Hardy Louise L, Baur Louise A, Wen Li Ming, Garnett Sarah P, Mihrshahi Seema
Prevention Research Collaboration, Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia.
Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia.
BMJ Open. 2018 Apr 7;8(4):e019391. doi: 10.1136/bmjopen-2017-019391.
Over the past 10-15 years there has been substantial investment in New South Wales (NSW), Australia, to reduce child obesity through interventions in children aged 0-5 years. We report changes in weight and weight-related behaviours of 5-year-old children.
Cross-sectional surveys conducted in 2010 and 2015.
NSW schools (2010 n=44; 2015 n=41) PARTICIPANTS: Australian children in kindergarten (2010 n=1141 and 2015 n=1150).
Change in anthropometry and indicators of diet, screen time, school travel and awareness of health recommendations. Additionally, we examined 2015 differences in weight-related behaviours by sociodemographic characteristics.
Prevalence of overweight/obesity was 2.1% lower (adjusted OR (AOR) 0.83, 95% CI 0.67 to 1.04) and abdominal obesity 1.7% higher (AOR 1.35, 95% CI 0.93 to 1.98) in 2015 than 2010. Significant improvements in multiple weight-related behaviours were observed among children in the highest tertile of junk food consumption (AOR 0.63, 95% CI 0.50 to 0.80), rewarded for good behaviour with sweets (AOR 0.59, 95% CI 0.47 to 0.74) and had a TV in their bedroom (AOR 0.65, 95% CI 0.43 to 0.96). In 2015, children from low socioeconomic neighbourhoods and non-English-speaking backgrounds were generally less likely to engage in healthy weight-related behaviours than children from high socioeconomic status neighbourhoods and from English-speaking backgrounds. Children in these demographic groups were less likely to eat breakfast daily, have high junk food intake and eat fast food regularly. Children from rural areas tended to have healthier weight-related behaviours than children from urban areas.
There were significant positive changes in 5-year-old children's weight-related behaviours but children from low socioeconomic neighbourhoods and from non-English-speaking backgrounds were more likely to engage in unhealthy weight-related behaviours than children from high socioeconomic neighbourhoods and English-speaking backgrounds. The findings indicate that there is a need to enhance population-level efforts and ensure community programmes are targeted and tailored to meet different subpopulation needs.
在过去10至15年里，澳大利亚新南威尔士州（NSW）投入了大量资金，通过对0至5岁儿童进行干预来减少儿童肥胖。我们报告了5岁儿童体重及与体重相关行为的变化情况。
2010年和2015年进行的横断面调查。
新南威尔士州的学校（2010年n = 44；2015年n = 41）
澳大利亚幼儿园儿童（2010年n = 1141，2015年n = 1150）。
人体测量指标的变化以及饮食、屏幕使用时间、上学出行方式和对健康建议的知晓情况等指标。此外，我们还按社会人口学特征研究了2015年与体重相关行为的差异。
与2010年相比，2015年超重/肥胖患病率降低了2.1%（调整后比值比（AOR）为0.83，95%置信区间为0.67至1.04），腹部肥胖患病率升高了1.7%（AOR为1.35，95%置信区间为0.93至1.98）。在垃圾食品消费处于最高三分位数的儿童中，在因良好行为获得糖果奖励的儿童中，以及卧室里有电视的儿童中，多项与体重相关的行为有显著改善（AOR分别为0.63，95%置信区间为0.50至0.80；AOR为0.59，95%置信区间为0.47至0.74；AOR为0.65，95%置信区间为0.43至0.96）。2015年，来自社会经济地位较低社区和非英语背景的儿童，与来自社会经济地位较高社区和英语背景的儿童相比，通常较少参与与健康体重相关的行为。这些人口群体中的儿童每天吃早餐的可能性较小，垃圾食品摄入量较高，且经常吃快餐。农村地区的儿童往往比城市地区的儿童有更健康的与体重相关的行为。
5岁儿童与体重相关的行为有显著的积极变化，但来自社会经济地位较低社区和非英语背景的儿童比来自社会经济地位较高社区和英语背景的儿童更有可能参与不健康的与体重相关的行为。研究结果表明，有必要加强全人群层面的努力，并确保社区项目具有针对性且能满足不同亚人群的需求。
