Deakin University, Institute for Health Transformation, Global Centre for Preventive Health and Nutrition, Geelong, Victoria, Australia.
Deakin University, Faculty of Health Biostatistics Unit, Geelong, Victoria, Australia.
Child Obes. 2024 Sep;20(6):403-415. doi: 10.1089/chi.2023.0054. Epub 2023 Nov 16.
Socioeconomic status is inversely associated with weight status in developed countries. Underlying mechanisms are still to be clarified. Our aim was to determine if weight-related behaviors and health-related quality of life (HRQoL) mediate the relationship between socio-educational advantage and weight status in Australian children 9 to 13 years of age. Secondary analysis of data collected by two cluster randomized trials (2019 wave). We measured children's ( = 3978) height, weight, diet, physical activity, sedentary behavior, and HRQoL. Socio-.educational advantage was assessed at school level using the Index of Community Socio-Educational Advantage (ICSEA). A counterfactual framework was used to explore potential mediators in the relationship between socio-educational disadvantage and (1) overweight/obesity and (2) BMI z-score (BMIz). Low socio-educational advantage was associated with increased overweight/obesity and BMIz. The overweight/obesity association was mediated by sedentary behavior (natural indirect effect as a proportion of total, 7.5%) sugar-sweetened beverage (SSB) consumption (12.7%), physical functioning (11.9%), psychosocial health (10.9%), school (6.8%) and social functioning (15.6%), and total HRQoL score (13.8%). The ICSEA-BMIz relationship was mediated by sedentary behavior (5.7%), sleep duration (4.1%), SSB (10.6%), physical functioning (9.9%), psychosocial health (9.1%), school (5.5%) and social (13.7%) functioning, and total HRQoL score (11.7%). Victorian Children with low socio-educational advantage were more likely to be living with overweight or obesity. This relationship was mediated by children's sedentary behavior, SSB consumption, and HRQoL. Trial Registration: Australian New Zealand Clinical Trials Registry (ANZCTR): ACTRN12616000980437 (registered July 26, 2016, retrospectively registered) and ACTRN12618001986268 (registered December 11, 2018, prospectively registered). https://www.anzctr.org.au/Trial/Registration.
在发达国家，社会经济地位与体重状况呈负相关。但其潜在机制仍需阐明。我们的目的是确定在澳大利亚 9 至 13 岁的儿童中，与体重相关的行为和健康相关的生活质量（HRQoL）是否会调节社会教育优势与体重状况之间的关系。这是对两项整群随机试验（2019 波）收集的数据进行的二次分析。我们测量了儿童的（ = 3978）身高、体重、饮食、体力活动、久坐行为和 HRQoL。社会教育优势在学校层面上使用社区社会教育优势指数（ICSEA）进行评估。采用反事实框架探讨社会教育劣势与（1）超重/肥胖和（2）BMIz 之间关系的潜在中介因素。社会教育劣势与超重/肥胖和 BMIz 呈正相关。超重/肥胖的相关性是由久坐行为（自然间接效应占总效应的比例为 7.5%）、含糖饮料（SSB）的消费（12.7%）、身体机能（11.9%）、心理社会健康（10.9%）、学校（6.8%）和社会功能（15.6%）以及总 HRQoL 评分（13.8%）介导的。ICSEA-BMIz 关系由久坐行为（5.7%）、睡眠时间（4.1%）、SSB（10.6%）、身体机能（9.9%）、心理社会健康（9.1%）、学校（5.5%）和社会（13.7%）功能以及总 HRQoL 评分（11.7%）介导。维多利亚州社会教育劣势较低的儿童更有可能超重或肥胖。这种关系是由儿童的久坐行为、SSB 消费和 HRQoL 介导的。试验注册：澳大利亚和新西兰临床试验注册中心（ANZCTR）：ACTRN12616000980437（2016 年 7 月 26 日注册，回顾性注册）和 ACTRN12618001986268（2018 年 12 月 11 日注册，前瞻性注册）。https://www.anzctr.org.au/Trial/Registration。
