West China School of Public Health, West China Fourth Hospital, Sichuan University, Chengdu, China.
Laboratory of Molecular Translational Medicine, Centre for Translational Medicine, Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Department of Paediatrics, West China Second University Hospital, Sichuan University, Chengdu, China.
J Glob Health. 2024 Nov 22;14:04215. doi: 10.7189/jogh.14.04215.
It is unclear whether the effects of dietary intake, parental education, and nutrition policy on childhood overweight and obesity is consistent between high-income (HICs) and low- and middle-income (LMICs) countries. The objective of this meta-analysis was to investigate the association of diet, parental education and nutrition policy with childhood overweight and obesity when the economic levels were controlled.
PubMed, Web of Science, Embase and Scopus were searched for observational studies published from January 1980 to October 2023 that examined the association of diet, parental education and nutrition policy with childhood overweight and obesity. Meta random effects model stratified by gross national income per capita was used to assess whether the associations were varied by economic levels.
From 18 191 identified studies, 154 met the inclusion criteria. Meta-analysis revealed that higher sugar-sweetened beverage intake was a risk factor for childhood overweight and obesity in both HICs and LMICs countries/regions, whereas higher intake of fruit and/or vegetable was a protective factor only in LMICs countries/regions (odds ratio (OR) = 0.77; 95% confidence interval (CI) = 0.69-0.85). Moreover, lower parental education level increased the risk (OR = 1.46; 95% CI = 1.32-1.61) and nutrition policy implementation decreased the risk (OR = 0.96; 95% CI = 0.91-0.99) of childhood overweight and obesity only in HICs.
Fruit and/or vegetable intake, parental education and nutritional policy exert different influences on childhood overweight and obesity in countries with varied economic levels. These findings will enhance the understanding of the complex interplay between these factors and their impact on childhood health.
目前尚不清楚饮食摄入、父母受教育程度和营养政策对儿童超重和肥胖的影响在高收入国家（HICs）和中低收入国家（LMICs）之间是否一致。本项荟萃分析的目的是在控制经济水平的情况下，研究饮食、父母教育和营养政策与儿童超重和肥胖之间的关联。
检索了从 1980 年 1 月至 2023 年 10 月发表的观察性研究，这些研究检查了饮食、父母教育和营养政策与儿童超重和肥胖之间的关系。使用基于人均国民总收入的元随机效应模型来评估这些关联是否因经济水平而不同。
从 18191 项确定的研究中，有 154 项符合纳入标准。荟萃分析显示，在 HICs 和 LMICs 国家/地区，较高的含糖饮料摄入量是儿童超重和肥胖的危险因素，而较高的水果和/或蔬菜摄入量是仅在 LMICs 国家/地区的保护因素（比值比（OR）=0.77；95%置信区间（CI）=0.69-0.85）。此外，较低的父母教育水平会增加风险（OR=1.46；95%CI=1.32-1.61），而营养政策的实施降低了风险（OR=0.96；95%CI=0.91-0.99），仅在 HICs 中如此。
在经济水平不同的国家，水果和/或蔬菜摄入、父母教育和营养政策对儿童超重和肥胖有不同的影响。这些发现将增强对这些因素之间复杂相互作用及其对儿童健康影响的理解。
