Chang Mei-Wei, Brown Roger, Nitzke Susan
College of Nursing, Ohio State University, 342 Newton Hall, 1585 Neil Avenue, Columbus, OH, 43210, USA.
School of Nursing, University of Wisconsin-Madison, Madison, WI, USA.
Matern Child Health J. 2016 Jul;20(7):1506-17. doi: 10.1007/s10995-016-1949-5.
Objective This study explored fast food intake as a potential mediator of the relationships among employment status; stress; depression; and fruit, vegetable, and fat intakes by race (African American vs. Non-Hispanic White) and body mass index (BMI category: overweight vs. obesity). Methods Low-income overweight and obese pregnant women (N = 332) were recruited from the Special Supplemental Nutrition Program for Women, Infants and Children in Michigan. Path analysis was performed to explore mediation effects by race and BMI category. Results Fast food intake mediated the relationship between employment status and fat intake (p = 0.02) in Non-Hispanic White women, but no mediation effect was detected in African American women. For overweight women, fast food intake mediated the relationship between employment status and fat intake (p = 0.04) and the relationship between depression and vegetable intake (p = 0.01). Also, fast food intake partially mediated the relationship between depression and fat intake (p = 0.003). For obese women, fast food intake mediated the relationship between employment status and fat intake (p = 0.04). Conclusion Fast food is an important topic for nutrition education for overweight and obese pregnant women. Future interventions may be more successful if they address issues associated with employment status (e.g., lack of time to plan and cook healthy meals) and depressive mood (e.g., inability to plan meals or shop for groceries when coping with negative emotions).
目的 本研究探讨快餐摄入作为就业状况、压力、抑郁以及按种族（非裔美国人与非西班牙裔白人）和体重指数（BMI类别：超重与肥胖）划分的水果、蔬菜及脂肪摄入量之间关系的潜在中介因素。方法 从密歇根州妇女、婴儿和儿童特别补充营养项目中招募低收入超重和肥胖孕妇（N = 332）。进行路径分析以探讨种族和BMI类别对中介效应的影响。结果 在非西班牙裔白人女性中，快餐摄入介导了就业状况与脂肪摄入量之间的关系（p = 0.02），但在非裔美国女性中未检测到中介效应。对于超重女性，快餐摄入介导了就业状况与脂肪摄入量之间的关系（p = 0.04）以及抑郁与蔬菜摄入量之间的关系（p = 0.01）。此外，快餐摄入部分介导了抑郁与脂肪摄入量之间的关系（p = 0.003）。对于肥胖女性，快餐摄入介导了就业状况与脂肪摄入量之间的关系（p = 0.04）。结论 快餐是超重和肥胖孕妇营养教育的一个重要话题。如果未来的干预措施能够解决与就业状况相关的问题（例如，缺乏时间计划和烹饪健康膳食）以及抑郁情绪（例如，在应对负面情绪时无法计划膳食或购买食品杂货），可能会更成功。
