Kruger R, Kruger H S, Macintyre U E
Department of Consumer Science, University of Pretoria, South Africa.
Public Health Nutr. 2006 May;9(3):351-8. doi: 10.1079/phn2006849.
To investigate the determinants of overweight and obesity among 10- to 15-year-old schoolchildren in a population in the transitional phase in the North West Province of South Africa.
A cross-sectional survey was used to investigate weight status (anthropometric indicators) and determinants of overweight/obesity including dietary intake, physical activity and socio-economic status. A single, random sample (n=1257), stratified for gender, type of school and ethnic group, was used. Data were collected on demographics, family circumstances, habitual physical activity, dietary intake and anthropometry to evaluate weight status and body fat content. One-way analysis of variance, the generalised linear models procedure of SAS and the Tukey post hoc honest significant difference test were used to analyse the data.
Few children were overweight or obese (7.8%) according to International Obesity Task Force (IOTF) standards (body mass index (BMI)-for-age). These standards were compared with other accepted standard values. Both Cole's IOTF/BMI-for-age standard and the sum of skinfold thicknesses standard classified normal-weight status similarly at a level of 92% (P<0.01) and were found to be useful in determining overweight/obesity. The prevalence rate was higher in females and white children, and was more apparent in urban areas, smaller households and children of parents with low- or high-income occupations. Boys and pre-menarcheal girls had mean body fat percentage in the normal/optimal range, whereas that of post-menarcheal girls was moderately high. Few variables showed a significant association with high body fat percentage: in boys, only the number of members in the household and physical activity levels over the weekend; in girls, only age. The overweight/obese boys mostly lived in smaller households, and the overweight/obese post-menarcheal girls were most inactive on both weekdays and weekends, and more overweight with increasing age.
Smaller households, inactivity and increasing age for girls were found to be determinants that influence the development of overweight/obesity, while female gender and age post-menarche were identified as determinants of higher body fat content. For overweight/obesity prevention, the focus should be on pre-menarcheal girls, aged 10-13 years, using these determinants to identify overweight/obesity risk. Preventive programmes should aim to increase the physical activity of children to improve their current and future weight status.
调查南非西北省处于过渡阶段人群中10至15岁学童超重和肥胖的决定因素。
采用横断面调查来研究体重状况（人体测量指标）以及超重/肥胖的决定因素，包括饮食摄入、身体活动和社会经济状况。使用了一个按性别、学校类型和种族分层的单一随机样本（n = 1257）。收集了有关人口统计学、家庭情况、习惯性身体活动、饮食摄入和人体测量学的数据，以评估体重状况和体脂含量。使用单因素方差分析、SAS的广义线性模型程序以及Tukey事后诚实显著性差异检验来分析数据。
根据国际肥胖特别工作组（IOTF）标准（年龄别体重指数（BMI）），很少有儿童超重或肥胖（7.8%）。将这些标准与其他公认的标准值进行了比较。科尔的IOTF/年龄别BMI标准和皮褶厚度总和标准在92%的水平上对正常体重状况的分类相似（P<0.01），并且被发现对确定超重/肥胖很有用。患病率在女性和白人儿童中较高，在城市地区、小家庭以及父母从事低收入或高收入职业的儿童中更为明显。男孩和月经初潮前的女孩平均体脂百分比处于正常/最佳范围内，而月经初潮后的女孩则中度偏高。很少有变量与高体脂百分比有显著关联：在男孩中，只有家庭中的成员数量和周末的身体活动水平；在女孩中，只有年龄。超重/肥胖的男孩大多生活在小家庭中，超重/肥胖的月经初潮后女孩在工作日和周末都最不活跃，并且随着年龄增长超重情况更严重。
发现小家庭、不活动以及女孩年龄增长是影响超重/肥胖发展的决定因素，而女性性别和月经初潮后年龄是较高体脂含量的决定因素。对于超重/肥胖的预防，应重点关注10至13岁月经初潮前的女孩，利用这些决定因素来识别超重/肥胖风险。预防计划应旨在增加儿童的身体活动，以改善他们当前和未来的体重状况。
