Nguyen Tuyen, Sokal-Gutierrez Karen, Lahiff Maureen, Fernald Lia, Ivey Susan L
School of Public Health and School of Medicine, UC Berkeley-UCSF Joint Medical Program, University of California, 2121 Berkeley Way, Room 5302, Berkeley, CA, USA.
School of Public Health, UC Berkeley-UCSF Joint Medical Program, University of California, 570 University Hall, MC 1190, Berkeley, CA, USA.
BMC Public Health. 2021 Feb 5;21(1):301. doi: 10.1186/s12889-021-10292-z.
Over recent decades, Vietnam has experienced rapid economic growth, a nutrition transition from the traditional diet to highly-processed and calorie-dense foods and beverages, and an increasing prevalence of childhood overweight/obesity (ow/ob). The goal of this study is to describe the patterns of ow/ob in a longitudinal sample of Vietnamese children from ages 1 to 8, and the sociodemographic and behavioral factors associated with ow/ob at age 8.
This study is a secondary data analysis of a geographically-representative, longitudinal cohort of 1961 Vietnamese children from the Young Lives Cohort Study from 2002 to 2009. Thirty-one communities were selected with oversampling in rural communities, and children age 1 were recruited from each community using simple random sampling. Surveys of families and measurements of children were collected at child ages 1, 5, and 8. Our specified outcome measure was childhood ow/ob at age 8, defined by the World Health Organization's thresholds for body-mass-index (BMI) for age Z-scores. Associations between early and concurrent socio-behavioral factors, childhood nutrition and physical activity variables were analyzed using STATA 15. Bivariate and multivariable analyses were completed utilizing logistic regression models.
The prevalence of ow/ob increased from 1.1% in both sexes at age 1 to 7% in females and 13% in males at age 8. Bivariate analyses show greater likelihood of ow/ob at age 8 was significantly associated with early life sociodemographic factors (at age 1), male sex (OR = 2.2, 1.6-3.1), higher wealth (OR = 1.1-1.4), and urban residence (OR = 4.3, 3-6). In adjusted analyses, ow/ob at age 8 was associated with early nutrition practices at age 5, including frequent consumption of powdered milk (OR = 2.8, 1.6-4.6), honey/sugar (OR = 2.7, 1.8-4.1), prepared restaurant/fast foods (OR = 4.6, 2.6-8.2), and packaged sweets (OR = 3.4, 2.3-4.9). In addition, breastfeeding for 6 months or longer was protective against obesity at age 8 (OR = 0.3, 0.1-0.9).
We found that increased consumption of powdered milk, honey/sugar, packaged sweets, and prepared restaurants/fast foods are associated with childhood ow/ob. In contrast, breastfeeding for 6 months or longer was protective against childhood ow/ob. These findings suggest that public health programs and campaigns aimed to prevent childhood ow/ob in Vietnam should target early feeding practices.
在最近几十年里，越南经历了快速的经济增长，饮食结构从传统饮食向高加工、高热量的食品和饮料转变，儿童超重/肥胖（ow/ob）的患病率也在不断上升。本研究的目的是描述越南1至8岁儿童纵向样本中的ow/ob模式，以及与8岁时ow/ob相关的社会人口学和行为因素。
本研究是对2002年至2009年“年轻生命队列研究”中1961名具有地理代表性的越南儿童纵向队列进行的二次数据分析。选取了31个社区，其中农村社区进行了过度抽样，并通过简单随机抽样从每个社区招募了1岁的儿童。在儿童1岁、5岁和8岁时收集家庭调查和儿童测量数据。我们指定的结局指标是8岁时的儿童ow/ob，根据世界卫生组织年龄别体重指数（BMI）Z评分阈值来定义。使用STATA 15分析早期和同期社会行为因素、儿童营养和身体活动变量之间的关联。利用逻辑回归模型完成二元和多变量分析。
ow/ob的患病率从1岁时两性的1.1%上升到8岁时女性的7%和男性的13%。二元分析显示，8岁时ow/ob的可能性更大与早期社会人口学因素（1岁时）、男性性别（OR = 2.2，1.6 - 3.1）、较高的财富（OR = 1.1 - 1.4）和城市居住（OR = 4.3，3 - 6）显著相关。在调整分析中，8岁时的ow/ob与5岁时的早期营养习惯有关，包括经常食用奶粉（OR = 2.8，1.6 - 4.6）、蜂蜜/糖（OR = 2.7，1.8 - 4.1）、餐厅预制食品/快餐（OR = 4.6，2.6 - 8.2）和包装糖果（OR = 3.4，2.3 - 4.9）。此外，母乳喂养6个月或更长时间可预防8岁时的肥胖（OR = 0.3，0.1 - 0.9）。
我们发现，奶粉、蜂蜜/糖、包装糖果和餐厅预制食品/快餐的消费增加与儿童ow/ob有关。相比之下，母乳喂养6个月或更长时间可预防儿童ow/ob。这些发现表明，越南旨在预防儿童ow/ob的公共卫生项目和运动应针对早期喂养习惯。
