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Parent and Guardian Opinions on Obesity Medications Use in Adolescents with Obesity and Related Comorbidities. 家长及监护人对肥胖及相关合并症青少年使用减肥药的意见
IF 1.5 4区 医学 Q2 PEDIATRICS Pub Date : 2024-12-18 DOI: 10.1089/chi.2024.0351
Sarah Raatz, Rebecca L Freese, Subin Jang, Alicia Kunin-Batson, Amy C Gross, Megan O Bensignor

Background: There are now four FDA-approved anti-obesity medications (AOMs) for youth ≥12 years, which can be effective therapies to treat obesity and obesity-related comorbidities. Objectives: This study describes parent/guardian (caregiver) openness to using AOMs for adolescents with obesity and evaluates factors that may contribute to openness. Methods: Caregivers of adolescents aged 12-17 years were surveyed. Self-reported height, weight, demographic information, family, and personal history of obesity or obesity-related comorbidities were collected. Participants rated their openness to starting an AOM for their child for obesity alone or obesity-related comorbidities on a 7-point Likert scale. A Likert rating of less than 4 was considered "less open" versus 4-7 was considered "more open." Results: A total of 344 participants completed the survey. Average openness toward AOM use for obesity as the only indication (as opposed to comorbid conditions) was 3.2 ± 1.74. Caregivers who were knowledgeable that the FDA-approved AOM use in adolescents had greater odds of being open to using these medications compared with caregivers who were not knowledgeable (odds ratio: 2.18; 95% confidence interval: 1.25-2.86). Conclusions: Caregivers reported openness to starting an AOM if they had prior knowledge of these medications, highlighting the need for family education on AOM use and indications.

背景:目前有4种fda批准的针对≥12岁青少年的抗肥胖药物(AOMs),可作为治疗肥胖及肥胖相关合并症的有效疗法。目的:本研究描述了父母/监护人(照顾者)对肥胖青少年使用AOMs的开放程度,并评估了可能有助于开放的因素。方法:对12 ~ 17岁青少年的照顾者进行调查。收集自我报告的身高、体重、人口统计信息、家庭和个人肥胖史或与肥胖相关的合并症。参与者根据7分李克特量表对他们是否愿意为孩子开设AOM单独的肥胖或肥胖相关的合并症进行评分。李克特评分低于4分被认为是“不太开放”,而4-7分被认为是“更开放”。结果:共有344名参与者完成了调查。对肥胖患者使用AOM作为唯一适应症(与合并症相反)的平均开放度为3.2±1.74。与不了解AOM的护理人员相比,了解fda批准的AOM在青少年中的使用的护理人员对使用这些药物持开放态度的几率更大(优势比:2.18;95%置信区间:1.25-2.86)。结论:护理人员报告说,如果他们事先了解这些药物,他们愿意开始使用AOM,这突出了对AOM使用和适应症进行家庭教育的必要性。
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引用次数: 0
The Prevalence of Obesity is Increased in Adolescents with Amblyopia: An Analysis of National Health and Nutrition Examination Survey Data. 弱视青少年肥胖患病率增加:全国健康与营养调查数据分析
IF 1.5 4区 医学 Q2 PEDIATRICS Pub Date : 2024-12-10 DOI: 10.1089/chi.2024.0258
Kyle Machicado, Ali A Weinstein, Jaffer Zaidi, Scott R Lambert, Carolyn Drews-Botsch

Background: Amblyopia is the most common cause of vision loss in children. Amblyopia has been associated with impaired depth perception but little attention has been paid to the extent to which amblyopia increases the risk of obesity. Methods: Public-use data from the 1999-2008 National Health and Nutrition Examination Survey were used. Analyses were limited to children aged 12-18, who had a visual examination, and a best corrected visual acuity (BCVA) of at least 20/40 in the better-seeing eye. Amblyopia was defined as two or more-line interocular difference in BCVA. Obesity was defined as Body Mass Index (BMI) or body fat percentage (BFP) ≥95th percentile for age and gender. Sedentary lifestyle was defined as cardiovascular fitness level (CFL) rating of "low." We used Mantel-Haenszel odds ratios (ORs) to examine the relative prevalence of obesity in children with/without amblyopia. Results: Adolescents with amblyopia (n = 360) were more likely than those without (n = 7935) to have a high BMI [OR = 1.56; 95% confidence interval (CI): 1.24-1.98; p < 0.001]. The associations with either high BFP (OR = 1.20; 95% CI: 0.86-1.56, p = 0.167) or low CFL (OR = 1.15; 95% CI: 0.83-1.57; p = 0.267) were not statistically significant but in the direction of a priori hypotheses. Conclusions: This analysis of population-based data suggests that adolescents with amblyopia may be at higher risk of having obesity. Given the high prevalence of amblyopia and the range of morbidities associated with childhood obesity, targeted interventions to reduce the risk of obesity among children with amblyopia could be warranted.

背景:弱视是儿童视力丧失的最常见原因。弱视与深度知觉受损有关,但很少有人注意到弱视增加肥胖风险的程度。方法:采用1999-2008年全国健康与营养检查调查的公共数据。分析仅限于12-18岁的儿童,他们进行了视力检查,视力较好的眼睛的最佳矫正视力(BCVA)至少为20/40。弱视定义为BCVA两线或两线以上眼间差异。肥胖定义为身体质量指数(BMI)或体脂率(BFP)≥95百分位,年龄和性别不同。久坐的生活方式被定义为心血管健康水平(CFL)评级为“低”。我们使用Mantel-Haenszel优势比(ORs)来检查有/无弱视儿童中肥胖的相对患病率。结果:弱视青少年(n = 360)比无弱视青少年(n = 7935)更容易出现高BMI [OR = 1.56;95%置信区间(CI): 1.24-1.98;P < 0.001]。高BFP (OR = 1.20;95% CI: 0.86-1.56, p = 0.167)或低CFL (or = 1.15;95% ci: 0.83-1.57;P = 0.267)无统计学意义,但符合先验假设的方向。结论:这项基于人群的数据分析表明,患有弱视的青少年可能有更高的肥胖风险。鉴于弱视的高患病率和与儿童肥胖相关的发病率范围,有针对性的干预措施可以降低弱视儿童肥胖的风险。
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引用次数: 0
Increased BMI Velocity is Associated with Elevated Patient Health Questionnaire-9 Scores in Adolescents with Obesity. 肥胖青少年BMI速度增加与患者健康问卷-9得分升高相关
IF 1.5 4区 医学 Q2 PEDIATRICS Pub Date : 2024-12-10 DOI: 10.1089/chi.2024.0323
Elizabeth Atteh, Sarah Armstrong, Asheley Skinner, Charles Wood

Existing studies that have demonstrated a positive association between obesity and depression have been among adults, did not utilize the Patient Health Questionnaire (PHQ), or were conducted in a homogenous patient population. In this retrospective longitudinal cohort study of patients >11 and <18 years old with obesity in one health system we analyzed associations between change in BMI between two BMI measurements and PHQ-9 scores using chi-square and Kruskal-Wallis tests. We used PHQ-9 scores dichotomized at

现有的研究表明肥胖和抑郁之间存在正相关,这些研究都是在成年人中进行的,没有使用患者健康问卷(PHQ),或者是在同质患者群体中进行的。在这项回顾性纵向队列研究中,患者bbbb11和
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引用次数: 0
Examining Changes in Implementation of Priority Healthy Eating and Physical Activity Practices, and Related Barriers, Over Time in Australian Early Childhood Education and Care Services: A Repeated Cross-Sectional Study. 在澳大利亚早期儿童教育和护理服务中,检查优先健康饮食和体育活动实践的实施变化以及相关障碍:一项重复的横断面研究。
IF 1.5 4区 医学 Q2 PEDIATRICS Pub Date : 2024-12-04 DOI: 10.1089/chi.2024.0341
Amy Anderson, Madeleine Hinwood, Luke Wolfenden, Maria Romiti, Alice Grady, Chris Oldmeadow, Hayley Christian, Melanie Lum, Rebecca Lorch, Gary Sacks, John Wiggers, Rebecca Hodder, Karen Gillham, Sze Lin Yoong

Background: Promoting healthy eating and physical activity in early childhood education and care (ECEC) is recommended within guidelines and supported by health promotion programs; however, implementation is suboptimal. Evidence suggests implementation within the sector varies over time; however, this has not been empirically examined in relation to implementation barriers. This study aims to: (1) describe changes in the prevalence of, and barriers to, implementation of priority healthy eating and physical activity practices; and (2) explore the associations between such barriers and implementation. Methods: This was a repeated cross-sectional study over an 8-month period. A cross-section of 150-180 Australian ECEC services were prospectively randomly sampled for each month (April-November 2023), with 1127 ECEC services sampled in total and 20% of services sampled twice. Services reported via survey their implementation of two priority practices: (1) healthy menu standards and (2) educating and engaging parents in child physical activity. They also reported on implementation status, implementation stage, and five core implementation barriers. Results: Overall, 716 services completed 809 surveys. There were no significant differences in the prevalence of implementation or general trends in barriers to implementation of the two priority practices across that time. Services reporting less barriers were significantly more likely to be implementing the priority practices, and services in more advanced implementation stages were significantly less likely to report barriers. Conclusions: To enhance the implementation of priority practices in ECEC services, key barriers to implementation need to be understood and targeted to progress services through to advanced implementation stages.

背景:在儿童早期教育和护理(ECEC)中提倡健康饮食和体育活动,并得到健康促进计划的支持;然而,实现是次优的。有证据表明,该部门的执行情况因时间而异;然而,还没有对这一点与实施障碍的关系进行经验检验。本研究旨在:(1)描述优先健康饮食和体育活动习惯的流行程度和实施障碍的变化;(2)探讨这些障碍与实施之间的联系。方法:这是一项为期8个月的重复横断面研究。每个月(2023年4月至11月)对150-180家澳大利亚ECEC服务进行前瞻性随机抽样,共抽样1127家ECEC服务,其中20%的服务抽样两次。各服务机构通过调查报告了它们实施两项优先做法的情况:(1)健康菜单标准;(2)教育和鼓励家长参与儿童体育活动。他们还报告了实施状况、实施阶段和五个核心实施障碍。结果:共有716家服务机构完成了809项调查。在这段时间内,在实施的普遍程度或实施两种优先做法的障碍的一般趋势方面没有显著差异。报告障碍较少的服务更有可能实现优先级实践,而处于更高级实现阶段的服务更不可能报告障碍。结论:为了加强ECEC服务中优先实践的实施,需要了解实施的主要障碍并有针对性地将服务推进到高级实施阶段。
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引用次数: 0
Association Between Picky Eating, Weight Status, Vegetable, and Fruit Intake in Children and Adolescents: Systematic Review and Meta-Analysis. 儿童和青少年挑食、体重状况、蔬菜和水果摄入量之间的关系:系统回顾与元分析》。
IF 1.5 4区 医学 Q2 PEDIATRICS Pub Date : 2024-12-01 Epub Date: 2024-07-11 DOI: 10.1089/chi.2023.0196
Rati Jani, Chris Irwin, Roshan Rigby, Rebecca Byrne, Penelope Love, Farheen Khan, Catalina Larach, Wai Yew Yang, Subhadra Mandalika, Catherine R Knight-Agarwal, Nenad Naumovski, Kimberley Mallan

Aim: Picky eating is a common appetitive trait reported among children and adolescents and may have detrimental effects on their weight, vegetable, and fruit intake, impacting health status. However, an updated systematic review of the literature and summary of effect estimates is required. This study aims to explore the association between picky eating with weight, vegetable and fruit intake, vegetable-only intake, and fruit-only intake. Methods: A systematic literature search of six electronic scientific databases and data extraction was performed between November 2022 and June 2023. Original articles that examined picky eating in association with weight, vegetable and/or fruit intake were included. PRISMA guidelines were followed and meta-analytical and meta-regression analyses were conducted to compute summary effect estimates and explore potential moderators. PROSPERO registration: CRD42022333043. Results: The systematic review included 59 studies of which 45 studies were included in the meta-analysis. Overall, the summarized effect estimates indicated that picky eating was inversely associated with weight [Cohen's dz: -0.27, 95% confidence interval (CI): -0.41 to -0.14, p < 0.0001]; vegetable and fruit intakes (Cohen's dz: -0.35, 95% CI: -0.45, -0.25, p < 0.0001); vegetable-only intake (Cohen's dz: -0.41, 95% CI: -0.56, -0.26, p < 0.0001), and fruit-only intake (Cohen's dz: -0.32, 95% CI: -0.45, -0.20, p < 0.0001). Picky eating was positively associated with underweight (Cohen's dz: 0.46, 95% CI: 0.20, 0.71 p = 0.0008). Conclusion: Although effect sizes were small, picky eating was inversely associated with weight, vegetable, and fruit intakes, and positively associated with underweight in children and adolescents aged birth to 17 years.

目的:据报道,挑食是儿童和青少年中常见的食欲特征,可能会对他们的体重、蔬菜和水果摄入量产生不利影响,从而影响健康状况。然而,我们需要对文献进行最新的系统回顾,并总结效果估计值。本研究旨在探讨挑食与体重、蔬菜和水果摄入量、纯蔬菜摄入量和纯水果摄入量之间的关系。研究方法在 2022 年 11 月至 2023 年 6 月期间,对六个电子科学数据库进行了系统的文献检索和数据提取。纳入了研究挑食与体重、蔬菜和/或水果摄入量相关性的原创文章。研究遵循了PRISMA指南,并进行了元分析和元回归分析,以计算简要效应估计值并探索潜在的调节因素。PROSPERO 注册:CRD42022333043。结果系统综述包括 59 项研究,其中 45 项研究被纳入荟萃分析。总体而言,汇总的效应估计值表明,挑食与体重[Cohen's dz:-0.27,95% 置信区间(CI):-0.41 至 -0.14,p < 0.0001]、蔬菜和水果摄入量(Cohen's dz:-0.35,95% CI:-0.45,-0.25,p <0.0001);纯蔬菜摄入量(Cohen's dz:-0.41,95% CI:-0.56,-0.26,p <0.0001)和纯水果摄入量(Cohen's dz:-0.32,95% CI:-0.45,-0.20,p <0.0001)。挑食与体重不足呈正相关(Cohen's dz:0.46,95% CI:0.20,0.71 p = 0.0008)。结论挑食与体重、蔬菜和水果摄入量呈负相关,与体重不足呈正相关。
{"title":"Association Between Picky Eating, Weight Status, Vegetable, and Fruit Intake in Children and Adolescents: Systematic Review and Meta-Analysis.","authors":"Rati Jani, Chris Irwin, Roshan Rigby, Rebecca Byrne, Penelope Love, Farheen Khan, Catalina Larach, Wai Yew Yang, Subhadra Mandalika, Catherine R Knight-Agarwal, Nenad Naumovski, Kimberley Mallan","doi":"10.1089/chi.2023.0196","DOIUrl":"10.1089/chi.2023.0196","url":null,"abstract":"<p><p><b><i>Aim:</i></b> Picky eating is a common appetitive trait reported among children and adolescents and may have detrimental effects on their weight, vegetable, and fruit intake, impacting health status. However, an updated systematic review of the literature and summary of effect estimates is required. This study aims to explore the association between picky eating with weight, vegetable and fruit intake, vegetable-only intake, and fruit-only intake. <b><i>Methods:</i></b> A systematic literature search of six electronic scientific databases and data extraction was performed between November 2022 and June 2023. Original articles that examined picky eating in association with weight, vegetable and/or fruit intake were included. PRISMA guidelines were followed and meta-analytical and meta-regression analyses were conducted to compute summary effect estimates and explore potential moderators. PROSPERO registration: CRD42022333043. <b><i>Results:</i></b> The systematic review included 59 studies of which 45 studies were included in the meta-analysis. Overall, the summarized effect estimates indicated that picky eating was inversely associated with weight [Cohen's <i>d<sub>z</sub></i>: -0.27, 95% confidence interval (CI): -0.41 to -0.14, <i>p</i> < 0.0001]; vegetable and fruit intakes (Cohen's <i>d<sub>z</sub></i>: -0.35, 95% CI: -0.45, -0.25, <i>p</i> < 0.0001); vegetable-only intake (Cohen's <i>d<sub>z</sub></i>: -0.41, 95% CI: -0.56, -0.26, <i>p</i> < 0.0001), and fruit-only intake (Cohen's <i>d<sub>z</sub></i>: -0.32, 95% CI: -0.45, -0.20, <i>p</i> < 0.0001). Picky eating was positively associated with underweight (Cohen's <i>d<sub>z</sub></i>: 0.46, 95% CI: 0.20, 0.71 <i>p</i> = 0.0008). <b><i>Conclusion:</i></b> Although effect sizes were small, picky eating was inversely associated with weight, vegetable, and fruit intakes, and positively associated with underweight in children and adolescents aged birth to 17 years.</p>","PeriodicalId":48842,"journal":{"name":"Childhood Obesity","volume":" ","pages":"553-571"},"PeriodicalIF":1.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141591802","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
High Blood Pressure in Children Aged 3 to 12 Years Old With Overweight or Obesity. 3 至 12 岁超重或肥胖儿童的高血压。
IF 1.5 4区 医学 Q2 PEDIATRICS Pub Date : 2024-12-01 Epub Date: 2024-05-03 DOI: 10.1089/chi.2023.0143
James T Nugent, Kaitlin R Maciejewski, Emily B Finn, Randall W Grout, Charles T Wood, Denise Esserman, Jeremy J Michel, Yuan Lu, Mona Sharifi

Objective: (1) To describe the prevalence of high blood pressure (BP) and the association with BMI in young children with overweight/obesity; (2) to evaluate the accuracy of a single high BP to diagnose sustained hypertension over three visits. Methods: We used pre-intervention data from the Improving Pediatric Obesity Practice Using Prompts (iPOP-UP) trial. We included children aged 3-12 years with BMI ≥85th percentile at well-visits in 2019-2021 at 84 primary care practices in 3 US health systems in the Northeast, Midwest, and South. BP percentiles were calculated from the first visit with BP recorded during the study period. Hypertensive-range BP was defined by the 2017 American Academy of Pediatrics guideline. We tested the association between BMI classification and hypertensive BP using multivariable logistic regression. Results: Of 78,280 children with BMI ≥85th percentile, 76,214 (97%) had BP recorded during the study period (mean 7.4 years, 48% female, 53% with overweight, and 13% with severe obesity). The prevalence of elevated or hypertensive BP was 31%, including 27% in children with overweight and 33%, 39%, and 49% with class I, II, and III obesity, respectively. Higher obesity severity was associated with higher odds of hypertensive BP in the multivariable model. Stage 2 hypertensive BP at the initial visit had specificity of 99.1% (95% confidence interval 98.9-99.3) for detecting sustained hypertension over ≥3 visits. Conclusions: High BP is common in 3- to 12-year-olds with overweight/obesity, with higher obesity severity associated with greater hypertension. Children with overweight/obesity and stage 2 BP are likely to have sustained hypertension and should be prioritized for evaluation. Trial Registration: ClinicalTrials.gov Identifier: NCT05627011.

目的:(1) 描述超重/肥胖幼儿的高血压(BP)患病率及其与体重指数(BMI)的关系;(2) 评估单次高血压诊断三次持续高血压的准确性。方法:我们使用了 "使用提示改进儿科肥胖症实践"(iPOP-UP)试验的干预前数据。我们纳入了2019-2021年在美国东北部、中西部和南部3个医疗系统的84个初级保健诊所进行健康检查时BMI≥85百分位数的3-12岁儿童。血压百分位数从研究期间有血压记录的首次就诊开始计算。高血压范围由 2017 年美国儿科学会指南定义。我们使用多变量逻辑回归法检验了 BMI 分级与高血压之间的关联。结果显示在体重指数≥85百分位数的78280名儿童中,76214名(97%)在研究期间记录了血压(平均7.4岁,48%为女性,53%超重,13%重度肥胖)。血压升高或高血压的发生率为 31%,其中超重儿童为 27%,I 级、II 级和 III 级肥胖儿童分别为 33%、39% 和 49%。在多变量模型中,肥胖严重程度越高,患高血压的几率越高。首次就诊时的第二阶段高血压对检测≥3 次就诊的持续高血压的特异性为 99.1%(95% 置信区间为 98.9-99.3)。结论:高血压常见于3-12岁的超重/肥胖儿童,肥胖严重程度越高,高血压越严重。超重/肥胖且血压处于第二阶段的儿童很可能患有持续性高血压,应优先进行评估。试验注册:ClinicalTrials.gov Identifier:NCT05627011。
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引用次数: 0
Considerations for Interpreting Childhood Obesity Treatment Trials from the COVID-19 Pandemic Era. 解读 COVID-19 大流行时代儿童肥胖症治疗试验的考虑因素。
IF 1.5 4区 医学 Q2 PEDIATRICS Pub Date : 2024-12-01 Epub Date: 2024-04-29 DOI: 10.1089/chi.2024.0232
Bethany Forseth, Bradley M Appelhans, Ann M Davis
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引用次数: 0
Emotional Eating Prevalence and Correlates in Adolescents in the United States. 美国青少年情绪性进食的普遍性及其相关因素。
IF 1.5 4区 医学 Q2 PEDIATRICS Pub Date : 2024-12-01 Epub Date: 2024-07-03 DOI: 10.1089/chi.2023.0184
Katherine M Kidwell, Megan A Milligan, Alexa Deyo, Jillian Lasker, Alison Vrabec

Background: Adolescent obesity rates continue to rise. A better understanding of who engages in emotional eating, a maladaptive eating style, is needed. Despite emotional eating being a frequent research target, the prevalence of emotional eating in US adolescents is currently unknown. Methods: Nationally representative adolescents (n = 1622, m = 14.48 years, 63.8% non-Hispanic White, 50.6% female) reported eating behaviors in the National Cancer Institute's Family Life, Activity, Sun, Health, and Eating (FLASHE) study. Frequencies and one-way ANOVAs were conducted to examine the rates of emotional eating across demographic and weight status groups. Correlations between emotional eating and dietary intake were examined. Results: In total, 30% of adolescents engaged in emotional eating. Older adolescents (35% of 17-year-olds), females (39%), non-Hispanic White individuals (32%), and adolescents with obesity (44%) had significantly higher rates of emotional eating. Controlling for weight status, greater adolescent emotional eating was correlated with more frequent intake of energy-dense/nutrient-poor foods (β = 0.10, p < 0.001), junk food (β = 0.12, p < 0.001), and convenience foods (β = 0.13, p < 0.001). Conclusions: This study fills a critical gap by providing insight into how common adolescent emotional eating is and highlighting demographic factors that are associated with higher rates. Nearly a third of adolescents in the United States reported eating due to anxiety or sadness, with rates higher in older adolescents, girls, non-Hispanic White adolescents, and adolescents with obesity. Emotional eating was associated with consuming less healthy foods, which conveys immediate and long-term health risks. Practitioners can intervene with emotional eating to reduce obesity and comorbid health risks.

背景:青少年肥胖率持续上升:青少年肥胖率持续上升。我们需要更好地了解哪些人会出现情绪化进食这种不适应的进食方式。尽管情绪化进食经常成为研究目标,但目前美国青少年情绪化进食的发生率尚不清楚。研究方法具有全国代表性的青少年(n = 1622,m = 14.48 岁,63.8% 为非西班牙裔白人,50.6% 为女性)在美国国家癌症研究所的家庭生活、活动、阳光、健康和饮食(FLASHE)研究中报告了饮食行为。研究人员通过频率和单因素方差分析来检测不同人口和体重状况组的情绪化进食率。研究还探讨了情绪化饮食与饮食摄入量之间的相关性。结果显示共有 30% 的青少年有情绪化进食行为。年龄较大的青少年(占 17 岁青少年的 35%)、女性(39%)、非西班牙裔白人(32%)和肥胖青少年(44%)的情绪化进食率明显更高。在控制体重状况的前提下,青少年情绪化饮食与更频繁地摄入高能量/低营养食物(β = 0.10,p < 0.001)、垃圾食品(β = 0.12,p < 0.001)和方便食品(β = 0.13,p < 0.001)相关。结论这项研究填补了一项重要空白,让我们了解了青少年情绪化饮食的普遍程度,并强调了与高发率相关的人口因素。据报告,美国近三分之一的青少年因焦虑或悲伤而进食,其中年龄较大的青少年、女孩、非西班牙裔白人青少年和肥胖青少年的进食率更高。情绪化进食与摄入较少的健康食品有关,会带来直接和长期的健康风险。医生可以对情绪化进食进行干预,以减少肥胖和并发症的健康风险。
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引用次数: 0
Disparities in Obesogenic Environments by Income, Race/Ethnicity, and Rurality Across All US Counties. 美国各县按收入、种族/族裔和乡村划分的肥胖环境差异。
IF 1.5 4区 医学 Q2 PEDIATRICS Pub Date : 2024-12-01 Epub Date: 2024-07-03 DOI: 10.1089/chi.2024.0217
Andrew T Kaczynski, Marilyn E Wende, Caylin A Eichelberger, Farnaz Hesam Shariati

Background: Research is needed to explore inequities in physical activity (PA) and access to healthy eating resources for children on a national scale. This study examined disparities in childhood obesogenic environments across all United States (US) counties by income and race/ethnicity and their interaction with county rurality. Methods: Data for four PA variables (exercise opportunities, school proximity, walkability, crime) and six nutrition variables (grocery stores, farmers markets, fast-food restaurants, full-service restaurants, convenience stores, and births at baby-friendly hospitals) were collected for all US counties (n = 3142) to comprise the Childhood Obesogenic Environment Index (COEI). Variables were ranked and allocated a percentile for each county, and a total obesogenic environment score was created by averaging variable percentiles. Analysis of variance was used to assess differences by tertiles of county-level median household income (low/intermediate/high) and percentage of non-Hispanic (NH) White residents (low/intermediate/high). Interaction tests were used to assess effect modification by rurality, and stratified results were presented for all significant interactions. Results: There were significant differences in COEI values according to tertiles of median household income (F = 260.9, p < 0.0001). Low-income counties (M = 54.3, SD = 8.3) had worse obesogenic environments than intermediate (M = 49.9, SD = 7.9) or high (M = 45.9, SD = 8.8) income counties. There was also a significant interaction between rurality and median household income (F = 13.9, p < 0.0001). Similarly, there were significant differences in COEI values according to tertiles of race/ethnicity (F = 34.5, p < 0.0001), with low percentage NH White counties (M = 51.8, SD = 9.8) having worse obesogenic environment scores than intermediate (M = 48.7, SD = 8.4) or high (M = 49.5, SD = 8.5) NH White counties. There was also a significant interaction between rurality and race/ethnicity (F = 13.9, p < 0.0001). Conclusion: Low-income counties and those with more racial/ethnic minority residents, especially in rural areas, had less supportive PA and healthy eating environments for youth. Targeted policy and environmental approaches that aimed to address concerns specific to underserved communities are needed.

背景:需要在全国范围内开展研究,探讨儿童在体育活动(PA)和获得健康饮食资源方面的不平等现象。本研究按收入、种族/族裔及其与乡村地区的交互作用,考察了美国所有县的儿童肥胖环境差异。研究方法:收集了美国所有县(n = 3142)的四个运动变量(锻炼机会、学校邻近程度、步行能力、犯罪率)和六个营养变量(杂货店、农贸市场、快餐店、全套服务餐馆、便利店和在爱婴医院分娩)的数据,以组成儿童致肥胖环境指数(COEI)。对每个县的变量进行排序并分配百分位数,通过平均变量百分位数得出致肥胖环境总分。方差分析用于评估县级家庭收入中位数(低/中/高)和非西班牙裔(NH)白人居民百分比(低/中/高)的差异。交互检验用于评估乡村地区的效应修正,所有显著交互检验的分层结果均已列出。结果根据家庭收入中位数的分层,COEI 值存在明显差异(F = 260.9,p < 0.0001)。低收入县(M = 54.3,SD = 8.3)的致肥环境比中等收入县(M = 49.9,SD = 7.9)或高收入县(M = 45.9,SD = 8.8)更差。农村地区与家庭收入中位数之间也存在明显的交互作用(F = 13.9,P < 0.0001)。同样,不同种族/族裔的 COEI 值也存在显著差异(F = 34.5,P < 0.0001),低百分比的 NH 白人县(M = 51.8,SD = 9.8)的致肥环境得分低于中等百分比(M = 48.7,SD = 8.4)或高百分比(M = 49.5,SD = 8.5)的 NH 白人县。农村地区与种族/族裔之间也存在明显的交互作用(F = 13.9,P < 0.0001)。结论:低收入县和少数民族居民较多的县,尤其是农村地区的县,对青少年的 PA 和健康饮食环境支持较少。需要采取有针对性的政策和环境方法来解决服务不足社区的具体问题。
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引用次数: 0
A Latent Class Analysis of Family Eating Behaviors and Home Environment Habits on Preschool-Aged Children's Body Mass Index. 家庭饮食行为和家庭环境习惯对学龄前儿童体重指数的潜类分析。
IF 1.5 4区 医学 Q2 PEDIATRICS Pub Date : 2024-12-01 Epub Date: 2024-07-11 DOI: 10.1089/chi.2024.0243
Jennifer E Carroll, Jennifer A Emond, Nicole VanKim, Elizabeth Bertone-Johnson, Susan R Sturgeon

Background: The etiology of obesity is multifaceted, with multiple risk factors occurring during early childhood (e.g., fast food frequency, eating dinner as a family, TV in the bedroom). Many past studies have largely considered obesity risk factors in isolation, when in reality, the risk factors likely cluster together. A latent class analysis can be used to identify patterns in child eating behaviors, parent feeding behaviors, and household habits among preschool-aged children and their families to identify distinct, heterogenous classes and to determine if classes are associated with overweight and obesity. Methods: We used data from a community-based study of 624 three- to five-year-old children and a parent in New Hampshire, from March 2014 to October 2015. Parent-reported data were used to determine frequency of eating behaviors and household habits. Height and weight were objectively measured. Results: Four classes were identified; Class 1: "Healthy/Mildly accommodating," Class 2: "Healthy/Accommodating," Class 3: "Moderately healthy/Moderately accommodating," and Class 4: "Least healthy/Least accommodating." Compared with Class 1, children in Class 4 had increased odds of being overweight or obese [adjusted odds ratio (aOR): 1.64, 95% confidence interval (CI): 1.13-2.15], whereas Classes 2 and 3 were not associated with BMI (Class 2: aOR: 1.24, 95% CI: 0.62-1.86; Class 3: aOR: 1.31, 95% CI: 0.81-1.81). Conclusion: Study findings highlight that child-parent interactions around meals differentially relate to children's weight status given the context of children's eating habits. Most important, our study findings confirm the importance of adapting multiple healthy habits within the home social and physical environment to offset obesity risk in young children.

背景:肥胖症的病因是多方面的,在儿童早期就存在多种风险因素(如快餐频率、全家共进晚餐、卧室看电视)。过去的许多研究大多孤立地考虑肥胖风险因素,而实际上,这些风险因素很可能聚集在一起。潜类分析可用于识别学龄前儿童及其家庭中儿童饮食行为、父母喂养行为和家庭习惯的模式,以确定不同的异质性类别,并确定这些类别是否与超重和肥胖有关。研究方法我们使用了 2014 年 3 月至 2015 年 10 月对新罕布什尔州 624 名三至五岁儿童和一名家长进行的社区研究数据。家长报告数据用于确定饮食行为频率和家庭习惯。身高和体重进行了客观测量。结果显示确定了四个等级:第1级:"健康/轻度迁就";第2级:"健康/迁就";第3级:"中度健康/中度迁就";第4级:"最不健康/最不迁就"。与 1 级相比,4 级儿童超重或肥胖的几率增加[调整后的几率比(aOR):1.64,95% 置信区间(CI):1.13-2.15],而 2 级和 3 级与 BMI 无关(2 级:aOR:1.24,95% CI:0.62-1.86;3 级:aOR:1.31,95% CI:0.81-1.81)。结论研究结果表明,在儿童饮食习惯的背景下,儿童与父母在进餐时的互动与儿童的体重状况有着不同的关系。最重要的是,我们的研究结果证实了在家庭社会和物理环境中培养多种健康习惯对抵消幼儿肥胖风险的重要性。
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引用次数: 0
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Childhood Obesity
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