1] Economic and Social Research Institute, Dublin 2, Ireland [2] Trinity College Dublin, University of Dublin, Dublin, Ireland.
Dublin Institute of Technology, Dublin, Ireland.
Int J Obes (Lond). 2014 Jan;38(1):82-90. doi: 10.1038/ijo.2013.160. Epub 2013 Aug 27.
To examine the extent to which early child nutrition, maternal antenatal lifestyle behaviours and child diet and lifestyle explain social class inequalities in the risk of rapid weight gain between birth and 3 years and obesity at age 3 years.
A longitudinal and prospective birth cohort study.
Nationally representative sample of 11,134 children and their parents followed from 9 months of age until 3 years. Child weight and maternal height and weight were measured at 9 months and 3 years and child birth weight was extracted from hospital records. Other predictors of child growth and obesity were collected by maternal report at 9 months and 3 years.
Although born lighter on average, children of unskilled manual parents were 274 g heavier than children of professional parents by 3 years of age. The fully adjusted model of rapid growth from birth to 3 years of age and obesity at 3 years of age accounted for all social class differentials. Breastfeeding and age at the introduction of solids were associated with the largest average reduction (41%) in the odds ratio (OR) of rapid growth in the first 9 months of life for each class relative to the professional class. In the period from 9 months to 3 years of age, the class differential in rapid growth was reduced most by measures of the child's diet and lifestyle. However, the impact of the groups of predictors varied by social class. For early life growth, among the non-manual classes the proportionate reductions are largest when adjusted for early infant nutrition, whereas maternal prenatal smoking is more important for the manual social classes.
Preventative interventions to reduce levels of childhood obesity should be multi-dimensional but different dimensions should be given more or less significance depending on socio-economic group.
探讨儿童早期营养、母亲产前生活方式行为以及儿童饮食和生活方式在多大程度上解释了出生至 3 岁期间体重快速增加和 3 岁时肥胖的社会阶层差异。
一项纵向和前瞻性出生队列研究。
从 9 个月大到 3 岁，对全国代表性的 11134 名儿童及其父母进行了随访。在 9 个月和 3 岁时测量了儿童的体重和母亲的身高和体重，并且从医院记录中提取了儿童的出生体重。通过母亲在 9 个月和 3 岁时的报告收集了其他预测儿童生长和肥胖的因素。
尽管出生时体重较轻，但从事非熟练体力劳动父母的孩子在 3 岁时比从事专业工作父母的孩子重 274 克。完全调整后的模型表明，从出生到 3 岁期间的快速生长和 3 岁时的肥胖可以解释所有的社会阶层差异。母乳喂养和固体食物引入的年龄与每个阶层相对于专业阶层的生命前 9 个月快速生长的比值比（OR）的平均降低幅度最大（41%）。在从 9 个月到 3 岁的时期，儿童饮食和生活方式措施对快速生长的阶层差异的影响最大。然而，预测因素的影响因社会阶层而异。对于生命早期的生长，在非体力劳动阶层中，当调整早期婴儿营养时，比例降低幅度最大，而母亲产前吸烟对体力劳动阶层更为重要。
为了降低儿童肥胖水平，预防干预措施应该是多维度的，但应该根据社会经济群体给予不同维度更多或更少的重视。
