Wojcicki Janet M, Young Margaret B, Perham-Hester Katherine A, de Schweinitz Peter, Gessner Bradford D
Department of Pediatrics (GI and Nutrition), University of California San Francisco, San Francisco, California, United States of America.
Maternal and Child Health Epidemiology Unit, Alaska Division of Public Health, Section of Women's, Children's and Family Health, Anchorage, Alaska, United States of America.
PLoS One. 2015 Mar 20;10(3):e0118711. doi: 10.1371/journal.pone.0118711. eCollection 2015.
Prenatal and early life risk factors are associated with childhood obesity. Alaska Native children have one of the highest prevalences of childhood obesity of all US racial/ethnic groups.
Using the Pregnancy Risk Assessment Monitoring System (PRAMS) and the follow-up survey at 3 years of age (CUBS), we evaluated health, behavioral, lifestyle and nutritional variables in relation to obesity (95th percentile for body mass index (BMI)) at 3 years of age. Multivariate logistic regression modeling was conducted using Stata 12.0 to evaluate independent risk factors for obesity in non-Native and Alaska Native children.
We found an obesity prevalence of 24.9% in all Alaskan and 42.2% in Alaska Native 3 year olds. Among Alaska Native children, obesity prevalence was highest in the Northern/Southwest part of the state (51.6%, 95%CI (42.6-60.5)). Independent predictive factors for obesity at age 3 years in Alaska non-Native children were low income (<$10,000 in the year before the child was born (OR 3.94, 95%CI 1.22--17.03) and maternal pre-pregnancy obesity (OR 2.01, 95%CI 1.01-4.01) and longer duration of breastfeeding was protective (OR 0.95, 95%CI 0.91-0.995). Among Alaska Native children, predictive factors were witnessing domestic violence/abuse as a 3 year-old (OR 2.28, 95%CI 1.17-7.60). Among obese Alaska Native children, there was an increased daily consumption of energy dense beverages in the Northern/Southwest region of the state, which may explain higher rates of obesity in this part of the state.
The high prevalence of obesity in Alaska Native children may be explained by differences in lifestyle patterns and food consumption in certain parts of the state, specifically the Northern/Southwest region, which have higher consumption of energy dense beverages.
产前及生命早期的风险因素与儿童肥胖相关。阿拉斯加原住民儿童的儿童肥胖患病率在美国所有种族/族裔群体中位居前列。
利用妊娠风险评估监测系统（PRAMS）以及3岁时的随访调查（CUBS），我们评估了与3岁时肥胖（体重指数（BMI）处于第95百分位）相关的健康、行为、生活方式和营养变量。使用Stata 12.0进行多变量逻辑回归建模，以评估非原住民和阿拉斯加原住民儿童肥胖的独立风险因素。
我们发现，所有阿拉斯加3岁儿童的肥胖患病率为24.9%，阿拉斯加原住民3岁儿童的肥胖患病率为42.2%。在阿拉斯加原住民儿童中，该州北部/西南部的肥胖患病率最高（51.6%，95%置信区间（42.6 - 60.5））。阿拉斯加非原住民儿童3岁时肥胖的独立预测因素为低收入（孩子出生前一年收入低于10,000美元（比值比3.94，95%置信区间1.22 - 17.03））、母亲孕前肥胖（比值比2.01，95%置信区间1.01 - 4.01），而较长时间的母乳喂养具有保护作用（比值比0.95，95%置信区间0.91 - 0.995）。在阿拉斯加原住民儿童中，预测因素为3岁时目睹家庭暴力/虐待（比值比2.28，95%置信区间1.17 - 7.60）。在肥胖的阿拉斯加原住民儿童中，该州北部/西南部地区能量密集型饮料的每日消费量增加，这可能解释了该州这一地区较高的肥胖率。
阿拉斯加原住民儿童肥胖患病率高可能是由于该州某些地区，特别是北部/西南部地区生活方式模式和食物消费的差异，这些地区能量密集型饮料的消费量较高。
