Khashayar Patricia, Kasaeian Amir, Heshmat Ramin, Motlagh Mohammad Esmaeil, Mahdavi Gorabi Armita, Noroozi Mehdi, Qorbani Mostafa, Kelishadi Roya
Chronic Disease Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
Center for Microsystems Technology, Imec and Ghent University, Ghent, Belgium.
Front Pediatr. 2018 Dec 21;6:393. doi: 10.3389/fped.2018.00393. eCollection 2018.
The purpose of this paper is to explore multidimensional factors related to childhood obesity and overweight based on the data gathered on different aspects of the general health status were assessed among a large number of Iranian children and adolescents in the fourth phase of the "Childhood and Adolescence Surveillance and Prevention of Adult Non-communicable disease" survey. It also aims to determine the degree to which each ecological context contributes to childhood overweight/obesity. A total of 14,880 students and their parents were recruited. They filled out a questionnaire on their relationship with peers, body image, and psychosocial environment of school, dietary habits, life-style habits, physical activity pattern and socioeconomic status (SES). Their height, weight, was measured and body mass index (BMI) was calculated. Obesity and overweight was defined based on the WHO growth chart. Multilevel modeling using three-level random intercept logistic regression models were used to assess predictors of overweight and obesity. In our hierarchical models, children (first level) were conceptualized as being nested within provinces (second level) and provinces within quad regions (third level). From among the 13,486 recruited students, 9.7% were overweight and 11.9% were obese. In multivariate model (adjusted model), being boy (OR:1.58), living in urban area (OR:1.58), having positive family history of obesity (OR = 2.04), breakfast skipping (OR: 1.46), socioeconomic status (OR = 1.44 and OR = 1.89), and birth weight (BW) (OR = 1.33 and OR = 1.8) were associated with childhood obesity. Increasing age was the only factor in the obesity model that had a significant preventive effect on the odds of becoming obese (OR = 0.96, < 0.001). In multivariate model, living in urban area, increasing age, high and moderate SES, high BW and family history of obesity were the significant predictors of overweight. Our findings show that high BW, sociodemographic characteristics, breakfast skipping, and family history of obesity are associated with childhood obesity and overweight. Therefore, developing strategies that consider the effects of diverse sociodemographic and environmental factors on childhood overweight and obesity would be the most effective way to prevent and manage this multifactorial health concern.
本文的目的是基于在“儿童和青少年成人非传染性疾病监测与预防”调查第四阶段对大量伊朗儿童和青少年的一般健康状况不同方面收集的数据，探讨与儿童肥胖和超重相关的多维度因素。它还旨在确定每个生态环境对儿童超重/肥胖的影响程度。总共招募了14,880名学生及其家长。他们填写了一份关于他们与同伴的关系、身体形象、学校的心理社会环境、饮食习惯、生活方式习惯、身体活动模式和社会经济地位（SES）的问卷。测量了他们的身高、体重，并计算了体重指数（BMI）。肥胖和超重是根据世界卫生组织生长图表定义的。使用三级随机截距逻辑回归模型的多水平建模用于评估超重和肥胖的预测因素。在我们的分层模型中，儿童（第一级）被概念化为嵌套在省份（第二级）内，而省份嵌套在四区（第三级）内。在13,486名招募的学生中，9.7%超重，11.9%肥胖。在多变量模型（调整模型）中，男性（比值比：1.58）、居住在城市地区（比值比：1.58）、有肥胖家族史阳性（比值比 = 2.04）、不吃早餐（比值比：1.46）、社会经济地位（比值比 = 1.44和比值比 = 1.89）以及出生体重（BW）（比值比 = 1.33和比值比 = 1.8）与儿童肥胖相关。年龄增长是肥胖模型中唯一对肥胖几率有显著预防作用的因素（比值比 = 0.96，<0.001）。在多变量模型中，居住在城市地区、年龄增长、高和中等社会经济地位、高出生体重和肥胖家族史是超重的显著预测因素。我们的研究结果表明，高出生体重、社会人口学特征、不吃早餐和肥胖家族史与儿童肥胖和超重有关。因此，制定考虑多种社会人口学和环境因素对儿童超重和肥胖影响的策略将是预防和管理这一多因素健康问题的最有效方法。
