The home environment and childhood obesity in low-income households: indirect effects via sleep duration and screen time.
The home environment and childhood obesity in low-income households: indirect effects via sleep duration and screen time.
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DOI：
10.1186/1471-2458-14-1160
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发表时间：
2014-11-09
影响因子：
4.5
通讯作者：
Pagoto SL
中科院分区：
文献类型：
--
作者：
Appelhans BM;Fitzpatrick SL;Li H;Cail V;Waring ME;Schneider KL;Whited MC;Busch AM;Pagoto SL
儿童肥胖症对低收入家庭儿童的影响不成比例。为了给干预措施提供信息，这项研究调查了物质和社会家庭环境可能促进低收入家庭儿童超重/肥胖的途径。在家访中收集了低收入城市家庭的健康行为和家庭环境数据，这些家庭只有正常体重(n = 48)或以超重/肥胖为主(n = 55)的6-13岁儿童。研究人员对每个家庭的食物、媒体和运动器材进行了全面的、面对面的审计。收集人体测量值，并通过加速度计评估儿童的体力活动。照顾者和儿童共同报告了儿童睡眠时间、屏幕时间和先前与儿童肥胖风险有关的食物的饮食摄入量。路径分析被用来通过评估的健康行为来测试家庭环境和儿童体重状况之间的直接和间接联系。睡眠时间是唯一与儿童体重状况相关的健康行为(OR = 为0.45，95%CI：0.27，0.77)，正常体重儿童平均每天睡眠时间比超重/肥胖儿童多33.3min/d。最佳拟合路径模型解释了儿童体重状况26%的差异，包括家庭环境混乱、照顾者屏幕时间监控较低、就寝时间常规执行不一致、儿童卧室里有一台电视通过影响屏幕时间和睡眠时间与儿童超重/肥胖有关的路径。这项研究通过间接影响低收入家庭儿童的屏幕时间和睡眠时间，确定了家庭环境对儿童体重状况的影响，从而补充了现有的文献。通过针对与睡眠相关的物质和社会家庭环境的各个方面，低收入家庭的儿科体重管理干预措施可能会得到改善。
Childhood obesity disproportionally affects children from low-income households. With the aim of informing interventions, this study examined pathways through which the physical and social home environment may promote childhood overweight/obesity in low-income households. Data on health behaviors and the home environment were collected at home visits in low-income, urban households with either only normal weight (n = 48) or predominantly overweight/obese (n = 55) children aged 6–13 years. Research staff conducted comprehensive, in-person audits of the foods, media, and sports equipment in each household. Anthropometric measurements were collected, and children’s physical activity was assessed through accelerometry. Caregivers and children jointly reported on child sleep duration, screen time, and dietary intake of foods previously implicated in childhood obesity risk. Path analysis was used to test direct and indirect associations between the home environment and child weight status via the health behaviors assessed. Sleep duration was the only health behavior associated with child weight status (OR = 0.45, 95% CI: 0.27, 0.77), with normal weight children sleeping 33.3 minutes/day longer on average than overweight/obese children. The best-fitting path model explained 26% of variance in child weight status, and included paths linking chaos in the home environment, lower caregiver screen time monitoring, inconsistent implementation of bedtime routines, and the presence of a television in children’s bedrooms to childhood overweight/obesity through effects on screen time and sleep duration. This study adds to the existing literature by identifying aspects of the home environment that influence childhood weight status via indirect effects on screen time and sleep duration in children from low-income households. Pediatric weight management interventions for low-income households may be improved by targeting aspects of the physical and social home environment associated with sleep.
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作者：
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