美国学龄前儿童饮食种类和多样性与体重指数的关联
Association of Dietary Variety and Diversity With Body Mass Index in US Preschool Children.
作者信息
Fernandez Carmen, Kasper Nicole M, Miller Alison L, Lumeng Julie C, Peterson Karen E
机构信息
Departments of Epidemiology.
Nutritional Sciences, and University of Colorado Pediatric Nutrition Section and Rocky Mountain Prevention Research Center, Denver, Colorado;
出版信息
Pediatrics. 2016 Mar;137(3):e20152307. doi: 10.1542/peds.2015-2307. Epub 2016 Feb 11.
BACKGROUND AND OBJECTIVES
Dietary variety and diversity are recommended in dietary guidelines, but their association with BMI in US preschool-aged children is unknown. This study examined predictors of dietary variety and diversity and their association with child BMI z score (BMIz).
METHODS
Primary caregivers responded to a food frequency questionnaire. Child anthropometry was obtained concurrently (n = 340) and prospectively (n = 264). Dietary variety scores and dietary diversity scores were computed. Multivariable linear regression was used to model predictors of these scores and their association with BMIz concurrently and BMIz change per year prospectively.
RESULTS
The sample was 49.4% boys; 69.4% of the primary caregivers were non-Hispanic white and 46.2% had a high school education or less. Girls and older children had greater Fruit and Vegetable Variety (gender: P = .03, age: P < .001), Healthy Foods Variety (P = .02, P < .001), and Dietary Diversity (P = .04, P = .03) scores. Older children also had greater scores for Overall Variety (P < .001) and Moderation Foods (eg, high-fat, high-sugar foods recommended to be consumed in moderation) (P < .001). Having a non-Hispanic white primary caregiver (versus not) was associated with lower Dietary Diversity (P = .01). Greater Healthy Variety, Overall Variety, and Dietary Diversity were associated with greater annual increases in BMIz prospectively (β[SE] = 0.009 [0.004], P = .04; β[SE] = 0.007 [0.003], P = .02; β[SE] = 0.003 [0.001], P = .02, respectively), adjusted for energy intake.
CONCLUSIONS
Greater dietary variety and diversity were prospectively associated with higher BMIz. Targeting dietary variety and diversity as an obesity prevention strategy in children requires careful consideration.
背景与目的
膳食指南推荐饮食应丰富多样，但在美国学龄前儿童中，这些因素与体重指数（BMI）的关联尚不清楚。本研究调查了饮食丰富度和多样性的预测因素及其与儿童BMI z评分（BMIz）的关联。
方法
主要照料者填写食物频率问卷。同时（n = 340）并前瞻性地（n = 264）获取儿童人体测量数据。计算饮食丰富度得分和饮食多样性得分。采用多变量线性回归对这些得分的预测因素及其与BMIz的同时关联以及前瞻性每年BMIz变化进行建模。
结果
样本中49.4%为男孩；69.4%的主要照料者为非西班牙裔白人，46.2%的照料者接受过高中及以下教育。女孩和年龄较大的儿童在水果和蔬菜种类（性别：P = 0.03，年龄：P < 0.001）、健康食物种类（P = 0.02，P < 0.001）以及饮食多样性（P = 0.04，P = 0.03）得分方面更高。年龄较大的儿童在总体种类（P < 0.001）和适度食用食物（如建议适量食用的高脂肪、高糖食物）（P < 0.001）方面得分也更高。主要照料者为非西班牙裔白人（与非此类情况相比）与较低的饮食多样性相关（P = 0.01）。前瞻性地，更高的健康种类、总体种类和饮食多样性与BMIz每年更大幅度的增加相关（β[标准误]= 0.009 [0.004]，P = 0.04；β[标准误]= 0.007 [0.003]，P = 0.02；β[标准误]= 0.003 [0.001]，P = 0.02），并对能量摄入进行了调整。
结论
更高的饮食丰富度和多样性与更高的BMIz前瞻性相关。将饮食丰富度和多样性作为儿童肥胖预防策略需要谨慎考虑。
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