Rush Elaine, Reed Peter W, Simmons David, Coppinger Tara, McLennan Stephanie, Graham David
Centre for Physical Activity and Nutrition Research, Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland, New Zealand.
J Paediatr Child Health. 2013 Apr;49(4):E324-31. doi: 10.1111/jpc.12015. Epub 2012 Dec 2.
School-based interventions to tackle the rise in childhood overweight and obesity remain inconclusive and are often limited in their application to diverse populations. To inform and measure the effect of the implementation of a primary school-based longitudinal randomised controlled nutrition and activity intervention, Project Energize, baseline measures of body size and blood pressure were required.
This cross-sectional study stratified by age, sex, ethnicity, rurality and school socio-economic-status (school-SES) measured body mass index (BMI), percentage body fat (%BF), waist and resting blood pressure from 2752 5- and 10-year-old children (62% European, 31% Māori) representative of the Waikato region of New Zealand.
Waikato children have a high prevalence of overweight and obesity that is linked with hypertension. Cardiovascular risk factors including raised blood pressure and hypertension, waist and arm circumference and percentage body fat (%BF) were more prevalent in 10-year-olds, lower school-SES and to some extent, urban living. In European children, BMI and waist circumference were similarly predictive of %BF, but for Māori children, waist circumference predicted %BF better than BMI.
A variety of stratified, baseline measurements is important when designing school-based interventions. In particular, waist circumference measures may be a more accurate predictor of %BF than BMI when determining measurement protocols that consider different ethnic groups and environments among children. The effect of targeted improvements of the school physical activity and nutrition environment on the rate of increase of weight, fatness and blood pressure in children should be examined.
旨在解决儿童超重和肥胖率上升问题的校本干预措施尚无定论,且在应用于不同人群时往往受到限制。为了了解并衡量一项以小学为基础的纵向随机对照营养与活动干预项目(“活力项目”)实施的效果,需要获取身体尺寸和血压的基线测量数据。
这项横断面研究按年龄、性别、种族、农村/城市以及学校社会经济地位(学校SES)进行分层,测量了来自新西兰怀卡托地区的2752名5岁和10岁儿童(62%为欧洲裔,31%为毛利人)的体重指数(BMI)、体脂百分比(%BF)、腰围和静息血压。
怀卡托地区儿童超重和肥胖的患病率很高,且与高血压有关。包括血压升高和高血压、腰围和臂围以及体脂百分比(%BF)在内的心血管危险因素在10岁儿童、学校SES较低的儿童以及在一定程度上在城市生活的儿童中更为普遍。在欧洲裔儿童中,BMI和腰围对%BF的预测能力相似,但对于毛利儿童,腰围对%BF的预测比BMI更好。
在设计校本干预措施时,进行各种分层的基线测量很重要。特别是,在确定考虑不同种族群体和儿童所处环境的测量方案时,腰围测量可能比BMI更能准确预测%BF。应研究针对性改善学校体育活动和营养环境对儿童体重、肥胖和血压增长率的影响。