Division of Pediatric Endocrinology, Department of Pediatrics, University of Virginia, Charlottesville, Virginia.
Division of Developmental Pediatrics, Department of Pediatrics, University of Virginia, Charlottesville, Virginia.
Nutrition. 2018 Jul-Aug;51-52:1-5. doi: 10.1016/j.nut.2017.12.008. Epub 2018 Feb 5.
The aim of this study was to determine if food insecurity is an independent risk factor for obesity in U.S. children.
We analyzed data from a nationally representative sample of children participating in the Early Childhood Longitudinal Study-Kindergarten Cohort 2011. Statistical analyses were performed to evaluate longitudinal associations between food security and body mass index (BMI) z-score. All regression models included race/ethnicity, household income, and parental education. Survey and anthropometric data was collected from teachers and parents of 8167 U.S. children entering kindergarten in fall 2010 with regular follow-up through third grade. Complete data regarding food security, socioeconomic assessment, and BMI z-score data were included for statistical analyses. All analyses were weighted to be nationally representative.
Children with household food insecurity had increased obesity prevalence from kindergarten through grade 3; for example, at kindergarten, with food insecurity 16.4% (95% confidence interval [CI], 13.7-19) versus food secure 12.4% (95% CI, 11.3-13.6). Adjusted means analysis showed first-grade food insecurity was significantly correlated with increased BMI z-score in first through third grades; for example, at first grade, with food insecurity 0.6 (95% CI, 0.5-0.7) versus food secure 0.4 (95% CI, 0.4-0.5). Logistic regression showed first-grade food insecurity was correlated with increased risk for obesity in that grade (odds ratio 1.4; 95% CI, 1.1-2).
Obesity is more prevalent among food-insecure children. First-grade food insecurity is an independent risk factor for longitudinal increases in BMI z-score. There are differences in the association between food insecurity and weight status between kindergarten and first grade.
本研究旨在确定食物不安全是否是美国儿童肥胖的一个独立风险因素。
我们分析了参与 2011 年幼儿纵向研究 - 幼儿园队列的具有全国代表性的儿童样本数据。进行统计分析以评估食物安全与体重指数（BMI）z 评分之间的纵向关联。所有回归模型均包括种族/民族、家庭收入和父母教育。从 2010 年秋季进入幼儿园的 8167 名美国儿童的教师和家长那里收集了关于食物安全、社会经济评估和 BMI z 评分数据的调查和人体测量数据，并通过三年级进行了常规随访。所有分析均经过加权处理以具有全国代表性。
从幼儿园到三年级，家庭食物不安全的儿童肥胖患病率增加；例如，在幼儿园，食物不安全者为 16.4%（95%可信区间[CI]，13.7-19），而食物安全者为 12.4%（95% CI，11.3-13.6）。调整均值分析显示，一年级食物不安全与一年级至三年级 BMI z 评分的增加显著相关；例如，在一年级，食物不安全者为 0.6（95% CI，0.5-0.7），而食物安全者为 0.4（95% CI，0.4-0.5）。Logistic 回归显示，一年级食物不安全与该年级肥胖风险增加相关（比值比 1.4；95% CI，1.1-2）。
食物不安全的儿童肥胖更为普遍。一年级食物不安全是 BMI z 评分纵向增加的独立风险因素。食物不安全与体重状况之间的关联在幼儿园和一年级之间存在差异。
