Desautels Faculty of Management, McGill Center for the Convergence of Health and Economics, McGill University, Montreal, QC, Canada.
PostGraduate Program in Pediatrics, Universidade Federal de Ciencias da Saude de Porto Alegre, Porto Alegre, RS, Brasil.
PLoS One. 2019 Feb 21;14(2):e0212290. doi: 10.1371/journal.pone.0212290. eCollection 2019.
Evidence shows that extremes of birth weight (BW) carry a common increased risk for the development of adiposity and related cardiovascular diseases, but little is known about the role of obesogenic behaviors in this process. Moreover, no one has empirically examined whether the relationship between BW, obesogenic behaviors and BMI along the full low-to-high birthweight continuum reflects the U-shape pattern expected from common risk at both BW extremes. Our objective was to characterize physical activity, screen time, and eating behavior and their relationship to BMI as a function of BW among school-aged boys and girls. In this cross-sectional study, 460 children aged 6 to 12 years (50% boys) from Montreal, Canada provided information on sleeping time, screen time, physical activity levels, eating behavior (emotional, external and restrained eating) and anthropometrics (height, weight, BW) through parent reported questionnaires. BMI was normalized using WHO Standards (zBMI), and BW expressed as ratio using Canadian population standards (BW for gestational age and sex). Analyses were conducted using generalized linear models with linear and quadratic terms for BW, stratified by sex and adjusted for age, ethnicity and household income. In boys, physical activity and screen time showed U-shaped associations with BW, while physical activity had an inverted U-shaped in girls. Emotional and restrained eating had positive linear relations with BW in boys and girls. Sleep time and external eating were not associated with BW. A U-shaped relationship between BW and zBMI was found in boys but no association was found in girls. Only sleep (in boys and girls), and emotional eating (girls only) were related to zBMI and mediation of the BW-zBMI relationship was only supported for emotional eating. In conclusion, BW relates to obesogenic behaviors and BMI in both non-linear and linear ways, and these associations differed by sex.
证据表明，出生体重（BW）的极端情况会增加肥胖和相关心血管疾病的发病风险，但人们对肥胖行为在这一过程中的作用知之甚少。此外，没有人通过实证检验来研究 BW、肥胖行为与 BMI 之间的关系，是否沿着整个低到高 BW 连续体反映了两个 BW 极端情况的共同风险所预期的 U 型模式。我们的目的是描述学龄期男孩和女孩的 BW 与 BMI 之间的身体活动、屏幕时间和饮食行为及其关系。在这项横断面研究中，来自加拿大蒙特利尔的 460 名 6 至 12 岁的儿童（50%为男孩）通过家长报告的问卷提供了关于睡眠时间、屏幕时间、身体活动水平、饮食行为（情绪性、外显性和约束性进食）和人体测量学（身高、体重、BW）的信息。使用世界卫生组织标准（zBMI）对 BMI 进行归一化，并用加拿大人群标准（BW 与胎龄和性别）表示 BW 的比值。分析使用了广义线性模型，模型包含 BW 的线性和二次项，按性别分层，并根据年龄、种族和家庭收入进行了调整。在男孩中，身体活动和屏幕时间与 BW 呈 U 型关系，而身体活动在女孩中呈倒 U 型关系。情绪性和约束性进食与 BW 呈正线性关系，无论男孩还是女孩。睡眠时间和外显性进食与 BW 无关。在男孩中发现 BW 与 zBMI 之间存在 U 型关系，但在女孩中没有发现这种关系。只有睡眠（在男孩和女孩中）和情绪性进食（仅在女孩中）与 zBMI 相关，并且仅支持情绪性进食对 BW-zBMI 关系的中介作用。总之，BW 与肥胖行为和 BMI 之间存在非线性和线性关系，且这些关联因性别而异。
