Shankardass K, McConnell R, Jerrett M, Lam C, Wolch J, Milam J, Gilliland F, Berhane K
Department of Psychology, Wilfrid Laurier University, Waterloo, ON, Canada; Centre for Research on Inner City Health in the Keenan Research Centre of the Li Ka Shing Knowledge Institute of St. Michael's Hospital, Toronto, ON, Canada.
Pediatr Obes. 2014 Dec;9(6):435-42. doi: 10.1111/j.2047-6310.2013.00208.x. Epub 2013 Dec 5.
Rates of childhood obesity have increased since the mid-1970s. Research into behavioural determinants has focused on physical inactivity and unhealthy diets. Cross-sectional studies indicate an association between psychological stress experienced by parents and obesity in pre-adolescents.
We provide evidence of a prospective association between parental psychological stress and increased weight gain in pre-adolescents. Family-level support for those experiencing chronic stress might help promote healthy diet and exercise behaviours in children.
We examined the impact of parental psychological stress on body mass index (BMI) in pre-adolescent children over 4 years of follow-up.
We included 4078 children aged 5-10 years (90% were between 5.5 and 7.5 years) at study entry (2002-2003) in the Children's Health Study, a prospective cohort study in southern California. A multi-level linear model simultaneously examined the effect of parental stress at study entry on the attained BMI at age 10 and the slope of change across annual measures of BMI during follow-up, controlled for the child's age and sex. BMI was calculated based on objective measurements of height and weight by trained technicians following a standardized procedure.
A two standard deviation increase in parental stress at study entry was associated with an increase in predicted BMI attained by age 10 of 0.287 kg m(-2) (95% confidence interval 0.016-0.558; a 2% increase at this age for a participant of average attained BMI). The same increase in parental stress was also associated with an increased trajectory of weight gain over follow-up, with the slope of change in BMI increased by 0.054 kg m(-2) (95% confidence interval 0.007-0.100; a 7% increase in the slope of change for a participant of average BMI trajectory).
We prospectively demonstrated a small effect of parental stress on BMI at age 10 and weight gain earlier in life than reported previously. Interventions to address the burden of childhood obesity should address the role of parental stress in children.
自20世纪70年代中期以来，儿童肥胖率一直在上升。对行为决定因素的研究主要集中在身体活动不足和不健康饮食上。横断面研究表明，父母所经历的心理压力与青春期前儿童的肥胖之间存在关联。
我们提供了证据，证明父母的心理压力与青春期前儿童体重增加之间存在前瞻性关联。为那些经历慢性压力的人提供家庭层面的支持，可能有助于促进儿童健康的饮食和运动行为。
我们研究了在4年的随访期内，父母心理压力对青春期前儿童体重指数（BMI）的影响。
我们纳入了儿童健康研究（一项在南加州进行的前瞻性队列研究）中在研究开始时（2002 - 2003年）年龄为5 - 10岁（90%在5.5至7.5岁之间）的4078名儿童。一个多层次线性模型同时研究了研究开始时父母压力对10岁时达到的BMI以及随访期间BMI年度测量值变化斜率的影响，并对儿童的年龄和性别进行了控制。BMI是由训练有素的技术人员按照标准化程序根据身高和体重的客观测量值计算得出的。
研究开始时父母压力增加两个标准差，与10岁时预测的BMI增加0.287 kg·m⁻²相关（95%置信区间0.016 - 0.558；对于平均BMI达到该年龄的参与者，此年龄增加2%）。父母压力同样的增加也与随访期间体重增加轨迹的增加相关，BMI变化斜率增加0.054 kg·m⁻²（95%置信区间0.007 - 0.100；对于平均BMI轨迹的参与者，变化斜率增加7%）。
我们前瞻性地证明了父母压力对10岁时的BMI以及生命早期体重增加有微小影响，这比之前报道的情况更早。应对儿童肥胖负担的干预措施应关注父母压力在儿童中的作用。
