Association of sedentary time, physical activity with overweight and obesity in children

doi:10.11852/zgetbjzz2022-0370

Abstract

Abstract: Objective To explore the combined associations of after-school sedentary time(ST) and daily physical activity(PA) with children's overweight and obesity, so as to provide basis for formulating prevention and control strategies for children's overweight and obesity from the perspective of PA patterns. Methods Using stratified cluster random sampling method, 3 936 children aged 7 to 12 years in Guangzhou were recruited from March to June 2017. Children's PA and ST were assessed using a reliable and valid questionnaire. Overweight and obesity were determined according to the standards established by the Working Group on Obesity in China. After-school ST ≥2 h/d was regarded as high ST, and daily participation in moderate to high-intensity PA ≥60 min/d was regarded as high PA. Participants were finally cross-classified into four groups. Results The overall overweight and obesity rate of children aged 7 to 12 in Guangzhou was 21.5%. The prevalence rates of overweight and obesity in low ST/high PA group, low ST/low PA group, high ST/high PA group and high ST/low PA group were 18.9%,17.8%,23.1% and 22.3%, respectively. Compared with children in the low ST/ high PA group, children in the high ST/high PA group(OR=1.286, 95%CI:1.078 - 1.724), and high ST/low PA group(OR=1.219, 95%CI:1.059 - 1.641) had a higher risk for overweight and obesity. Conclusion PA and ST have a combined association with children's overweight and obesity, suggesting that intervention efforts should focus on ST reduction in addition to promoting PA.

Key words: sedentary time, physical activity, children, overweight and obesity

摘要： 目的探明久坐时间(ST)、体力活动(PA)与儿童超重肥胖的联合关系,为从身体活动角度制定儿童超重肥胖的防控策略提供依据。方法本研究采用分层整群随机抽样方法,于2017年3-6月共抽取3 936名广州市7~12岁儿童。采用信效度良好的问卷评估儿童的ST和PA水平,儿童超重肥胖依据中国肥胖工作组制定的标准进行判定。每天进行课后ST≥2 h/d视为高ST,每天参加中高等强度PA≥60 min/d视为高PA;高、低ST和PA两两交叉分组后形成四组别。结果广州市7~12岁儿童总体的超重肥胖率为21.5%。低ST高PA、低ST低PA、高ST高PA、高ST低PA四组别儿童的超重肥胖率分别为18.9%,17.8%,23.1%和22.3%。在控制了混杂因素后,与低ST高PA组儿童相比较,高ST高PA组儿童的超重肥胖风险是其1.286倍(95%CI:1.078~1.724),高ST低PA组儿童的超重肥胖风险是其1.219倍(95%CI:1.059~1.641)。结论 ST、PA与儿童超重肥胖间存在联合关系,有关部门从身体活动角度防控儿童超重肥胖时,除了考虑增加儿童中高等强度PA水平,也应多关注减少课后ST。

关键词: 久坐时间, 体力活动, 儿童, 超重肥胖

CLC Number:

R723.14

ZENG Xia, HUANG Ji-tian, CHEN Ya-jun. Association of sedentary time, physical activity with overweight and obesity in children[J]. Chinese Journal of Child Health Care, 2022, 30(7): 720-724.

曾霞, 黄吉填, 陈亚军. 久坐时间及体力活动与儿童超重肥胖的联合关系研究[J]. 中国儿童保健杂志, 2022, 30(7): 720-724.

References

[1] The GBD 2015 Obesity Collaborators. Health effects of overweight and obesity in 195 countries over 25 years[J]. N Engl J Med, 2017, 377(1):13-27.
[2] NCD Risk Factor Collaboration. Worldwide trends in body-mass index, underweight, overweight, and obesity from 1975 to 2016:A pooled analysis of 2416 population-based measurement studies in 128.9 million children, adolescents, and adults[J]. Lancet,2017, 390(10113):2627-2642.
[3] Pan XF, Wang L, Pan A. Epidemiology and determinants of obesity in China[J]. Lancet Diabetes Endocrinol, 2021,9(6):373-392.
[4] 袁金娜,金冰涵,斯淑婷,等. 2009至2019年6~15岁中国儿童超重和肥胖趋势分析[J]. 中华儿科杂志, 2021,59(11):935-941.
[5] 席波. 重视儿童肥胖与近期亚临床心血管损害[J]. 中国学校卫生,2019,40(6):803-804.
[6] Zhao M,López-Bermejo A, Caserta CA, et al. International childhood vascular structure evaluation consortium. metabolically healthy obesity and high carotid intima-media thickness in children and adolescents:International childhood vascular structure evaluation consortium[J]. Diabetes Care, 2019,42(1):119-125.
[7] Umer A, Kelley GA, Cottrell LE, et al. Childhood obesity and adult cardiovascular disease risk factors:A systematic review with meta-analysis[J]. BMC Public Health. 2017,17(1):683.
[8] 马冠生,张玉. 中国儿童肥胖防控面临的挑战和机遇[J].中国儿童保健杂志. 2020,28(2):117-119.
[9] Rosenberg DE, Lee I, Young DR, et al. Novel strategies for sedentary behavior research[J]. Med Sci Sports Exerc[J]. 2015,47(6):1311-1315.
[10] 李婷婷,伍晓艳,陶舒曼,等.大学生体力活动与身体健康及抑郁症状的关联[J].中国学校卫生,2020,41(6):867-870.
[11] 陈畅, 张云婷, 马生霞, 等. 儿童青少年久坐行为与健康风险[J]. 教育生物学杂志, 2018,6(4):207-212.
[12] Santos R,Mota J, Okely AD, et al. The independent associations of sedentary behaviour and physical activity on cardiorespiratory fitness[J]. Brit J Sport Med, 2014,48(20):1508-1512.
[13] Zeng X, Cai L, Wong SH, et al. Association of sedentary time and physical activity with executive function among children[J]. Acad Pediatr, 2021,21(1):63-69.
[14] 中国肥胖问题工作组. 中国学龄儿童青少年超重、肥胖筛查体重指数值分类标准[J]. 中华流行病学杂志, 2004,25(2):97-102.
[15] 吕雅杰,赖丽娟,李丹玲,等. 广州市小学生体质健康监测系统问卷的信效度研究[J].中国妇幼保健, 2020,35(8):1511-1516.
[16] 王娇,朱艳娜,麦锦城,等. 广州市7～12岁儿童超重肥胖状况及其与高血压的关系[J].中国学校卫生, 2014,35(10):1567-1569.
[17] 卢少敏,蔡莉,杨杰文,等. 广州市儿童静态生活与心血管代谢危险因素的关系[J].中华疾病控制杂志, 2019,23(10):1196-1201.
[18] 卢少敏,潘德鸿,刘金东,等.辽宁广东7~12岁儿童肥胖现状比较[J].中国学校卫生, 2017,38(2):173-176.
[19] 许良.我国中小学生体格发育南北差异比较[J].中国学校卫生, 2011,32(2):136-138.
[20] 黄鹤元,张唯,汤灿,等.南北方饮食文化差异对身体状况及性格影响[J].经营管理者,2016,32(1):347-348.
[21] Chomistek AK, Manson JE, Stefanick ML, et al. Relationship of sedentary behavior and physical activity to incident cardiovascular disease[J]. J Am Coll Cardiol,2013,61(23):2346-2354.
[22] Kett AR, Milani TL, Sichting F. Sitting for too long, moving too little:Regular muscle contractions can reduce muscle stiffness during prolonged periods of chair-sitting[J]. Front Sports Act Living, 2021,3:760533.
[23] Rezende LFMD, Rey-López JP, Matsudo VKR, et al. Sedentary behavior and health outcomes among older adults:A systematic review[J]. BMC Public Health, 2014,14(1):333.
[24] Ford ES,Caspersen CJ. Sedentary behaviour and cardiovascular disease:A review of prospective studies[J]. Int J Epidemiol, 2012,41(5):1338-1353.
[25] Stamatakis E, Gale J, Bauman A, et al. Sitting time, physical activity, and risk of mortality in adults[J]. J Am Coll Cardiol, 2019,73(16):2062-2072.
[26] Grøntved A, Hu FB. Television viewing and risk of type 2 diabetes, cardiovascular disease, and all-cause mortality[J]. JAMA, 2011,305(23):2448-2455.