Food Insecurity Influences Weight Trajectory in Children with Obesity.
Food Insecurity Influences Weight Trajectory in Children with Obesity.
复制标题
粮食不安全影响肥胖儿童的体重轨迹。
DOI：
10.1089/chi.2021.0311
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发表时间：
2022
期刊：
影响因子：
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通讯作者：
Rosas,LisaG
中科院分区：
文献类型：
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作者：
Tester,JuneM;Xiao,Lan;Tinajero-Deck,Lydia;Juarez,Lourdes;Rosas,LisaG
背景：社会弱势与儿童超重或肥胖的风险有关，但对其如何影响体重轨迹知之甚少。这项纵向分析研究了多学科体重管理诊所中低收入儿童随时间推移的食物不安全和体重变化。方法：在2008年至2016年期间，对794名参加3234次就诊的低收入患者（家庭收入<6万美元/年）进行了食物不安全评估。采用混合效应生长曲线模型，使用BMI第95百分位数的百分比（%BMIp95），检查基线食品安全状况与体重轨迹之间的关联。随机效应（每个孩子的生长曲线）和固定效应（食物不安全，起始年龄和%BMIp95，人口统计学，和月自首次访问）进行了建模，食物不安全和经过的时间之间的相互作用估计食物不安全对体重轨迹的影响。结果：平均%BMIp95为129%（SD 24%），对应于严重肥胖。30%的患者在基线时食物不安全。在调整其他因素后，与食物安全的同龄人相比，食物不安全儿童的%BMIp95月变化显著较小（斜率系数差异：0.13，SE 0.05，p = 0.009）。模拟的12个月%BMIp95的变化对于食物安全的儿童是显著的（-2.28，SE0.76，p = 0.0026），但对于食物不安全的儿童不是（-1.54，SE1.22，p = 0.21）。结论：家庭食物不安全与肥胖儿童的不太理想的体重轨迹相关。
Background:Social disadvantage is associated with children's risk of being overweight or obese, but little is known about how it impacts weight trajectory. This longitudinal analysis examines food insecurity and weight change over time among low-income children in a multidisciplinary weight management clinic.Methods:Food insecurity was assessed between 2008 and 2016 among 794 low-income patients (household income <$60k/year) who attended 3234 visits. Mixed-effects growth curve modeling was used to examine the association between baseline food security status and weight trajectory, using percentage of the 95th percentile for BMI (%BMIp95). Random effects (each child's growth curve) and fixed effects (food insecurity, starting age and %BMIp95, demographics, and months since the initial visit) were modeled, and interactions between food insecurity and elapsed time estimated the influence of food insecurity on weight trajectory.Results:Mean %BMIp95 was 129% (SD 24%), corresponding to severe obesity. Thirty percent of patients were food-insecure at baseline. After adjusting for other factors, monthly change in %BMIp95 was significantly smaller for food-insecure children compared to food-secure peers (difference in the coefficients for slope: 0.13, SE 0.05,p= 0.009). The modeled 12-month change in %BMIp95 was significant for food-secure children (−2.28, SE 0.76,p= 0.0026), but not for food-insecure children (−1.54, SE 1.22,p= 0.21).Conclusion:Household food insecurity was associated with a less optimal weight trajectory among children with obesity.