School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada.
Department of Sociology and Legal Studies, University of Waterloo, Waterloo, Ontario, Canada.
Health Promot Chronic Dis Prev Can. 2017 Mar;37(3):77-86. doi: 10.24095/hpcdp.37.3.03.
Indigenous children are twice as likely to be classified as obese and three times as likely to experience household food insecurity when compared with non- Indigenous Canadian children. The purpose of this study was to explore the relationship between food insecurity and weight status among Métis and off-reserve First Nations children and youth across Canada.
We obtained data on children and youth aged 6 to 17 years (n = 6900) from the 2012 Aboriginal Peoples Survey. We tested bivariate relationships using Pearson chi-square tests and used nested binary logistic regressions to examine the food insecurity-weight status relationship, after controlling for geography, household and school characteristics and cultural factors.
Approximately 22% of Métis and First Nations children and youth were overweight, and 15% were classified as obese. Over 80% of the sample was reported as food secure, 9% experienced low food security and 7% were severely food insecure. Off-reserve Indigenous children and youth from households with very low food security were at higher risk of overweight or obese status; however, this excess risk was not independent of household socioeconomic status, and was reduced by controlling for household income, adjusted for household size. Negative school environment was also a significant predictor of obesity risk, independent of demographic, household and geographic factors.
Both food insecurity and obesity were prevalent among the Indigenous groups studied, and our results suggest that a large proportion of children and youth who are food insecure are also overweight or obese. This study reinforces the importance of including social determinants of health, such as income, school environment and geography, in programs or policies targeting child obesity.
与非印第安裔加拿大儿童相比，土著儿童肥胖的可能性是后者的两倍，而经历家庭食物无保障的可能性则是后者的三倍。本研究的目的是探讨加拿大梅蒂斯和非保留地第一民族儿童和青少年的食物无保障状况与体重状况之间的关系。
我们从 2012 年的原住民调查中获取了 6 至 17 岁儿童和青少年的数据（n = 6900）。我们使用 Pearson 卡方检验测试了双变量关系，并使用嵌套二元逻辑回归，在控制地理、家庭和学校特征以及文化因素后，检验了食物无保障与体重状况的关系。
大约 22%的梅蒂斯和第一民族儿童和青少年超重，15%被归类为肥胖。超过 80%的样本被报告为食物有保障，9%经历低食物保障，7%严重食物无保障。来自食物非常无保障家庭的非保留地土著儿童和青少年超重或肥胖的风险更高；然而，这种额外的风险不是独立于家庭社会经济地位的，通过控制家庭收入（根据家庭规模进行调整）来调整后，这种风险会降低。负面的学校环境也是肥胖风险的一个重要预测因素，独立于人口、家庭和地理因素。
在研究的土著群体中，食物无保障和肥胖都很普遍，我们的研究结果表明，很大一部分食物无保障的儿童和青少年也超重或肥胖。这项研究强调了在针对儿童肥胖的计划或政策中纳入健康的社会决定因素（如收入、学校环境和地理位置）的重要性。
