1 Department of Epidemiology, Columbia University, New York, NY.
2 Department of Sociomedical Sciences, Columbia University, New York, NY.
Child Obes. 2019 Jan;15(1):48-55. doi: 10.1089/chi.2018.0116. Epub 2018 Oct 26.
Childhood social risk has been associated with increased risk of childhood obesity. However, little is known about early exposure of cumulative social risk on BMI percentile (BMIp) trajectories in early childhood.
Public data from the Fragile Families and Child Wellbeing Study were analyzed (N = 3809). Maternal reports of experiences of multiple social risk factors were obtained at age 1 and 3 assessments of children. Two cumulative social risk scores were calculated by summing social factors assessed at age 1 and at age 3. Child BMIp was assessed at ages 3, 5, and 9. Linear mixed models were used to examine the effect of cumulative social risk on sex-specific BMIp trajectories.
Compared with girls experiencing low social risk at either age 1 or 3, girls experiencing high social risk (≥ 2 factors) at age 1 or 3 only had higher initial BMIp at age 3 [β = 5.70 (95% confidence interval, CI: 0.15-1.26) and 1.37 (95% CI: -2.25 to 4.99), respectively] and had nonsignificantly greater BMIp growth rate [β = 0.39 (95% CI: -0.86 to 1.63) and 0.32 (95% CI: -0.86 to 1.63)]. Girls experiencing high social risk at both ages had nonsignificantly but consistently lower BMIp [β = -1.24 (95% CI: -2.93 to 0.46)]. In addition, girls experiencing a sum of ≥4 risk factors at both ages had lower BMIp growth rate [β = -1.77 (95% CI: -3.39 to -0.15)] compared to girls experiencing no risk factor. No associations were observed among boys.
Early exposure to cumulative social risk may have long-term impact on BMIp trajectories among girls, depending on timing of exposure. Understanding the effect of cumulative social risk in different contexts, including sex, chronicity, and timing of exposure, may have practical implications for informing effective intervention to combat childhood obesity.
儿童期社会风险与儿童肥胖风险增加有关。然而，对于儿童早期累积社会风险对 BMI 百分位数（BMIp）轨迹的早期暴露知之甚少。
分析了脆弱家庭和儿童福利研究的公共数据（N=3809）。在儿童 1 岁和 3 岁评估时，母亲报告了多种社会风险因素的经历。通过将 1 岁和 3 岁评估的社会因素相加，计算了两个累积社会风险评分。在 3、5 和 9 岁时评估儿童 BMIp。使用线性混合模型来检验累积社会风险对性别特异性 BMIp 轨迹的影响。
与在 1 岁或 3 岁时仅经历低社会风险的女孩相比，仅在 1 岁或 3 岁时经历高社会风险（≥2 个因素）的女孩在 3 岁时的初始 BMIp 更高[β=5.70（95%置信区间，CI：0.15-1.26）和 1.37（95%CI：-2.25 至 4.99）]，且 BMIp 增长率无显著差异[β=0.39（95%CI：-0.86 至 1.63）和 0.32（95%CI：-0.86 至 1.63）]。在两个年龄都经历高社会风险的女孩 BMIp 略有但始终较低[β=-1.24（95%CI：-2.93 至 0.46）]。此外，在两个年龄都经历≥4 个危险因素的女孩 BMIp 增长率较低[β=-1.77（95%CI：-3.39 至-0.15）]，而没有危险因素的女孩则没有。在男孩中没有观察到关联。
在女孩中，早期暴露于累积社会风险可能对 BMIp 轨迹产生长期影响，具体取决于暴露的时间。了解累积社会风险在不同背景下的影响，包括性别、持续性和暴露时间，可能对制定有效的干预措施以对抗儿童肥胖具有实际意义。
