Body mass index and parent-reported self-esteem in elementary school children: evidence for a causal relationship
Body mass index and parent-reported self-esteem in elementary school children: evidence for a causal relationship
复制标题
DOI：
10.1038/sj.ijo.0802624
复制
发表时间：
2004-10-01
影响因子：
4.9
通讯作者：
Waters, E
中科院分区：
文献类型：
--
作者：
Hesketh, K;Wake, M;Waters, E
目的：在人群水平上阐明幼儿体重指数（BMI）与自尊之间的关系。评估低自尊是否先于或跟随超重/肥胖儿童的发展。设计：前瞻性队列研究，在整个维多利亚，澳大利亚的小学。研究对象：随机抽取1157名小学前4年（5-10岁）儿童作为研究对象，测量身高和体重，计算BMI，并将其转换为Z分数。根据国际标准，儿童被分为非超重、超重或肥胖。低儿童自尊被定义为低于第15百分位数的父母报告的儿童健康Questionnaire.RESULTS：超重/肥胖儿童的自尊子量表的分数较低的中位数比非超重儿童在这两个时间点，特别是在后续。在考虑基线自尊后，较高的基线BMI z评分预测随访时自尊较差（P=0.008）。在考虑基线BMI z评分后，基线自尊较差并不能预测随访时BMI z评分较高。而非超重儿童低基线自尊更容易发展超重/肥胖（OR=2.1，95%CI =1.2，3.6），这只占一小部分的发病率overweight.CONCLUSIONS：我们的数据显示，越来越强的关联低自尊和高的身体质量在整个小学。在许多儿童中，超重/肥胖先于低自尊，这表明了因果关系。这表明儿童超重/肥胖的预防和管理策略需要及早开始，以尽量减少对自尊的影响。
OBJECTIVE: To clarify relationships between body mass index (BMI) and self-esteem in young children at a population level. To assess whether low self-esteem precedes or follows development of overweight/obesity in children.DESIGN: Prospective cohort study in elementary schools throughout Victoria, Australia. Child BMI and self-esteem were measured in 1997 and 2000.SUBJECTS: Random sample of 1157 children who were in the first 4 y of elementary school (aged 5-10 y) at baseline.MEASURES: BMI was calculated from measured height and weight, then transformed to z-scores. Children were classified as nonoverweight, overweight or obese based on international cut-points. Low child self-esteem was defined as a score below the 15th percentile on the self-esteem subscale of the parent-reported Child Health Questionnaire.RESULTS: Overweight/obese children had lower median self-esteem scores than nonoverweight children at both timepoints, especially at follow-up. After accounting for baseline self-esteem, higher baseline BMI z-score predicted poorer self-esteem at follow-up (P=0.008). After accounting for baseline BMI z-score, poorer baseline self-esteem did not predict higher BMI z-score at follow-up. While nonoverweight children with low baseline self-esteem were more likely to develop overweight/obesity (OR=2.1, 95% Cl=1.2, 3.6), this accounted for only a small proportion of the incidence of overweight.CONCLUSIONS: Our data show an increasingly strong association between lower self-esteem and higher body mass across the elementary school years. Overweight/obesity precedes low self-esteem in many children, suggesting a causal relationship. This indicates that prevention and management strategies for childhood overweight/obesity need to begin early to minimise the impact on self-esteem.