托幼机构儿童身体活动和屏幕时间及膳食安排现状分析

Analysis of the status of physical activity, screen time and dietary arrangement for children in nursery schools

摘要

目的 了解我国托幼机构儿童在园期间的身体活动、屏幕时间及膳食安排现状,为掌握托幼机构卫生保健重点问题、完善管理措施提供科学依据.方法 采用多阶段分层随机抽样方法,于2019年7月至2020年12月在我国7类地区的14个省级行政区随机抽取70所托幼机构进行问卷调查.调查内容包括:托幼机构的基本情况、儿童每日身体活动时间和屏幕时间及膳食安排等情况.使用非参数检验和χ²检验对城乡、机构性质和地域之间托幼机构的儿童一日生活安排差异进行比较分析.结果 有68家托幼机构纳入研究.在儿童每日户外身体活动时间方面,公立与私立托幼机构中班、大班、班级合计的儿童每日户外身体活动时间比较差异均有统计学意义(Z值分别为-2.320、-2.454、-3.844,P<0.05),南方与北方托幼机构各班级儿童的每日户外身体活动时间比较差异均有统计学意义(Z值分别为-2.745、-2.401、-2.507、-4.418,P<0.05).公立与私立托幼机构的各班级儿童每日总身体活动时间比较差异均有统计学意义(Z值分别为-2.740、-2.289、-2.409、-4.297,P<0.05),南方与北方托幼机构小班、班级合计的儿童每日总身体活动时间比较差异均有统计学意义(Z值分别为-1.972、-3.196,P<0.05).在儿童每日屏幕时间方面,不同类型托幼机构各班级的屏幕时间均<60min.在儿童每日膳食方面,城市与农村托幼机构各班级的儿童每日饮水量比较差异均有统计学意义(Z值分别为-2.811、-2.684、-2.571、-4.597,P<0.05),公立与私立托幼机构大班、班级合计的儿童每日饮水量比较差异均有统计学意义(Z值分别为-2.240、-2.765,P<0.05),南方与北方托幼机构班级合计的儿童每日饮水量比较差异有统计学意义(Z=-2.054,P<0.05);儿童每日摄入蔬菜、水果的托幼机构占比分别为94.1%和88.2%,存在部分托幼机构儿童每日摄入含糖饮料的情况;城市与农村托幼机构的儿童每日摄入乳类及乳制品的占比比较差异有统计学意义(χ²=5.029,P<0.05).结论 学龄前儿童在园期间普遍存在每日总身体活动时间不足的情况,公立、北方托幼机构的儿童还存在每日户外活动时间不足的问题.部分托幼机构的儿童饮水量未达到«中国学龄前儿童膳食指南(2016)»的推荐要求,农村托幼机构乳制品供应情况较差.托幼机构应关注现有园内对儿童生活一日安排的不足之处,与家长一起培养儿童良好的生活习惯.

Abstract

Objective To understand the current status of physical activity, screen time and dietary arrangement for children in nursery schools, and to provide scientific basis for grasping the key issues of health care and improving management measures in nursery schools. Methods From July 2019 to December 2020, a multi-stage stratified random sampling method was used to conduct a questionnaire survey in 70 nursery schools randomly selected from 14 provinces across 7 types of regions in China. The contents of the survey include: basic information of nursery schools, daily physical activities, screen time of children and dietary arrangement. The nonparametric tests and Chi-square tests were used to compare and analyze the differences in daily life arrangements of children in nursery schools across urban and rural areas, institutional types, and regions. Results Eventually 68 nursery schools were included in the study. In terms of children's daily outdoor physical activity, there were statistically significant differences in children's daily outdoor physical activity time in the middle class, top class, and combined classes between public and private nursery schools (Z=-2.320, -2.454 and -3.844, respectively, P<0.05). There were statistically significant differences in children's daily outdoor physical activity time in each class between nursery schools in the southern and northern regions (Z=-2.745, -2.401, -2.507 and -4.418, respectively, P<0.05). There were statistically significant differences in children's total daily physical activity time in each class between public and private nursery schools (Z=-2.740, -2.289, -2.409 and -4.297, respectively, P<0.05). There were statistically significant differences in children's total daily physical activity time in bottom class and combined classes between nursery schools in the southern and northern regions (Z=-1.972 and -3.196, respectively, P<0.05). In terms of children's daily screen time, the average screen time in each class of different types of nursery schools was all <60 minutes. In terms of children's daily dietary intake, there were statistically significant differences in the daily water intake of children in each classes between urban and rural nursery schools (Z=-2.811, -2.684, -2.571 and -4.597, respectively, P<0.05). There were statistically significant differences in the children's daily water intake in top class and combined classes between public and private nursery schools (Z=-2.240 and -2.765, respectively, P<0.05), and there were statistically significant differences in the children's daily water intake in the combined classes between nursery schools in the southern and northern regions (Z=-2.054, P<0.05). The proportion of children's daily intake of vegetables and fruits in nursery schools was 94.1% and 88.2%. Children in some nursery schools consumed sugary beverages daily. There was statistically significant difference in the proportion of children's daily intake of dairy products between urban and rural nursery schools (χ ²=5.029, P<0.05). Conclusion The total physical activity time of preschool children is generally insufficient during nursery schools, and the daily outdoor activity time of children in public and northern nursery schools is also insufficient. The water intake of children in some nursery schools does not meet the recommendations of the Dietary Guidelines for Preschool Children in China (2016), and the supply of dairy products in rural nursery schools relatively inadequate. Nursery schools should pay attention to their shortcomings of the current daily routines for children and work with parents to help children cultivate healthy living habits.

关键词

托幼机构 / 学龄前儿童 / 身体活动 / 屏幕时间 / 膳食

Key words

nursery schools / preschool child / physical activity / screen time / diet

参考文献

[1] 孙晶晶, 罗丽丝, 崔继华, 等. 学龄前儿童饮食行为与生长发育及其相关性分析[J]. 中国妇幼健康研究, 2022, 33(05): 85-90.

[2] 世界卫生组织, 何黎明, 盛群力. 5岁以下儿童身体活动、久坐行为与睡眠建议[J]. 数字教育, 2020, 6(4): 84-92.

[3] 汪静, 张娟, 闵开元, 等. 北京市东城区3~5岁学龄前儿童膳食、身体活动和屏幕时间达到指南推荐要求情况及相关因素研究[J]. 中国健康教育, 2020, 36(03): 210-214.

[4] 中华人民共和国卫生部,中华人民共和国教育部. 托儿所幼儿园卫生保健管理办法[R]. 北京: 中华人民共和国卫生部,中华人民共和国教育部, 2010-09-06.

[5] 中华人民共和国卫生部. 托儿所幼儿园卫生保健工作规范[R]. 北京: 中华人民共和国卫生部, 2012-05-09.

[6] 杨月欣, 苏宜香, 汪之顼, 等. 中国学龄前儿童膳食指南(2016)[J]. 中国儿童保健杂志, 2017, 25(04): 325-327.

[7] 学龄前儿童(3~6岁)运动指南编制工作组, 关宏岩, 赵星, 等. 学龄前儿童(3~6岁)运动指南[J]. 中国儿童保健杂志, 2020, 28(6): 714-720.

[8] 国家统计局. «中国儿童发展纲要(2011-2020年)»终期统计监测报告[EB/OL].(2021-12-21). http://www.stats.gov.cn/tjsj/zxfb/202112/t20211221_1825519.html.

[9] Bower JK, Hales DP, Tate DF, et al. The childcare environment and children's physical activity[J]. Am J Prev Med, 2008, 34(1): 23-29.

[10] 潘利萍, 蒋竞雄. 儿童肥胖的发生原因及群体干预策略[J]. 中国妇幼健康研究, 2010, 21(06): 832-834.

[11] 宋鸽, 陈君颖, 孙凌宇, 等. 运动干预与儿童肥胖的定性循证研究[J]. 中国妇幼健康研究, 2022, 33(10): 13-25.

[12] 国家卫生健康委员会疾病预防控制局. 发布«儿童青少年防控近视系列手册»[EB/OL].(2020-10-27). http://www.nhc.gov.cn/jkj/pqt/202010/faf2bf5e6c924e9a92985f8d7ba05fff.shtml.

[13] 许梦雪, 王晓娟, 王博, 等. 北京市学龄前儿童园外身体活动及其社区家庭运动环境调查[J]. 中国儿童保健杂志, 2022, 30(01): 30-33.

[14] Chang Z, Wang S, Zhang X. Seasonal variations in physical activity and sedentary behavior among preschool children in a Central China city[J]. Am J Hum Biol, 2020, 32(6): e23406.

基金资助

科技部基础资源调查专项:中国学龄前儿童生长发育数据分析及报告和图集制作(2017FY101104)