地中海饮食与儿童肥胖的相关性；家庭结构的作用：来自对 1728 名希腊学生进行的一项流行病学研究的结果。

The association between adherence to the Mediterranean diet and childhood obesity; the role of family structure: Results from an epidemiological study in 1728 Greek students.

机构信息

68996Harokopio University, Kallithea, Greece.

523391University of West Attica, Athens, Greece.

出版信息

Nutr Health. 2021 Mar;27(1):39-47. doi: 10.1177/0260106020952600. Epub 2020 Oct 19.

DOI:10.1177/0260106020952600

PMID:33073650

Abstract

BACKGROUND

Childhood obesity is among the leading public health challenges, worldwide.

AIM

To examine the association between children's adherence to the Mediterranean diet (MD) and weight status taking into account family structure and related behaviors.

METHODS

1728 primary-school Greek students (46% males), from Athens metropolitan area, island of Crete, and the Peloponnese region, were enroled during school years 2014-2016. Children and their parents completed questionnaires which, among others, recorded family structure (i.e., married/cohabited, divorced, single parent, and widowed), dietary and lifestyle habits. Adherence to the MD was assessed through the KIDMED score (range - 4 to 12). Children's body mass index was calculated and classified as normal, overweight/obese, according to the International Obesity Task Force classification. The working sample was 1142 children (44% males) with a recorded family structure.

RESULTS

The prevalence of overweight was 21.7% and obesity was 5.0%; overweight/obesity prevalence was higher among males than females (32.4% vs. 23.3%; < 0.001). Overweight/obese children had a lower KIDMED score compared to normal weight (median (range): 4 (-2, 11) vs. 5 (-1, 10), = 0.05). An inverse association between KIDMED score and children's weight status (odds ratio (OR) (95% confidence interval (CI)): 0.95 (0.89-0.99)) was observed. Interaction between family structure and KIDMED was observed ( < 0.001); stratified analysis revealed that in children from nuclear families the KIDMED score was inversely associated with the likelihood of overweight/obesity (OR (95% CI): 0.95 (0.88-1.00)), whereas in children from single-parent families it was not (OR (95% CI): 0.94 (0.79-1.12)).

CONCLUSION

Adherence to the MD plays a protective role against childhood overweight/obesity, particularly among children living in nuclear families.

摘要

背景

儿童肥胖是全球主要的公共卫生挑战之一。

目的

研究儿童对地中海饮食（Mediterranean diet，MD）的依从性与体重状况之间的关系，同时考虑家庭结构和相关行为。

方法

2014-2016 年，在雅典大都市区、克里特岛和伯罗奔尼撒地区的 1728 名小学生（46%为男生）参与了此次研究。儿童及其家长填写了问卷，内容包括家庭结构（已婚/同居、离婚、单亲、丧偶）、饮食和生活方式习惯等。采用 KIDMED 评分（范围-4 至 12）评估 MD 的依从性。根据国际肥胖工作组的分类，计算儿童的体重指数（BMI）并将其归类为正常、超重/肥胖。记录了家庭结构的 1142 名儿童（44%为男生）被纳入研究。

结果

超重的患病率为 21.7%，肥胖的患病率为 5.0%；男性的超重/肥胖患病率高于女性（32.4%比 23.3%；<0.001）。与正常体重的儿童相比，超重/肥胖的儿童的 KIDMED 评分较低（中位数（范围）：4（-2，11）比 5（-1，10），=0.05）。KIDMED 评分与儿童体重状况呈负相关（比值比（OR）（95%置信区间（CI））：0.95（0.89-0.99））。观察到家庭结构和 KIDMED 之间存在交互作用（<0.001）；分层分析显示，在核心家庭的儿童中，KIDMED 评分与超重/肥胖的可能性呈负相关（OR（95% CI）：0.95（0.88-1.00）），而在单亲家庭的儿童中则没有（OR（95% CI）：0.94（0.79-1.12））。