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采用结构方程模型探讨阿根廷儿童肥胖相关因素。

Exploring factors associated with obesity in Argentinian children using structural equation modeling.

机构信息

Instituto de Desarrollo e Investigaciones Pediátricas, Buenos Aires, Argentina.

Centro de Matemática La Plata, Facultad de Ciencias Exactas, La Plata, Argentina.

出版信息

Cad Saude Publica. 2023 Aug 11;39(7):e00087822. doi: 10.1590/0102-311XEN087822. eCollection 2023.

Abstract

Habits and behaviors related to obesity risk are strongly associated with the family environment and are affected by socioeconomic factors. Structural equation modeling (SEM) allows us to hypothesize on how the relationships between these factors occur and measure their impact. This study aimed to explore the relationship between family socioeconomic indicators and childhood obesity, mediated by habits linked to energy balance, applying a SEM. A cross sectional study was performed on 861 Argentinian schoolchildren aged 6-12 years, from 2015 to 2016. The model included three latent variables: socioeconomic status, healthy habits, and obesity. Socioeconomic status indicators and healthy habits were surveyed by self-administered parental questionnaires, whereas obesity indicators were evaluated with anthropometry. The applied model showed an acceptable fit (NFI = 0.966; CFI = 0.979; RMSEA = 0.048). Socioeconomic status positively influenced parental education, health insurance, and car possession, while negatively influenced crowding (p < 0.001). Healthy habits significantly influenced physical activity, meals frequency, and sleep hours, while negatively influenced sedentary hours and mother's nutritional status (p < 0.001). Obesity factor positively influenced body mass index, body fat, and waist-to-height ratio (p < 0.001). Finally, socioeconomic status positively influenced health habits, which in turn negatively influenced obesity factor. Healthy habits (especially physical activity and mother's nutritional status) mediated the relationship between socioeconomic status and child obesity. Further research should include other indicators related to diet, eating habits, and physical activity like neighborhood characteristics.

摘要

与肥胖风险相关的习惯和行为与家庭环境密切相关,并受社会经济因素影响。结构方程模型(SEM)允许我们假设这些因素之间的关系如何发生,并衡量其影响。本研究旨在通过 SEM 探讨家庭社会经济指标与儿童肥胖之间的关系,中介变量为与能量平衡相关的习惯。这是一项 2015 年至 2016 年期间针对 861 名年龄在 6-12 岁的阿根廷学童进行的横断面研究。该模型包括三个潜在变量:社会经济地位、健康习惯和肥胖。社会经济地位指标和健康习惯通过家长自我管理问卷进行调查,而肥胖指标则通过人体测量学进行评估。所应用的模型显示出可接受的拟合度(NFI = 0.966;CFI = 0.979;RMSEA = 0.048)。社会经济地位对父母教育、健康保险和汽车拥有量有积极影响,而对拥挤程度有负面影响(p < 0.001)。健康习惯对身体活动、用餐频率和睡眠时间有显著影响,而对久坐时间和母亲营养状况有负面影响(p < 0.001)。肥胖因素对体重指数、体脂肪和腰高比有积极影响(p < 0.001)。最后,社会经济地位对健康习惯有积极影响,而健康习惯反过来又对肥胖因素有负面影响。健康习惯(尤其是身体活动和母亲的营养状况)介导了社会经济地位与儿童肥胖之间的关系。进一步的研究应包括与饮食、饮食习惯和身体活动相关的其他指标,如邻里特征。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8742/10494703/2ee2a3f2aef5/1678-4464-csp-39-07-EN087822-gf1.jpg

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