Woo Baidal Jennifer A, Nelson Candace C, Perkins Meghan, Colchamiro Rachel, Leung-Strle Peggy, Kwass Jo-Ann, Gortmaker Steve L, Davison Kirsten K, Taveras Elsie M
Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, Columbia University Medical Center, New York, New York, USA.
Division of General Academic Pediatrics, Department of Pediatrics, MassGeneral Hospital for Children, Boston, Massachusetts, USA.
Obesity (Silver Spring). 2017 Jul;25(7):1167-1174. doi: 10.1002/oby.21865.
To examine the extent to which a Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) intervention improved BMI z scores and obesity-related behaviors among children age 2 to 4 years.
In two Massachusetts communities, practice changes in WIC were implemented as part of the Massachusetts Childhood Obesity Research Demonstration (MA-CORD) initiative to prevent obesity among low-income children. One WIC program was the comparison. Changes in BMI z scores pre and post intervention and prevalence of obesity-related behaviors of WIC participants were assessed. Linear mixed models were used to examine BMI z score change, and logistic regression models were used to examine changes in obesity-related behaviors in each intervention site versus comparison over 2 years.
WIC-enrolled children in both intervention sites (vs. comparison) had improved sugar-sweetened beverage consumption and sleep duration. Compared to the comparison WIC program (n = 626), no differences were observed in BMI z score among children in Intervention Site #1 (n = 198) or #2 (n = 637). In sensitivity analyses excluding Asian children, a small decline was observed in BMI z score (-0.08 units/y [95% confidence interval: -0.14 to -0.02], P = 0.01) in Intervention Site #2 versus comparison.
Among children enrolled in WIC, the MA-CORD intervention was associated with reduced prevalence of obesity risk factors in both intervention communities and a small improvement in BMI z scores in one of two intervention communities in non-Asian children.
研究妇女、婴儿和儿童特殊补充营养计划(WIC)干预措施在多大程度上改善了2至4岁儿童的BMI z评分及与肥胖相关的行为。
在马萨诸塞州的两个社区,作为马萨诸塞州儿童肥胖研究示范项目(MA-CORD)预防低收入儿童肥胖倡议的一部分,实施了WIC的实践变革。一个WIC项目作为对照。评估了干预前后WIC参与者的BMI z评分变化以及与肥胖相关行为的患病率。使用线性混合模型来检验BMI z评分的变化,并使用逻辑回归模型来检验每个干预地点与对照相比在2年时间里与肥胖相关行为的变化。
两个干预地点(与对照相比)中参加WIC的儿童的含糖饮料消费量和睡眠时间均有所改善。与对照WIC项目(n = 626)相比,干预地点1(n = 198)或干预地点2(n = 637)的儿童在BMI z评分上未观察到差异。在排除亚洲儿童的敏感性分析中,干预地点2与对照相比,BMI z评分出现了小幅下降(-0.08单位/年[95%置信区间:-0.14至-0.02],P = 0.01)。
在参加WIC的儿童中,MA-CORD干预措施与两个干预社区中肥胖风险因素患病率的降低相关,并且在两个干预社区中的一个社区,非亚洲儿童的BMI z评分有小幅改善。