MRC Centre of Epidemiology for Child Health, UCL Institute of Child Health, London, UK.
Int J Obes (Lond). 2010 Apr;34(4):624-32. doi: 10.1038/ijo.2010.10. Epub 2010 Feb 2.
To examine risk factors for rapid weight gain between 3 and 5 years of age.
Nationally representative prospective cohort study.
A total of 11 653 preschool children participating in the UK Millennium Cohort Study, with anthropometry at 3 and 5 years.
Weight gain z-scores were calculated from 3 to 5 years. Children in the top quarter of this distribution were classified as gaining weight rapidly. A total of 26 biological and early life, social, psychological, behavioural and environmental risk factors were examined.
Among the participants, 13% of normal weight, 63% of overweight and 88% of obese 5-year olds had experienced rapid weight gain since 3 years of age. Six biological and early life factors and two social factors were found to be significantly associated with this growth pattern. In a mutually adjusted model, children were more likely to gain weight rapidly if they had a higher body mass index at age 3 (adjusted odds ratio: 1.27, 95% confidence interval: 1.23-1.32), if they were of Bangladeshi (adjusted odds ratio: 1.88, 95% confidence interval: 1.27-2.79) or black (adjusted odds ratio: 1.47, 95% confidence interval: 1.07-2.02) ethnicity, if their mother was overweight (adjusted odds ratio: 1.32, 95% confidence interval: 1.15-1.51) or had been overweight before pregnancy (adjusted odds ratio: 1.56, 95% confidence interval: 1.36-1.79), if their father was overweight (adjusted odds ratio: 1.56, 95% confidence interval: 1.34-1.81) or if their mother smoked during pregnancy (adjusted odds ratio:1.23, 95% confidence interval: 1.09-1.38). Children were also more likely to gain weight rapidly if others smoked in the same room (adjusted odds ratio: 1.31, 95% confidence interval: 1.16-1.49) or if they were a lone child in the household (adjusted odds ratio: 1.14, 95% confidence interval: 1.01-1.30).
Factors operating during pregnancy and early life increase the risk of rapid weight gain in young children; thus, signalling the importance of obesity prevention programmes before and during pregnancy and for children at an early age. In particular, these programmes should address parental weight status and smoking habits, both modifiable risk factors.
研究 3 至 5 岁期间体重快速增加的风险因素。
全国代表性的前瞻性队列研究。
共有 11653 名参与英国千禧年队列研究的学龄前儿童，他们在 3 岁和 5 岁时进行了人体测量。
从 3 岁到 5 岁期间计算体重增加 z 分数。体重分布在前四分之一的儿童被归类为体重快速增加。共检查了 26 个生物和早期生活、社会、心理、行为和环境风险因素。
在参与者中，13%的正常体重儿童、63%的超重儿童和 88%的肥胖 5 岁儿童自 3 岁以来体重快速增加。有 6 个生物和早期生活因素以及 2 个社会因素与这种生长模式显著相关。在相互调整的模型中，如果儿童在 3 岁时体重指数较高（调整后的优势比：1.27，95%置信区间：1.23-1.32）、属于孟加拉国（调整后的优势比：1.88，95%置信区间：1.27-2.79）或黑人（调整后的优势比：1.47，95%置信区间：1.07-2.02）种族、母亲超重（调整后的优势比：1.32，95%置信区间：1.15-1.51）或怀孕前超重（调整后的优势比：1.56，95%置信区间：1.36-1.79）、父亲超重（调整后的优势比：1.56，95%置信区间：1.34-1.81）或母亲在怀孕期间吸烟（调整后的优势比：1.23，95%置信区间：1.09-1.38），那么他们更有可能快速增加体重。如果其他在同一房间吸烟（调整后的优势比：1.31，95%置信区间：1.16-1.49）或家中只有一个孩子（调整后的优势比：1.14，95%置信区间：1.01-1.30），那么儿童也更有可能快速增加体重。
妊娠和生命早期的因素会增加幼儿体重快速增加的风险；因此，这表明在妊娠前和妊娠期间以及在儿童早期开展肥胖预防计划的重要性。特别是，这些计划应解决父母的体重状况和吸烟习惯这两个可改变的风险因素。
