实用多场景生活方式干预对儿童期至青年期主要 BMI 轨迹的影响：一项基于社区的试验。
Effectiveness of a practical multi-setting lifestyle intervention on the main BMI trajectories from childhood to young adulthood: A community-based trial.
机构信息
Research Center for Social Determinants of Health, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Department of Epidemiology and Biostatistics, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
出版信息
BMC Public Health. 2022 Oct 31;22(1):1995. doi: 10.1186/s12889-022-14306-2.
BACKGROUND
Preventing overweight in childhood and subsequent stages of life is still a global challenge. Despite numerous relevant lifestyle interventions, data on their impact on different BMI change pathways over time is rare. The present study aimed to investigate the effect of a multi-setting lifestyle intervention on BMI trajectories from childhood to young adulthood.
METHODS
A multi-setting lifestyle intervention at the school, family, and community levels have been conducted in the Tehran Lipid and Glucose Study framework. A total of 2145 children (4-18 years, 49% boys, and 18% intervention) were recruited for the baseline assessment and were followed through five follow-up examinations during a median of 16.1 years. Using a group-based trajectory model, BMI trajectories from childhood to young adulthood were identified, and their association with the implemented intervention was assessed.
RESULTS
Four trajectory groups of BMI from childhood to young adulthood were identified, including Normal weight (41%), Young adulthood overweight (36%), Early childhood increasing overweight and adulthood obesity (19%), and Early childhood increasing obesity (4%). Only Young adulthood overweight and Early childhood increasing obesity were affected by the intervention and were concomitant with lower BMI levels than the control group, with the highest estimated effect in the latter (β=-0.52 and p = 0.018; β=-1.48 and p < 0.001, respectively).
CONCLUSION
The current findings indicate the highest effectiveness of a practical, healthy lifestyle intervention on those whose obesity started in the early years of life or youth. Our results could help policymakers and planners design more targeted lifestyle modification and weight control interventions.
TRIAL REGISTRATION
This study is registered at Iran Registry for Clinical Trials, a WHO primary registry ( http://irct.ir ). The Iran Registry for Clinical Trials ID and date are IRCTID:IRCT138705301058N1, 29/10/2008.
背景
预防儿童期及以后各阶段超重仍然是一个全球性挑战。尽管有许多相关的生活方式干预措施，但关于这些措施对不同 BMI 变化途径的影响的数据却很少。本研究旨在调查多环境生活方式干预对儿童期至成年早期 BMI 轨迹的影响。
方法
在德黑兰血脂和血糖研究框架内，在学校、家庭和社区层面开展了多环境生活方式干预。共有 2145 名儿童（4-18 岁，49%为男孩，18%为干预组）参加了基线评估，并在中位数为 16.1 年的 5 次随访检查中进行了随访。使用基于群组的轨迹模型，确定了儿童期至成年早期的 BMI 轨迹，并评估了它们与实施干预的关联。
结果
从儿童期到成年早期，共确定了 4 种 BMI 轨迹组，包括正常体重（41%）、成年早期超重（36%）、儿童早期超重增加和成年肥胖（19%）和儿童早期肥胖增加（4%）。只有成年早期超重和儿童早期肥胖增加受到干预的影响，与对照组相比，BMI 水平较低，后者的估计效果最高（β=-0.52，p=0.018；β=-1.48，p<0.001）。
结论
目前的研究结果表明，对于那些肥胖始于生命早期或青年时期的人来说，实用、健康的生活方式干预效果最佳。我们的研究结果可以帮助政策制定者和规划者设计更有针对性的生活方式改变和体重控制干预措施。
试验注册
本研究在世界卫生组织初级注册机构伊朗临床试验注册中心（http://irct.ir）注册。伊朗临床试验注册中心 ID 和日期为 IRCTID：IRCT138705301058N1，2008 年 10 月 29 日。
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