| BackgroundChildren and adolescents are at a critical period of growth.They need adequate nutrition to sustain growth,life and study.Inadequate intake of protein and micronutrients,is likely to cause malnutrition and micronutrient deficiency,that is a serious impediment to children's physical and mental development.ObjectivesThis study analyzes the baseline data of Nutrition Improvement Plan for Rural Compulsory Education Students,to understand the various forms and features of nutrition improvement work,forms of school feeding,the students nutrition knowledge and dietary status,to explore factors affecting nutritional status,and provide scientific basis and data support for rural Nutrition Improvement Plan.MethodsThis study was a cross-sectional study.In pilot areas of Nutrition Improvement Plan for Rural Compulsory Education Students,selected key monitoring county,each county to extract 20%to 30%of elementary and junior high school,each school stratified by grade,and selected 1-2 classes in each grade.There were 40 students in each grade,boys and girls each half.All the students measured the height and weight.Each county selected 360 schoolchildren measuring hemoglobin.We collected economic conditions of counties,grant funding,the feeding methods and other measures to improve nutrition by questionnaires.Using school questionnaire collected nature of the school,location,feeding conditions,health education classes,etc.We also conducted a questionnaire survey to collect basic information,family socioeconomic status,food intake,and student nutrition knowledge of pupil on the third grade and above,and junior school students.On the county level,school level and student level,using multiple linear regression and multilevel logistic regression model analyzed factors of malnutrition and anemia,respectively.Results46 counties,6,125 schools and 30,912 school children have been investigated.The height and weight of 7 to 15 years old children in rural in midwest were significantly lower than the results of 2010 National Student Physical Fitness and Health Survey.Malnourished children aged 6 to 15 was 17.7%.Malnutrition rates increased with age increasing(P<0.05).Boys' malnutrition rate(19.2%)was higher than girls'(16.1%).Girls' anemia rate(16.0%)was higher than boys'(14.7%).Anemia rate of aged 12 and older students was relatively high.54.5%county had high malnutrition rate,above 15%.And these counties were mainly concentrated in the western region.Multiple linear regression analysis showed that there was higher malnutrition rate in some counties with a high proportion of boarders than those with low proportion of boarders.46.3%counties had high rate of anemia,above 15%.And these counties were mainly concentrated in the western region,too.But on the county level,meaningful factors of anemia rates were not found.There were more village school(53.7%)with malnutrition rates above 15%,than school in the town(43.5%)and county(30.8%)(P<0.05).Among providing water schools,there were a lower proportion(45.9%)which malnutrition rate was above 15%than those not providing water(61.3%)(P<0.05).Establishing health education course,or at least one lesson of health education every 2 weeks were good to reduce malnutrition rate.The results of multiple linear regression analysis showed that if there were provincial local grant funding the malnutrition would be lower,the school in the village is a risk factor of malnutrition,establishing health education course was a protect factor of malnutrition.There was lower anemia rate among schools having a canteen than those not having canteen(P<0.05).If schools provided hot water,they would have low anemia rate,but the difference was not statistically significant.However,multiple linear regression analysis showed that meaningful factors of anemia were not found.In Midwest,students' family is relatively large,53.1%students in the families with four more people.Relatively high proportion of children left behind,49%students were at least one parent working outside.48.7%students need more than 30 minutes walking to school,41.9%students were boarders.Students' intake of meat,eggs,milk,soy products and fresh vegetables were relatively low,did not meet the Dietary Guidelines.Student nutrition knowledge level is relatively low.Multilevel Logistic regression results showed that age,gender,family size and nutrition knowledge scores were factors of malnutrition.The malnutrition risk among over 12 year old students was 1.57 times of students under 12 years old.Boys' risk of malnutrition is girls' 1.57 times.Big family had higher risk of malnutrition than small family(OR=1.09).And nutrition knowledge score not above 5 point was a risk factor(OR=1.12).On school level,provincial grant funding and establishing health education course were protected factor of malnutrition.Students who didn't eat breakfast daily had high anemia rate.Students' anemia rate was relatively low,which their intake of meat,eggs,milk,soy products and fresh vegetables reached Chinese dietary guidelines recommended amount..But multilevel Logistic regression analysis showed that only the student's age,gender were factors of anemia.Students over the age of 12 had a higher risk of anemia than students under 12 years old(OR=1.8).Boys' risk of anemia is girls' 0.84 times.ConclusionsThe Midwest rural compulsory education students' growth level is still lower than students in ordinary rural and city,malnutrition and anemia prevalence rate is high.The school canteen has limited conditions,feeding ability failed to meet the needs of students.Some schools don't offer health education,and the frequency of health education class is low.Dietary nutrition status of students in the Midwest is still relatively poor,the intake of animal foods and fresh vegetables is low,students'nutrition knowledge level is relatively low,all of those affect the healthy growth of students.Malnutrition is influenced by age,gender,family population and nutrition knowledge level,and related with school health education lessons.While the students'anemia rate is correlated with age,sex factors. |
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