Division of Children's Health Services Research, Indiana University School of Medicine, Indianapolis, Indiana, USA.
Indiana University School of Medicine, Indianapolis, Indiana, USA.
Pediatr Obes. 2024 Oct;19(10):e13151. doi: 10.1111/ijpo.13151. Epub 2024 Aug 2.
Childhood obesity is a growing worldwide epidemic that requires a biopsychosocial treatment approach to achieve a healthy lifestyle. This study on children in a weight management program examines the relationship between obesity, disease complications, and social determinants of health. We expect that children with higher degrees of obesity are more likely to live in areas lacking access to healthy food and have similar behavioural and socioeconomic characteristics.
Program participants were identified by neighbourhood food access status based on their home address. The prevalence of comorbidities in the participants was analyzed according to neighbourhood food accessibility. Multivariate regressions evaluated the association between participants' health outcomes and their sociodemographic and geographical characteristics.
A total of 283 (98.3%) participants had a BMI ≥95th percentile for their age and sex and 68 (23.6%) lived in neighbourhoods with limited food access. Almost a third (Adj. R = 0.3302; p < 0.01) of the variability in study population's BMI was driven by sociodemographic factors, self-reported eating and physical activity behaviours, and had a positive relationship with access to healthy food. Nonetheless, HbA1c had a negative relationship with access to healthy food given the limited variation in the sample of participants with HbA1c levels indicating diabetes.
Children living in neighbourhoods with limited food access had higher BMIs than other program participants. Thus, it is critical to identify children with limited neighbourhood food accessibility and promote societal and legislative change to improve access to healthy food.
儿童肥胖是一种在全球范围内日益严重的流行疾病,需要采取生物心理社会治疗方法来实现健康的生活方式。本项针对参加体重管理项目的儿童的研究考察了肥胖、疾病并发症和健康的社会决定因素之间的关系。我们预计肥胖程度较高的儿童更有可能居住在缺乏健康食品的地区,并且具有相似的行为和社会经济特征。
根据家庭住址确定参加者所处的邻里食物获取状况,以此来识别方案参与者。根据邻里食物获取情况分析参与者的合并症患病率。采用多元回归评估参与者的健康结果与其社会人口统计学和地理位置特征之间的关联。
共有 283 名(98.3%)参与者的 BMI 超过其年龄和性别的第 95 百分位数,68 名(23.6%)参与者居住在食物获取有限的社区。研究人群 BMI 的近三分之一(调整后的 R=0.3302;p<0.01)可由社会人口统计学因素、自我报告的饮食和身体活动行为驱动,与获取健康食品呈正相关。尽管如此,鉴于研究参与者中糖化血红蛋白(HbA1c)水平的样本变化有限,HbA1c 与获取健康食品呈负相关,表明糖尿病的存在。
居住在食物获取有限的社区的儿童的 BMI 高于其他方案参与者。因此,识别出获取有限邻里食物的儿童并促进社会和立法变革以改善健康食品的获取至关重要。