经济增长是南非儿童肥胖症的潜在系统性驱动因素之一：10 年来的 Joinpoint 回归和生态分析。

Economic growth as an underlying probable systemic driver for childhood obesity in South Africa: A Joinpoint regression and ecological analysis over 10 years.

机构信息

MRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics and Child Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; Department of Human Nutrition and Dietetics, Faculty of Health Sciences, University of Pretoria, South Africa; Right to Care, Centurion, South Africa.

出版信息

S Afr Med J. 2021 Mar 2;111(3):220-226. doi: 10.7196/SAMJ.2021.v111i3.14669.

DOI:10.7196/SAMJ.2021.v111i3.14669

PMID:33944743

Abstract

BACKGROUND

Childhood obesity has become a global public health problem and is a known risk factor for type 2 diabetes, cardiovascular disease, hypertension, stroke, myocardial infarction and various cancers in later adulthood.Associations between adult obesity and economic growth, technological changes, socioeconomic status and economic inequities have been reported, but limited data are available for children and adolescents in countries that are undergoing an epidemiological health transition exhibiting both under- and overnutrition.

OBJECTIVES

To demonstrate childhood obesity trends and explore their associations with economic growth in South Africa (SA).

METHODS

This was a retrospective review and analysis of obesity and economic growth trends in SA. Data for obesity levels were obtained from national surveys conducted in SA youths in 2002, 2008 and 2012. Economic growth indicators (EGIs), namely gross domestic product (GDP) per capita, household final consumption expenditure and Gini coefficient, were obtained from the World Bank and IHS Global Insight databases. Obesity trends for 2002 - 2012 are presented by gender and ethnicity. Annual percentage changes (APCs) in obesity prevalence were computed to assess obesity trends using the linear Joinpoint regression.

RESULTS

An overall increase in obesity prevalence over time from 3.8% to 6.0% was observed. Females had higher levels across all time points. APCs in both males (7.8%; 95% confidence interval (CI) 0.3 - 15.9; p=0.01) and females (3.1%; 95% CI -14.7 - 24.7; p=0.30) were observed. Among black Africans, coloureds and whites, females had higher obesity levels than males for the three time points. For males, the prevalence of obesity was highest in whites and Asians/Indians, whereas coloureds and blacks had lower levels across all time points. However, the black male population had the highest APC increase (9.4%; 95% CI -23.0 - 55.3; p=0.20). The prevalence of obesity was positively and inversely associated with GDP per capita and the Gini coefficient, respectively.

CONCLUSIONS

An increase in childhood and adolescent obesity over time was observed, while trend associations between obesity and EGIs exist.

摘要

背景

儿童肥胖已成为全球性公共卫生问题，也是成年后患 2 型糖尿病、心血管疾病、高血压、中风、心肌梗死和各种癌症的已知风险因素。有研究报告称，成人肥胖与经济增长、技术变革、社会经济地位和经济不平等之间存在关联，但在经历营养不足和营养过剩双重转变的国家中，有关儿童和青少年肥胖的数据有限。

目的

展示南非儿童肥胖趋势，并探讨其与经济增长的关系。

方法

这是一项对南非儿童肥胖趋势及其与经济增长关系的回顾性研究和分析。肥胖水平数据来自南非 2002 年、2008 年和 2012 年进行的全国青少年调查。经济增长指标（EGI），即人均国内生产总值（GDP）、家庭最终消费支出和基尼系数，取自世界银行和 IHS 环球透视数据库。2002-2012 年期间，按性别和族裔展示肥胖趋势。使用线性 Joinpoint 回归计算肥胖流行率的年百分比变化（APC），以评估肥胖趋势。

结果

研究发现，肥胖流行率总体呈上升趋势，从 3.8%增加到 6.0%。所有时间点女性的肥胖水平均较高。男性的 APC 为 7.8%（95%置信区间（CI）0.3-15.9；p=0.01），女性的 APC 为 3.1%（95%CI-14.7-24.7；p=0.30）。在黑非洲人、有色人和白人中，女性在三个时间点的肥胖水平均高于男性。对于男性，肥胖流行率在白人以及亚洲/印度人中最高，而有色人和黑人在所有时间点的肥胖率均较低。然而，黑人男性的肥胖率增幅最高（9.4%；95%CI-23.0-55.3；p=0.20）。肥胖与人均 GDP 和基尼系数呈正相关和负相关。