Torres Roxana, Serrano Mónica, Pérez Cynthia M, Palacios Cristina
P R Health Sci J. 2014 Mar;33(1):14-21.
Physical environment influences diet and has been proposed as a determinant of childhood obesity. This cross-sectional study explored physical environment and its associations with diet quality and weight status in a sample of 114 12-year-old children from 4 public schools in the metropolitan area of San Juan, PR.
Physical environment was assessed by asking questions regarding the availability and accessibility of healthy and unhealthy foods and food outlets as well as of recreational and sports facilities and equipment. Food intake was determined using a 24-hour diet-recall questionnaire, with the gathered data being used to assess diet quality and calculate the Healthy Eating Index (HEI)-2010. The HEI includes 12 components that are used to determine the compliance of a given diet with federal guidelines. HEI-2010 total score ranges from 0 to 100 and is divided into the following classifications: poor (< or = 50), needs improvement (51-80), and good (> 80). Body mass index was computed using measured weight and height and categorized according to the CDC Growth Charts.
Thirty-six percent of the participating children were overweight or obese. Nearly 57% had poor diet quality. The lowest HEI-2010 component scores were found for total fruits, whole fruits, total vegetables, whole grains, seafood and plant proteins, and fatty acids. However, diet quality was not associated with weight status or physical environment factors. Compared to the other children in the study, overweight or obese children reported having a significantly (p < 0.05) lower availability of unhealthy foods and the highest access to recreational and sports facilities at home but also lower utilization of recreational and sports facilities at school and reduced participation in the school breakfast program.
This study showed that some home- and school-environment factors influenced body weight in the children in this sample. However, these same factors did not appear to affect diet quality.
物理环境会影响饮食，并且已被认为是儿童肥胖的一个决定因素。这项横断面研究在来自波多黎各圣胡安都会区4所公立学校的114名12岁儿童样本中，探究了物理环境及其与饮食质量和体重状况的关联。
通过询问有关健康和不健康食品及食品销售点以及娱乐和体育设施与器材的可得性和可达性的问题，来评估物理环境。使用24小时饮食回顾问卷确定食物摄入量，所收集的数据用于评估饮食质量并计算2010年健康饮食指数（HEI）。HEI包括12个成分，用于确定特定饮食符合联邦指南的情况。2010年HEI总分范围为0至100，并分为以下类别：差（≤50）、需改善（51 - 80）和好（>80）。使用测量的体重和身高计算体重指数，并根据美国疾病控制与预防中心生长图表进行分类。
36%的参与儿童超重或肥胖。近57%的儿童饮食质量差。在总水果、完整水果、总蔬菜、全谷物、海鲜和植物蛋白以及脂肪酸方面，2010年HEI的成分得分最低。然而，饮食质量与体重状况或物理环境因素无关。与研究中的其他儿童相比，超重或肥胖儿童报告称不健康食品的可得性显著较低（p<0.05），在家中使用娱乐和体育设施的机会最多，但在学校使用娱乐和体育设施的情况较少，并且参与学校早餐计划的比例也较低。
本研究表明，一些家庭和学校环境因素影响了该样本中儿童的体重。然而，这些相同因素似乎并未影响饮食质量。
