Fiechtner Lauren, Cheng Erika R, Lopez Gabriel, Sharifi Mona, Taveras Elsie M
1 Division of General Academic Pediatrics, Department of Pediatrics, MassGeneral Hospital for Children , Boston, MA.
2 Division of Pediatric Gastroenterology and Nutrition, Department of Pediatrics, MassGeneral Hospital for Children , Boston, MA.
Child Obes. 2017 Apr;13(2):146-153. doi: 10.1089/chi.2016.0261. Epub 2017 Jan 11.
To examine predictors of healthy BMI maintenance (HBM) or return to a healthy BMI (RHB) among children.
We studied 33,272 children in Massachusetts between 2008 and 2012. We used multinomial logistic regression to examine associations of individual- and neighborhood-level factors with the odds of: (1) HBM: maintenance of a healthy BMI ≥5th to <85th percentile and (2) RHB: transition to a healthy BMI range from an initial BMI ≥85th percentile between two clinic visits spanning an average of 3.5 years.
Racial/ethnic minorities had lower odds of HBM and RHB than non-Hispanic white children. Higher neighborhood educational attainment was associated with an increased odds of HBM and RHB. Higher neighborhood median household income, proximity to a supermarket, and access to more open recreational space were associated with a higher odds of HBM. Children of ages 2-5 years at baseline had higher odds of RHB and HBM than children 13 years and older.
Early childhood interventions and efforts to create health-promoting neighborhoods including improving access to supermarkets and open recreational space could have important effects on obesity prevention and management.
研究儿童维持健康体重指数（HBM）或恢复至健康体重指数（RHB）的预测因素。
我们在2008年至2012年间对马萨诸塞州的33272名儿童进行了研究。我们使用多项逻辑回归分析个体和社区层面因素与以下情况发生几率的关联：（1）HBM：维持健康体重指数，即体重指数处于第5百分位数至低于第85百分位数之间；（2）RHB：在平均间隔3.5年的两次门诊就诊期间，从初始体重指数≥第85百分位数转变为健康体重指数范围。
少数族裔儿童维持健康体重指数（HBM）和恢复至健康体重指数（RHB）的几率低于非西班牙裔白人儿童。社区教育水平较高与维持健康体重指数（HBM）和恢复至健康体重指数（RHB）的几率增加相关。社区家庭收入中位数较高、距离超市较近以及有更多开放的休闲空间与维持健康体重指数（HBM）的几率较高相关。基线时年龄在2至5岁的儿童恢复至健康体重指数（RHB）和维持健康体重指数（HBM）的几率高于13岁及以上的儿童。
幼儿干预措施以及建设促进健康的社区的努力，包括改善超市购物便利性和开放休闲空间的可达性，可能对肥胖预防和管理产生重要影响。
