Hui L L, Nelson E A S, Yu L M, Li A M, Fok T F
Department of Paediatrics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong.
Int J Obes Relat Metab Disord. 2003 Nov;27(11):1411-8. doi: 10.1038/sj.ijo.0802423.
To identify risk factors for overweight in Hong Kong children aged 6-7 y.
Case-control study.
Student Health Service Centres, Hong Kong.
A total of 343 Hong Kong Chinese children aged 6-7 y old categorised into three groups, an overweight group (> or =92 nd centile for BMI), a normal middle-weight group (45th-55th centile for BMI) and a normal low-weight group (< or =8th centile for BMI).
Subjects and their parents/caregivers were interviewed at home. Data on lifestyle habits, dietary habits, family structure and demographic background were collected by questionnaire. A 3-day dietary record was administrated by the parents/caregivers to assess dietary intake of the children.
Logistic regression analyses (overweight group compared with middle-weight plus low-weight groups) showed that childhood overweight was significantly associated with parental obesity (BMI > or =25 kg/m(2), Asian reference) (paternal: OR=2.66, 95% CI=1.51-4.70; maternal: 5.07, 2.62-9.79) but not parental overweight (BMI=23-25 kg/m(2)). After adjustment for parental obesity, the odds ratio for childhood overweight was increased by birth weight (<3.0 kg as reference, 3.0-3.5 kg: 2.13, 1.18-3.84; > or =3.5 kg: 4.89, 2.49-9.60) and decreased by sleeping duration (<9 h/day as reference, 9-11 h/day: 0.54, 0.30-0.97; > or =11 h/day: 0.31, 0.11-0.87). Childhood overweight was also significantly associated with higher energy consumption (2.62, 1.20-5.74) and having a father who was a current smoker (2.08, 1.25-3.46).
Although healthy diet and regular exercise will remain the cornerstones of obesity management in children, our data support the view that education about maintaining a healthy weight could be introduced much earlier in those families with high-risk children, as indicated by high parental BMI or high birth weight. The utility and practicality of such an approach should be carefully evaluated before becoming part of any public health policy. Further study of the role of short sleeping duration and parental smoking on childhood obesity development is warranted.
确定香港6至7岁儿童超重的风险因素。
病例对照研究。
香港学生健康服务中心。
共343名6至7岁的中国香港儿童,分为三组,超重组(BMI大于或等于第92百分位数)、正常中等体重组(BMI第45至55百分位数)和正常低体重组(BMI小于或等于第8百分位数)。
在受试者家中对其本人及其父母/照顾者进行访谈。通过问卷调查收集生活方式习惯、饮食习惯、家庭结构和人口统计学背景数据。由父母/照顾者进行为期3天的饮食记录,以评估儿童的饮食摄入量。
逻辑回归分析(超重组与中等体重加低体重组比较)显示,儿童超重与父母肥胖显著相关(BMI大于或等于25kg/m²,亚洲参考标准)(父亲:比值比=2.66,95%置信区间=1.51 - 4.70;母亲:5.07,2.62 - 9.79),但与父母超重(BMI = 23 - 25kg/m²)无关。在调整父母肥胖因素后,儿童超重的比值比因出生体重而增加(以<3.0kg为参考,3.0 - 3.5kg:2.13,1.18 - 3.84;大于或等于3.5kg:4.89,2.49 - 9.60),因睡眠时间而降低(以<9小时/天为参考,9 - 11小时/天:0.54,0.30 - 0.97;大于或等于11小时/天:0.31,0.11 - 0.87)。儿童超重还与较高的能量消耗(2.62,1.20 - 5.74)以及父亲为当前吸烟者显著相关(2.08,1.25 - 3.46)。
尽管健康饮食和规律运动仍是儿童肥胖管理的基石,但我们的数据支持这样一种观点,即对于那些有高危儿童的家庭,如父母BMI高或出生体重高的家庭,可以更早地开展关于保持健康体重的教育。在成为任何公共卫生政策的一部分之前,应仔细评估这种方法的实用性和可行性。有必要进一步研究短睡眠时间和父母吸烟对儿童肥胖发展的作用。