卫生研究

目的 了解中国学龄儿童体重管理知识的掌握水平及其分布特征。方法 基于2023—2024年中国学龄儿童营养健康知识知晓率调查数据，调查覆盖31个省(自治区、直辖市)195个调查点，采用多阶段分层整群随机抽样方法，共纳入90 240名小学高年级(4～6年级)、初中和高中阶段在校学生。依据复杂抽样设计进行加权处理，权重由抽样权重和事后分层权重构成，标准误采用Taylor线性化方法估计。组间比较采用基于复杂抽样设计的t/F检验评估差异。结果 我国在校学生体重管理知识的总体加权正确率为83.97%(95%CI 83.83%～84.10%)。女生的加权正确率显著高于男生(85.68%比82.49%,P<0.01),高中阶段学生掌握水平最高[86.21%(95%CI 85.96%～86.45%)]。城市学生整体优于农村学生，东部地区高于中部和西部地区，达到85.80%(95%CI 85.59%～86.00%)。在知识维度方面，学生对“身体活动与行为习惯”和“饮食认知误区”掌握较好(加权正确率均>88.0%),而“健康食物选择”相关知识掌握相对薄弱，尤其小学高年级和初中阶段的加权正确率仅为70.15%(95%CI 69.75%～70.54%)和70.75%(95%CI 70.29%～71.20%)。其中，“外餐避免油炸”、“外餐健康选择”等应用型知识点为各学段的主要薄弱环节。结论 2023—2024年中国学龄儿童体重管理知识总体掌握较好，但男生、农村、中西部学生的掌握水平相对较低,健康食物选择类知识点为各学段中掌握率最低的维度。

OBJECTIVE To assess the level and distribution of weight management knowledge among Chinese school-aged children at different educational stages.METHODS Based on data from the 2023-2024 China Nutrition and Health Knowledge Survey of school-aged children, which covered 195 survey sites across 31 provinces(autonomous regions and municipalities), a multistage stratified cluster sampling design was applied. A total of 90 240 students from upper primary(grades 4-6), junior high, and senior high schools were included. Weighted analyses were performed according to the complex sampling design, with weights derived from sampling and post-stratification weights. Standard errors were estimated using the Taylor linearization method. Group differences were assessed by t or Wald F tests based on the complex sampling design.RESULTS The overall weighted correct response rate for weight management knowledge was 83.97%(95%CI 83.83%-84.10%). Female students scored significantly higher than male students(85.68% vs. 82.49%, P<0.01). Senior high school students demonstrated the highest knowledge level(86.21%(95%CI 85.96%-86.45%)). Urban students performed better than rural students(85.44% vs. 81.48%, P<0.01), and those in eastern regions scored higher(85.80%(95%CI 85.59%-86.00%)) than peers in central and western regions. Across knowledge domains, students showed higher mastery of “physical activity and sedentary behavior” and “dietary misconceptions”(weighted accuracy>88.00%), while “healthy food choices” was the weakest domain, particularly among upper primary and junior high students(70.15%(95%CI 69.75%-70.54%) and 70.75%(95%CI 70.29%-71.20%), respectively). Items such as “avoiding fried foods when eating out” and “making healthy dining-out choices” were common weak points across stages.CONCLUSION Chinese school-aged children demonstrated generally good knowledge of weight management, but boys, rural students, and those in central and western regions had relatively lower mastery. Knowledge related to healthy food choices remained the weakest across all stages.