National Institute for Public Health and the Environment, Bilthoven, The Netherlands.
Obesity (Silver Spring). 2012 Mar;20(3):590-6. doi: 10.1038/oby.2011.327. Epub 2011 Oct 27.
The aim of this study was to assess the association between overweight and school performance among primary school children prospectively and including a broad range of potential confounding factors. In addition it was investigated what factors mediate this association. For this purpose, data of 2,159 12-year-old children who participated in the Prevention and Incidence of Asthma and Mite Allergy (PIAMA) birth cohort study were used. Two indicators of school performance were parental reported when children were 12 years of age and included (i): the score on a standardized achievement test that Dutch children have to complete at the end of their primary education (Cito)-test and (ii): the teacher's advice regarding a child's potential performance level in secondary education. Children's height and weight were measured by a trained research assistant at the age of 8 and by their parents at the age of 12. Overweight was defined using age and gender specific cut-off points. Multivariate regression analyses were performed to assess the association between overweight and school performance. Besides, both confounder and mediation analyses were conducted. Results showed lower Cito-test scores and lower teacher's school-level advice among overweight children. These associations were no longer significant when adjusting for parental educational level, skipping breakfast, and screen time. This study found no independent association between overweight and school performance among primary school children. Results showed strong confounding by parental educational level.
本研究旨在前瞻性地评估超重与小学生学业表现之间的关系，并纳入广泛的潜在混杂因素。此外，还研究了哪些因素在介导这种关联。为此，使用了参加预防和发生哮喘和螨变应性（PIAMA）出生队列研究的 2159 名 12 岁儿童的数据。当孩子 12 岁时，父母报告了两个学业表现指标，包括：（i）荷兰孩子在小学结束时必须完成的标准化成绩测试（Cito）-测试的分数和（ii）老师关于孩子在中学教育中潜在表现水平的建议。在 8 岁和 12 岁时，由经过培训的研究助理测量儿童的身高和体重。超重使用年龄和性别特定的截断点定义。进行多元回归分析以评估超重与学业表现之间的关系。此外，还进行了混杂因素和中介分析。结果显示，超重儿童的 Cito 测试分数较低，教师对学校水平的建议较低。当调整父母的教育水平、不吃早餐和屏幕时间后，这些关联不再显著。本研究未发现小学生超重与学业表现之间存在独立的关联。结果表明，父母教育水平的混杂作用很强。
