兰州市城区学龄期儿童超重肥胖流行现状及影响因素分析

目的 了解兰州市城区学龄期儿童超重肥胖流行现状及影响因素，为预防和控制学龄期儿童超重肥胖提供理论依据。方法 采用多阶段整群随机抽样的方法，于2022年2—3月对兰州市城关区6所小学36个班级1 507名学龄期儿童进行超重、肥胖及影响因素调查并对数据进行分析。结果 兰州市城区学龄期儿童超重肥胖总检出率为28.53%，超重、肥胖检出率分别为13.93%和14.60%。多因素logistic回归分析显示，男性（OR=2.205,95%CI:1.716～2.834）、父亲超重肥胖（OR=1.787,95%CI:1.384～2.307）、母亲超重肥胖（OR=1.872,95%CI:1.385～2.530）、饭量中等1～<2碗饭/餐（OR=1.911,95%CI:1.316～2.774）或较大≥2碗饭/餐（OR=3.979,95%CI:1.984～7.981）、在外就餐≥2次/周（OR=1.529,95%CI:1.149～2.035）与学龄期儿童超重肥胖高风险有关，五六年级（OR=0.718,95%CI:0.531～0.972）、新鲜水果摄入≥1次/d(OR=0.676,95%CI:0.48...     

中国3～6岁儿童照料方式与超重肥胖关系

目的探究中国3~6岁儿童的家庭照料和正式照料(幼儿园/托儿所)与其超重肥胖的关系,为儿童肥胖的预防与干预策略设计提供科学依据。方法基于1991—2011年中国营养与健康调查数据,获得2 725名来自9省区、3个直辖市3~6岁儿童的相关信息,通过Z值法计算儿童体质指数得分(BMIZ),评估其超重肥胖现状,利用二元logistic回归方法分析不同照料方式对儿童超重肥胖的影响及导致儿童超重肥胖的影响路径。结果 3~6岁儿童总超重肥胖率为20.99%,其中家庭照料超重肥胖率(22.08%)明显高于正式照料(15.82%)。logistic回归分析结果显示,与家庭照料相比,正式照料可显著降低儿童超重肥胖的概率(OR=0.598,90%CI=0.465~0.770,P=0.001)。进一步分析发现,与家庭照料相比,正式照料大幅度提高了儿童参加体育活动的概率(OR=2.204,90%CI=1.715~2.833,P=0.000);但是正式照料使儿童脂肪摄入超过参考范围的概率略高于家庭照料(OR=1.242,90%CI=1.028~1.501,P=0.059)。结论正式照料可以降低儿童超重肥胖的概率,同时体育活动对预防和干预儿童超重肥胖具有重要作用。     

浙江省某市2002-2015年婴幼儿营养状况分析

目的 了解浙江省某市2002-2015年婴幼儿营养状况,分析有关影响因素。方法 利用该市电子医疗记录数据库,提取孕妇首次随访数据与婴幼儿体格检查数据。采用Z值评分对婴幼儿营养状况进行评价,应用Logistic回归探讨婴幼儿生长不良的影响因素。结果 在48 827名体检的婴幼儿中,低体重、生长迟缓、消瘦、超重、肥胖率分别为1.43%、1.31%、1.90%、2.62%、0.34%。不同性别间肥胖发生率的差别具有统计学意义（χ2=5.164,P=0.023）。婴幼儿超重、肥胖检出率呈逐年下降趋势,低体重率呈上升趋势。Logistic回归分析显示,母亲高文化程度是婴幼儿低体重、生长迟缓、消瘦的保护因素;孕前体重指数（body mass index,BMI）较高是婴幼儿超重（OR=1.063,95%CI:1.057~1.069,P<0.001）、肥胖（OR=1.074,95%CI:1.060~1.088,P<0.001）的危险因素;高危妊娠是婴幼儿低体重（OR=2.214,95%CI:1.928~2.542,P<0.001）、生长迟缓（OR=2.543,95%CI:2.193~2.949,P<0.001）、消瘦（OR=1.211,95%CI:1.062~1.380,P=0.004）的危险因素。结论 该地区婴幼儿生长发育情况总体良好,但仍面临营养不良与营养过剩的双重问题。母亲孕前BMI、文化程度及是否高危妊娠是儿童生长不良的影响因素。     

家庭喂养方式对青少年儿童肥胖的影响

目的分析家庭喂养方式对青少年儿童肥胖的影响。方法采用多级整群抽样方法抽取深圳市龙华新区青少年儿童进行研究,自行设计访谈内容对青少年儿童家长进行访谈调查,并采用标准喂养方式调查问卷调查儿童饮食行为习惯及父母的认知和养育行为情况。结果 5086名青少年儿童中肥胖人数365人(肥胖率为7.18%),其中男童肥胖人数为215人(肥胖率为8.29%),女童肥胖人数为150人(肥胖率为6.01%),不同性别的肥胖率比较,差异具有统计学意义(χ~2=9.921,P=0.002)。Logistic多因素分析结果显示进食速度快(OR=1.089,95%CI:1.043~1.138)、喜欢吃甜的食物(OR=2.461,95%CI:1.419~4.267)、喜欢吃西式快餐(OR=2.327,95%CI:1.284~4.216)与青少年儿童肥胖的发生呈显著正相关(P0.05);而喜欢吃蔬菜类食物(OR=0.628,95%CI:0.437~0.912)、父母对于孩子饮食量的干预(OR=0.298,95%CI:0.109~0.814)、父母对孩子饮食结构的控制(OR=0.387,95%CI:0.216~0.721)与青少年儿童肥胖的发生呈显著负相关(P0.05)。结论不良饮食习惯和不恰当的父母认知和养育行为对可引起青少年儿童肥胖。     

中国城市学龄儿童超重肥胖流行现状及危险因素分析

目的了解中国城市学龄儿童超重肥胖流行现状并分析其危险因素。方法于2013年12月-2014年6月,选取石家庄、上海、深圳、兰州、武汉5个城市共3896名小学生进行问卷调查。结果超重肥胖检出率为19.8%,其中超重率为10.6%,肥胖率为9.2%;超重肥胖分布存在年龄、性别、地区差异,男童超重肥胖率(22.8%)高于女童(16.5%)(P0.01)。校正地域和年龄后,多因素分析结果显示,儿童超重肥胖危险因素:体力活动不足(OR=4.179,95%CI=3.492~5.002)、男童(OR=1.218,95%CI 1.019~1.456)、不爱吃零食(OR=1.346,95%CI=1.047~1.731);而进食速度一般(OR=0.532,95%CI=0.335~0.845)或进食速度慢(OR=0.352,95%CI=0.211~0.586)、不爱吃肉类食物(OR=0.723,95%CI=0.549~0.952)、饮食结构为荤素搭配(OR=0.556,95%CI=0.324~0.965)有助于降低城市儿童超重肥胖发生率。结论以促进儿童体力活动水平、促进健康饮食习惯为目标的干预策略是预防和干预超重肥胖的重点和关键。     

学龄前儿童饮食行为与体质量指数相关性研究

目的探讨学龄前儿童饮食行为与体质量指数(BMI)的关联,为制定儿童早期肥胖的综合干预措施提供依据。方法 2016年5~6月,随机整群抽取武汉市4所一级一类公立日托幼儿园共1 113例儿童,并对其进行一般情况问卷调查和体格测量,利用《儿童饮食行为问卷》评估儿童饮食行为。结果本研究中儿童平均年龄为(4.80±0.97)岁,男女童BMI_Z值分别为(0.37±1.25)和(0.20±1.13),儿童合并超重肥胖率为23.81%。随儿童体质量状态的上升,"情绪性多食""享受食物""总要喝东西"和"对食物的反应"等食物趋向饮食行为得分呈上升趋势(P0.05),"挑食""对饱足感的反应"和"进食速度慢"等食物逃避饮食行为得分呈下降趋势(P0.05);多元线性回归校正混杂因素后,"享受食物"(β=0.22,95%CI:0.07~0.37,P0.05)对儿童BMI_Z仍呈正相关,而"对饱足感的反应"(β=-0.25,95%CI:-0.39~-0.11,P0.05)和"进食速度慢"(β=-0.12,95%CI:-0.22~-0.02,P0.05)对儿童BMI_Z呈负相关。结论学龄前儿童超重肥胖和BMI与饮食行为密切相关,及早培养儿童良好饮食行为习惯有助于预防和控制超重肥胖的发生,维持正常BMI。     

北京市学龄前儿童单纯性肥胖影响因素研究

目的分析影响学龄前儿童肥胖的主要因素,为采取干预措施提供理论依据。方法采用方便样本整群抽样方法,对北京市五所幼儿园中2~7岁儿童的家长共计400名进行问卷调查和访谈。定性访谈结果采用关键词提取,进行归纳分析。根据中国学龄前儿童生长发育标准[体质指数(body mass index,BMI)≥85%为超重或肥胖]判断是否超重或肥胖;将人口学特征,家庭因素及饮食和运动行为作为自变量进行多因素Logistic回归分析。结果儿童超重或肥胖的独立危险因素包括:儿童高出生体重(≥4 000g)(OR=31.55;95%CI:1.78~4.17,P0.001);母亲选择剖宫产(OR=4.89;95%CI:1.42~16.89,P=0.01);混合喂养(OR=25.90;95%CI:3.07~218.39,P0.001),人工喂养(OR=11.15;95%CI:1.686~73.7121,P=0.01)。保护因素包括:父亲的受教育程度高(OR=0.32;95%CI:0.12~0.89,P=0.03)、每天吃粗粮的次数多(OR=0.43;95%CI:0.21~0,87,P=0.02)、家人一起吃饭的次数多(OR=0.86;95%CI:0.75~0.98,P=0.02)。结论学龄前儿童肥胖的危险因素与父母受教育程度、对肥胖的认知及儿童的饮食运动行为有关。     

针对饮食行为的肥胖早期干预效果分析

【目的】对0~3岁婴幼儿针对饮食行为的肥胖早期干预的效果进行初步分析,为探索儿童肥胖症的有效早期干预方法提供依据。【方法】在沈阳、青岛、重庆、厦门每个城市随机选择干预社区和对照社区各4个,收集0~1岁儿童及其家长作为研究对象。采用WHO体质指数标准作为儿童超重的判定标准。干预组通过群体宣教与个体咨询相结合的方法对婴幼儿家长进行喂养和营养方面的健康教育,培养婴幼儿健康的饮食行为和生活方式,并针对超重儿进行饮食和生活习惯的调整。通过干预前后儿童的饮食行为、超重率等指标的变化判断干预效果。【结果】干预结束时干预组不健康食物的进食明显少于对照组。多元Logistic回归显示对超重影响最大的是干预前的状况(OR为2.445,95%CI为1.950~3.066),干预时间、4个月内纯母乳喂养、月龄均为保护因素[OR及其95%CI分别为0.835(0.776~0.900),0.744(0.590~0.938)和0.925(0.895~0.957)],而父母体质指数(body mass index,BMI)均增加儿童超重的风险(OR分别为1.045,95%CI为1.005~1.087和1.052,95%CI为1.011~1.094)。【结论】干预措施虽然尚未显示出对肥胖的作用,但可有效改善婴幼儿的饮食行为。     

广州市某社区2~6岁儿童超重肥胖与生命早期因素研究

分析2~6岁儿童超重肥胖与生命早期因素的关系,为预防学龄前儿童超重肥胖提供理论依据.方法 采用随机整群抽样方法,于2018年在广州市抽取1个社区的所有托幼园所922名儿童为研究对象.调查内容包括问卷调查和体格检查.采用Logistic回归分析学龄前儿童超重肥胖与生命早期因素的关系.结果 学龄前儿童超重肥胖检出率为13.4%,男童超重肥胖检出率(16.1%)高于女童(10.1%),差异有统计学意义(Z=2.69,P<0.05).学龄前儿童超重肥胖检出率在大于胎龄儿、剖宫产、出生后6月内人工喂养、母亲孕前体质量指数(BMI)超重或肥胖、母亲孕期体重增重过多组内较高(P值均<0.01).二项式Logistic回归分析显示,大于胎龄儿(OR=2.62,95%CI=1.42~4.82)、剖宫产(OR=1.59,95%CI=1.08~2.36)、出生后6月内人工喂养(OR=2.00,95%CI=1.19~3.37);母亲孕前超重或肥胖(OR=1.97,95%CI=1.08~3.58)和母亲孕期增重过多(OR=2.07,95%CI=1.26~3.39)与学龄前儿童超重肥胖呈正相关(P值均<0.05);母亲孕前消瘦(OR=0.51,95%CI=0.29~0.88)与学龄前儿童超重肥胖呈负相关(P<0.05).结论 该社区2~6岁儿童超重肥胖检出率较高,学龄前儿童超重肥胖与出生体重、分娩方式、出生后6月内喂养方式、母亲孕前BMI和母亲孕期增重等生命早期因素相关,积极有效的早期干预可预防学龄前儿童超重肥胖.     

饮食、运动习惯对学龄前儿童超重和肥胖的影响

目的:了解武汉市学龄前儿童超重和肥胖的流行情况,探讨其影响因素。方法:随机整群抽取武汉市江汉区5所幼儿园共1 120名儿童,按照标准方法测量其身高、体重,并以WHO儿童BMI标准作为超重和肥胖评价标准;采用自拟问卷对儿童及其家庭基本情况、饮食和运动习惯进行调查。结果:1 120名儿童中,超重和肥胖发生率分别为13.2%和11.9%,男童发生率均显著高于女童(P<0.001);多因素非条件Logistic回归分析结果显示,出生为巨大儿(OR=1.662,95%CI:1.066～2.590)、进食量多(OR=4.640,95%CI:3.319～6.486)、进食速度快(OR=2.121,95%CI:1.452～3.098)、喜欢吃洋快餐(OR=1.907,95%CI:1.363～2.668)、喜欢吃蛋类(OR=1.518,95%CI:1.115～2.086)等5个因素是学龄前儿童超重和肥胖的危险因素;经常吃蔬菜、水果(OR=0.659,95%CI:0.477～0.911)、周末平均户外活动时间≥2 h(OR=0.635,95%CI:0.469～0.858)则是超重和肥胖的保护因素。结论:武汉市学龄前儿童超重和肥胖流行率高于全国平均水平,改善不良饮食和运动习惯可有效地预防超重和肥胖的发生。     

广州市儿童生命早期因素与超重肥胖的关联

  目的  探讨广州市6~11岁儿童生命早期因素与超重肥胖之间的关系, 为儿童超重肥胖的预防提供科学依据。  方法  基线采用分层整群随机抽样的方法, 于2017年抽取广州市5所小学共5 172名学生作为研究对象, 进行2年的随访, 最终纳入学生3 315名。通过问卷调查收集学生的生命早期因素, 并测量基线和随访中身高和体重等指标。采用Logistic回归分析儿童生命早期因素与超重肥胖的关系。  结果  广州市6~11岁儿童超重肥胖发生率为8.7%。校正混杂因素后, Logistic回归分析显示, 母亲孕前消瘦的儿童超重肥胖发生风险比母亲孕前正常体重的儿童降低了46%(OR=0.54, 95%CI=0.38~0.76);母亲孕期增重过多的儿童超重肥胖发生风险比孕期增重正常的儿童增加了55%(OR=1.55, 95%CI=1.14~2.10);与自然分娩儿童相比, 剖宫产的儿童超重肥胖发生风险增加了30%(OR=1.30, 95%CI=1.00~1.68)(P值均 < 0.05)。  结论  母亲孕期增重过多和剖宫产增加儿童超重肥胖的发生风险, 母亲孕前消瘦降低儿童超重肥胖的发生风险。     

北京市小学生进食行为与超重肥胖的关系

分析北京市三~五年级小学生进食行为与超重肥胖的关系,为儿童超重肥胖预防和控制提供依据.方法 采取整群抽样的方法,选取北京市某城区12所小学三~五年级的学生1 788名,测量身高、体重,计算身体质量指数(BMI),通过问卷调查了解学生的进食行为、膳食摄入频率、身体活动情况,分析进食行为与超重肥胖之间的关系.结果男生的超重肥胖率为47.8%,女生为25.6%,差异有统计学意义(x2=94.54,P<0.01);男生在家吃饭时用碗大小和进食速度分布与女生的差异均有统计学意义(x2值分别为6.75,57.33,P值均<0.01).在Logistic回归模型中,控制年龄、性别、膳食评分、身体活动能量消耗值因素后,在家吃饭时用碗比大人小、吃饭速度比同班同性别的同学快是儿童超重肥胖的危险因素(OR值分别为1.55,2.50,95%CI=1.14~2.11,1.51~4.16).结论 小学生的用碗大小和吃饭速度快慢可能与超重肥胖有关.为预防和控制儿童超重肥胖,应提倡小学生和家长使用一样大小的碗,并减慢进食速度.     

儿童人格特征和饮食行为与肥胖的相关性

  目的  探讨饮食行为在人格特征与儿童肥胖关联中的作用, 为有效预防中国儿童肥胖提供科学依据。  方法  2018年9月在北京、山西长治、新疆乌鲁木齐3个地区调查1 271名小学四年级儿童。采用大五人格量表简表测量人格特征, 使用儿童饮食行为问卷测量儿童饮食行为, 通过体格检查获取5个肥胖相关指标。  结果  校正性别、年龄和地区后, 严谨性人格标准化评分与儿童BMI(B=-0.227, 95%CI=-0.422~-0.031)、BMI Z评分(B=-0.081, 95%CI=-0.158~-0.006)、腰围(B=-0.720, 95%CI=-1.281~-0.159)、腰臀围比(B=-0.004, 95%CI=-0.007~ -0.001)和体脂百分比(B=-0.727, 95%CI=-1.293~-0.162)均呈负相关(P值均 < 0.05)。中介作用分析结果显示, 严谨性人格可能通过食物响应和情绪性过食行为影响BMI、BMI Z评分、腰围、腰臀围比和体脂百分比; 食物响应和情绪性过食行为在严谨性人格与5个肥胖相关指标的中介作用占总效应的比例分别为27.5%~47.1%和0.9%~18.0%(P值均 < 0.05)。  结论  严谨性人格与较低的儿童肥胖风险相关, 食物响应和情绪性过食行为是两者关联的中介因素。应针对严谨性较低的儿童及时开展健康教育, 以早期预防肥胖的发生。     

河北省儿童青少年在外就餐相关因素及与超重肥胖的关系

  目的  分析河北省6~17岁儿童青少年在外就餐现状及其与超重肥胖的关系,为指导儿童青少年建立健康的饮食习惯和遏制肥胖流行趋势提供参考。  方法  调查数据来自2016—2017年中国儿童与乳母营养健康状况监测,通过问卷调查和体格检查收集河北省12个监测点3 330名6~17岁儿童青少年最近1周的就餐情况、家庭基本情况和体检信息等资料。采用多因素Logistic逐步回归的方法,对调查对象在外就餐情况,在外就餐影响因素及与超重肥胖的关系进行分析。  结果  河北省6~17岁儿童青少年在外就餐率为16.19%,超重肥胖率为29.43%。多因素Logistic回归分析显示,年龄较大(初中生:OR=1.36,高中生OR=3.57,P值均＜0.05)和家庭人均收入高的儿童青少年(1~＜2万元:OR=1.48,≥2万元:OR=2.93,P值均＜0.05)在外就餐的可能性更高;居住地为农村(OR=0.20)、非独生子女(OR=0.76)、走读生(OR=0.21)以及主要抚养人为老人的儿童青少年(OR=0.69)在外就餐的可能性更低(P值均＜0.05)。在外就餐与超重肥胖风险增高存在统计学关联(OR=1.31,P＜0.01)。  结论  河北省6~17岁儿童青少年在外就餐现象较为普遍。居住地、年龄段、人均年收入、是否为独生子女、是否住校、主要抚养人是在外就餐的相关因素,在外就餐可能会增加儿童青少年超重肥胖的风险。     

Influence of Behavioral and Environmental Factors on the Development of Obesity in Three-year-old Children —A Case-Control Study Based on Toyama Study—

Obesity in children seems to be a risk factor for chronic diseases in adulthood. From the viewpoint of preventive medicine, factors influencing the development of obese children should be removed early in life. The purpose of this study was to the elucidate relationship between obesity in 3-year-old children and both behavioral and environmental factors by conducting a case-control study. Subjects were selected from the Toyama study. Matched-pair comparisons were performed between obese children whose Kaup’s index was 18 or more (N=117) and control children (N=234) . Multivariate stepwised logistic regression analysis also applied to assess influence of confounding factors. The results indicated that the following 6 factors significantly influenced the development of obese 3-year-old children in exact Fisher’s method analysis (p<0.05): person other than the mother responsible for taking care of the child, short sleep duration (9 hours or less), physical inactivity, eating snacks irregularly, overweight father (BMI≥24), and overweight mother (BMI≥24). For both sexes, after adjusting for confounders by multivariate stepwise logistic analysis, overweight mother (OR 2.54, 95 % CI 1.64-3.95), birth overweight (birth weight≥3,500g; OR 1.76, 95 % CI 1.15-2.69), the mother not responsible for taking care of the child (OR 1.65, 95% CI 1.10-2.48), overweight father (OR 1.62, 95%CI 1.09-2.40), eating snacks irregularly (OR 1.56, 95% CI 1.04-2.33), and gender (female;OR 0.51, 95% CI 0.34-0.77) had significant relationships with obesity in childhood. For boys, overweight mother (OR 2.53, 95 % CI 1.47-4.35), birth overweight (OR 2.03, 95%CI 1.22-3.39), eating snacks irregularly (OR 1.94, 95 %CI 1.19-3.18), and birth month (36-41 months; OR 0.47, 95 % CI 0.23-0.96) had significant relationships. For girls, overweight mother (OR 2.62, 1.28-5.35), and short sleep duration (OR 2.24, 1.11-4.52) had significant relationships. In neither Fisher’s exact method nor multivariate logistic models, time to wake up, bedtime, duration of playing outdoors, regularity of meals, care about salty food, or frequency of eating snacks had significant relations with obesity in 3-year-old children (p<0.05).     

广州市城区小学二年级学生家庭在外就餐频次与学生肥胖的关系

目的 了解广州市城区小学二年级学生的家庭在外就餐现状及其影响因素,并分析其与儿童超重肥胖的关系。方法 抽取广州市12所小学的二年级学生2 206名,进行问卷调查和体格检查。应用logistic回归模型分析家庭在外就餐的影响因素及其与儿童超重肥胖的关系。结果 学生家庭在外就餐≥1次/周者占53.99%。多因素分析显示,独生子女家庭比非独生子女家庭有更高的可能性在外就餐（OR = 1.45,95% CI:1.18～1.78,P＜0.001）。与家庭人均月收入＜5 000元的家庭相比,收入高的家庭在外就餐的可能性更高（家庭人均月收入为5 000～9 999元:OR = 1.60,95% CI:1.21～2.13,P = 0.001;≥10 000元:OR = 2.22,95% CI:1.68～2.94,P＜0.001）。类似,与父母文化程度为高中及以下的家庭相比,父母文化程度为大专或本科的家庭有更高的在外就餐可能性（OR = 1.87,95% CI:1.44～2.43,P＜0.001）。而中等营养知识得分的家长较得分高的家长有减少带孩子外出就餐的倾向（OR = 0.75,95% CI:0.59～0.95,P = 0.016）。此外,家庭在外就餐与儿童超重肥胖风险增高存在统计学关联（OR = 1.31,95% CI:1.03～1.67,P = 0.032）。结论 广州市城区小学二年级学生家庭在外就餐现象较为普遍。独生子女家庭、家庭收入和父母文化程度和营养知识水平是家庭在外就餐的影响因素。家庭在外就餐可能会增加儿童超重肥胖的风险。     

学龄前儿童身体活动和视屏时间与超重肥胖的关联

  目的  分析学龄前儿童身体活动和视屏时间与超重肥胖的关联,为学龄前儿童超重肥胖的预防和控制提供依据。  方法  采用病例对照研究设计,选取北京市朝阳区某社区4所幼儿园109名超重肥胖儿童作为病例组,在同样的幼儿园内选择体重正常的117名儿童作为对照组,对照组与病例组的年龄和性别频数匹配。用单因素分析比较两组人口学、身体活动时间、视屏时间、睡眠、饮食等特征,采用Logistic回归在调整协变量的情况下分析学龄前儿童身体活动和视屏时间与超重肥胖的关联。  结果  在调整年龄、性别、平均每日睡眠时间、儿童睡眠习惯问卷(CSHQ)总评分、中国学龄前儿童平衡膳食指数(DBI-C)正端分等因素后,每日身体活动时间 < 3 h的儿童与身体活动时间≥3 h的儿童相比超重肥胖风险增加1.55倍(OR=2.55,95%CI=1.16~5.64,P=0.02),儿童每日视屏时间每增加一个四分位数超重肥胖风险增加1.44倍(OR=2.44,95%CI=1.69~3.52,P < 0.01)。  结论  学龄前儿童身体活动时间不足和视屏时间较长都与超重肥胖相关。应采取综合干预措施有效增加身体活动时间并且减少儿童的视屏行为,降低学龄前儿童超重肥胖的发生率。     

Risk factors for overweight in children from Southern Brazil

Risk factors for overweight were investigated in a cross-sectional survey of children aged 12-59 months in the Southern Brazilian city of Porto Alegre (n = 2,660). Odds ratios (OR) for overweight, defined by weight/height > 2 z-scores of the NCHS standards, were estimated for socioeconomic and demographic conditions, social environment, and childhood health events. Prevalence of overweight was 6.5%. In the multivariate model, the odds of overweight were positively associated with maternal education (schooling > 12 years, OR = 2.36; 95%CI: 1.21-4.60; 9-11 years, OR = 2.07; 95%CI: 1.16-3.70) and family income per capita > 2 times the minimum wage (OR = 1.86; 95%CI: 1.13-3.08) and negatively associated with maternal work (OR = 0.72; 95%CI: 0.52-0.99). Odds were higher for children born large-for-gestational-age (OR = 2.29; 95%CI: 1.36-3.85) and lower for children born small (OR = 0.57; 95%CI: 0.33-0.99), as compared to those born with adequate birth weight for gestational age. Paternal schooling, parental occupation, and maternal age at the child's birth were associated with overweight in the unadjusted model only. Programs are needed to prevent overweight during childhood, with special attention to families and children at increased risk.     

Neonatal cytokines associated with infant overweight and obesity at 1 year of age

ObjectiveThe incidence of childhood overweight and obesity has been increasing in recent years. Immune dysregulation has been demonstrated as a condition related to childhood obesity. Whether the neonatal immune status is related to infant overweight and obesity at 1 year of age is unclear.MethodsTo explore the relationship between neonatal cytokines and infant overweight and obesity, we conducted a prospective study in Suzhou Municipal Hospital Affiliated to Nanjing Medical University from 2015 to 2016. 514 neonates were recruited and their dried blood spots were collected after birth. Infants were grouped into normal size groups and overweight and obesity groups based on BMI at 1 year of age. 27 neonatal cytokines levels were compared between the two groups.Results370 infants were included in final analysis. Granulocyte colony stimulating factor (GCSF), interleukin-17A (IL17A) and platelet derived growth factor-BB (PDGF-BB) levels were independently associated with childhood overweight and obesity (OR =1.27, 95%CI 1.03, 1.57; OR =1.29, 95%CI: 1.06, 1.60; OR =0.69, 95%CI: 0.49, 0.96). Additionally, neonatal GCSF and IL17A levels were positively associated with increased BMI (β = 0.11, 95%CI: 0.02, 0.19; β = 0.07, 95%CI 0.01, 013) and BMI z-scores (β = 0.10, 95%CI: 0.02, 0.18; β = 0.06, 95%CI 0.01, 0.13). Neonatal PDGF-BB levels were negatively associated with BMI (β = −0.12, 95%CI: −0.23, −0.01) and BMI z-scores (β = −0.12, 95%CI: −0.23, −0.01). The inverse probability weighting (IPW) was performed to account for potential selection bias of this study, and the results were consistent with the above mentioned findings.ConclusionsNeonatal GCSF, IL17A and PDGF-BB levels were correlated with infant overweight and obesity at 1 year of age, suggesting that early life immune status play a significant role of late obesity.     

Additive interactions of maternal prepregnancy BMI and breast-feeding on childhood overweight

OBJECTIVE: To examine the interactions of maternal prepregnancy BMI and breast-feeding on the risk of overweight among children 2 to 14 years of age. RESEARCH METHODS AND PROCEDURES: The 1996 National Longitudinal Survey of Youth, Child and Young Adult data in the United States were analyzed (n = 2636). The weighted sample represented 51.3% boys, 78.0% whites, 15.0% blacks, and 7.0% Hispanics. Childhood overweight was defined as BMI >/=95th percentile for age and sex. Maternal prepregnancy obesity was determined as BMI >/=30 kg/m(2). The duration of breast-feeding was measured as the weeks of age from birth when breast-feeding ended. RESULTS: After adjusting for potential confounders, children whose mothers were obese before pregnancy were at a greater risk of becoming overweight [adjusted odds ratio (OR), 4.1; 95% confidence interval (CI), 2.6, 6.4] than children whose mothers had normal BMI (<25 kg/m(2); p < 0.001 for linear trend). Breast-feeding for >/=4 months was associated with a lower risk of childhood overweight (OR, 0.6; 95% CI, 0.4, 1.0; p = 0.06 for linear trend). The additive interaction between maternal prepregnancy obesity and lack of breast-feeding was detected (p < 0.05), such that children whose mothers were obese and who were never breast-fed had the greatest risk of becoming overweight (OR, 6.1; 95% CI, 2.9, 13.1). DISCUSSION: The combination of maternal prepregnancy obesity and lack of breast-feeding may be associated with a greater risk of childhood overweight. Special attention may be needed for children with obese mothers and lack of breast-feeding in developing childhood obesity intervention programs.