Epstein Leonard H, Carr Katelyn A, Guth Catherine, Shapiro Lilianna, Leone Lucia A, Temple Jennifer L
Department of Pediatrics, University at Buffalo, Jacobs School of Medicine and Biomedical Sciences, USA.
Department of Community Health and Health Behaviors, University at Buffalo, School of Public Health and Health Sciences, USA.
Prev Med Rep. 2021 Jun 4;23:101440. doi: 10.1016/j.pmedr.2021.101440. eCollection 2021 Sep.
Longitudinal research suggests that living in a cognitively enriched home environment, in which access to activities including hobbies and books are plentiful, can prevent excess weight gain and obesity in children. In order for the enriched home environment to influence weight it should influence energy and macronutrient intake and/or energy expenditure. To test this hypothesis, we used a cross sectional design to study aspects of the child's enriched home environment along with energy and macronutrient intake. A sample of 158 6-9-year-old children measured between February 2017 - April 2019 in Buffalo, NY were selected from a larger study based on criteria for accurate reporting of energy intake using the Block Kid's Food Frequency Questionnaire. Results showed that the Home Observation for Measurement of the Environment (HOME) subscales enriched environment, parental warmth and an integrated family structure were negatively related to child percent overBMI. Hierarchical regression showed that each of these factors improved variance in child percent overBMI accounted for beyond dietary intake or macronutrients, specifically accounting for a total of 18.2% variance in models controlling for total energy intake. These results provide the first demonstration that characteristics of a child's home environment are associated with lower energy intake and independently associated with percent overBMI beyond knowledge of diet. Enriching a child's home environment by providing alternative activities to eating, improving parental warmth and providing opportunities for parents to interact positively with their children may be novel ways to reduce childhood obesity that should be experimentally tested in future research.
纵向研究表明，生活在认知丰富的家庭环境中，即有大量机会参与包括爱好和阅读书籍在内的活动，可以预防儿童体重过度增加和肥胖。为了使丰富的家庭环境对体重产生影响，它应该影响能量和常量营养素的摄入及/或能量消耗。为了验证这一假设，我们采用横断面设计来研究儿童丰富的家庭环境以及能量和常量营养素摄入的各个方面。从2017年2月至2019年4月在纽约州布法罗市测量的158名6至9岁儿童样本中，根据使用布洛克儿童食物频率问卷准确报告能量摄入的标准，从一项更大的研究中选取。结果显示，家庭环境测量（HOME）量表中的丰富环境、父母温暖和完整的家庭结构与儿童超重百分比呈负相关。分层回归表明，这些因素中的每一个都能改善儿童超重百分比的方差，超出饮食摄入或常量营养素的影响，具体而言，在控制总能量摄入的模型中总共占18.2%的方差。这些结果首次证明，儿童家庭环境的特征与较低的能量摄入相关，并且在饮食知识之外独立地与超重百分比相关。通过提供除饮食之外的其他活动、改善父母温暖程度以及为父母提供与孩子积极互动的机会来丰富儿童的家庭环境，可能是减少儿童肥胖的新方法，应在未来研究中进行实验验证。
