饮食节律与青少年抑郁症状的关联

饮食节律与青少年抑郁症状的关联

作者：张雅迪，谢阳，王娇娇，张新宇，万宇辉，陶芳标

来源：张雅迪, 谢阳, 王娇娇,等. 饮食节律与青少年抑郁症状的关联[J]. 中国学校卫生: 1-5[2024-05-07].

Abstract

Objective To describe the prevalence and association between dietary rhythms and depressive symptoms among adolescents, and to provide a basis for improving adolescents' unhealthy behavioural habits and promoting adolescents' physical and mental health.

Methods From October to December 2021, a total of 22,868 junior high school and senior high school students were selected from one junior high school and one senior high school in urban and rural areas of eight cities, namely, Shenyang, Xuzhou, Shenzhen, Taiyuan, Nanchang, Zhengzhou, Chongqing, and Kunming, using a combination of purposive sampling and cluster random sampling. A self-administered questionnaire was used to assess adolescents' dietary rhythms, and the Patient Health Questionnaire (PHQ-9) was used to assess depressive symptoms. Binary logistic regression models were used to analyse the associations between adolescent dietary rhythms and depressive symptoms, and the associations between adolescent dietary rhythms and depressive symptoms across gender and physical activity levels were stratified by gender and physical activity levels.

Results The detection rate of depressive symptoms in adolescents was 44.4%. The differences in the detection rates of depressive symptoms among adolescents of different genders, physical activity levels, and eating rhythm disorders are statistically significant (χ² = 157.51, 105.02, 3 282.50, P<0.01). Binary logistic regression analyses showed that after adjusting for confounders, with the low disordered dietary rhythms group as the reference, the adolescents in the moderate disordered dietary rhythms group (OR = 2.63, 95% CI: 2.45-2.83) and the high disordered dietary rhythms group (OR = 6.38, 95% CI: 5.93-6.86) were positively correlated with depressive symptoms; and after stratifying by gender, the boys' and girls' dietary rhythms were positively correlated with depression symptoms. The moderately disordered group (male: OR = 2.62, 95% CI: 2.37-2.89; female: OR = 2.67, 95% CI: 2.40-2.97) and the highly disordered group (male: OR = 5.74, 95% CI: 5.19-6.35; female: OR = 7.11, 95% CI: 6.40-7.89) were positively correlated with depression symptoms; After stratification by physical activity level, low, moderate and above physical activity level adolescents in the dietary rhythms in the disordered group (low physical activity: OR = 2.91, 95% CI: 2.58-3.29; moderate and above physical activity: OR = 2.50, 95% CI: 2.28-2.74), high disordered group (low physical activity: OR = 6.51, 95% CI: 5.94-7.13; moderate and higher physical activity: OR = 6.18, 95% CI: 5.47-6.97) were positively associated with depressive symptoms ( P<0.01). There was an interaction between dietary rhythm and physical activity level on the development of depressive symptoms in adolescents, and the detection rate of depressive symptoms was higher in adolescents with low physical activity level and moderate or high disordered dietary rhythm group (OR = 1.50, 3.90, P<0.01).

Conclusion Dietary rhythm disorders are positively associated with the detection of depressive symptoms in adolescents. Regular dietary behaviours and increased physical activity have positive significance in promoting adolescent mental health.

摘要

目的  描述青少年饮食节律和抑郁症状的流行现状及关联,为改善青少年不健康行为习惯并促进青少年身心健康提供依据。

方法  于2021年10—12月，采用立意抽样与分层整群随机抽样相结合的方法分别在沈阳市、徐州市、深圳市、太原市、南昌市、郑州市、重庆市、昆明市8个城市的城区和农村分别选取1所初中和1所高中,共22 868名在校初中和高中学生为研究对象。采用自编问卷评估青少年饮食节律，用患者健康问卷(PHQ-9)评定抑郁症状。运用二元Logistic回归模型分析青少年饮食节律与抑郁症状之间的关联，并按照性别和体力活动水平进行分层分析青少年饮食节律与抑郁症状的关联性。

结果  青少年抑郁症状检出率为44.4%。不同性别、体力活动水平、饮食节律紊乱程度青少年抑郁症状检出率差异均有统计学意义(χ2值分别为157.51,105.02,3 282.50，P值均<0.01)。二元Logistic回归分析结果显示,调整年龄、性别、家庭所在地、家庭经济情况、是否独生子女、父母文化程度、学习负担、体力活动等混杂因素后,以饮食节律低紊乱组为参照,青少年饮食节律中紊乱组(OR=2.63, 95%CI=2.45～2.83)、高紊乱组(OR=6.38, 95%CI=5.93～6.86)与抑郁症状均呈正相关；按性别分层后，男生和女生饮食节律中紊乱组(男：OR=2.62, 95%CI=2.37～2.89；女：OR=2.67, 95%CI=2.40～2.97)、高紊乱组(男：OR=5.74, 95%CI=5.19～6.35；女：OR=7.11, 95%CI=6.40～7.89)与抑郁症状均呈正相关；按体力活动水平分层后，低、中等及以上体力活动水平青少年饮食节律中紊乱组(低体力活动：OR=2.91, 95%CI=2.58～3.29；中等及以上体力活动：OR=2.50, 95%CI=2.28～2.74)、高紊乱组(低体力活动：OR=6.51, 95%CI=5.94～7.13；中等及以上体力活动：OR=6.18, 95%CI=5.47～6.97)与抑郁症状均呈正相关(P值均<0.01)。饮食节律与体力活动水平对青少年抑郁症状的发生存在交互作用，以中等及以上体力活动水平且饮食节律低紊乱组为参照，低体力活动水平且饮食节律中、高紊乱组青少年抑郁症状检出率更高(OR值分别为1.50,3.90,95%CI分别为1.39～1.61, 3.63～4.19,P值均<0.01)。

结论  饮食节律紊乱与青少年抑郁症状检出率呈正向关联。规律性膳食行为、增加体力活动对促进青少年心理健康具有积极意义。