青少年中SNAP参与情况与饮食敏感型心脏代谢风险因素
SNAP Participation and Diet-Sensitive Cardiometabolic Risk Factors in Adolescents.
作者信息
Leung Cindy W, Tester June M, Rimm Eric B, Willett Walter C
机构信息
Center for Health and Community, University of California, San Francisco, California.
University of California, San Francisco Benioff Children's Hospital Oakland, Oakland, California.
出版信息
Am J Prev Med. 2017 Feb;52(2S2):S127-S137. doi: 10.1016/j.amepre.2016.06.011.
INTRODUCTION
Previous research suggests participation in the Supplemental Nutrition Assistance Program (SNAP) is associated with poorer adult cardiometabolic health; the extent to which these associations extend to adolescents is unknown. Differences in diet quality, obesity, and cardiometabolic risk factors were examined among SNAP participants, income-eligible nonparticipants, and higher-income adolescents.
METHODS
The study population comprised 4,450 adolescents ≤300% federal poverty level from the 2003-2010 National Health and Nutrition Examination Survey. Generalized linear models were used to examine associations between SNAP participation and the Alternate Healthy Eating Index-2010. Linear and logistic regression models were used to examine associations between SNAP participation, obesity, and risk factors comprising the metabolic syndrome. Data were analyzed in 2015.
RESULTS
All surveyed adolescents consumed inadequate amounts of vegetables, fruits, whole grains, and long-chain fatty acids, while exceeding limits for sugary beverages, processed meats, and sodium. Although there were few dietary differences, SNAP participants had 5% lower Alternate Healthy Eating Index-2010 scores versus income-eligible nonparticipants (95% CI=-9%, -1%). SNAP participants also had higher BMI-for-age Z scores (β=0.21, 95% CI=0.01, 0.41), waist circumference Z scores (β=0.21, 95% CI=0.03, 0.39), and waist-to-height ratios (β=0.02, 95% CI=0.00, 0.03) than higher-income nonparticipants. SNAP participation was not associated with most cardiometabolic risk factors; however, SNAP participants did have higher overall cardiometabolic risk Z scores than higher-income nonparticipants (β=0.75, 95% CI=0.02, 1.49) and income-eligible nonparticipants (β=0.55, 95% CI=0.03, 1.08).
CONCLUSIONS
Adolescent SNAP participants have higher levels of obesity, and some poorer markers of cardiometabolic health compared with their low-income and higher-income counterparts.
引言
先前的研究表明，参与补充营养援助计划（SNAP）与成年人较差的心脏代谢健康状况相关；这些关联在青少年中的延伸程度尚不清楚。我们对SNAP参与者、符合收入条件的非参与者以及高收入青少年的饮食质量、肥胖和心脏代谢风险因素差异进行了研究。
方法
研究人群包括来自2003 - 2010年国家健康和营养检查调查的4450名联邦贫困水平≤300%的青少年。使用广义线性模型来研究SNAP参与情况与2010年替代健康饮食指数之间的关联。使用线性和逻辑回归模型来研究SNAP参与情况、肥胖以及构成代谢综合征的风险因素之间的关联。数据于2015年进行分析。
结果
所有接受调查的青少年蔬菜、水果、全谷物和长链脂肪酸的摄入量不足，而含糖饮料、加工肉类和钠的摄入量超过了限量。尽管饮食差异不大，但与符合收入条件的非参与者相比，SNAP参与者的2010年替代健康饮食指数得分低5%（95%置信区间=-9%，-1%）。与高收入非参与者相比，SNAP参与者的年龄别BMI Z评分（β=0.21，95%置信区间=0.01，0.41）、腰围Z评分（β=0.21，95%置信区间=0.03，0.39）和腰高比（β=0.02，95%置信区间=0.00，0.03）也更高。SNAP参与与大多数心脏代谢风险因素无关；然而，与高收入非参与者（β=0.75，95%置信区间=0.02，1.49）和符合收入条件的非参与者（β=0.55，95%置信区间=0.03，1.08）相比，SNAP参与者的总体心脏代谢风险Z评分确实更高。
结论
与低收入和高收入同龄人相比，参与SNAP的青少年肥胖水平更高，心脏代谢健康的一些指标更差。
Zotero 插件