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目的 评估女性产后1个月内的膳食多样性评分(dietary diversity score, DDS)并分析其与产后1年内超重/肥胖之间的关联。方法 基于一项前瞻性队列研究，招募孕早期18～45岁女性作为研究对象。孕期、产后42天及3个月由医生测量身高(仅第一次产检时测量)和体重，医生电话随访研究对象产后6月及1年的体重数据，计算体质指数(body mass index, BMI),BMI≥24.0 kg/m2为超重/肥胖。利用食物频率问卷调查其产后1个月内的食物摄入情况，将食物分为6个大类及27个亚类并计算DDS(-2～10分)。按DDS的四分位数将研究对象分为Q1～Q4共4组，运用多因素Logistic回归模型，分析DDS与女性产后1年内超重/肥胖风险的关联。结果 纳入257名女性，孕前、分娩后42天、3月、6月及1年的超重/肥胖率分别为10.89%、23.74%、18.78%、17.90%和15.17%,产后1个月内DDS为6.71(5.43,7.65)。在调整孕前体重、妊娠期体重增长及新生儿出生体重后，与Q1组相比，Q3组在产后1年内各时间点超重/肥胖风险均较低(42天：OR=0.32,95%CI 0.10～1.00;3月：OR=0.19,95%CI 0.05～0.72;6月：OR=0.22,95%CI 0.07～0.69;1年：OR=0.22,95%CI 0.06～0.84);而Q4组仅在产后3月超重/肥胖风险较低(OR=0.19,95%CI 0.04～0.88)。进一步对194名膳食能量摄入量为1000～4000 kcal/d的研究对象调整能量摄入后，与Q1组相比，Q3组在产后6月(OR=0.19,95%CI 0.05～0.76)及1年(OR=0.16,95%CI 0.03～0.96)的超重/肥胖风险较低，而Q4组在各时间点的超重/肥胖风险差异均无统计学意义。结论 在控制膳食总能量摄入量的前提下，较高的DDS有利于产后女性的体重控制。
Abstract：OBJECTIVE To investigate the association between the dietary diversity score(DDS) at one month postpartum and the risk of overweight/obesity during the first year after childbirth.METHODS Based on Taicang and Wuqiang mother-child cohort study(TAWS) in China, we recruited women aged 18 to 45 in their first trimester of pregnancy and tracked their weight changes until one year postpartum. Doctors measured women's heights(at the first prenatal care) and measured their weights during pregnancy at 42 days and 3 months postpartum. Women measured their weights at home and reported to doctors by phone at 6 months and 1 year postpartum. The body mass index(BMI) was calculated and BMI ≥ 24.0 kg/m2 was defined as overweight/obesity. The food frequency questionnaire(FFQ) was used to collect their food intake information. Foods were classified into six major categories and 27 subcategories, and the DDS was calculated(range:-2 to 10). Subjects were divided into four groups based on their DDS quartiles(Q1-Q4). Multivariate Logistic regression analysis was used to analyze the association between DDS and the risk of overweight/obesity.RESULTS There were 257 women in this study, and the rates of overweight/obesity were 10.89% before pregnancy, 23.74%, 18.78% 17.90%, and 15.17% at 42 days, 3 months, 6 months and 1 year postpartum. The median(P25, P75) DDS was 6.71(5.43, 7.65). Compared with the Q1 group, the Q3 group had a significantly lower likelihood of overweight/obesity after childbirth within 1 year postpartum(42 days: OR=0.32, 95%CI 0.10-1.00; 3 months: OR=0.19, 95%CI 0.05-0.72; 6 months: OR=0.22, 95%CI 0.07-0.69; 1 year: OR=0.22, 95%CI 0.06-0.84); whereas the Q4 group had a lower likelihood of overweight/obesity at 3 months postpartum(OR=0.19, 95%CI 0.04-0.88). In the subgroup of 194 women with a daily energy intake between 1000 and 4000 kcal/d, after adjusting for energy intake, the Q3 group had a lower likelihood of overweight/obesity at 6 months(OR=0.19, 95%CI 0.05-0.76) and 1 year postpartum(OR=0.16, 95%CI 0.03-0.96) compared with Q1; while the likelihood of overweight/obesity in the Q4 group was not statistically different from that in the Q1 group at any time point.CONCLUSION When dietary energy intake is within a appropriate range, a higher DDS is beneficial for weight control in postpartum women.
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基本信息:
DOI：10.19813/j.cnki.weishengyanjiu.2026.03.004
中图分类号:R153.1
引用信息:
[1]谭新妍,杨振宇,庞学红,等.膳食多样性评分与产后女性超重/肥胖的关联[J].卫生研究,2026,55(03):382-389.DOI:10.19813/j.cnki.weishengyanjiu.2026.03.004.
基金信息:
国家重点研发计划(No.2023YFC2506701); 国家财政项目(No.102393260020070000001)
2026-05-21
2026-05-21