Department of Maternal and Child Health, School of Public Health, Peking University, Beijing 100191, China.
National Health Commission Key Laboratory of Reproductive Health, Peking University, Beijing 100191, China.
Nutrients. 2022 Aug 10;14(16):3272. doi: 10.3390/nu14163272.
Some studies have found associations between dietary quality and obesity and their concurrent changes were observed in a few interventions. The present study aimed to assess the effect of a multifaceted intervention for childhood obesity on dietary quality and examine the mediating effect of dietary quality between the intervention and changes in adiposity indicators. Based on the social ecological model, the cluster randomized controlled trial included five components (three targeted children and two targeted their environment). In total, 1176 children from three cities in China participated in a baseline (2018) and end-of-trial (2019) examination, including 605 children in the intervention group and 571 in the control group. Self-reported behavior and anthropometric measures were collected at both time points. The Diet Balance Index Revision (DBI-07) was calculated to assess dietary quality. Generalized linear mixed models were used to estimate the intervention effect on dietary quality and its mediating effects were examined. Compared to the controls, the proportion of sugar-sweetened beverage (SSB) intake (OR = 0.27, p < 0.001, corrected p < 0.001) decreased in the intervention group. Higher bound scores (HBS) of the DBI-07 indicating over-intake decreased in the intervention group compared to the controls (mean difference = −1.52, p = 0.005, corrected p = 0.015). Changes in the HBS partially mediated the associations between the intervention and changes in body mass index, waist circumference, and body fat percentage. Future intervention should promote knowledge, attitudes, and behaviors related to dietary quality.
一些研究发现饮食质量与肥胖之间存在关联，并且在一些干预措施中观察到了它们的同时变化。本研究旨在评估针对儿童肥胖的多方面干预对饮食质量的影响，并检验饮食质量在干预与肥胖指标变化之间的中介作用。本研究基于社会生态学模型，采用了包括三个针对儿童和两个针对环境的部分的集群随机对照试验。共有来自中国三个城市的 1176 名儿童参加了基线（2018 年）和试验结束（2019 年）检查，其中干预组 605 名，对照组 571 名。在两个时间点都收集了自我报告的行为和人体测量学指标。通过计算饮食平衡指数修订版（DBI-07）来评估饮食质量。使用广义线性混合模型来估计干预对饮食质量的影响，并检验其中介作用。与对照组相比，干预组含糖饮料（SSB）摄入量的比例降低（OR=0.27，p<0.001，校正后 p<0.001）。与对照组相比，干预组 DBI-07 的高边界得分（HBS）表示过度摄入的情况减少（平均差异=-1.52，p=0.005，校正后 p=0.015）。HBS 的变化部分介导了干预与体重指数、腰围和体脂百分比变化之间的关联。未来的干预措施应促进与饮食质量相关的知识、态度和行为。
