Datar A, Sturm R
RAND Corporation, Santa Monica, CA 90407-2138, USA.
Int J Obes (Lond). 2006 Sep;30(9):1449-60. doi: 10.1038/sj.ijo.0803311. Epub 2006 Mar 14.
To examine the link between childhood overweight status and elementary school outcomes.
Prospective study design: multivariate regression models examining the association between changes in overweight status and school outcomes between kindergarten entry and end of third grade, after controlling for various child, family and school characteristics.
Nationally representative sample of US children who entered kindergarten in 1998, with longitudinal data on body mass index (BMI) and school outcomes at kindergarten entry and end of third grade.
Wide range of elementary school outcomes collected in each wave including academic achievement (math and reading standardized test scores); teacher reported internalizing and externalizing behavior problems (BP), social skills (self-control, interpersonal skills) and approaches to learning; school absences; and grade repetition. Measurements of height and weight in each wave were used to compute BMI and indicators of overweight status based on CDC growth charts. A rich set of control variables capturing child, family, and school characteristics.
Moving from not-overweight to overweight between kindergarten entry and end of third grade was significantly associated (P<0.05) with reductions in test scores, and teacher ratings of social-behavioral outcomes and approaches to learning among girls. However, this link was mostly absent among boys, with two exceptions - boys who became overweight had significantly fewer externalizing BPs (P<0.05), but more absences from school compared to boys who remained normal weight. Being always-overweight was associated with more internalizing BP among girls but fewer externalizing BPs among boys.
Change in overweight status during the first 4 years in school is a significant risk factor for adverse school outcomes among girls but not boys. Girls who become overweight during the early school years and those who start school being overweight and remain that way may need to be monitored carefully.
探讨儿童超重状况与小学学业成果之间的联系。
前瞻性研究设计：采用多元回归模型，在控制各种儿童、家庭和学校特征后，研究幼儿园入学至三年级末超重状况变化与学业成果之间的关联。
1998年进入幼儿园的具有全国代表性的美国儿童样本，拥有幼儿园入学时和三年级末体重指数（BMI）及学业成果的纵向数据。
每一轮收集的广泛的小学学业成果，包括学业成绩（数学和阅读标准化测试分数）；教师报告的内化和外化行为问题（BP）、社交技能（自我控制、人际技能）和学习方法；学校缺勤情况；以及留级情况。每一轮的身高和体重测量数据用于根据美国疾病控制与预防中心（CDC）生长图表计算BMI和超重状况指标。一组丰富的控制变量涵盖儿童、家庭和学校特征。
在幼儿园入学至三年级末，从不超重转变为超重与女孩的测试分数降低以及教师对社交行为成果和学习方法的评分显著相关（P<0.05）。然而，男孩中大多不存在这种联系，有两个例外——超重的男孩外化行为问题显著减少（P<0.05），但与体重保持正常的男孩相比，缺勤情况更多。一直超重与女孩更多的内化行为问题相关，但与男孩较少的外化行为问题相关。
入学后头4年超重状况的变化是女孩而非男孩不良学业成果的重要风险因素。在小学早期超重的女孩以及入学时超重并一直保持超重的女孩可能需要仔细监测。
