Department of Social and Preventive Medicine, École de Santé Publique, Université de Montréal, Montréal, Canada.
CHU Sainte-Justine Research Centre, Montreal, Canada.
Child Obes. 2024 Jul;20(5):336-345. doi: 10.1089/chi.2023.0062. Epub 2023 Dec 13.
The aim of this study was to examine associations of childhood physical activity, sedentary behavior, and dietary intake with adiposity trajectories from childhood to adolescence. Quebec Adipose and Lifestyle Investigation in Youth (QUALITY) cohort ( = 630) data from 3 time points (8-10, 10-12, and 15-17 years) for 377 Caucasian children with parental obesity were analyzed. Height and weight, physical activity and sedentary behavior (7-day accelerometry), screen time (self-reported), and dietary intake (three 24-hour diet recalls) were measured. Group-based trajectory modeling identified longitudinal trajectories of body-mass index z-scores (zBMIs). Inverse probability of exposure-weighted multinomial logistic regressions examined associations between baseline lifestyles and zBMI trajectory groups. Six trajectory groups were identified: Stable-Low-Normal-Weight (two groups, 5.7% and 33.0%, which were combined), Stable-High-Normal-Weight (24.8%), Stable-Overweight (19.8%), Stable-Obesity (8.8%), and Overweight-Decreasers (7.9%). For every additional portion of fruits and vegetables, the likelihood of being in the group of Overweight-Decreasers increased by 29% (odds ratio [OR]: 1.29, 95% confidence interval [CI]: 1.09-1.55) compared with the reference group (Stable-Low-Normal-Weight). For every additional hour of sedentary behavior, the likelihood of belonging to the group of Overweight-Decreasers increased 2-fold (OR: 1.99, 95% CI: 1.28-3.21) and Stable-Obesity increased 1.5-fold (OR: 1.56, 95% CI: 1.08-2.23), compared with the reference. Every additional 10 minutes of moderate-to-vigorous physical activity was associated with a lower likelihood of belonging to the Stable-Obesity group (OR: 0.75, 95% CI: 0.61-0.89) and to the group of Overweight-Decreasers (OR: 0.79, 95% CI: 0.64-0.95) compared with the reference. Finally, children were more likely to belong to the Stable-Obesity group with each additional hour/day of screen time (OR: 1.23, 95% CI: 1.01-1.58). Trajectories of zBMIs from childhood to late adolescence were stable, except for one group which decreased from overweight in childhood to normal weight in adolescence. The latter had more favorable baseline dietary intake of fruits and vegetables. ClinicalTrials.org no. NCT03356262.
本研究旨在探讨儿童期体力活动、久坐行为和饮食摄入与儿童期至青春期肥胖轨迹的相关性。对来自魁北克青少年脂肪与生活方式调查(QUALITY)队列(n=630)的 377 名父母肥胖的白种人儿童的 3 个时间点(8-10、10-12 和 15-17 岁)的数据进行了分析。测量了身高和体重、体力活动和久坐行为(7 天加速计)、屏幕时间(自我报告)和饮食摄入(3 次 24 小时饮食回忆)。基于群组的轨迹建模确定了身体质量指数 z 分数(zBMI)的纵向轨迹。逆概率暴露加权多项逻辑回归检验了基线生活方式与 zBMI 轨迹组之间的关联。确定了 6 个轨迹组:稳定低正常体重(两组,5.7%和 33.0%,合并为一组)、稳定高正常体重(24.8%)、稳定超重(19.8%)、稳定肥胖(8.8%)和超重减少者(7.9%)。与参考组(稳定低正常体重)相比,每多吃一份水果和蔬菜,成为超重减少者的可能性就会增加 29%(比值比 [OR]:1.29,95%置信区间 [CI]:1.09-1.55)。与参考组相比,每增加 1 小时久坐行为,属于超重减少者的可能性增加 2 倍(OR:1.99,95%CI:1.28-3.21),属于稳定肥胖者的可能性增加 1.5 倍(OR:1.56,95%CI:1.08-2.23)。与参考组相比,每增加 10 分钟中等到剧烈的体力活动与较低的稳定肥胖组(OR:0.75,95%CI:0.61-0.89)和超重减少者(OR:0.79,95%CI:0.64-0.95)归属可能性相关。最后,与参考组相比,每天每增加 1 小时/天的屏幕时间,儿童更有可能属于稳定肥胖组(OR:1.23,95%CI:1.01-1.58)。从儿童期到青春期晚期,zBMI 的轨迹是稳定的,除了一个从儿童期超重到青春期正常体重的轨迹有所下降。后者的水果和蔬菜基础饮食摄入更有利。ClinicalTrials.org 编号:NCT03356262。