作为群体现象的独生子女(1976-2001)超重及肥胖问题研究
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摘要
以1976-2001年出生的独生子女为主要研究对象,从体质指数出发,探索独生子女群体的健康受损可能性。研究发现独生子女群体体重过轻、超重及肥胖比例高于非独生子女,其中青少年群体与中年群体的独生子女超重及肥胖比例(分别为14. 2%、25. 6%)与同出生组非独生子女差异最显著(分别为7. 9%、20. 1%)。BMI指数随年龄增长,且独生子女高于非独生子女,尤其在青少年时期与中年时期,第一代独生子女目前承受最高的健康风险。在对超重及肥胖的影响因素分析中,发现:在年龄、受教育程度的共同影响下,整体趋势而言,不同文化程度、不同年龄段群体中独生子女超重及肥胖可能性高于非独生子女;独生子女群体内部整体呈现出受教育程度越高,超重及肥胖比例可能性越低于同龄群体;虽然超重及肥胖的可能性随年龄增长,但是非独生子女群体在中年阶段这一可能性开始呈现缓慢走低趋势,而独生子女群体除高文化程度群体外,均为持续上升趋势;第一代独生子女中高文化程度人群超重及肥胖可能性表现最突出,需要引起注意及干预。考虑到独生子女目前在我国总人口中的比重,这一群体的体重问题及其表现出的趋势可能是非常重要的公共卫生潜在危机,而其背后的深层原因需要进行更深入的研究。
Based on physical fitness index,this study researches into the possibility of health problem suffered by the only-children group born between 1976 and 2001. Our findings are as follows: The proportion of underweight,overweight and obesity in only-children 's group is higher than the non-only-children group,among which the percentage of overweight and obesity in teenager and middle-age group( 14. 2% and 25. 6% respectively) is most significantly higher than the non-only-children group( 7. 9% and 20. 1% respectively). BMI increases with age,and is higher among only-children. Also,the first generation only-children in teenager and middle age periods suffer from highest health hazard. In the factor analysis of overweight and obesity,our findings are as following: on the whole,under the influence of age and education,the proportion of overweight and obese only-children is higher than non-only-children across different educational and age groups; among the only-children at the same age group,the higher the educational level,the lower the possibility of overweight and obesity; although the probability of overweight and obesity increases with age,it slows down during the middle-age period for non-only-children. Yet for only-children,this rising trend continues except for those with higher educational level; the first generation only-children of high education level are most likely to be overweight or obese,which deserves special attention or even intervention. Considering the percentage of only-children in our population,the group's weight problem and future trend could be very a very prominent potential hazard for public health,while the underlying causes need more in-depth research to reveal.
Based on physical fitness index,this study researches into the possibility of health problem suffered by the only-children group born between 1976 and 2001. Our findings are as follows: The proportion of underweight,overweight and obesity in only-children 's group is higher than the non-only-children group,among which the percentage of overweight and obesity in teenager and middle-age group( 14. 2% and 25. 6% respectively) is most significantly higher than the non-only-children group( 7. 9% and 20. 1% respectively). BMI increases with age,and is higher among only-children. Also,the first generation only-children in teenager and middle age periods suffer from highest health hazard. In the factor analysis of overweight and obesity,our findings are as following: on the whole,under the influence of age and education,the proportion of overweight and obese only-children is higher than non-only-children across different educational and age groups; among the only-children at the same age group,the higher the educational level,the lower the possibility of overweight and obesity; although the probability of overweight and obesity increases with age,it slows down during the middle-age period for non-only-children. Yet for only-children,this rising trend continues except for those with higher educational level; the first generation only-children of high education level are most likely to be overweight or obese,which deserves special attention or even intervention. Considering the percentage of only-children in our population,the group's weight problem and future trend could be very a very prominent potential hazard for public health,while the underlying causes need more in-depth research to reveal.
引文
Abraham. S, Nordsieck. M,1960. Relationship of Excess Weight in Children and Adults. Public Health Rep,75(3):263-273.
BaumⅡ. C.L, Ruhm. C. J,2007. Age, Socioeconomic Status and Obesity Growth. National Bureau of Economic Research 1050 Massachusetts Avenue:Cambridge MA02138 August.
F Celi,V Bini,G De Giorgi,D Molinari,F Faraoni,G Di Stefano,ML Bacosi,MG Berioli,G Contessa,A Falorni,2003. Epidemiology of
Overweight and Obesity among School Children and Adolescents in Three Provinces of Central Italy, 1993-2001:Study of Potential Influencing Variables. European Journal of Clinical Nutrition,57:1045-1051.
Finucane. M.M, Stevens. G. A, Cowan. M. J,et al, and the Global Burden of Metabolic Risk Factors of Chronic Diseases Collaborating
Group(Body Mass Index),2011. National, Regional, and Global Trends in Bodymass Index Since 1980:Systematic Analysis of Health
Examination Surveys and Epidemiological Studies with 960 Country-years and 9. 1 Million Participants.Lancet, 377:557-567.
Guo. S. S, Roche. A. F,Chumlea. W. C,et al. 1994. The Predictive Value of Childhood Body Mass Index Values for Overweight at Age35 y. The American Journal of Clinical Nutvition, 59(4):810-819.
Lissau. I, Sorenson TIA, 1994. Parental Neglect during Childhood and In-creased Risk of Obesity in Young Adulthood. Lancet,343:324-327
Mackay, J,Mensah. G. A,Mendis. S,et al,2004. The Atlas of Heart Disease and Stroke. Geneva:WHO:5-6.
Marie Ng,et al,2014. Global,Regional,and National Prevalence of Overweightand Obesity in Children and Adults during 1980-2013:A Systematic Analysis for the Global Burden of Disease Study 2013. Lancet, 384:766-781.
NCD Risk Factor Collaboration(NCD-RisC),2017. Worldwide Trends in Body-mass Index,Underweight,Overweight,and Obesity from 1975 to 2016:A PooledAnalysis of 2416 Population-based Measurement Studies in128·9 Million Children,Adolescents, and Adults. Lancet, 390:2627-2642.
Popkin. B.M, Adair. L. S,Ng. Shu. Wen,2012. Global Nutrition Transition and the Pandemic of Obesity in Developing Countries. Nutr Rev,70:3-21.
Ravelli. G. P&Belmont. L, 1979. Obesity in Nineteen-year-old Men:Family Size and Birth Order Association. Am. J. Epidemiol.109,66-70.
Singh. A.S, Mulder. C,Twisk. J. W, van Mechelen W, Chinapaw. M. J,2008. Tracking of Childhood Overweight into Adulthood:A Systematic Review of the Literature. Obesity Reviews. 9(5):474-488.
Stamatakis, E, Primatesta, P, Chinn. S,et al.2005. Overweight and Obesity Trends from 1974 to 2003 in English Children:What is the Role of Socioeconomic Factors?. Archives of Disease in Childhood, 90(10):999-1004.
Swinburn. B. A, Sacks. G, Hall. K. D,et al,2011. The Global Obesity Pandemic:Shaped by Global Drivers and Local Environments.Lancet,378:804-814.
Whitaker. R. C, Wright J. A, Seidel. K. D,et al, 1997. Predicting Obesity in Young Adulthood from Childhood and Parental Obesity. The New England Journal of Medicine,33(13):869-873.
World Health Organization. 2000. Obesity:preventing and managing the global epidemic. WHOGeneva. WHO Technical Report Series:9.
和红,杨心柔.北京市京籍与流动中小学生超重肥胖状况分析[J].中国学校卫生,2016,37(4):585-588.
季成叶,孙军玲,陈天娇.中国学龄儿童青少年1985-2000年超重、肥胖流行趋势动态分析[J].中华流行病学杂志,2004,25(2):103-108.
刘德寰,李雪莲.七八月的孩子们——小学入学年龄限制与青少年教育获得及发展[J].社会学研究,2015,(6):169-192.
倪国华,郑风田.西式快餐、肥胖与公共健康危机——基于行为经济学偏好理论的实证分析[J].中国农村经济,2011,(9):37-48.
石倩,王莉,王芳芳,郑建中.儿童超重和肥胖影响因素的Logistic回归分析[J].中国儿童保健杂志,2012,20(2):106-108.
武阳丰,马冠生,胡永华,李艳平,李贤,崔朝辉,陈春明,孔灵芝.中国居民的超重和肥胖流行现状[J].中华预防医学杂志,2005,39(5):316-320.
郭志刚.清醒认识中国低生育率风险[J].国际经济评论,2015,(2):100-119.
马冠生,李艳平,武阳丰,翟凤英,崔朝辉,胡小琪,栾德春,胡永华,杨晓光.1992至2002年间中国居民超重率和肥胖率的变化[J].中国预防医学杂志,2005,39(5):311-315.
武阳丰,周北凡,陶寿淇,吴锡桂,杨军,李莹,赵连成,谢高强.我国中年人群超重率和肥胖率的现状及发展趋势[J].中华流行病学杂志,2002,23(1):316-320.
姚旭辉,任臻,王立鑫,张寅平.室内环境对学龄前儿童超重影响的logistic回归分析[J].中国儿童保健杂志,2016,24(4):370-376.
中国肥胖问题工作组.中国成人超重和肥胖症预防与控制指南(节录)[J].营养学报,2004,26(1):-4.
中国肥胖问题工作组.中国学龄儿童青少年超重、肥胖筛查体重指数值分类标准[J].中华流行病学杂志,2004,25(2):97-102.
朱庆庆,花静,古桂雄.独生子女家庭儿童忽视现状及影响因素研究[J].中国儿童保健杂志,2014,22(12):1267-1270.
朱艳波,王琦,吴承玉,庞国民,赵健雄,沈世林,夏仲元,闫雪.18805例中国成年人中医体质类型与超重和肥胖关系的Logistic回归分析[J].中西医结合学报,2010,8(11):1023-1028.
(1)这一时间点的选择依据在于,从时间点推算,1980年9月《中共中央关于控制我国人口增长问题致全体共产党员、共青团员的公开信》中首次明确规定“一对夫妇只生育一个孩子”,但整个1970年代这项工作已经开始逐步实施,根据1978年10月,“一对夫妇生育子女最好一个最多两个和生育间隔三年以上”的要求,计划生育政策实质上已经形成并开始实施,1976年拥有第一个小孩的家庭正好在两次政策推进中失去了生育二胎的机会,而进入受广义计划生育和计划生育政策双重影响下的第一代独生子女群体。详见冯立天,马瀛通,冷眸,50年来中国生育政策演变之历史轨迹,人口与经济,1999,2:3-12。
(2)目前在关于体质指数的计算方面,目前出现一些新的提法,如将体脂率纳入测量等。但均无统一、科学的界定标准,加之大范围完成这类测量的客观难度,我们仍然沿用较成熟完善的BMI指数进行计算。
(1)本次调查在全国范围内通过线上调查的方式展开,因此BMI值计算所涉及的身高、体重数据均属被访者自填。
(2)有必要澄清的是,本文进行的研究以及关于受损可能性的考察,仅基于目前医学界已发现的超重与肥胖问题会对生理健康产生威胁这一原因。
(1)为便于与文化程度的交互及模型呈现的完整性,15-17岁的样本统一采用成人BMI超重及肥胖标准纳入模型。
BaumⅡ. C.L, Ruhm. C. J,2007. Age, Socioeconomic Status and Obesity Growth. National Bureau of Economic Research 1050 Massachusetts Avenue:Cambridge MA02138 August.
F Celi,V Bini,G De Giorgi,D Molinari,F Faraoni,G Di Stefano,ML Bacosi,MG Berioli,G Contessa,A Falorni,2003. Epidemiology of
Overweight and Obesity among School Children and Adolescents in Three Provinces of Central Italy, 1993-2001:Study of Potential Influencing Variables. European Journal of Clinical Nutrition,57:1045-1051.
Finucane. M.M, Stevens. G. A, Cowan. M. J,et al, and the Global Burden of Metabolic Risk Factors of Chronic Diseases Collaborating
Group(Body Mass Index),2011. National, Regional, and Global Trends in Bodymass Index Since 1980:Systematic Analysis of Health
Examination Surveys and Epidemiological Studies with 960 Country-years and 9. 1 Million Participants.Lancet, 377:557-567.
Guo. S. S, Roche. A. F,Chumlea. W. C,et al. 1994. The Predictive Value of Childhood Body Mass Index Values for Overweight at Age35 y. The American Journal of Clinical Nutvition, 59(4):810-819.
Lissau. I, Sorenson TIA, 1994. Parental Neglect during Childhood and In-creased Risk of Obesity in Young Adulthood. Lancet,343:324-327
Mackay, J,Mensah. G. A,Mendis. S,et al,2004. The Atlas of Heart Disease and Stroke. Geneva:WHO:5-6.
Marie Ng,et al,2014. Global,Regional,and National Prevalence of Overweightand Obesity in Children and Adults during 1980-2013:A Systematic Analysis for the Global Burden of Disease Study 2013. Lancet, 384:766-781.
NCD Risk Factor Collaboration(NCD-RisC),2017. Worldwide Trends in Body-mass Index,Underweight,Overweight,and Obesity from 1975 to 2016:A PooledAnalysis of 2416 Population-based Measurement Studies in128·9 Million Children,Adolescents, and Adults. Lancet, 390:2627-2642.
Popkin. B.M, Adair. L. S,Ng. Shu. Wen,2012. Global Nutrition Transition and the Pandemic of Obesity in Developing Countries. Nutr Rev,70:3-21.
Ravelli. G. P&Belmont. L, 1979. Obesity in Nineteen-year-old Men:Family Size and Birth Order Association. Am. J. Epidemiol.109,66-70.
Singh. A.S, Mulder. C,Twisk. J. W, van Mechelen W, Chinapaw. M. J,2008. Tracking of Childhood Overweight into Adulthood:A Systematic Review of the Literature. Obesity Reviews. 9(5):474-488.
Stamatakis, E, Primatesta, P, Chinn. S,et al.2005. Overweight and Obesity Trends from 1974 to 2003 in English Children:What is the Role of Socioeconomic Factors?. Archives of Disease in Childhood, 90(10):999-1004.
Swinburn. B. A, Sacks. G, Hall. K. D,et al,2011. The Global Obesity Pandemic:Shaped by Global Drivers and Local Environments.Lancet,378:804-814.
Whitaker. R. C, Wright J. A, Seidel. K. D,et al, 1997. Predicting Obesity in Young Adulthood from Childhood and Parental Obesity. The New England Journal of Medicine,33(13):869-873.
World Health Organization. 2000. Obesity:preventing and managing the global epidemic. WHOGeneva. WHO Technical Report Series:9.
和红,杨心柔.北京市京籍与流动中小学生超重肥胖状况分析[J].中国学校卫生,2016,37(4):585-588.
季成叶,孙军玲,陈天娇.中国学龄儿童青少年1985-2000年超重、肥胖流行趋势动态分析[J].中华流行病学杂志,2004,25(2):103-108.
刘德寰,李雪莲.七八月的孩子们——小学入学年龄限制与青少年教育获得及发展[J].社会学研究,2015,(6):169-192.
倪国华,郑风田.西式快餐、肥胖与公共健康危机——基于行为经济学偏好理论的实证分析[J].中国农村经济,2011,(9):37-48.
石倩,王莉,王芳芳,郑建中.儿童超重和肥胖影响因素的Logistic回归分析[J].中国儿童保健杂志,2012,20(2):106-108.
武阳丰,马冠生,胡永华,李艳平,李贤,崔朝辉,陈春明,孔灵芝.中国居民的超重和肥胖流行现状[J].中华预防医学杂志,2005,39(5):316-320.
郭志刚.清醒认识中国低生育率风险[J].国际经济评论,2015,(2):100-119.
马冠生,李艳平,武阳丰,翟凤英,崔朝辉,胡小琪,栾德春,胡永华,杨晓光.1992至2002年间中国居民超重率和肥胖率的变化[J].中国预防医学杂志,2005,39(5):311-315.
武阳丰,周北凡,陶寿淇,吴锡桂,杨军,李莹,赵连成,谢高强.我国中年人群超重率和肥胖率的现状及发展趋势[J].中华流行病学杂志,2002,23(1):316-320.
姚旭辉,任臻,王立鑫,张寅平.室内环境对学龄前儿童超重影响的logistic回归分析[J].中国儿童保健杂志,2016,24(4):370-376.
中国肥胖问题工作组.中国成人超重和肥胖症预防与控制指南(节录)[J].营养学报,2004,26(1):-4.
中国肥胖问题工作组.中国学龄儿童青少年超重、肥胖筛查体重指数值分类标准[J].中华流行病学杂志,2004,25(2):97-102.
朱庆庆,花静,古桂雄.独生子女家庭儿童忽视现状及影响因素研究[J].中国儿童保健杂志,2014,22(12):1267-1270.
朱艳波,王琦,吴承玉,庞国民,赵健雄,沈世林,夏仲元,闫雪.18805例中国成年人中医体质类型与超重和肥胖关系的Logistic回归分析[J].中西医结合学报,2010,8(11):1023-1028.
(1)这一时间点的选择依据在于,从时间点推算,1980年9月《中共中央关于控制我国人口增长问题致全体共产党员、共青团员的公开信》中首次明确规定“一对夫妇只生育一个孩子”,但整个1970年代这项工作已经开始逐步实施,根据1978年10月,“一对夫妇生育子女最好一个最多两个和生育间隔三年以上”的要求,计划生育政策实质上已经形成并开始实施,1976年拥有第一个小孩的家庭正好在两次政策推进中失去了生育二胎的机会,而进入受广义计划生育和计划生育政策双重影响下的第一代独生子女群体。详见冯立天,马瀛通,冷眸,50年来中国生育政策演变之历史轨迹,人口与经济,1999,2:3-12。
(2)目前在关于体质指数的计算方面,目前出现一些新的提法,如将体脂率纳入测量等。但均无统一、科学的界定标准,加之大范围完成这类测量的客观难度,我们仍然沿用较成熟完善的BMI指数进行计算。
(1)本次调查在全国范围内通过线上调查的方式展开,因此BMI值计算所涉及的身高、体重数据均属被访者自填。
(2)有必要澄清的是,本文进行的研究以及关于受损可能性的考察,仅基于目前医学界已发现的超重与肥胖问题会对生理健康产生威胁这一原因。
(1)为便于与文化程度的交互及模型呈现的完整性,15-17岁的样本统一采用成人BMI超重及肥胖标准纳入模型。