Department of Internal Medicine, University of Michigan, Ann Arbor, MI 48109-5852, USA.
Am Heart J. 2010 Dec;160(6):1185-9. doi: 10.1016/j.ahj.2010.09.019.
Childhood obesity is one of the nation's foremost health challenges. How much of this is due to lifestyle choices? The objective of the study was to determine health behaviors that contribute to obesity in sixth-grade children.
To assess which health habits contribute to childhood obesity, we studied body mass index, blood pressure, lipid profile, glucose, and heart rate recovery after a 3-minute step test among sixth-grade children enrolled in a school-based intervention study from 2004 to 2009, comparing health behaviors and physiologic markers in obese versus nonobese children. Univariate associations with obesity (P values≤.10) were entered into a stepwise logistic regression to identify independent predictors.
Among 1,003 sixth graders (55% white, 15% African American; average age 11.5 years), 150 (15%) were obese. Obese students had higher levels of total cholesterol, low-density lipoprotein cholesterol, triglycerides, blood pressure, and recovery heart rates. They consumed more regular soda and school lunches but were less likely to engage in physical activities. Obese students were more likely to watch TV≥2 hours per day. Independent predictors were watching TV or video games (odds ratio [OR] 1.19, 95% CI 1.06-1.33) and school lunch consumption (OR 1.29, 95% CI 1.02-1.64); moderate exercise was protective (OR 0.89, 95% CI 0.82-0.98).
Obesity is present in 15% of our sixth graders and is associated with major differences in cardiovascular risk factors. Opportunities to improve childhood health should emphasize programs that increase physical activity, reduce recreational screen time, and improve nutritional value of school lunches. Whether genetic or not, childhood obesity can be attacked.
儿童肥胖是美国面临的首要健康挑战之一。造成这种情况的原因有多少是由于生活方式的选择？本研究的目的是确定导致六年级儿童肥胖的健康行为。
为了评估哪些健康习惯会导致儿童肥胖，我们研究了 2004 年至 2009 年期间参加基于学校的干预研究的六年级儿童的体重指数、血压、血脂谱、血糖和 3 分钟踏步测试后的心率恢复情况，比较肥胖儿童和非肥胖儿童的健康行为和生理指标。将与肥胖相关的单变量（P 值≤.10）纳入逐步逻辑回归，以确定独立预测因素。
在 1003 名六年级学生（55%为白人，15%为非裔美国人；平均年龄为 11.5 岁）中，有 150 名（15%）肥胖。肥胖学生的总胆固醇、低密度脂蛋白胆固醇、甘油三酯、血压和恢复心率更高。他们更常喝普通苏打水和学校午餐，但更不可能进行体育活动。肥胖学生更有可能每天看电视≥2 小时。独立预测因素是看电视或玩视频游戏（比值比 [OR] 1.19，95%CI 1.06-1.33）和食用学校午餐（OR 1.29，95%CI 1.02-1.64）；适度运动具有保护作用（OR 0.89，95%CI 0.82-0.98）。
我们的六年级学生中有 15%存在肥胖问题，且与心血管风险因素存在显著差异。改善儿童健康的机会应该强调增加体育活动、减少娱乐性屏幕时间和提高学校午餐营养价值的计划。无论是否与遗传有关，儿童肥胖都可以得到治疗。
