| ObjectiveTo study on the nutritional status and influencing factors of children aged 0-5 in Hainan Province for providing a scientific basis for the Hainan Provincial government to formulate nutritional intervention strategies for aged 0-5 children.Method1.Research objects:The Cross-sectional Survey and The Stratified Random Sampling Method were applied in this study.And the 19 cities and counties in Hainan Province into urban areas and rural areas according to the degree of social and economic development.Based on the population of each city and county,2-3 towns(communities)were randomly selected from each city and county.From December2020 to March 2022,the children aged 0-5 who had lived in the selected towns(communities)for a long time were investigated According to the sample size requirements,a total of 8244 children were investigated excluding the children aged0-5 who have major diseases that seriously affect their growth and development,such as those with obvious physical disabilities or paralysis,and those who did not cooperate with the survey,and those whose questionnaires were invalid.2.Research methods The basic data of children and their parents were collected through face-to-face questionnaires,and physical growth status such as height,weight,and head circumference of children were obtained through anthropometric measurement.The evaluation indicators of children’s nutritional status,including underweight,growth retardation,wasting,and overweight(obesity),were calculated by the Z-score method.The survey subjects were grouped according to their age groups,that is,within 12 months of age,one group every six months,and one group every year between 12-60 months of age,that is,0-month-group,6-month-group,12-month-group,and 24-month-group,36-months-group,48-months-group,a total of 6 groups.Using Excel 97-2003 and SPSS 25.0 software to organize,statistically describe and analyze the collected data,and utilizing the X~2test to compare the differences in children’s nutritional status in terms of gender,age in months,and urban and rural areas.Logistic regression analysis was applied to explore the factors affecting the nutritional status of children aged 0-5 years in Hainan Province.Result1.A total of 8524 questionnaires were recovered in this study.After excluding the unqualified questionnaires,there were 8244 valid questionnaires,and the valid rate of the questionnaires was 96.7%.This study included 2,266 and 5,978 children aged 0-5 in urban and rural areas of Hainan Province,respectively,with a male-to-femaile sex ratio of 1.1:1.2.The underweight rate,stunting rate,wasting rate,and overweight/obesity rate of 8244 children aged 0-5 in Hainan respectively were 3.1%,4.5%,3.2%,and 2.2%,respectively.Through the comparison between different regions,it was found that both the low body weight rate and growth retardation rate in rural areas were higher than those in urban areas(3.4%VS.2.2%,P<0.05;5.0%VS.3.0%,P<0.05);Compared with other children,it was found that the rate of growth retardation and overweight/obesity in boys was higher than that in girls(5.3%VS.3.6%,P<0.05;2.7%VS.1.7%,P<0.05).The low body weight rate,growth retardation rate,and weight loss of the 24 months to group were the highest,which were 4.4%,5.7%,and4.7%,respectively.With the increase of age group,the prevalence of wasting and overweight/obesity showed a downward trend(X~2trend test,P<0.05).Through the comparison between different ethnic groups,it was found that the underweight rate and weight loss rate of ethnic minorities were higher than those of Han people(5.1%VS.2.5%,P<0.05;5.4%VS.2.4%,P<0.05).3.The growth curve distribution of WAZ,LAZ/HAZ,CAZ,WLZ/WHZ obtained by the Z-score method,compared with the WHO standard curve,the WAZ,LAZ/HAZ,CAZ,WLZ/WHZ of children aged 0-5 in Hainan Province,its peaks of the growth curves all shifted to the left,which were lower than the WHO reference standard.T The peaks of WAZ,LAZ/HAZ,CAZ,and WLZ/WHZ in children aged0-5 from rural area were more significantly shifted to the left than children aged 0-5from urban area.Compared with the WHO standard Z value curve,the growth curves of WAZ,LAZ/HAZ,CAZ,WLZ/WHZ of boys and girls aged 0-5 in Hainan Province all shifted to the left.The WLZ/WHZ growth curve of Zero-five-year-old girls shifted to the left more significantly than that of Zero-five-year-old boys.4.With the application of logistic regression analysis in exploring the influencing factors of malnutrition status such as underweight,stunting,wasting,overweight/obesity,etc,this study.This study investigated out that the risky factors for low body weight were low birth weight,picky eating,and recreational eating(OR=3.86,95%CI=1.99-7.49;OR=1.49,95%CI=1.12-2.00;OR=1.92,95%CI=1.07-3.47),the protective factors were that the father’s education level was college/undergradua-te and above,and the children were raised by parents themself(OR=0.55,95%CI=0.37-0.80;OR=1.50,95%CI=1.09-2.05).The risky factor for stunted growth were growth up in rural area and low birth weight(OR=2.27,95%CI=1.27-4.04;OR=2.59,95%CI=1.87-3.60),and the protective factors were female gender,and annual family income>100,000,the father’s education level is college/undergraduate and above.(OR=0.62,95%CI=0.49-0.79;OR=0.38,95%CI=0.21-0.71;OR=0.49,95%CI=0.28-0.86).Risky factors for wasting were low birth weight,minority paternal ethnicity,non-exclusive breastfeeding beyond 6 months of age,picky eating and(OR=2.80,95%CI=1.77-4.43;OR=2.25,95%CI=1.26-4.01;OR=2.01,95%CI=1.11-3.63;OR=1.56,95%CI=1.11-2.18),the pro-tective factor was that the father’s occupation was specialized(OR=0.40,95%CI=0.22-0.74).Risky factors for overweight/obesity were that assisted reproduction,father’s occupation was business and public officials,snacking(OR=2.71,95%CI=1.04-7.06;OR=1.70,95%CI=1.07-2.69;OR=2.50,95%CI=1.54-4.08;OR=2.52,95%CI=1.24-5.11),the protective factors ar-e that gender is the girl’s staple food texture is soft rice,picky eater,dental caries and the mother’s ethnicity is a minority(OR=0.60,95%CI=0.43-0.85;OR=0.45,95%CI=0.22-0.90;OR=0.54,95%CI=0.30-0.97;OR=0.27,95%CI=0.13-0.56;OR=0.58,95%CI=0.38-0.91).Conclusion1.Compared with the WHO standard Z-value curve for children aged 0-5,the current values of physique growth indicators such as WAZ,LAZ/HAZ,WLZ/WHZ for children aged 0-5 in Hainan Province are lower than the WHO standard,among them,rural area and girl take more significant role.2.The results of this study showed that the underweight rate and stunting rate of the 8,244 children aged 0-5 in Hainan Province has reached the development goals of the"Two Outlines",and the malnutrition status of children aged 0-5 in Hainan Province has been improved.However,this study found that the prevalence of malnutrition(underweight,stunting,wasting)among children aged 0-5 in Hainan Province was higher than that of the China Child Development Outline(2011-2020)statistical monitoring report in 2019 and the Chinese Resident Nutrition and Health Status Survey and Monitoring Report in2013,especially in rural areas and the nutritional problems of ethnic minority children are more prominent.3.The prevalence of underweight,stunting,wasting,and overweight/obesity in children aged 0-5 in Hainan Province are varied by gender,region,age and ethnicity.This study found that the rates of underweight and stunted growth in rural areas were higher than those in urban areas;The rates of stunted growth and overweight/obesity in boys were higher than those in girls;The rate of underweight,stunted growth,and wasting in the 24-month-group was the highest,with the increase of the age group,the prevalence of wasting and overweight/obesity showed a downward trend;The underweight and wasting rates of ethnic minorities were higher than those of Han.4.The prevalence of low body weight,growth retardation,emaciation,overweight/obesity in zero-five-year-old children in Hainan province is also influenced by many factors,such as parenting style(exclusive breastfeeding,picky eating,recreational eating,etc.),disease,family characteristics(parents’ethnic,professional,educational level,family income,etc.),etc.The results of this study showed that the risky factors for low body weight are low birth weight,picky eating,and recreational eating;The risk factors for growth retardation were rural areas and low birth weight;The risky factors for wasting are ethnic minorities,low birth weight,and non-exclusive breastfeeding to over 6 months of age,picky eaters.The risky factors for overweight/obesity are that assisted reproduction,father’s occupation is business and public officials,eating snacks. |
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