Papandreou Alexandra, Bopp Matthias, Braun Julia, Staub Kaspar, Faeh David
School Health Services, Department of School and Sport, Zurich, Switzerland.
Epidemiology, Biostatistics and Prevention Institute (EBPI), University of Zurich, Switzerland.
Swiss Med Wkly. 2017 Sep 13;147:w14501. doi: 10.4414/smw.2017.14501. eCollection 2017.
Excess body weight is a major public health concern already at a young age. The aim of this study was to track weight status among pupils aged 6-14 years in the City of Zurich, to examine the association between sociodemographic and environmental factors and excess weight at school entry and excess weight gain thereafter.
Longitudinal study.
Data were from the medical examinations routinely performed at public schools in Zurich, the largest city in Switzerland. Weight and height were measured in kindergarten (mean age: 5.9 years), grade 1 (7.2 years), grade 4 (10.1 years) and grade 8 (14.2 years).
The study included 7145 children who enrolled in kindergarten in 2003/04 or 2004/05 and had more than one measurement of weight and height.
Body weight and height were measured by physicians or nurses during the medical examinations at schools. For each measurement point, body mass index (BMI) was calculated and converted to the age- and sex-specific BMI z-scores and BMI percentiles. The stability of children's weight status categories, sociodemographic and environmental factors associated with excess weight gain and with overweight/obesity at school entry were investigated using multiple linear and logistic regression models.
The prevalence of overweight/obesity increased between kindergarten and grade 8 (from 17.6 to 26.0%). Overall, 86.2% of the children remained in the same weight category; 10.8% shifted to a higher and 3% to a lower category. There was a strong correlation between migration background and overweight/obesity at school entry (odds ratios between 1.62 and 3.42, all p <0.05). In addition, boys with Southern/Eastern European background (+2.29 BMI percentile, p = 0.023) and girls in lower level school type (+12.98 BMI percentile, p <0.001) had the highest risk for excess weight gain over a school period.
Overweight/obesity developed prior to school entry and mostly persisted through childhood. In order to better exploit obesity prevention potential, measures to prevent the development of the excess weight need to be implemented at a very early stage in life.
超重问题在年轻时就已成为主要的公共卫生问题。本研究的目的是追踪苏黎世市6至14岁小学生的体重状况，研究社会人口学和环境因素与入学时超重及此后体重增加之间的关联。
纵向研究。
数据来自瑞士最大城市苏黎世公立学校定期进行的体检。在幼儿园（平均年龄：5.9岁）、一年级（7.2岁）、四年级（10.1岁）和八年级（14.2岁）测量体重和身高。
该研究纳入了2003/04年或2004/05年进入幼儿园且有多次体重和身高测量数据的7145名儿童。
在学校体检期间，由医生或护士测量体重和身高。对于每个测量点，计算体重指数（BMI）并转换为年龄和性别特异性的BMI z评分和BMI百分位数。使用多元线性和逻辑回归模型研究儿童体重状况类别的稳定性、与体重增加过多以及入学时超重/肥胖相关的社会人口学和环境因素。
超重/肥胖的患病率在幼儿园到八年级之间有所增加（从17.6%增至26.0%）。总体而言，86.2%的儿童体重类别保持不变；10.8%的儿童体重类别上升，3%的儿童体重类别下降。移民背景与入学时超重/肥胖之间存在很强的相关性（优势比在1.62至3.42之间，均p<0.05）。此外，具有南欧/东欧背景的男孩（BMI百分位数增加2.29，p = 0.023）和就读于低水平学校类型的女孩（BMI百分位数增加12.98，p<0.001）在整个上学期间体重增加过多的风险最高。
超重/肥胖在入学前就已出现，且大多持续到儿童期。为了更好地挖掘肥胖预防潜力，需要在生命的早期阶段实施预防体重增加过多的措施。
