Datar Ashlesha, Chung Paul J
1 Center for Economic and Social Research, University of Southern California , Los Angeles, CA.
2 RAND Health, RAND Corporation , Santa Monica, CA.
Child Obes. 2018 May/Jun;14(4):238-247. doi: 10.1089/chi.2017.0217. Epub 2018 May 29.
Whether self-control at school entry and changes in self-control in the early school years are predictive of BMI change and obesity onset over the next 8 years using longitudinal data on a nationally representative sample of US children.
Data from the Early Childhood Longitudinal Study-Kindergarten Class 1998 were analyzed. The analysis sample included 7060 children with data from kindergarten (mean age = 6 years) until eighth grade (mean age = 14 years). Self-control was assessed using teacher-reported scales. Child BMI and obese status (BMI ≥95th percentile for age and gender) were computed from height and weight measurements. Weighted linear and logistic regression models were estimated, adjusting for child's cognitive ability and a rich set of child and family covariates.
High self-control in kindergarten was associated with lesser BMI increase (p < 0.05) and 43% lower odds (adjusted OR [AOR] = 0.57, 95% confidence interval [CI]: 0.38-0.86) of new onset obesity over the subsequent 8 years. The beneficial effect of high self-control in kindergarten emerged between fifth and eighth grade. Among children with low self-control in kindergarten, increase in self-control between kindergarten and fifth grade was associated with a 1.42 kg/m (95% CI: -2.82 to -0.02) lesser increase in BMI and 66% lower odds of new obesity onset (AOR = 0.34; 95% CI: 0.14-0.83), between kindergarten and eighth grade.
Low self-control at school entry is an important risk factor for unhealthy BMI increase during the transition to adolescence. Increase in self-control in the early school years may prevent unhealthy BMI increase and obesity in adolescence.
利用美国儿童全国代表性样本的纵向数据，探讨入学时的自我控制能力以及小学早期自我控制能力的变化是否能预测未来8年的体重指数（BMI）变化和肥胖症发病情况。
对1998年幼儿园班级的儿童早期纵向研究数据进行分析。分析样本包括7060名儿童，他们从幼儿园（平均年龄 = 6岁）到八年级（平均年龄 = 14岁）都有数据。自我控制能力通过教师报告量表进行评估。根据身高和体重测量数据计算儿童的BMI和肥胖状态（BMI≥年龄和性别的第95百分位数）。估计加权线性和逻辑回归模型，并对儿童的认知能力以及一系列丰富的儿童和家庭协变量进行调整。
幼儿园时自我控制能力高与BMI增长较少（p < 0.05）以及在随后8年新发性肥胖的几率降低43%（调整后的比值比[AOR] = 0.57，95%置信区间[CI]：0.38 - 0.86）相关。幼儿园时自我控制能力高的有益影响在五年级到八年级之间显现出来。在幼儿园时自我控制能力低的儿童中，幼儿园到五年级之间自我控制能力的提高与BMI增长减少1.42kg/m²（95% CI：-2.82至-0.02）以及幼儿园到八年级之间新发性肥胖几率降低66%（AOR = 0.34；95% CI：0.14 - 0.83）相关。
入学时自我控制能力低是向青春期过渡期间BMI不健康增长的重要危险因素。小学早期自我控制能力的提高可能预防青春期BMI的不健康增长和肥胖症。
