Centre de Recherche du Centre Hospitalier Universitaire Sainte-Justine, University of Montreal, Montréal, Québec, Canada; Department of Pediatrics, Faculty of Medicine, Université de Montréal, Montréal, Québec, Canada.
Ingram School of Nursing, McGill University, Montreal, Québec, Canada.
J Pediatr. 2019 Jan;204:46-52.e1. doi: 10.1016/j.jpeds.2018.08.063. Epub 2018 Oct 23.
To determine whether lifestyle habits and dietary factors at age 8-10 years predict the development of metabolically unhealthy obesity 2 years later among children who were previously metabolically healthy obese.
The QUebec Adipose and Lifestyle InvesTigation in Youth cohort comprises 630 youth with a parental history of obesity. Metabolically healthy obesity and metabolically unhealthy obesity were defined using cut-offs for the components of pediatric metabolic syndrome. Dietary factors, physical activity, fitness, sedentary behavior, screen time, and sleep duration were measured. Multivariable logistic regressions were used to examine associations.
At baseline, 48 participants with metabolically healthy obesity were identified; 2 years later, 19 became metabolically unhealthy obese and 29 remained metabolically healthy obese. Every additional daily portion of fruits and vegetables decreased the risk of converting to metabolically unhealthy obesity by 39% (OR 0.61, 95% CI 0.40-0.94). Cumulating more hours of screen time and diets high in saturated fat and sugar-sweetened beverages and low in protein were associated with a tendency to develop metabolically unhealthy obesity.
Fruit and vegetable intake and possibly screen time, saturated fat, sugar-sweetened beverages, and protein intake may be important targets for the prevention of cardiometabolic complications in obese children.
ClinicalTrials.gov: NCT03356262.
确定 8-10 岁时的生活方式习惯和饮食因素是否可预测先前代谢健康肥胖的儿童在 2 年后出现代谢不健康肥胖。
魁北克青少年脂肪和生活方式研究队列包括 630 名有肥胖家族史的青少年。代谢健康肥胖和代谢不健康肥胖是根据儿科代谢综合征各组成部分的临界值定义的。测量了饮食因素、体力活动、健康状况、久坐行为、屏幕时间和睡眠时间。采用多变量逻辑回归来检查关联。
在基线时，确定了 48 名代谢健康肥胖者；2 年后，有 19 名转为代谢不健康肥胖，29 名仍为代谢健康肥胖。每天多吃一份水果和蔬菜，可使转化为代谢不健康肥胖的风险降低 39%（OR 0.61，95%CI 0.40-0.94）。累积更多的屏幕时间以及饮食中饱和脂肪和含糖饮料含量高而蛋白质含量低与发生代谢不健康肥胖的趋势有关。
水果和蔬菜的摄入以及可能的屏幕时间、饱和脂肪、含糖饮料和蛋白质摄入可能是预防肥胖儿童发生心脏代谢并发症的重要目标。
ClinicalTrials.gov：NCT03356262。
