Kim TaeEung, Kwon Junhye, Lee Chung Gun, Jang Chang-Yong
Department of Epidemiology, University of California, Irvine, CA, 92697, USA.
Department of Physical Education, College of Education, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul, 08826, South Korea.
Arch Public Health. 2020 Nov 13;78(1):116. doi: 10.1186/s13690-020-00494-z.
Childhood obesity is a serious public health threat. Although many researchers conducted research on socioecological determinants of childhood obesity, their longitudinal effects remain inconclusive especially among young children. This study examined socioecological factors and associated transitions of children's body mass index (BMI) status throughout children's kindergarten to elementary school years, using data from a national longitudinal sample.
The baseline sample of this study included 1264 children (weighted N = 379,297) extracted from the Early Childhood Longitudinal Study (baseline mean age: 5.24 years). The socioecological framework guided selection of socioecological obesogenic variables (e.g., family activity and parental involvement). Longitudinal ordered logistic regressions were performed to determine the associations between socioecological obesogenic variables and unhealthy/healthy changes in BMI status that captured transitions between healthy and unhealthy weight status (i.e., overweight, obesity, and severe obesity).
Children with Hispanic ethnicity and nonwhite, less socioeconomic and environmental support, and living in households with fewer family members were more likely than their counterparts to have unhealthy BMI status changes over time (all ps < 0.05). Over the study period, girls were less likely than boys to experience transitions to unhealthy BMI status (all ps < 0.05).
As hypothesized a priori, the findings of the current affirmed multiple dimensions of how sociological obesogenic factors may influence children's BMI status changes in a longitudinal setting. In order to maintain children's long-term healthy weight, more attention should be paid to socioeconomic obesogenic factors surrounding children as well as individual determinants of obesity (e.g., being physically active and having well-balanced nutrition).
儿童肥胖是对公共卫生的严重威胁。尽管许多研究人员对儿童肥胖的社会生态决定因素进行了研究,但其纵向影响仍不明确,尤其是在幼儿中。本研究利用全国纵向样本数据,考察了儿童从幼儿园到小学期间的社会生态因素及其体重指数(BMI)状况的相关转变。
本研究的基线样本包括从早期儿童纵向研究中提取的1264名儿童(加权N = 379,297)(基线平均年龄:5.24岁)。社会生态框架指导了社会生态致胖变量(如家庭活动和父母参与度)的选择。进行纵向有序逻辑回归,以确定社会生态致胖变量与BMI状况的不健康/健康变化之间的关联,这些变化反映了健康与不健康体重状况(即超重、肥胖和重度肥胖)之间的转变。
随着时间的推移,西班牙裔儿童、社会经济和环境支持较少的非白人儿童以及家庭成员较少的家庭中的儿童,比其他儿童更有可能出现不健康的BMI状况变化(所有p值<0.05)。在研究期间,女孩比男孩更不容易出现向不健康BMI状况的转变(所有p值<0.05)。
如先前所假设的,本研究结果证实了社会致胖因素在纵向环境中可能影响儿童BMI状况变化具有多个维度。为了维持儿童的长期健康体重,应更加关注儿童周围的社会经济致胖因素以及肥胖的个体决定因素(如进行体育活动和保持营养均衡)。