NUTRISS (Nutrition, Health, and Society) Research Center, Institute on Nutrition and Functional Foods, Laval University, Québec City, Québec, Canada; Faculty of Pharmacy, Laval University, Québec City, Québec, Canada.
Maison de Santé Prévention-Approche 180 de Montréal, Québec, Canada.
J Nutr. 2023 May;153(5):1323-1329. doi: 10.1016/j.tjnut.2023.03.022. Epub 2023 Mar 23.
Multicomponent lifestyle interventions are fundamental in pediatric obesity management. However, whether household food insecurity influences the efficacy of such interventions remains undocumented.
The objective was to compare changes in BMI z-score (BMIz) among children whose family received lifestyle counseling at a pediatric obesity management clinic in Montréal (Canada) according to their household food security status.
This is a retrospective, longitudinal analysis of medical records of children (2-17 y) with overweight or obesity who received lifestyle counseling at a pediatric obesity management clinic. The number of visits at the clinic and the duration of the follow-up were individualized. Household food security status was assessed using the Health Canada's Household Food Security Survey Module at the first visit at the clinic. BMIz was calculated and updated at each visit. A reduction of ≥0.25 in BMIz between the last and the first visit at the clinic was considered clinically meaningful. Statistical significance was considered at P < 0.05.
Among the 214 children included in the study, 83 (38.8%) lived in a food insecure household. In multivariable-adjusted analyses, differences in BMIz between the last and the first appointment tended to be smaller among children who lived in a food insecure household than those in children living in a food secure household [ΔBMIz = -0.432 (95% CI: -0.672, -0.193) compared with ΔBMIz = -0.556 (95% CI: -0.792, -0.319; P = 0.14)]. Differences were most notable in the first 6 mo of follow-up. The OR of achieving a clinically significant reduction in BMIz over follow-up associated with household food insecurity, compared with household food security, was 0.57 (95% CI: 0.31, 1.05; P = 0.07).
In this sample of children followed up at a pediatric obesity clinic, those who lived in a food insecure household experienced smaller BMIz reductions than those who lived in a food secure household.
多组分生活方式干预措施是儿童肥胖管理的基础。然而，家庭食物不安全是否会影响此类干预措施的效果仍未被记录。
本研究旨在比较在蒙特利尔（加拿大）一家儿科肥胖管理诊所接受生活方式咨询的儿童中，根据家庭食物保障状况，其 BMIz 变化情况。
这是一项对在儿科肥胖管理诊所接受生活方式咨询的超重或肥胖儿童的病历进行的回顾性、纵向分析。就诊次数和随访时间由个体决定。在诊所首次就诊时，使用加拿大卫生部家庭食物安全调查模块评估家庭食物安全状况。计算并更新 BMIz，在每次就诊时更新。就诊最后一次和第一次之间 BMIz 下降≥0.25 被认为具有临床意义。统计学显著性定义为 P<0.05。
在 214 名纳入研究的儿童中，83 名（38.8%）生活在食物不安全的家庭中。在多变量调整分析中，与生活在食物安全家庭的儿童相比，生活在食物不安全家庭的儿童 BMIz 的变化趋势更小[ΔBMIz=-0.432（95%CI：-0.672，-0.193）与ΔBMIz=-0.556（95%CI：-0.792，-0.319；P=0.14）]。在随访的前 6 个月，差异最为显著。与家庭食物安全相比，家庭食物不安全与随访期间 BMIz 显著降低的 OR 为 0.57（95%CI：0.31，1.05；P=0.07）。
在本研究中，与生活在食物安全家庭的儿童相比，在儿科肥胖诊所接受随访的儿童中，生活在食物不安全家庭的儿童 BMIz 降低幅度较小。
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