Takahashi E, Yoshida K, Sugimori H, Miyakawa M, Izuno T, Yamagami T, Kagamimori S
Department of Preventive Medicine, St. Marianna University School of Medicine, Kawasaki, Japan.
Prev Med. 1999 Mar;28(3):293-6. doi: 10.1006/pmed.1998.0428.
Obesity in childhood increases the risk of obesity in adulthood. Obesity in adulthood is a risk factor for chronic diseases such as hypertension and atherosclerosis. Therefore, it is important to eliminate factors influencing the development of obesity in children from the viewpoint of preventive medicine. The purpose of this study is to elucidate the relationship between obesity and lifestyle in 3-year-old children in a case-control study.
Subjects were selected from the Toyama study at health checkups for 3-year-old children which are done routinely by local governments in Japan on all children of that age. A special questionnaire consisting of items on lifestyle and environmental factors of the children and past histories of parents was distributed to the Toyama study participants beforehand and was collected at the checkup. Matched-pair comparisons were performed between obese children whose body mass index was 18 or more (N = 427) and control children (N = 854) matched by sex and birth month. Multivariate stepwise conditional logistic regression analysis was also applied to assess the influence of confounding factors.
The following six factors significantly influenced the development of obese 3-year-old children using the Mantel-Haenszel method: the mother's job, limited playtime outdoors (1 hour or less), snacking irregularity, an overweight father (body mass index >/= 24), an overweight mother (body mass index >/= 24), and overweight at birth (birth weight >/= 3,500 g). An overweight mother or father, limited playtime outdoors, overweight at birth, and snacking irregularity were significantly related to obesity in 3-year-old children after adjusting for confounding factors by multivariate stepwise conditional logistic regression analysis.
We have suggested several factors influencing the development of obesity in 3-year-old Japanese children: parental overweight and overweight at birth as host factors, physical inactivity and snacking irregularity as behavioral factors, the mother's job as an environmental factor.
儿童期肥胖会增加成年期肥胖的风险。成年期肥胖是高血压和动脉粥样硬化等慢性病的危险因素。因此,从预防医学的角度消除影响儿童肥胖发展的因素很重要。本研究的目的是在一项病例对照研究中阐明3岁儿童肥胖与生活方式之间的关系。
研究对象选自富山研究,该研究是日本地方政府对所有3岁儿童进行的常规健康检查。事先向富山研究的参与者发放了一份关于儿童生活方式和环境因素以及父母既往病史的特殊问卷,并在体检时收集。对体重指数为18或更高的肥胖儿童(N = 427)与按性别和出生月份匹配的对照儿童(N = 854)进行配对比较。还应用多变量逐步条件逻辑回归分析来评估混杂因素的影响。
使用Mantel-Haenszel方法,以下六个因素对3岁肥胖儿童的发展有显著影响:母亲的工作、户外玩耍时间有限(1小时或更少)、零食摄入不规律、父亲超重(体重指数≥24)、母亲超重(体重指数≥24)以及出生时超重(出生体重≥3500克)。经过多变量逐步条件逻辑回归分析调整混杂因素后,超重的母亲或父亲、户外玩耍时间有限、出生时超重以及零食摄入不规律与3岁儿童肥胖显著相关。
我们提出了几个影响日本3岁儿童肥胖发展的因素:父母超重和出生时超重作为宿主因素,身体活动不足和零食摄入不规律作为行为因素,母亲的工作作为环境因素。