Rose Donald, Bodor J Nicholas
School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA 70112, USA.
Pediatrics. 2006 Feb;117(2):464-73. doi: 10.1542/peds.2005-0582.
Recent work on the determinants of obesity has shown a positive association between household food insecurity and overweight status in adult women, yet research exploring this issue in children has been inconclusive. In this study we examine the association between food insecurity and overweight status in young school children by using a large, nationally representative sample.
Data from the Early Childhood Longitudinal Study-Kindergarten Cohort (ECLS-K) were analyzed. Replicate heights and weights were measured on kindergarten children (N = 16889) in the spring of 1999. Children with a body mass index > or = 95th percentile of their gender-specific BMI-for-age chart were considered overweight. Food-insecurity status was assessed by using the full 18-question US Department of Agriculture Household Food Security Scale. Multivariate logistic regression was used to assess the relationship between overweight and food-insecurity status while controlling for potential demographic, socioeconomic, and behavioral confounders.
Overall, 11.2% of the girls and 11.8% of the boys were overweight. Children from food-insecure households were 20% less likely to be overweight than their food-secure counterparts. Similar results on the food-insecurity/overweight link were found across a range of different models and expressions for key variables. Positive predictors of overweight status included low physical activity, television watching for > 2 hours/day, high birth weight, black or Latino ethnicity, and low income.
There are strong arguments for reducing food insecurity among households with young children. This research suggests that these arguments would be based on reasons other than a potential link to obesity. Low activity levels and excessive television watching, however, were strongly related to overweight status, a finding that supports continued efforts to intervene in these areas.
近期关于肥胖决定因素的研究表明，家庭粮食不安全状况与成年女性超重状态之间存在正相关关系，但在儿童中探索这一问题的研究尚无定论。在本研究中，我们通过使用一个具有全国代表性的大样本，来检验粮食不安全状况与低龄学童超重状态之间的关联。
对来自儿童早期纵向研究——幼儿园队列（ECLS-K）的数据进行分析。1999年春季对幼儿园儿童（N = 16889）测量了重复身高和体重。体重指数大于或等于其按年龄和性别划分的BMI百分位图表第95百分位的儿童被视为超重。使用完整的18个问题的美国农业部家庭粮食安全量表评估粮食不安全状况。在控制潜在的人口统计学、社会经济和行为混杂因素的同时，使用多变量逻辑回归来评估超重与粮食不安全状况之间的关系。
总体而言，11.2%的女孩和11.8%的男孩超重。来自粮食不安全家庭的儿童超重的可能性比粮食安全家庭的儿童低20%。在一系列不同的模型和关键变量表达式中，都发现了粮食不安全/超重关联的类似结果。超重状态的积极预测因素包括低体力活动、每天看电视超过2小时、高出生体重、黑人或拉丁裔种族以及低收入。
有充分理由减少有幼儿家庭的粮食不安全状况。这项研究表明，这些理由将基于与肥胖潜在联系以外的其他原因。然而，低活动水平和过度看电视与超重状态密切相关，这一发现支持继续在这些领域进行干预的努力。
