無家可歸孩童的過重與齲齒


  【24drs.com】新研究發現,無家可歸孩童的齲齒與肥胖比率高於一般孩童。線上刊載於兒科健康照護期刊的研究顯示,因為無家可歸而居住在庇護所的孩童,其齲齒率和身體質量指數(BMI)都偏高,但是未達統計上的顯著程度( P = .08)。
  
  研究者推論,類似的飲食因素可能會導致齲齒和肥胖;Marguerite DiMarco博士表示,困苦孩童無法獲得有營養的食物。
  
  DiMarco博士研究這些貧童數十年,有些家庭甚至沒有冰箱儲放牛奶,有些家庭連自來水都沒有;她表示,部分無家可歸的孩童依賴便利商店和速食店取得食物。
  
  肥胖孩童比率日增。報告指出,肥胖孩童百分比自1980年來已經加倍。齲齒也是孩童常見疾病,影響超過25%的2-5歲孩童以及50%的12-15歲孩童。
  
  同時有齲齒且肥胖的孩童中,研究者針對兩者之間的關聯性研究結果互異。
  
  DiMarco博士等人報告指出,無家可歸孩童的齲齒率相當高,甚至比住在家中的貧童還高;口腔健康不佳影響了飲食和營養,也會導致發育、語言和學習不佳。
  
  為了更加暸解無家可歸孩童的肥胖與齲齒,研究者調查了居住在俄亥俄州庇護所的157名2-17歲孩童,其中64%是黑人、34%是白人、2%是西班牙裔或其他種族,多數孩童是來自20多歲女性當家的家庭。
  
  研究者測量了這些孩童的BMI,若超過疾病管制中心學齡BMI量表的95%者則分類為肥胖;使用「孩童口腔健康狀態視覺篩檢」測量齲齒。他們發現,30.6%孩童為肥胖,50.3%有齲齒,這些比率高於美國的一般報告:2-5歲孩童約四分之一有齲齒,約五分之一有齲齒但未接受治療,16.3%為肥胖。
  
  DiMarco博士等人發現,無家可歸孩童的BMI百分位隨年紀而增加,從2-6歲的74.1%增加到12-17歲的76.8%。
  
  他們發現年紀和BMI百分位之間( P = .03)、年紀和齲齒分數之間( P = .003)有統計顯著的正相關;不過,研究者並未發現齲齒和BMI之間有統計顯著關聯( r = 0.14;P = .08);作者們表示,研究限制在於他們未能控制營養等其他變項。
  
  之前的研究發現,常喝含糖飲料和攝取咖啡因都會促成肥胖和齲齒。營養師Teresa A. Marshall博士表示,但是,飲食對肥胖和齲齒的關聯是難以分析的。
  
  愛荷華大學預防與社區牙科副教授、未參與此次研究的Marshall博士表示,這是根據有限案例之有趣的初步資料,希望這些研究者繼續研究且增加案例數,以便可以比較正常體重、過重和肥胖孩童之間的齲齒率。
  
  資料來源:http://www.24drs.com/professional/list/content.asp?x_idno=6962&x_classno=0&x_chkdelpoint=Y
  

High Obesity, Caries Documented in Homeless Children

By Laird Harrison
Medscape Medical News

Homeless children have higher rates of caries and obesity than children in the general population, a new study shows.

The study, published online November 13 in the Journal of Pediatric Healthcare, showed that rates of caries among children living in shelters for the homeless increased with body mass index (BMI), but this correlation did not reach statistical significance ( P = .08).

The researchers speculated that similar dietary factors might contribute to both caries and obesity. "Poor kids don't have access to nutritious foods," Marguerite DiMarco, PhD, RN, CPNP, told Medscape Medical News.

DiMarco said she had spent decades working with very poor children. "Some families don't even have a refrigerator to keep milk," she said. "Some families might not even have running water."

Some homeless children depend on convenience stores and fast-food restaurants as sources of food, she said.

Obesity is increasing among children. The percentage of children who are obese has more than doubled since 1980, the researchers reported. And caries is a common disease among children, afflicting more than 25% of children aged 2 to 5 years and 50% of children aged 12 to 15 years.

Although many children have both caries and obesity, researchers so far have reported contradictory findings about the relationship of these conditions.

Caries rates are extremely high among homeless children, higher even than among poor children who live in houses, DiMarco and her colleagues reported.

Poor oral health affects diet and nutrition and can lead to deficits in growth, speech, and learning, they said.

In effort to learn more about obesity and caries in homeless children, the researchers surveyed a population of 157 children aged 2 to 17 years living in an Ohio shelter. Sixty-four percent of the children were black, 34% were white, and 2% were Hispanic or other ethnicity. Most children were in families headed by a woman in her twenties.

The researchers measured the children's BMI and classified them as obese if they were above 95% on the Centers for Disease Control and Prevention BMI Tool for Schools.

They measured caries by using the Visual Screening for Evaluating Oral Health Status in Children.

They found that 30.6% of the children were obese and 50.3% had caries. The rates are higher than those reported for the United States as a whole: In those reports, about a quarter of children aged 2 to 5 years have had caries, about a fifth have untreated caries, and 16.3% are obese.

DiMarco and her colleagues found that BMI percentile increased with age in the homeless children: from 74.1% at age 2 to 6 years to 76.8% at age 12 to 17 years.

They found a statistically significant positive correlation between age and BMI percentile ( P = .03) and between age and caries score ( P = .003).

However, the researchers did not find a statistically significant correlation between caries and BMI ( r = 0.14; P = .08).

The authors acknowledged as a weakness of their study that they did not control for other variables, such as nutrition.

Previous research has found that increased consumption of highly sweetened drinks and habitual use of caffeine can contribute to both obesity and caries.

But the relationship of diet to both obesity and caries is "difficult to analyze," dietitian Teresa A. Marshall, PhD, told Medscape Medical News in an email.

"This is interesting preliminary data based on a limited number of subjects," said Marshall, an associate professor in the Department of Preventive and Community Dentistry at the University of Iowa in Iowa City, who was not involved in this study.

"I hope these researchers continue investigation with additional subjects where they are able to compare caries rates between normal, overweight and obese children."

    
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