学龄前儿童家庭环境中超重和肥胖危险因素分析

Family risk factors of overweight and obesity in preschool children

目的对北京市1173名儿童家长进行问卷调查,探讨北京市学龄前儿童家庭中与儿童超重和肥胖有关的危险因素。方法在北京市2个城区在园儿童数200人以上的机关直属幼儿园中随机选择5所幼儿园为调查单位,5所幼儿园中的1364名儿童为调查对象,对调查儿童进行身高和体重的测量,采用国际肥胖工作组不同年龄和性别的体重指数作为儿童超重和肥胖的判定标准。对所有调查儿童家长发放问卷进行调查,共收集填写完整的问卷1173份,回收率86%。问卷内容为家庭饮食习惯和生活方式、喂养方式、家长特征等。结果调查儿童中肥胖和超重的检出率分别为4.1%和6.9%。父母均肥胖的家庭儿童肥胖和超重的总检出率为15.2%,父母非肥胖家庭肥胖和超重的总检出率为7.5%;父母和儿童在体重指数、餐馆就餐频率、运动时问和看电视时间上存在正相关;多因素分析发现,父母肥胖、母亲文化程度低、儿童看电视和玩电脑游戏时间长是儿童肥胖和超重的危险因素。结论家庭环境对儿童肥胖的发生、发展影响较大,应针对家庭危险因素对儿童超重和肥胖进行有效干预。

Objective To explore family risk factors of overweight and obesity focusing on parental characteristics, feeding practice and lifestyle. Methods Five kindergartens were selected randomly from two of all the six urban districts in Beijing. The body height and weight of all the children in the 5 kindergartens were measured in light clothing and without shoes. Information on parental characteristics, dietary habits, lifestyle, and feeding practice was collected from 1173 families by parental self-report questionnaires in the 5 kindergartens. Overweight and obesity were defined according to sex- and age-spocific body mass index （BMI） cut-points proposed by the International Obesity Task Force. Correlations and multivariate regression analysis was used to explore risk factors of child overweight and obesity. Results The prevalence of overweight and obesity was 6. 9% and 4. 1%, respectively, among the sample children. Significantly more overweight and obese children were from obese families （ 15.2% ） than they were from non-obese families （7. 5% ）. Significant associations could be observed between children and parents＇ characteristics for BMI, frequency of eating in restaurant, television-watching hours, and physical activity hours. Parental obesity, low maternal education level and television watching for 〉 2 h/d were risk factors of child overweight and obesity after adjusting for sex, age, family income, and kindergarten. Conclusions Child overweight and obesity were influenced by family environment. Strategies for prevention should include identified family risk factors.