Romon M, Duhamel A, Collinet N, Weill J
Department of Nutrition, University Hospital of Lille, Lille, France.
Int J Obes (Lond). 2005 Jan;29(1):54-9. doi: 10.1038/sj.ijo.0802788.
To assess the prevalence of obesity and changes in body mass index (BMI) distribution between 1989 and 1999 in 5-y-old children, and to study the influence of parental socioeconomic status on these parameters.
Two cohorts of children in the final year of nursery school (in the city of Lille, France) were enrolled in 1989 (705 children: mean age=5.6+/-0.4 y) and 1999 (1258 children: mean age=5.6+/-0.5 y). Weight and height were measured, and data about parental occupation were collected during a school medical examination. International Obesity Task Force cutoff points were used to define overweight and obesity. Parental occupation was classified into four categories.
The prevalence of obesity increased from 1.8 to 4.9%, and the prevalence of overweight rose from 9.6 to 16.9%. Mean-difference plots allowed qualitative comparisons of the BMI distribution between the surveys: for children from the highest social classes, there was no change in BMI; for children from intermediate classes, there was a up-shift only in the upper part of the distribution with the heaviest children becoming heavier still; finally, for children from the lowest class, there was an increase in BMI across the entire population.
This study of the changes in BMI distribution gives greater insight into the 'obesity epidemic'. Our results show the influence of an interaction between genetic and environmental factors. The increase in BMI in the upper part of the distribution suggests that this is a population with a high degree of susceptibility, whereas the increase in BMI across the whole population in the lowest social class suggests a strong influence of the environment on this group and thus the necessity of appropriate, preventive measures.
评估1989年至1999年间5岁儿童的肥胖患病率及体重指数（BMI）分布变化，并研究父母社会经济地位对这些参数的影响。
1989年（705名儿童：平均年龄=5.6±0.4岁）和1999年（1258名儿童：平均年龄=5.6±0.5岁）在法国里尔市选取了两组处于幼儿园最后一年的儿童。测量了体重和身高，并在学校体检期间收集了有关父母职业的数据。采用国际肥胖特别工作组的切点来定义超重和肥胖。父母职业分为四类。
肥胖患病率从1.8%增至4.9%，超重患病率从9.6%升至16.9%。均值差异图有助于对两次调查间的BMI分布进行定性比较：对于来自最高社会阶层的儿童，BMI无变化；对于来自中等阶层的儿童，仅分布的上部出现上移，最重的儿童变得更重；最后，对于来自最低阶层的儿童，整个人群的BMI都有所增加。
这项关于BMI分布变化的研究能更深入地洞察“肥胖流行”情况。我们的结果显示了遗传和环境因素相互作用的影响。分布上部BMI的增加表明这是一个易感性较高的人群，而最低社会阶层整个人群BMI的增加表明环境对该群体有强烈影响，因此有必要采取适当的预防措施。
