*Department of Pediatrics †Department of Public Health ‡Department of Epidemiology, Erasmus Medical Center, Rotterdam §Department of Healthy Living, Expertise Centre Life Style TNO, Leiden (SIdV), The Netherlands.
J Pediatr Gastroenterol Nutr. 2013 Dec;57(6):768-74. doi: 10.1097/MPG.0b013e3182a313fc.
Decreased physical activity levels in children may partly explain the rising prevalence of functional constipation in childhood. The aim of the present study, therefore, was to examine the association between physical activity and functional constipation during the preschool period.
This study was embedded in the Generation R study, a large prospective birth-cohort study in Rotterdam, The Netherlands. Physical activity was measured by an Actigraph accelerometer in 347 children (182 boys, 165 girls; mean age 25.1 months) and data were expressed as counts per minute. Data were categorized into light activity (302-614 counts/15 seconds), moderate activity (615-1230 counts/15 seconds), and vigorous activity (≥1231 counts/15 seconds). Functional constipation in the third and fourth year of life was defined according to the Rome II criteria.
Children spending time in the highest tertile of light (adjusted odds ratio [OR] 0.34; 95% confidence interval [CI] 0.13-0.87), moderate (adjusted OR 0.37; 95% CI 0.14-0.97), and total activity (adjusted OR 0.37; 95% CI 0.15-0.92) at the age of 2 years had significantly less functional constipation in the fourth year of life. For functional constipation in the third year of life, the results were in similar direction but not statistically significant. Additionally, children with physical activity of more than the WHO recommendation of 60 min/day had significantly less functional constipation in the fourth year of life (adjusted OR 0.48; 95% CI 0.24-0.97).
Physical activity is associated with a decreased risk of functional constipation in the preschool period, but this may be time dependent.
儿童体力活动水平下降可能部分解释了儿童功能性便秘患病率的上升。因此,本研究旨在探讨学龄前儿童体力活动与功能性便秘之间的关系。
本研究嵌入了荷兰鹿特丹的一项大型前瞻性出生队列研究——“Generation R 研究”。使用 Actigraph 加速度计测量 347 名儿童(182 名男孩,165 名女孩;平均年龄 25.1 个月)的体力活动,数据以每分钟计数表示。数据分为低强度活动(302-614 计数/15 秒)、中强度活动(615-1230 计数/15 秒)和高强度活动(≥1231 计数/15 秒)。根据罗马 II 标准定义 3 至 4 岁儿童的功能性便秘。
2 岁时处于高强度活动(校正优势比 [OR] 0.34;95%置信区间 [CI] 0.13-0.87)、中强度活动(校正 OR 0.37;95% CI 0.14-0.97)和总活动(校正 OR 0.37;95% CI 0.15-0.92)最高三分位的儿童在 4 岁时功能性便秘明显减少。对于 3 岁时的功能性便秘,结果方向相似,但无统计学意义。此外,体力活动超过世卫组织推荐的 60 分钟/天的儿童在 4 岁时功能性便秘明显减少(校正 OR 0.48;95% CI 0.24-0.97)。
体力活动与学龄前儿童功能性便秘的风险降低相关,但可能与时间有关。