Growth Trajectories of Refugee and Nonrefugee Children in the United States
Growth Trajectories of Refugee and Nonrefugee Children in the United States
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DOI：
10.1542/peds.2016-0953
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发表时间：
2016-12-01
期刊：
影响因子：
8
通讯作者：
Mendoza, Jason A.
中科院分区：
文献类型：
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作者：
Dawson-Hahn, Elizabeth;Pak-Gorstein, Suzinne;Mendoza, Jason A.
背景和结论：有限的数据研究了美国重新安置后难民儿童的纵向营养结果。在难民儿童中，我们的目的是（1）评估基线和基线之间基于体重的营养状况的变化，（2）比较抵达后36个月内非难民儿童的BMI（BMIz）或身长体重z评分（WFLz）轨迹。我们对来自华盛顿和宾夕法尼亚州的0-16岁难民进行了回顾性研究，并将其与来自华盛顿的年龄和性别匹配的非难民低收入样本进行了比较。数据包括从最初的筛选医疗访问和随后的初级保健访问的人体测量。多水平线性混合效应回归模型评估BMIz或WFLz轨迹的变化。结果：该研究包括512名难民和1175名非难民儿童。从基线到10-24个月，2- 16岁难民的超重/肥胖未校正患病率从8.9%增加到20%（P <0.001）。与非难民相比，难民（2-16岁）每12个月的BMIz增加幅度更大（系数0.18 vs 0.03; P <0.001）。与非难民儿童相比，< 2岁的难民儿童每12个月的WFLz增加幅度较小（系数为0.12 vs 0.36，P = .002）。结论：年龄较大的难民儿童比非难民儿童肥胖的风险更高，而< 2岁的难民儿童比非难民儿童肥胖的风险增加较慢。所有年龄组的肥胖患病率都在增加。有针对性和文化上适合的肥胖预防干预措施可以减轻难民儿童的健康和营养不平等。
BACKGROUND AND OBJECTIVES: Limited data examine longitudinal nutrition outcomes of refugee children after United States resettlement. Among refugee children, our aims were to (1) assess the changes in weight-based nutritional status between baseline (0-3 months) and 10-24 months after arrival and (2) compare the BMI (BMIz) or weight-for-length z score (WFLz) trajectories to nonrefugee children for up to 36 months after arrival.METHODS: We conducted a retrospective study of refugees aged 0-16 years from Washington and Pennsylvania and compared them with an age and sex-matched nonrefugee low-income sample from Washington. Data included anthropometric measurements from the initial screening medical visit and subsequent primary care visits. Multilevel linear mixed-effects regression models evaluated the change in BMIz or WFLz trajectory.RESULTS: The study included 512 refugee and 1175 nonrefugee children. The unadjusted prevalence of overweight/obesity increased from 8.9% to 20% (P < .001) for 2- to 16-year-old refugees from baseline to 10-24 months. Refugees (2-16 years old) had a steeper increase in their BMIz per 12 months compared with nonrefugees (coefficient 0.18 vs 0.03; P < .001). Refugees < 2 years old had a less steep increase in their WFLz per 12 months compared with nonrefugees (coefficient 0.12 vs 0.36, P = .002).CONCLUSIONS: Older refugee children exhibited a higher risk of obesity than nonrefugees, whereas refugees < 2 years old exhibited a slower increase in their risk of obesity than nonrefugee children. All age groups experienced increasing obesity prevalence. Targeted and culturally tailored obesity prevention interventions may mitigate health and nutrition inequities among refugee children.