澳大利亚原住民 0-3 岁儿童含糖饮料消费情况及其与社会人口学、生活状况和健康因素的关联。
Sugar-sweetened beverage consumption among Indigenous Australian children aged 0-3 years and association with sociodemographic, life circumstances and health factors.
机构信息
National Centre for Epidemiology and Population Health, Research School of Population Health, Australian National University, 54 Mills Road, Acton, ACT2602, Australia.
Medical School, Australian National University, Acton, ACT, Australia.
出版信息
Public Health Nutr. 2020 Feb;23(2):295-308. doi: 10.1017/S1368980019001812. Epub 2019 Aug 28.
OBJECTIVE
To explore beverage intake and associations between sugar-sweetened beverage (SSB) intake and sociodemographic, life circumstances, health and well-being factors in a national cohort of Indigenous children.
DESIGN
We calculated prevalence ratios for any SSB consumption across exposures, using multilevel Poisson regression (robust variance), adjusted for age group and remoteness. A key informant focus group contextualised these exploratory findings.
SETTING
Diverse settings across Australia.
PARTICIPANTS
Families of Indigenous children aged 0-3 years, in the Longitudinal Study of Indigenous Children.
RESULTS
Half (50·7 %, n 473/933) of children had ever consumed SSB at survey, increasing from 29·3 % of 0-12-month-olds to 65·7 % of 18-36-month-olds. SSB consumption prevalence was significantly lower in urban and regional v. remote areas, and in families experiencing socio-economic advantage (area-level advantage, caregiver employed, financial security), better life circumstances (caregiver social support, limited exposure to stressors) and caregiver well-being (non-smoking, social and emotional well-being, physical health). SSB consumption prevalence was significantly lower among those engaged with health services (adequate health-service access, regular prenatal check-ups), except SSB consumption prevalence was higher among those who received home visits from an Aboriginal Health Worker compared with no home visits. Key informants highlighted the role of water quality/safety on SSB consumption.
CONCLUSIONS
A substantial proportion of Indigenous children in this sample consumed SSB from an early age. Health provider information needs to be relevant to the context of families' lives. Health system strategies must be paired with upstream strategies, such as holistic support programmes for families, reducing racism and improving water quality.
目的
探索饮料摄入量以及含糖饮料（SSB）摄入量与社会人口统计学、生活环境、健康和幸福感因素之间的关系，该研究基于澳大利亚一个全国性的原住民儿童队列。
设计
我们使用多层泊松回归（稳健方差）计算了各种暴露因素下饮用任何 SSB 的患病率比，调整了年龄组和偏远程度。一个关键信息提供者的焦点小组对这些探索性发现进行了背景介绍。
设置
澳大利亚各地的各种环境。
参与者
0-3 岁原住民儿童的家庭，参加原住民儿童纵向研究。
结果
一半（50·7%，n=473/933）的儿童在调查中曾经饮用过 SSB，从 0-12 个月大的婴儿的 29·3%增加到 18-36 个月大的婴儿的 65·7%。在城市和地区与偏远地区相比，在社会经济地位较高（地区优势、有工作的照顾者、经济保障）、生活环境较好（照顾者社会支持、压力源暴露受限）和照顾者幸福感较高（不吸烟、社会和情感幸福感、身体健康）的家庭中，SSB 的消费率显著较低。在接受卫生服务的儿童中（获得充分的卫生服务机会、定期产前检查），SSB 的消费率明显较低，但与没有接受家庭访视的儿童相比，接受原住民卫生工作者家访的儿童 SSB 消费率更高。关键信息提供者强调了水质/安全对 SSB 消费的影响。
结论
在这个样本中，相当一部分原住民儿童在很小的时候就开始饮用 SSB。卫生服务提供者的信息需要与家庭生活的背景相关。卫生系统的策略必须与上游策略相结合，例如为家庭提供全面支持计划，减少种族主义和改善水质。
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