Afzal Amna Sadaf, Gortmaker Steven
1 Division of Pediatric Gastroenterology and Nutrition, Children's Hospital at Montefiore, Albert Einstein College of Medicine, Bronx, NY.
2 Department of Society, Human Development, and Health, Harvard School of Public Health , Boston, MA.
Child Obes. 2015 Aug;11(4):466-74. doi: 10.1089/chi.2014.0129.
The relationship between obesity and academic outcomes remains unclear. We evaluated the association between obesity and cognitive performance in US children.
We analyzed two nationally representative prospective cohorts of children in the 1979 National Longitudinal Survey of Youth, ages 2 through 8 at baseline and followed for 6 years, from 1988 to 1994 (cohort 1, n=2672) and 1994 to 2000 (cohort 2, n=1991). The main exposure variable was obesity (defined as never obese, became obese, always obese, and became nonobese). The main outcomes were standardized scores on four cognitive assessments. Univariate regression analyses of test scores on obesity were performed. Fixed-effects regression models, controlling for measured and unmeasured time-invariant confounders, were additionally adjusted for time-variant confounders to analyze the impact of change in obesity status on change in test scores.
Unadjusted analyses revealed a significant association between obesity and Peabody Individual Achievement Test (PIAT) scores. In cohort 1, always obese children had lower PIAT math scores than never obese children (β=-7.48; p<0.05). Always obese boys had lower PIAT math scores than those who were never obese (β=-16.45; p<0.01). In cohort 2, PIAT math scores were lower in the became obese category than the never obese category (β=-4.10; p<0.05). Always obese girls had lower PIAT reading scores than those who were never obese (β=-11.28; p<0.01). Fixed-effects models additionally adjusted for Home Observation Measurement of the Environment, Short Form score and height percentile showed no significant relationship between obesity and test scores in either cohort.
Childhood obesity is unlikely to be causally related to cognitive performance.
肥胖与学业成绩之间的关系仍不明确。我们评估了美国儿童肥胖与认知能力之间的关联。
我们分析了1979年全国青年纵向调查中两个具有全国代表性的儿童前瞻性队列，基线时年龄为2至8岁，随访6年，分别为1988年至1994年（队列1，n = 2672）和1994年至2000年（队列2，n = 1991）。主要暴露变量为肥胖（定义为从未肥胖、变为肥胖、一直肥胖和变为非肥胖）。主要结局是四项认知评估的标准化分数。对肥胖与测试分数进行单变量回归分析。固定效应回归模型在控制了已测量和未测量的时间不变混杂因素后，还针对随时间变化的混杂因素进行了调整，以分析肥胖状态变化对测试分数变化的影响。
未经调整的分析显示肥胖与皮博迪个人成就测验（PIAT）分数之间存在显著关联。在队列1中，一直肥胖的儿童PIAT数学分数低于从未肥胖的儿童（β = -7.48；p < 0.05）。一直肥胖的男孩PIAT数学分数低于从未肥胖的男孩（β = -16.45；p < 0.01）。在队列2中，变为肥胖组的PIAT数学分数低于从未肥胖组（β = -4.10；p < 0.05）。一直肥胖的女孩PIAT阅读分数低于从未肥胖的女孩（β = -11.28；p < 0.01）。固定效应模型在进一步调整了家庭环境观察测量简表得分和身高百分位数后，两个队列中肥胖与测试分数之间均未显示出显著关系。
儿童肥胖不太可能与认知能力存在因果关系。
