _2 test, t test and unconditional logistic regression were used to analyze the data. Results: The data were compared with those in the Dietary Guidelines for Chinese Residents (2016). The intake of fruits, fish, shrimp, milk, beans and nuts was obviously lower than the recommended intake. The intake of grains, potatoes, legumes, cooking oil was slightly higher than the recommended intake. The intake of cooking salt was 10.81g, almost twice the recommended intake. The rate of regular exercise was only 15.5%, and the intake of men was lower. Children and adolescents (6-17 years old) had the highest rate of regular exercise and exercise time. The exercise rate and time of other age groups increased with age. The average daily leisure meditation time was 3.04 hours. The meditation time of patients with diabetes mellitus and dyslipidemia was significantly longer than that of normal people. The smoking rate of middle-aged people is the highest, 35.4%; the standardized smoking rate of women is 9.0%, much higher than the smoking rate of adult women (2.4%) in 2010. The passive smoking rate decreases gradually with the increase of age, and the drinking rate of teenagers is the highest (57.0%). The standardized overweight rate decreased from 39.1% in 2002 to 37.2%. The standardized obesity rate increased from 29.0% in 2002 to 20.6% in 2002. The prevalence rate of central obesity was 64.3% and increased with age. The standardized prevalence of hypertension was 34.9%, lower than 39.3% in 2002, higher in men (44.3%) than in women (35.7%). The prevalence increased with age and tended to be younger. The standardized prevalence of dyslipidemia was 27.2%, 26.2% in 2002, a slight increase of 1.0% in men, higher than in women. Age (middle-aged), family history, gender (male), TC (elevated), TG (marginal elevation), smoking, lack of sleep and other factors are risk factors for hypertension, regional (suburban relative to urban), economic income (medium) is protective of hypertension; family history, regional (suburban relative to urban), age (middle-aged and old), TC (elevated), TG (elevated), hypertension, sleep. Insufficient sleep, sedentary, BMI (obesity), central obesity and other factors are risk factors for diabetes. Male, overweight, obesity, diabetes, sedentary are risk factors for dyslipidemia, and exercise is the protective factor. Conclusion: Tianjin residents consume a wide range of food in 2010-2012, but low intake of vegetables, fruits, milk, beans and nuts, salt, fat. The rate of regular exercise in the leisure time of the residents was lower than that of the middle-aged and young people. The proportion of children and adolescents with insufficient sleep was significantly higher than that of other age groups. The prevalence of chronic diseases, overweight, hypertension and obesity, diabetes and dyslipidemia increased to varying degrees compared with 2002. Age (middle-aged and elderly), sex (male), excessive oil intake, smoking, sedentary and so on are one or more chronic disease risks, respectively. Risk factors. Prevention and treatment of chronic diseases should start with changing unhealthy lifestyle, strengthening the theme of "reasonable diet, moderate exercise, smoking and alcohol restriction" health promotion, reducing the incidence of chronic diseases and the resulting burden of disease.
【學(xué)位授予單位】：天津醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R151.42

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