Nesbit Kathryn C, Kolobe Thubi A, Arnold Sandra H, Sisson Susan B, Anderson Michael P
Dept of Physical Therapy, University of the Pacific, Stockton, CA.
J Phys Act Health. 2014 Aug;11(6):1179-86. doi: 10.1123/jpah.2012-0245. Epub 2013 Jun 24.
The purpose of this study was to determine how proximal (home) and distal (neighborhood) environmental characteristics interact to influence obesity in early and middle adolescents.
This was a descriptive, cross-sectional study using the 2007 National Survey of Children's Health (NCSH). Participants were 39,542 children ages 11 to 17 years. Logistic regressions were used to examine the relationship between adolescent obesity and environmental factors, the relative strength of these factors, and the influence of age and gender.
Proximal environmental factors were stronger correlates of adolescent obesity than distal environmental factors. Sedentary behavior related to TV watching time at home was the strongest correlate of adolescent obesity overall (OR 1.13, 95% CI 1.11-1.15). Parks and playgrounds (OR 0.86, 95% CI 0.08-0.92), as well as recreation centers (OR 0.91, 95% CI 0.85-0.97) were significant distal environmental factor correlates. Girls and middle adolescents were at less risk for obesity than boys and early adolescents (OR 0.51, 95% CI 0.68-0.82; OR 0.75, 95% CI 0.68-0.96).
The results of this study reveal the importance of proximal environmental characteristics on adolescent obesity relative to distal environmental characteristics. Obesity intervention strategies for adolescents should target sedentary behavior and opportunities for physical activity with a focus on early adolescents and boys.
本研究的目的是确定近端（家庭）和远端（社区）环境特征如何相互作用以影响青少年早期和中期的肥胖情况。
这是一项描述性横断面研究，使用了2007年全国儿童健康调查（NCSH）。参与者为39542名11至17岁的儿童。采用逻辑回归分析来检验青少年肥胖与环境因素之间的关系、这些因素的相对强度以及年龄和性别的影响。
近端环境因素比远端环境因素与青少年肥胖的相关性更强。与在家看电视时间相关的久坐行为是青少年肥胖总体上最强的相关因素（比值比1.13，95%置信区间1.11 - 1.15）。公园和游乐场（比值比0.86，95%置信区间0.08 - 0.92）以及娱乐中心（比值比0.91，95%置信区间0.85 - 0.97）是显著的远端环境因素相关因素。女孩和青少年中期肥胖风险低于男孩和青少年早期（比值比0.51，95%置信区间0.68 - 0.82；比值比0.75，95%置信区间0.68 - 0.96）。
本研究结果揭示了相对于远端环境特征，近端环境特征对青少年肥胖的重要性。青少年肥胖干预策略应针对久坐行为和体育活动机会，重点关注青少年早期和男孩。
