Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN.
Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN.
J Pediatr. 2019 Oct;213:115-120. doi: 10.1016/j.jpeds.2019.06.031. Epub 2019 Jul 26.
To determine the magnitude of risk of factors that contribute to the emergence of childhood obesity among low-income minority children.
We conducted a prospective cohort analysis of parent-child pairs with children aged 3-5 years who were nonobese (n = 605 pairs) who participated in a 3-year randomized controlled trial of a healthy lifestyle behavioral intervention. After baseline, height and weight were measured 5 times over 3 years to calculate body mass index (BMI) percentiles and classify children as normal, overweight, or obese. Multivariable logistic regression was used to estimate the odds of obesity after 36 months. Predictors included age, sex, birth weight, gestational age, months of breastfeeding, ethnicity, baseline child BMI, energy intake, physical activity, food security, parent baseline BMI, and parental depression.
Among this predominantly low-income minority population, 66% (398/605) of children were normal weight at baseline and 34% (n = 207/605) were overweight. Among normal weight children at baseline, 24% (85/359) were obese after 36 months; among overweight children at baseline, 55% (n = 103/186) were obese after 36 months. Age at enrollment (OR 2.11, 95% CI 1.64-2.72), child baseline BMI (OR 3.37, 95% CI 2.51-4.54), and parent baseline BMI (OR for a 6-unit change 1.36, 95% CI 1.09-1.70) were significantly associated with the odds of becoming obese for children.
The combination of child age, parent BMI, and child overweight as predictors of child obesity suggest a paradigm of family-centered obesity prevention beginning in early childhood, emphasizing the relevance of child overweight as a phenotype highly predictive of child obesity.
Clinicaltrials.gov: NCT01316653.
确定导致低收入少数族裔儿童肥胖的因素的风险程度。
我们对参加为期 3 年的健康生活方式行为干预随机对照试验的 3-5 岁非肥胖儿童及其父母进行了前瞻性队列分析。在基线后，3 年内共测量了 5 次身高和体重，以计算体重指数（BMI）百分位，并将儿童分类为正常、超重或肥胖。采用多变量逻辑回归估计 36 个月后肥胖的几率。预测因子包括年龄、性别、出生体重、胎龄、母乳喂养月数、种族、基线儿童 BMI、能量摄入、体力活动、食品安全、父母基线 BMI 和父母抑郁。
在这个以低收入少数族裔为主的人群中，66%（398/605）的儿童在基线时体重正常，34%（n=207/605）超重。在基线时体重正常的儿童中，24%（85/359）在 36 个月后肥胖；在基线时超重的儿童中，55%（n=103/186）在 36 个月后肥胖。入组年龄（OR 2.11，95% CI 1.64-2.72）、儿童基线 BMI（OR 3.37，95% CI 2.51-4.54）和父母基线 BMI（OR 每增加 6 个单位 1.36，95% CI 1.09-1.70）与儿童肥胖的几率显著相关。
儿童年龄、父母 BMI 和儿童超重作为儿童肥胖的预测因素相结合，提示以家庭为中心的肥胖预防模式始于儿童早期，强调儿童超重作为肥胖高度预测指标的相关性。
Clinicaltrials.gov：NCT01316653。
