Hampshire County Council, Winchester, UK.
School of Primary Care and Population Sciences, Faculty of Medicine, University of Southampton, Southampton, UK.
Int J Obes (Lond). 2020 Mar;44(3):628-636. doi: 10.1038/s41366-019-0418-9. Epub 2019 Jul 22.
BACKGROUND/OBJECTIVES: Childhood obesity is a serious public health challenge. Cross-sectional evidence indicates that childhood obesity is strongly linked to area deprivation level, yet longitudinal research is scarce. We assessed the association of home-based and school-based deprivation indices with change in childhood body-mass index (BMI) z-score and BMI status over 6 years in Hampshire, England.
SUBJECTS/METHODS: This longitudinal study linked the National Child Measurement Programme data for children aged 4-5 years (2007-08 to 2009-10) to 10-11 years. The dataset was stratified into two groups: 18,733 children for whom home deprivation quintiles, according to the Index of Multiple Deprivation (IMD), remained constant, and 6153 children who moved home deprivation quintiles between the two time points. The associations between IMD quintiles and change in BMI z-score and status were analysed.
63.7% of children remained a healthy weight, 3.1% remained overweight, 5.3% remained with obesity, 8.3% became overweight, and 10.3% developed obesity. Children living in the most deprived quintile increased their BMI z-score by 0.13 units more than those in the least deprived quintile (95% CI: 0.08-0.19). Home-based deprivation displayed associations with change in BMI status. (Relative risk for the most deprived quintile: become overweight 1.47, 1.21-1.78, remain obese 1.82, 1.34-2.40, become obese 2.07, 1.73-2.48.) School-based deprivation was not associated with change in BMI z-score or BMI status. Moving home to a more deprived quintile was associated with developing obesity (1.22, 1.04-1.43).
More children living in deprived areas developed obesity over time. Home-based deprivation level is more strongly associated with adverse change in childhood weight than school-based deprivation. Scholarly settings can provide opportunities for interventions, however obesity prevention interventions should tackle the obesogenic environment combining family and area-based measures.
背景/目的：儿童肥胖是一个严重的公共卫生挑战。横断面研究表明，儿童肥胖与地区贫困程度密切相关，但纵向研究却很少。我们评估了家庭和学校贫困指数与汉普郡儿童体重指数（BMI）z 评分变化以及 6 年内 BMI 状况的关系。
研究对象/方法：这项纵向研究将全国儿童测量计划（National Child Measurement Programme）2007-08 至 2009-10 年间 4-5 岁儿童的数据与 10-11 岁儿童的数据相联系。该数据集分为两组：18733 名儿童，他们的家庭贫困五分位数（根据多维贫困指数（Index of Multiple Deprivation，IMD）划分）保持不变；6153 名儿童在两个时间点之间家庭贫困五分位数发生了变化。分析了 IMD 五分位数与 BMI z 评分和 BMI 状况变化之间的关系。
63.7%的儿童体重保持健康，3.1%的儿童体重超重，5.3%的儿童肥胖，8.3%的儿童超重，10.3%的儿童肥胖。居住在最贫困五分位的儿童比居住在最不贫困五分位的儿童 BMI z 评分增加了 0.13 个单位（95%置信区间：0.08-0.19）。家庭贫困与 BMI 状况的变化有关。（最贫困五分位的相对风险：超重 1.47，1.21-1.78；肥胖 1.82，1.34-2.40；肥胖 2.07，1.73-2.48。）学校贫困与 BMI z 评分或 BMI 状况的变化无关。家庭搬入更贫困的五分位与肥胖的发生有关（1.22，1.04-1.43）。
随着时间的推移，越来越多生活在贫困地区的儿童肥胖。家庭贫困程度与儿童体重的不良变化关系更为密切，而学校贫困程度则不然。学术环境为干预措施提供了机会，但肥胖预防干预措施应针对家庭和地区措施相结合的致肥胖环境。
