Holben David H, Taylor Christopher A
J Am Osteopath Assoc. 2015 Sep;115(9):536-43. doi: 10.7556/jaoa.2015.111.
Food insecurity is a preventable health threat and may precipitate central obesity and metabolic syndrome in children and adolescents in the United States.
To examine (1) health by household food security status; and (2) differences and prevalence of central obesity among persons aged 12 to 18 years in the United States.
The National Health and Nutrition Examination Survey was administered to a cross-sectional sample of persons aged 12 to 18 years in 1999 to 2006. Controlling for age, race/ethnicity, and sex differences in mean obesity and chronic disease factors across levels of food insecurity (analysis of covariance [Bonferroni post hoc] and ORs [logistic regression analyses]) were examined, as were differences in the rates of risk factors (χ(2) statistics).
A total of 7435 participants were analyzed. Those from marginally food secure (n=751) and low-food secure (n=1206) (population size estimate, 26,714,182) households were significantly more likely than their high-food secure counterparts (n=4831) to be overweight (P=.036) (OR, 1.44), and those from marginally food secure households were 1.3-times more likely to be obese (P=.036). Nearly 25% of respondents from marginally food secure, low-food secure, and very low-food secure (n=647) households reported central obesity (P=.002), which was 1.4 to 1.5 times more likely than those from high-food secure households. Participants from high-food secure households had significantly higher mean high-density lipoprotein values (P=.019). Risk factors indicative of metabolic syndrome were present in 3.1%.
Household food insecurity was associated with an increased likelihood of being overweight and having central obesity. Limitations included the use of cross-sectional data and some self-reported data and the inability to control for all moderating variables in obesity and overall health status.
粮食不安全是一种可预防的健康威胁，可能会在美国儿童和青少年中引发中心性肥胖和代谢综合征。
（1）按家庭粮食安全状况研究健康状况；（2）研究美国12至18岁人群中心性肥胖的差异和患病率。
1999年至2006年对12至18岁人群的横断面样本进行了国家健康和营养检查调查。在控制年龄、种族/族裔以及不同粮食安全水平下平均肥胖和慢性病因素的性别差异（协方差分析[Bonferroni事后检验]和比值比[逻辑回归分析]）的同时，还研究了危险因素发生率的差异（χ²统计量）。
共分析了7435名参与者。来自粮食安全状况处于边缘水平（n = 751）和粮食安全状况较差（n = 1206）（人口规模估计为26,714,182）家庭的参与者比粮食安全状况良好（n = 4831）家庭的参与者超重的可能性显著更高（P = 0.036）（比值比，1.44），来自粮食安全状况处于边缘水平家庭的参与者肥胖的可能性是其1.3倍（P = 0.036）。来自粮食安全状况处于边缘水平、粮食安全状况较差和粮食安全状况极差（n = 647）家庭的近25%的受访者报告有中心性肥胖（P = 0.002），这比来自粮食安全状况良好家庭的受访者高出1.4至1.5倍。来自粮食安全状况良好家庭的参与者平均高密度脂蛋白值显著更高（P = 0.019）。表明存在代谢综合征的危险因素占3.1%。
家庭粮食不安全与超重和中心性肥胖可能性增加相关。局限性包括使用横断面数据和一些自我报告数据，以及无法控制肥胖和总体健康状况中的所有调节变量。
