Coexistence of social inequalities in undernutrition and obesity in preschool children: population based cross sectional study
Coexistence of social inequalities in undernutrition and obesity in preschool children: population based cross sectional study
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DOI：
10.1136/adc.88.8.671
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发表时间：
2003-08-01
影响因子：
5.2
通讯作者：
Emmett, PM
中科院分区：
文献类型：
--
作者：
Armstrong, J;Dorosty, AR;Emmett, PM
目的：检验学龄前儿童营养不良和肥胖是否存在社会不平等。方法：回顾性、横断面研究1998/99年常规收集的74 500例39 ~ 42月龄儿童资料。主要结果测量指标为健康访视者常规记录的体重、身高、性别和年龄。相对于英国1990年的参考数据，采用年龄和性别标准化的体重指数（BMI）来定义营养不良（BMI < 2百分位）和肥胖（BMI > 95百分位；BMI > 98百分位）。社会剥夺被评估为Carstairs剥夺类别（1 =最富裕到7 =最贫困）。结果：营养不良（3.3%）和肥胖（95百分位以上8.5%，98百分位以上4.3%）显著超过英国1990年参考数据的预期频率。营养不良和肥胖在贫困家庭中更为普遍。第7类相对于第1类，营养不良（BMI < 2百分位）的比值比为1.51 (95% CI 1.22 ~ 1.87)，肥胖（BMI < 98百分位）的比值比为1.30 （95% CI 1.05 ~ 1.60）。最贫困群体中营养不足和营养过剩（营养不良）的累积患病率为9.5%，而最贫困群体为6.9%。结论：营养不良和肥胖在幼儿中比预期的要普遍得多，并且与社会剥夺密切相关。营养不良和肥胖都对健康有短期和长期的不利影响。公共卫生战略需要解决儿童营养不良（营养不足和肥胖）问题，并考虑到与社会剥夺的关系。
Aims: To test for the coexistence of social inequalities in undernutrition and obesity in preschool children.Methods: Retrospective, cross sectional, study of routinely collected data from 74 500 children aged 39 - 42 months in 1998/99. Main outcome measures were weight, height, sex, and age routinely recorded by health visitors. Body mass index (BMI) standardised for age and sex, relative to UK 1990 reference data, was used to define undernutrition ( BMI < 2nd centile) and obesity ( BMI > 95th centile; BMI > 98th centile). Social deprivation was assessed as Carstairs deprivation category ( 1 = most affluent to 7 = most deprived).Results: Both undernutrition (3.3%) and obesity (8.5% above 95th centile; 4.3% above 98th centile) significantly exceeded expected frequencies from UK 1990 reference data. Undernutrition and obesity were significantly more common in the more deprived families. Odds ratios in deprivation category 7 relative to category 1 were 1.51 (95% CI 1.22 to 1.87) for undernutrition ( BMI < 2nd centile) and 1.30 ( 95% CI 1.05 to 1.60) for obesity ( BMI > 98th centile). The cumulative prevalence of under and overnutrition ( malnutrition) in the most deprived group was 9.5% compared to 6.9% in the least deprived group.Conclusions: Undernutrition and obesity are significantly more common than expected in young children and strongly associated with social deprivation. Both undernutrition and obesity have adverse short and long term health effects. Public health strategies need to tackle malnutrition ( both undernutrition and obesity) in children and take into consideration the association with social deprivation.