Understanding the complex determinants of height and adiposity in disadvantaged daycare preschoolers in Salvador, NE Brazil through structural equation modelling

BMC Public Health

Research Article

Rebecca L. Lander¹  Lisa A. Houghton¹  Alastair G. Lander¹  Karl B. Bailey¹  Rosalind S. Gibson¹  Sheila M. Williams²  Hugo Costa-Ribeiro³  Angela P. Mattos³  Danile L. Barreto³ 

[1] Department of Human Nutrition, University of Otago, PO Box 56, 9015, Dunedin, New Zealand;Department of Preventive and Social Medicine, University of Otago, PO Box 56, Dunedin, New Zealand;Hospital Universitario Professor Edgard Santos, Fima Lifshitz Research Unit, Salvador, Bahia, Brazil;

关键词: Structural equation modelling;    Height;    Body mass index;    Adiposity;    Disadvantaged preschoolers;   

DOI  :  10.1186/s12889-015-2406-x

 received in 2014-08-17, accepted in 2015-10-12,  发布年份 2015

来源: Springer

【 摘 要 】

BackgroundEarlier we reported on growth and adiposity in a cross-sectional study of disadvantaged Brazilian preschoolers. Here we extend the work on these children, using structural equation modelling (SEM) to gather information on the complex relationships between the variables influencing height and adiposity. We hope this information will help improve the design and effectiveness of future interventions for preschoolers.MethodsIn 376 preschoolers aged 3–6 years attending seven philanthropic daycares in Salvador, we used SEM to examine direct and indirect relationships among biological (sex, ethnicity, birth order, maternal height and weight), socio-economic, micronutrient (haemoglobin, serum selenium and zinc), and environmental (helminths, de-worming) variables on height and adiposity, as reflected by Z-scores for height-for-age (HAZ) and body mass index (BMIZ).ResultsOf the children, 11 % had HAZ < −1, 15 % had WHZ < −1, and 14 % had BMIZ > 1. Of their mothers, 8 % had short stature, and 50 % were overweight or obese. Based on standardized regression coefficients, significant direct effects (p < 0.05) for HAZ were maternal height (0.39), being white (−0.07), having helminth infection (−0.09), and serum zinc (−0.11). For BMIZ, significant direct effects were maternal weight (0.21), extremely low SES (−0.15), and haemoglobin (0.14). Indirect (p < 0.05) effects for HAZ were sex (being male) (−0.02), helminth infection (−0.01), de-worming treatment (0.01), and serum selenium (−0.02), and for BMIZ were extremely low SES (−0.001), helminth infection (−0.004), and serum selenium (0.02).ConclusionsOf the multiple factors influencing preschoolers’ growth, helminth infection was a modifiable risk factor directly and indirectly affecting HAZ and BMIZ, respectively. Hence the WHO de-worming recommendation should include preschoolers living in at-risk environments as well as school-aged children.

【 授权许可】

CC BY   
© Lander et al. 2015