Dong Fei, Howard Annie Green, Herring Amy H, Thompson Amanda L, Adair Linda S, Popkin Barry M, Aiello Allison E, Zhang Bing, Gordon-Larsen Penny
Departments of Nutrition, Gillings School of Global Public Health and School of Medicine.
Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC; and.
Am J Clin Nutr. 2017 Jul;106(1):168-178. doi: 10.3945/ajcn.116.146217. Epub 2017 May 24.
Little is known about intergenerational differences in associations of urbanization-related lifestyle behaviors with cardiometabolic risk factors in children and their parents in rapidly urbanizing China. We tested the intergenerational differences in longitudinal associations of away-from-home eating, snacking, screen time, and leisure-time sports with high waist-to-height ratio (WHtR), elevated blood pressure (BP), elevated glycated hemoglobin (HbA1c), and elevated C-reactive protein (CRP) among Chinese children and their parents. We studied children enrolled in the longitudinal China Health and Nutrition Survey (1991-2009, 7 surveys) aged 7-17 y in ≥2 surveys (average follow-up: 2.3 surveys out of a possible 4 surveys with the age restriction; = 3875, including 1175 siblings) and their parents (2947 mothers, 2632 fathers) living in the same household. We used 3 consecutive interviewer-administered 24-h dietary recalls to derive a 3-d average for away-from-home eating (nonconsumer, >0 and <1 meal/d, or ≥1 meals/d) and consumption of fruit or vegetable snacks (any or none) and other snacks (any or none) and a self-reported 7-d physical activity recall for screen time (≤1, >1 and ≤2, or >2 h/d) and leisure-time sports (any or none). Random-effects logistic regression was used to examine the associations of lagged (average: 3 y) behaviors with cardiometabolic risk factors (WHtR, BP, HbA1c, and CRP). We detected intergenerational differences in associations between lagged behaviors and risk factors (interaction < 0.1). Generation-specific models showed that lagged away-from-home eating of ≥1 meal/d (compared with none) was negatively associated with parents' high WHtR (OR: 0.68; 95% CI: 0.53, 0.88) but positively associated with children's high WHtR (OR: 1.46; 95% CI: 1.01, 2.12). Lagged fruit and vegetable snack consumption was negatively related to parents' (OR: 0.76; 95% CI: 0.59, 0.97) and children's (OR: 0.58; 95% CI: 0.33, 1.00) high WHtR. Lagged screen time (>2 compared with ≤1 h/d) was positively associated with parents' (OR: 2.58; 95% CI: 1.56, 4.28) and children's high WHtR (OR: 2.26; 95% CI: 1.06, 4.83). Parent-offspring differences in associations between lifestyle behaviors and cardiometabolic risk factors provide insight into intergenerational differences in cardiometabolic risk with urbanization.
在中国快速城市化的进程中，关于城市化相关生活方式行为与儿童及其父母心血管代谢危险因素之间的代际差异，人们了解甚少。我们测试了外出就餐、吃零食、屏幕时间和休闲运动与高腰高比（WHtR）、血压升高（BP）、糖化血红蛋白升高（HbA1c）和C反应蛋白升高（CRP）之间纵向关联的代际差异，研究对象为中国儿童及其父母。我们研究了参加中国健康与营养纵向调查（1991 - 2009年，共7次调查）的儿童，这些儿童年龄在7 - 17岁，至少参加了2次调查（平均随访：在可能的4次调查中有2.3次，受年龄限制；n = 3875，包括1175对兄弟姐妹）以及与他们同住一个家庭的父母（2947名母亲，2632名父亲）。我们使用连续3次由访员进行的24小时饮食回忆来得出外出就餐（非消费者、每天外出就餐次数>0且<1次或≥1次）以及水果或蔬菜零食消费（有或无）和其他零食消费（有或无）的3天平均值，并通过自我报告的7天身体活动回忆来获取屏幕时间（≤1小时、>1小时且≤2小时或>2小时/天）和休闲运动（有或无）。采用随机效应逻辑回归来检验滞后（平均：3年）行为与心血管代谢危险因素（WHtR、BP、HbA1c和CRP）之间的关联。我们检测到滞后行为与危险因素之间的关联存在代际差异（交互作用<0.1）。特定代际模型显示，滞后的每天外出就餐≥1次（与从不外出就餐相比）与父母的高WHtR呈负相关（OR：0.68；95%CI：0.53，0.88），但与儿童的高WHtR呈正相关（OR：1.46；95%CI：1.01，2.12）。滞后的水果和蔬菜零食消费与父母（OR：0.76；95%CI：0.59，0.97）和儿童（OR：0.58；95%CI：0.33，1.00）的高WHtR呈负相关。滞后的屏幕时间（>2小时与≤1小时/天相比）与父母（OR：2.58；95%CI：1.56，4.28）和儿童的高WHtR呈正相关（OR：2.26；95%CI：1.06，4.83）。生活方式行为与心血管代谢危险因素之间的亲子差异为城市化进程中心血管代谢风险的代际差异提供了见解。
