与围产期危险因素相比，父母 BMI 和国民总收入分类是青少年前前瞻性 BMI 恶化的更强决定因素：Feel4Diabetes 研究。
Parental BMI and country classification by Gross National Income are stronger determinants of prospective BMI deterioration compared to perinatal risk factors at pre-adolescence: Feel4Diabetes Study.
机构信息
Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece; Institute of Agri-food and Life Sciences, Hellenic Mediterranean University Research Centre, Heraklion, Greece.
Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece; Department of Dietetics, Nutrition and Sport, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia.
出版信息
Nutrition. 2023 Oct;114:112128. doi: 10.1016/j.nut.2023.112128. Epub 2023 Jun 8.
OBJECTIVES
This study aimed to evaluate all known risk factors, from perinatal to adolescence and identify those predominantly related with prospective BMI deterioration.
METHODS
Prospective data analysis from the European Feel4Diabetes-study involving 12,211 children from six countries. Details on perinatal and sociodemographic characteristics were collected by parental self-reported questionnaires. Children's anthropometric data were measured by research personnel. Associations between risk factors and children's BMI deterioration (i.e increase) from baseline (mean age 8.2 ± 0.98 years) to the 2-year follow-up (10.3 ± 1.0 years) were explored by applying logistic regression analyses.
RESULTS
Univariate analysis revealed that all known risk factors for early overweight/obesity development, remained dominant in prospective BMI deterioration. When multivariate analysis was applied including additional variables such as parents' current BMI status, family socio-demographic characteristics and country economic classification based on Gross National Income, most perinatal risk factors were no longer significant. Multivariate analysis revealed that pre-pregnancy maternal overweight/obesity (OR, 95%CI: 2.71, 1.67-4.38), early introduction of solid foods (2.54, 1.21-5.31), parental current BMI status (3.53, 2.17-5.72) and country economic classification (low income: 4.67, 2.20-9.93; under austerity measures: 6.78, 3.18-14.48) were the only parameters associated with higher odds for children's BMI deterioration from the study baseline to 2-year follow-up after adjusting for children's gender.
CONCLUSIONS
The most predominant risk factors influencing children's prospective BMI deterioration were parental BMI and country economic classification as compared to perinatal. These findings should guide public health initiatives aiming to tackle the childhood obesity epidemic and social inequalities on a European level.
目的
本研究旨在评估所有已知的风险因素，包括围产期到青春期，并确定与前瞻性 BMI 恶化主要相关的因素。
方法
本研究是对欧洲 Feel4Diabetes 研究的前瞻性数据分析，该研究纳入了来自六个国家的 12211 名儿童。通过父母的自我报告问卷收集围产期和社会人口统计学特征的详细信息。研究人员测量了儿童的人体测量数据。通过应用逻辑回归分析，探讨了从基线（平均年龄 8.2±0.98 岁）到 2 年随访（10.3±1.0 岁）期间，风险因素与儿童 BMI 恶化（即增加）之间的关联。
结果
单因素分析显示，所有与早期超重/肥胖发展相关的已知风险因素在前瞻性 BMI 恶化中仍然占主导地位。当应用多元分析包括其他变量，如父母当前的 BMI 状况、家庭社会人口统计学特征和基于国民总收入的国家经济分类时，大多数围产期风险因素不再显著。多元分析显示，孕前母亲超重/肥胖（OR，95%CI：2.71，1.67-4.38）、早期引入固体食物（2.54，1.21-5.31）、父母当前的 BMI 状况（3.53，2.17-5.72）和国家经济分类（低收入：4.67，2.20-9.93；实行紧缩措施：6.78，3.18-14.48）是调整儿童性别后与儿童 BMI 从研究基线到 2 年随访期间恶化的几率更高相关的唯一参数。
结论
影响儿童前瞻性 BMI 恶化的最重要风险因素是父母的 BMI 和国家经济分类，而不是围产期因素。这些发现应指导旨在解决欧洲儿童肥胖流行和社会不平等问题的公共卫生倡议。
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