Locard E, Mamelle N, Billette A, Miginiac M, Munoz F, Rey S
GREPS, Groupe de Recherche en Education Pour La Santé, Lyon, France.
Int J Obes Relat Metab Disord. 1992 Oct;16(10):721-9.
To be more effective, the prevention of obesity in childhood should be focused on the population at risk. The purpose of the present study is firstly to find correlations between certain environmental factors and obesity in childhood, and secondly to measure the influence of the environmental factors after taking the parental history of obesity into account. This case controlled study includes 704 controls vs. 327 cases selected in a population of five year old school children. The anthropometric assessment was completed at school. Obesity was defined as a weight for height > or = 2 s.d. using the French weight charts for French children based on sex and height. Interviews of the parents recorded parental overweight and child birth overweight as 'constitutional' factors and family structure, socio-economic level and daily lifestyle (sleep, TV viewing, after school care, etc.) as 'environmental' factors. The results show that parental overweight and birth overweight are closely related to the child's obesity at five years of age (estimated relative risks 3.1 and 2.4 respectively). The environmental factors which contribute to child obesity are: southern European origin of the mother, snacks, excessive television viewing and, more importantly, short sleep duration (estimated relative risks = 1.9, 1.3, 2.1 and 4.9 respectively). A logistic regression model, after taking parental overweight into account, shows that the relationship between obesity and short sleep duration persists independently of television viewing. The hypotheses raised by these findings are discussed.
为提高效果，儿童肥胖预防应聚焦于高危人群。本研究目的一是找出某些环境因素与儿童肥胖之间的关联，二是在考虑父母肥胖史后衡量环境因素的影响。这项病例对照研究纳入了从5岁学童群体中选取的704名对照儿童和327名病例儿童。人体测量评估在学校完成。根据法国儿童按性别和身高制定的体重图表，肥胖定义为身高体重比大于或等于2个标准差。对父母的访谈记录了父母超重和出生时超重作为“体质”因素，以及家庭结构、社会经济水平和日常生活方式（睡眠、看电视、课后照料等）作为“环境”因素。结果显示，父母超重和出生时超重与5岁儿童肥胖密切相关（估计相对风险分别为3.1和2.4）。导致儿童肥胖的环境因素有：母亲来自南欧、吃零食、看电视过多，更重要的是睡眠时间短（估计相对风险分别为1.9、1.3、2.1和4.9）。在考虑父母超重因素后建立的逻辑回归模型显示，肥胖与睡眠时间短之间的关系独立于看电视情况而持续存在。对这些研究结果所提出的假设进行了讨论。
