个体与环境交互作用下中国成人超重肥胖情况变化趋势及影响因素研究

doi:10.18306/dlkxjz.2020.01.010

摘要/Abstract

摘要：

论文基于中国25个省份内635个社区的29586个成年居民2010—2016年的纵向追踪调查数据,分别利用非线性发展模型和多层Logistic回归模型,阐释中国居民超重肥胖情况的变化趋势,同时探究其在个体与环境交互作用下的影响机制。研究发现：① 以身体质量指数衡量的中国成人超重肥胖发生风险逐年增加,其中女性、年龄、有配偶人群、日均锻炼时长负向作用于成人身体质量指数增长速率;② 中国成人超重肥胖差异具有多层级性,个体层面社会经济属性、饮食习惯和行为方式,社区层面建成环境和自然环境,省域层面城市化水平,均能影响成人超重肥胖发生;③ 不同层级间超重肥胖影响因子具有交互作用关系,环境能通过影响个体心理状态及行为选择对个体健康结果的作用,间接作用于居民超重肥胖结果。研究结果旨在帮助中国成人居民达到更好的健康状态,以及为相关政府部门制定促进人口健康的政策提供理论依据。

关键词: 成人, 城市化, 超重肥胖, 多层回归模型, 中国家庭, 追踪调查

Abstract:

In recent years, with the rapid development of socio-economy and acceleration of urbanization, China has entered the stage of a health transition, which means a shift to low fiber, high sugar and cholesterol diet, as well as a sedentary lifestyle. During the health transition, Chinese residents are facing severe obesity and the problems caused by metabolic system-related diseases. So it is significantly important to find the factors which influencing the physical health of Chinese residents during the special period. This study is based on longitudinal tracking survey data of 29586 adult residents from 635 communities in 25 provinces across the country from 2010 to 2016, using non-linear development models and multi-level logistic regression models to explain the trends of overweight or obesity in Chinese residents, and explore the mechanism under the interaction of individuals and the environment. The results show that the risk of overweight and obesity in Chinese adults measured by body mass index increased year by year, in which women, age, spouses, and average daily exercise time negatively affect the growth rate of Chinese body mass index. Moreover, the differences in overweight and obesity among Chinese adults are multilayered. Socioeconomic attributes, dietary habits, and behavioral patterns at the individual level, the built environment and natural environment at the community level, and the level of urbanization at the provincial level can all affect the occurrence of overweight and obesity in China. Finally, the influence factors of overweight and obesity between different levels have an interactive relationship, and the environment can indirectly affect the residents' overweight and obesity results by affecting the individual's psychological state and behavior choices. The purpose of this research is to help residents achieve better health and to provide theoretical basis for government agencies to formulate policies to promote population health.

Key words: adult, urbanization, overweight or obesity, multilevel model, Chinese family, panel studies

王依茹, 王琛, 曾金迪. 个体与环境交互作用下中国成人超重肥胖情况变化趋势及影响因素研究[J]. 地理科学进展, 2020, 39(1): 100-110.

WANG Yiru, WANG Chen, ZENG Jindi. Study on the trend and influencing factors of overweight and obesity in Chinese adults under interactions of individual and environment[J]. PROGRESS IN GEOGRAPHY, 2020, 39(1): 100-110.

图/表 7

表1

变量的描述性统计"

影响因素	描述	最小值	最大值	平均值
个体层面
性别	男=1;女=0	0	1	0.48
年龄	2010年个体年龄(岁)	16	110	45.51
教育年限	2010年个体接受教育年限(a)	0	22	7
城乡属性	城镇=1;乡村=0	0	1	0.46
工作性质	没有工作=0;农业工作=1;非农工作=2	0	2	0.76
有无配偶	有配偶=1;无配偶=0	0	1	0.8
是否吸烟	吸烟=1;不吸烟=0	0	1	0.3
是否酗酒	一周饮酒3次以上=1;一周饮酒未超过3次=0	0	1	0.16
出行方式	步行或自行车=1;其他=0	0	1	0.71
有无确诊慢性病	近半年有确诊慢性病=1;无确诊慢性病=0	0	1	0.15
抑郁得分	家庭追踪调查综合指标,用以衡量成人抑郁程度	6	30	26.93
工作日睡眠时间	工作日均睡眠时间(h)	0	20	8.1
工作日锻炼时间	工作日均锻炼健身时间(h)	0	8	0.27
工作日吃饭时间	工作日均用餐及其他饮食活动时间(h)	0	10	1.46
工作日看电视时间	工作日均观看电视包括其他音频设备时间(h)	0	16	1.66
休息日睡眠时间	节假日均睡眠时间(h)	0	20	8.49
休息日锻炼时间	节假日均锻炼健身时间(h)	0	15	0.3
休息日吃饭时间	节假日均用餐及其他饮食活动时间(h)	0	10	1.49
休息日看电视时间	节假日均观看电视包括其他音频设备时间(h)	0	16	2.03
肉类频次	最近一个月每周食用肉类次数(次)	0	43	3.94
奶制频次	最近一个月每周食用奶制品次数(次)	0	45	1.31
豆制频次	最近一个月每周食用豆制品次数(次)	0	34	2.02
蛋类频次	最近一个月每周食用蛋类次数(次)	0	43	3.05
油炸食物频次	最近一个月每周食用膨化/油炸食品次数(次)	0	21	0.53
腌制食物频次	最近一个月每周食用腌制食品的次数(次)	0	50	2.35
社区层面
社区属性	居委会=1;村委会=0	0	1	0.35
环境污染	方圆5 km内是否有化工厂、造纸厂等高污染企业	0	1	0.21
道路条件	社区内土路占比(%)	0	100	41.22
省域层面
人口城市化率	城镇人口占常住人口的百分比(%)	34	89	53

表1

表2

表3

表4

表5

表6

图1

参考文献 33

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个体层面变量	因子1	因子2	因子3	因子4	因子5	因子6
工作日吃饭时间	0.957
节假日吃饭时间	0.955
工作日锻炼时间		0.942
节假日锻炼时间		0.939
工作日看电视时间			0.934
节假日看电视时间			0.931
工作日睡眠时间				0.930
节假日睡眠时间				0.930
食用肉类频次					0.670
食用奶制品频次					0.650
食用豆制品频次					0.650
食用蛋类频次					0.650
食用油炸食品频次					0.480
食用腌制食品频次						0.931

年份	超重BMI≥24	肥胖BMI≥28
2010	27.8	5.4
2012	29.6	6.1
2014	32.4	6.8
2016	33.5	7.0

参数	空模型		线性发展模型		非线性发展模型
参数	估计值	标准误	估计值	标准误	估计值	标准误
第一层
身体质量指数	22.719^***	0.018	22.454^***	0.019	22.430^***	0.019
时间编码			0.177^***	0.004	0.247^***	0.013
时间编码的平方					-0.023^***	0.004
随机部分ε	2.124	1.458	2.072	1.440	2.071	1.439
第二层
随机部分γ	9.185	3.031	9.198	3.033	9.198	3.033
偏差度	508029		505839		505815

第一层
	估计值		标准误
身体质量指数	19.259^***		0.158
时间编码	0.679^***		0.037
时间编码的平方	-0.023^***		0.004
第二层
	第一层截距		第一层增长斜率
	估计值	标准误	估计值	标准误
城乡属性	0.499^***	0.042	-0.007	0.009
性别	0.518^***	0.049	0.033^**	0.011
年龄	0.020^***	0.002	-0.008^***	0.000
是否有配偶	1.203^***	0.054	-0.051^***	0.012
教育年限	0.012^**	0.005	0.001	0.001
是否有确诊慢性病	0.310^***	0.054	-0.013	0.012
是否抽烟	-0.368^***	0.050	-0.018	0.011
是否酗酒	0.120^**	0.053	-0.024	0.012
抑郁得分	0.040^***	0.005	-0.002	0.001
出行方式	-0.507^***	0.041	0.005	0.009
没有工作
农业工作	-0.064	0.047	0.027^**	0.011
非农工作	0.342^***	0.048	-0.006	0.011
日均吃饭时间	-0.022	0.018	0.008^*	0.004
日均锻炼时间	0.244^***	0.021	-0.018^***	0.005
食用易胖食品频次	-0.024	0.020	-0.007	0.005
日均看电视时间	0.203^***	0.019	-0.004	0.004
日均睡眠时间	-0.081^***	0.019	0.002	0.004
食用不健康食品频次	0.159^***	0.018	0.003	0.004
偏差度	502025

	空模型		模型1		模型2		模型3		模型4		模型5
	估计值	标准误	估计值	标准误	估计值	标准误	估计值	标准误	估计值	标准误	估计值	标准误
个体层面
城乡属性			0.444^***	0.065	0.386^***	0.058	0.281^***	0.053	0.440^***	0.063	0.276^***	0.053
性别			0.276^***	0.041	0.236^***	0.047	0.275^***	0.042	0.275^***	0.041	0.245^***	0.047
年龄			0.013^***	0.002	0.013^***	0.002	0.013^***	0.002	0.013^***	0.002	0.013^***	0.002
是否有配偶			0.686^***	0.048	0.674^***	0.045	0.687^***	0.048	0.684^***	0.047	0.691^***	0.046
是否有确诊慢性病			0.205^***	0.044	0.223^***	0.046	0.204^***	0.044	0.204^***	0.045	0.229^***	0.047
是否吸烟			-0.224^***	0.034	-0.237^***	0.033	-0.221^***	0.034	-0.223^***	0.035	-0.243^***	0.033
是否酗酒			0.125^**	0.041	0.106^**	0.038	0.126^**	0.041	0.125^**	0.041	0.111^**	0.039
抑郁得分					0.015^***	0.004					0.016^***	0.004
出行方式					-0.222^***	0.036					-0.230^***	0.036
吃饭时间					-0.051^*	0.016					-0.048^**	0.015
锻炼时间					0.073^***	0.018					0.070^***	0.017
食用易胖食品频次					0.021	0.021					0.016	0.021
看电视时间					0.103^***	0.018					0.104^***	0.017
睡眠时间					-0.034^**	0.017					-0.032^**	0.016
食用不健康食品频次					0.050^**	0.019					0.053^**	0.020
社区层面
社区性质							0.138^**	0.053			0.114^**	0.055
环境污染							0.049^*	0.031			0.048^*	0.032
道路条件							-0.002^**	0.001			-0.002^*	0.001
省级层面
城市化水平									1.064^**	0.368	0.725^*	0.381
偏差度	85600		84415		83813		84390		84410		82597