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儿童肥胖与必需微量营养素:来自印度全国综合营养调查(2016 - 2018年)的见解

Childhood Obesity and Essential Micronutrients: Insights from India's Comprehensive National Nutrition Survey (2016-18).

作者信息

Verma Madhur, Aditi Aditi, Kapoor Nitin, Sharma Priyanka, Kakkar Monica, Kakkar Rakesh, Kalra Sanjay

机构信息

Department of Community and Family Medicine, All India Institute of Medical Sciences Bathinda, Bathinda, Punjab, India.

International Institute for Population Sciences (IIPS), Mumbai, Maharashtra, 400088, India.

出版信息

Diabetes Ther. 2023 Aug;14(8):1267-1283. doi: 10.1007/s13300-023-01424-2. Epub 2023 Jun 1.

Abstract

INTRODUCTION

Based on the long-term impact of childhood obesity, there is a compelling need to assess the burden of obesity and micronutrient deficiency and the interactions between the two. Thus, the aims of the study were to estimate the prevalence of overweight and obese children and adolescents to compare micro-nutrient levels in these children with normal and underweight categories and explore the factors affecting overweight and obesity in the presence of micronutrient deficiencies.

METHODS

Secondary data analysis of the Comprehensive National Nutrition Survey-India (2017-2018) was done. The survey recorded information from 112,245 preschool children (6-60 months), school age children (5-9 years), and adolescents (10-19 years). Half of these participants were invited for biochemical testing and were included in our analysis. The presence of overweight or obesity and micronutrient (serum erythrocyte folate; vitamin B12, A, and D; ferritin; zinc; and urinary iodine) deficiencies were the primary outcomes. The secondary outcome included the mean serum levels and predictors of overweight and obesity in the presence of micronutrient deficiencies.

RESULTS

Of the 38,060, 38,355, and 35,830 preschool, school-age, and adolescent study participants, about 2.69, 4.18, and 4.99% were overweight or obese. We observed significant variations in the mean folate and vitamin B12 levels among the overweight and obese preschool and school-age children compared to the normal weight group. School-age children exhibited significant differences in all micronutrient levels. In contrast, adolescents only showed substantial differences in vitamin D and A and serum ferritin levels. The predictors of overweight and obesity included geographical locations, wealth quintiles, and societal castes. Iron, folate, vitamin D, and zinc levels significantly affect the odds of developing childhood overweight and obesity.

CONCLUSIONS

It is vital to halt the growing burden of childhood overweight and obesity. Addressing micronutrient deficiencies can help us bring a sustainable and feasible approach to managing this menace.

摘要

引言

鉴于儿童肥胖的长期影响,迫切需要评估肥胖和微量营养素缺乏的负担以及两者之间的相互作用。因此,本研究的目的是估计超重和肥胖儿童及青少年的患病率,比较这些儿童与正常体重和体重不足儿童的微量营养素水平,并探讨在存在微量营养素缺乏的情况下影响超重和肥胖的因素。

方法

对印度全国综合营养调查(2017 - 2018年)进行二次数据分析。该调查记录了112,245名学龄前儿童(6 - 60个月)、学龄儿童(5 - 9岁)和青少年(10 - 19岁)的信息。这些参与者中有一半被邀请进行生化检测并纳入我们的分析。超重或肥胖以及微量营养素(血清红细胞叶酸;维生素B12、A和D;铁蛋白;锌;以及尿碘)缺乏的存在是主要结果。次要结果包括在存在微量营养素缺乏的情况下超重和肥胖的平均血清水平及预测因素。

结果

在38,060名学龄前、38,355名学龄和35,830名青少年研究参与者中,约2.69%、4.18%和4.99%超重或肥胖。与正常体重组相比,我们观察到超重和肥胖的学龄前及学龄儿童的平均叶酸和维生素B12水平存在显著差异。学龄儿童在所有微量营养素水平上均表现出显著差异。相比之下,青少年仅在维生素D、A和血清铁蛋白水平上存在实质性差异。超重和肥胖的预测因素包括地理位置、财富五分位数和社会种姓。铁、叶酸、维生素D和锌水平显著影响儿童超重和肥胖的发生几率。

结论

遏制儿童超重和肥胖日益加重的负担至关重要。解决微量营养素缺乏问题有助于我们找到一种可持续且可行的方法来应对这一威胁。

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