Health Economics and Decision Science, School of Health and Related Research, University of Sheffield, Sheffield, S1 4DA, UK.
Institute of Public Health, University of Cambridge, Cambridge, CB2 0SR, UK.
BMC Public Health. 2018 Apr 16;18(1):500. doi: 10.1186/s12889-018-5398-5.
The prevalence of childhood obesity has been increasing but the causes are not fully understood. Recent public health interventions and guidance aiming to reduce childhood obesity have focused on the whole family, as opposed to just the child but there remains a lack of empirical evidence examining this relationship.
Using data from the longitudinal Millennium Cohort Study (MCS), we investigate the dynamic relationship between underlying family lifestyle and childhood obesity during early childhood. The MCS interviewed parents shortly after the birth of their child and follow up interviews were carried out when the child was 3, 5 and 7 years. We use a dynamic latent factor model, an approach that allows us to identify family lifestyle, its evolution over time (in this case between birth and 7 years) and its influence on childhood obesity and other observable outcomes.
We find that family lifestyle is persistent, 87.43% of families which were above the 95th percentile on the lifestyle distribution, remained above the 95th percentile when the child was 7 years old. Family lifestyle has a significant influence on all outcomes in the study, including diet, exercise and parental weight status; family lifestyle accounts for 11.3% of the variation in child weight by age 7 years.
The analysis suggests that interventions should therefore be prolonged and persuasive and target the underlying lifestyle of a family as early as possible during childhood in order to have the greatest cumulative influence. Our results suggest that children from advantaged backgrounds are more likely to be exposed to healthier lifestyles and that this leads to inequalities in the prevalence of obesity. To reduce inequalities in childhood obesity, policy makers should target disadvantaged families and design interventions specifically for these families.
儿童肥胖症的患病率一直在上升,但病因尚未完全明了。最近旨在减少儿童肥胖症的公共卫生干预措施和指导方针侧重于整个家庭,而不仅仅是儿童,但仍缺乏实证研究来检验这种关系。
我们使用纵向千年队列研究(MCS)的数据,研究儿童早期儿童肥胖症与家庭生活方式之间的动态关系。MCS 在孩子出生后不久对父母进行了访谈,并在孩子 3、5 和 7 岁时进行了后续访谈。我们使用动态潜在因素模型,这种方法使我们能够识别家庭生活方式及其随时间的演变(在这种情况下,从出生到 7 岁)及其对儿童肥胖症和其他可观察结果的影响。
我们发现家庭生活方式具有持久性,在生活方式分布中处于 95 百分位以上的家庭中,有 87.43%在孩子 7 岁时仍处于 95 百分位以上。家庭生活方式对研究中的所有结果都有显著影响,包括饮食、运动和父母的体重状况;家庭生活方式占儿童 7 岁时体重变化的 11.3%。
分析表明,干预措施应因此延长并具有说服力,并尽早针对家庭的潜在生活方式进行干预,以产生最大的累积影响。我们的结果表明,来自优势背景的儿童更有可能接触到更健康的生活方式,这导致肥胖症的患病率不平等。为了减少儿童肥胖症的不平等,政策制定者应针对弱势家庭,并为这些家庭设计专门的干预措施。