Metallinos-Katsaras Elizabeth, Sherry Bettylou, Kallio Jan
Department of Nutrition, School for Health Sciences, Simmons College, Boston, MA 02115, USA.
J Am Diet Assoc. 2009 Oct;109(10):1790-4. doi: 10.1016/j.jada.2009.07.007.
Both household food insecurity and childhood overweight are serious public health problems that appear to be paradoxically correlated. This study examines the relationship between overweight and household food insecurity with/without hunger in low-income children participating in the Special Supplemental Nutrition Program for Women, Infants, and Children. Weight, height, and household food insecurity data were collected on 8,493 children ages 1 month to 5 years and analyzed by sex and age groups using logistic regression to model the odds of being overweight (weight for length or body mass index [calculated as kg/m(2)] for age > or =95th percentile) given household food insecurity status, controlling for race/ethnicity and maternal education. Analyses were stratified by age and sex because interaction terms with household food insecurity were significant (P<0.10). In this sample, prevalence of household food insecurity was 30.7% (8.3% with hunger) and 18.4% were overweight. Among girls younger than 2 years of age, household food insecurity was associated with reduced odds of overweight compared with food-secure households (odds ratio=0.65; 95% confidence interval: 0.47 to 0.88); hunger status did not alter this association. Among 2- to 5-year-old girls, there was no overall significant association between household food insecurity and overweight; however, household food insecurity with hunger was positively associated with overweight compared with those from food-secure households (odds ratio=1.49; 95% confidence interval: 1.06 to 2.10). No association between household food insecurity and overweight was found among boys. These findings suggest an association between household food insecurity and overweight prevalence in this low-income population. However, sex and age appear to modify both the magnitude and direction of the association.
家庭粮食不安全和儿童超重都是严重的公共卫生问题，而这两者之间的关联似乎自相矛盾。本研究调查了参与妇女、婴儿和儿童特别补充营养计划的低收入儿童中，超重与有/无饥饿的家庭粮食不安全之间的关系。收集了8493名1个月至5岁儿童的体重、身高和家庭粮食不安全数据，并按性别和年龄组进行分析，使用逻辑回归模型来确定在考虑家庭粮食不安全状况、种族/族裔和母亲教育程度的情况下超重（年龄≥95百分位数时的身长体重或体重指数[计算为kg/m²]）的几率。由于与家庭粮食不安全的交互项具有显著性（P<0.10），分析按年龄和性别进行了分层。在这个样本中，家庭粮食不安全的患病率为30.7%（8.3%伴有饥饿），超重率为18.4%。在2岁以下的女孩中，与粮食安全的家庭相比，家庭粮食不安全与超重几率降低相关（比值比=0.65；95%置信区间：0.47至0.88）；饥饿状况并未改变这种关联。在2至5岁的女孩中，家庭粮食不安全与超重之间总体上没有显著关联；然而，与粮食安全家庭的女孩相比，伴有饥饿的家庭粮食不安全与超重呈正相关（比值比=1.49；95%置信区间：1.06至2.10）。在男孩中未发现家庭粮食不安全与超重之间存在关联。这些发现表明，在这个低收入人群中，家庭粮食不安全与超重患病率之间存在关联。然而，性别和年龄似乎会改变这种关联的程度和方向。
