College of Medicine, Swansea University, Swansea, Wales, United Kingdom.
PLoS One. 2012;7(5):e36597. doi: 10.1371/journal.pone.0036597. Epub 2012 May 31.
This study examines obesity and factors associated with obesity in children aged 11-13 years in the UK.
1147 children from ten secondary schools participated in a health survey that included blood samples, fitness test and anthropometric measures. Factors associated with obesity were examined using multilevel logistic regression.
Of the children examined (490 male; 657 female) a third were overweight, 1 in 6 had elevated blood pressure, more than 1 in 10 had high cholesterol, 58% consumed more fat than recommended, whilst 37% were classified as unfit. Children in deprived areas had a higher proportion of risk factors; for example, they had higher blood pressure (20% (deprived) compared to 11% (non-deprived), difference: 9.0% (95%CI: 4.7%-13.4%)). Obesity is associated with risk factors for heart disease and diabetes. Maintaining fitness is associated with a reduction in the risk factors for heart disease (high blood pressure and cholesterol) but not on risk factors for diabetes (insulin levels). In order of importance, the main risk factors for childhood obesity are being unfit, having an obese father, and being large at birth.
The high proportion of children with risk factors suggests future interventions need to focus on community and policy change to shift the population norm rather than targeting the behaviour of high risk individuals. Interventions need to focus on mothers' lifestyle in pregnancy, fathers' health, as well as promoting fitness among children. Obesity was not associated with deprivation. Therefore, strategies should be adopted in both deprived and non deprived areas.
本研究调查了英国 11-13 岁儿童的肥胖状况及相关因素。
来自十所中学的 1147 名儿童参与了一项健康调查,包括血液样本、体能测试和人体测量学测量。使用多水平逻辑回归分析了肥胖的相关因素。
在所检查的儿童中(490 名男性;657 名女性),三分之一超重,六分之一血压升高,十分之一以上胆固醇偏高,58%摄入的脂肪超过推荐量,而 37%体能不达标。贫困地区的儿童有更高比例的危险因素;例如,他们的血压更高(20%(贫困地区)与 11%(非贫困地区)相比,差异:9.0%(95%CI:4.7%-13.4%))。肥胖与心脏病和糖尿病的危险因素有关。保持健康的体能与降低心脏病的危险因素(高血压和胆固醇)有关,但与糖尿病的危险因素(胰岛素水平)无关。按重要性顺序排列,儿童肥胖的主要危险因素是体能不达标、父亲肥胖和出生时体重过大。
高比例的儿童存在危险因素,这表明未来的干预措施需要侧重于社区和政策的改变,以改变人群的常态,而不是针对高危个体的行为。干预措施需要关注母亲在怀孕期间的生活方式、父亲的健康状况,以及促进儿童的健康体能。肥胖与贫困程度无关。因此,在贫困和非贫困地区都应采取相应的策略。