Hoyt Lindsay T, Kushi Lawrence H, Leung Cindy W, Nickleach Dana C, Adler Nancy, Laraia Barbara A, Hiatt Robert A, Yen Irene H
Robert Wood Johnson Foundation Health and Society Scholar, University of California, San Francisco and Berkeley, California;
Division of Research, Kaiser Permanente, Oakland, California;
Pediatrics. 2014 Nov;134(5):942-9. doi: 10.1542/peds.2014-1286. Epub 2014 Oct 13.
The neighborhoods in which children live, play, and eat provide an environmental context that may influence obesity risk and ameliorate or exacerbate health disparities. The current study examines whether neighborhood characteristics predict obesity in a prospective cohort of girls.
Participants were 174 girls (aged 8-10 years at baseline), a subset from the Cohort Study of Young Girls' Nutrition, Environment, and Transitions. Trained observers completed street audits within a 0.25-mile radius around each girl's residence. Four scales (food and service retail, recreation, walkability, and physical disorder) were created from 40 observed neighborhood features. BMI was calculated from clinically measured height and weight. Obesity was defined as BMI-for-age ≥ 95%. Logistic regression models using generalized estimating equations were used to examine neighborhood influences on obesity risk over 4 years of follow-up, controlling for race/ethnicity, pubertal status, and baseline BMI. Fully adjusted models also controlled for household income, parent education, and a census tract measure of neighborhood socioeconomic status.
A 1-SD increase on the food and service retail scale was associated with a 2.27 (95% confidence interval, 1.42 to 3.61; P < .001) increased odds of being obese. A 1-SD increase in physical disorder was associated with a 2.41 (95% confidence interval, 1.31 to 4.44; P = .005) increased odds of being obese. Other neighborhood scales were not associated with risk for obesity.
Neighborhood food and retail environment and physical disorder around a girl's home predict risk for obesity across the transition from late childhood to adolescence.
儿童生活、玩耍和饮食的社区环境可能会影响肥胖风险，并改善或加剧健康差异。本研究旨在探讨社区特征是否能预测一组前瞻性队列中女孩的肥胖情况。
研究对象为174名女孩（基线年龄8 - 10岁），她们是少女营养、环境与转变队列研究的一个子集。经过培训的观察员在每个女孩住所周围0.25英里半径范围内完成街道审计。根据40个观察到的社区特征创建了四个量表（食品和服务零售、娱乐、步行便利性和物理环境紊乱）。通过临床测量的身高和体重计算体重指数（BMI）。肥胖定义为年龄别BMI≥95%。使用广义估计方程的逻辑回归模型来检验在4年随访期间社区对肥胖风险的影响，同时控制种族/族裔、青春期状态和基线BMI。完全调整模型还控制了家庭收入、父母教育程度以及社区社会经济地位的普查区测量值。
食品和服务零售量表上1个标准差单位的增加与肥胖几率增加2.27（95%置信区间，1.42至3.61；P <.001）相关。物理环境紊乱方面1个标准差单位的增加与肥胖几率增加2.41（95%置信区间，1.31至4.44；P =.005）相关。其他社区量表与肥胖风险无关。
女孩家周围的社区食品和零售环境以及物理环境紊乱可预测从儿童晚期到青春期过渡期间的肥胖风险。
