Centre for Health Equity Studies, Karolinska Institutet/Stockholm University, Stockholm, Sweden.
Pediatr Res. 2013 Sep;74(3):356-63. doi: 10.1038/pr.2013.108. Epub 2013 Jun 25.
Ethnic minorities/immigrants have differential health as compared with natives. The epidemic in child overweight/obesity (OW/OB) in Sweden is leveling off, but lower socioeconomic groups and immigrants/ethnic minorities may not have benefited equally from this trend. We investigated whether nonethnic Swedish children are at increased risk for being OW/OB and whether these associations are mediated by parental socioeconomic position (SEP) and/or early-life factors such as birth weight, maternal smoking, BMI, and breastfeeding.
Data on 10,628 singleton children (51% boys, mean age: 4.8 y, born during the period 2000-2004) residing in Uppsala were analyzed. OW/OB was computed using the International Obesity Task Force's sex- and age-specific cutoffs. The mother's nativity was used as proxy for ethnicity. Logistic regression was used to analyze ethnicity-OW/OB associations.
Children of North African, Iranian, South American, and Turkish ethnicity had increased odds for being overweight/obese as compared with children of Swedish ethnicity (adjusted odds ratio (OR): 2.60 (95% confidence interval (CI): 1.57-4.27), 1.67 (1.03-2.72), 3.00 (1.86-4.80), and 2.90 (1.73-4.88), respectively). Finnish children had decreased odds for being overweight/obese (adjusted OR: 0.53 (0.32-0.90)).
Ethnic differences in a child's risk for OW/OB exist in Sweden that cannot be explained by SEP or maternal or birth factors. As OW/OB often tracks into adulthood, more effective public health policies that intervene at an early age are needed.
与本地人相比,少数民族/移民的健康状况存在差异。瑞典儿童超重/肥胖(OW/OB)的流行已趋于平稳,但社会经济地位较低的群体和移民/少数民族可能并未从这一趋势中平等受益。我们调查了非瑞典族儿童是否有更高的风险出现 OW/OB,以及这些关联是否通过父母的社会经济地位(SEP)和/或生命早期因素(如出生体重、母亲吸烟、BMI 和母乳喂养)来介导。
分析了居住在乌普萨拉的 10628 名单胎儿童(51%为男孩,平均年龄:4.8 岁,出生于 2000-2004 年期间)的数据。OW/OB 使用国际肥胖工作组(IOTF)的性别和年龄特异性截断值进行计算。母亲的原籍国被用作种族的替代指标。使用逻辑回归分析了种族与 OW/OB 的关联。
与瑞典族儿童相比,来自北非、伊朗、南美和土耳其的儿童超重/肥胖的几率更高(调整后的比值比(OR):2.60(95%置信区间(CI):1.57-4.27)、1.67(1.03-2.72)、3.00(1.86-4.80)和 2.90(1.73-4.88))。芬兰儿童超重/肥胖的几率降低(调整后的 OR:0.53(0.32-0.90))。
瑞典存在儿童 OW/OB 风险的种族差异,这些差异不能用 SEP 或母亲或出生因素来解释。由于 OW/OB 常常会持续到成年期,因此需要制定更有效的公共卫生政策,以便在早期进行干预。