Department of General Practice & Elderly Care Medicine, EMGO+ Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands.
Department of Social Policy, London School of Economics and Political Science, London, UK.
Eur J Public Health. 2018 Feb 1;28(1):88-94. doi: 10.1093/eurpub/ckx037.
Childhood overweight/obesity has been associated with environmental, parenting and socioeconomic status (SES) factors. This paper assesses the influence of the amount of green space, accessibility to a garden and neighbourhood condition on being overweight/obese. It investigates whether parental behaviours moderate or mediate this influence and evaluates the interaction of SES with environmental context.
6467 children from the UK Millennium Cohort Study living in England were analysed. We estimated logistic regressions to examine the initial association between environment and overweight. Subsequently, parenting determinants comprising: food consumption, physical activity, rules and regularity were evaluated as moderators or mediators. Lastly SES related variables were tested as moderators or mediators of the associations.
Statistically significant associations were found between low levels of green space, no access to a garden, run down area and childhood overweight/obesity [odds ratio (OR) [95% confidence interval (CI)] respectively: 1.14 (1.02-1.27), 1.35 (1.16-1.58), 1.22 (1.05-1.42)]. None of the parental constructs mediated or moderated the relationships between environment and childhood overweight/obesity. Including SES, parental education moderated the effect of environmental context. Specifically, among lower educated households lack of garden access and less green space was associated with overweight/obesity; and among higher educated households poor neighbourhood condition influenced the probability of overweight/obesity respectively: 1.38 (1.12-1.70) OR 1.38, 95% CI (1.21-1.70).
This study suggests that limits on access to outdoor space are associated with future childhood overweight/obesity although the ways in which this occurs are moderated by parental education level.
儿童超重/肥胖与环境、养育方式和社会经济地位（SES）因素有关。本文评估了绿地数量、花园可达性和邻里环境条件对超重/肥胖的影响。研究探讨了父母行为是否调节或介导了这种影响，并评估了 SES 与环境背景的相互作用。
对英国千禧年队列研究中居住在英格兰的 6467 名儿童进行了分析。我们估计了逻辑回归来检验环境与超重之间的初始关联。随后，评估了包括食物摄入、体育活动、规则和规律性在内的养育决定因素，以确定它们是调节因素还是中介因素。最后，测试 SES 相关变量是否为关联的调节因素或中介因素。
绿地水平低、没有花园、破旧地区与儿童超重/肥胖之间存在统计学显著关联[比值比（OR）[95%置信区间（CI）]分别为：1.14（1.02-1.27）、1.35（1.16-1.58）、1.22（1.05-1.42）]。父母结构中的任何一个都没有介导或调节环境与儿童超重/肥胖之间的关系。SES 包括父母的教育程度，调节了环境背景的影响。具体而言，在受教育程度较低的家庭中，缺乏花园通道和较少的绿地与超重/肥胖有关；而在受教育程度较高的家庭中，较差的邻里环境条件则影响了超重/肥胖的概率，分别为：1.38（1.12-1.70）OR 1.38，95% CI（1.21-1.70）。
本研究表明，户外活动空间受限与未来儿童超重/肥胖有关，尽管这种情况的发生方式受到父母教育水平的调节。
