【疫学的研究方法の実際：ケースコントロール研究】小児肥満予防のための地域看護的介入に関する基礎的研究

A Basic Study Relating to Community Health Nursing Intervention in Preventing Childhood Obesity

はじめに

　小児肥満は小児成人病や大人の生活習慣病との関連などのため，近年注目を浴びており，研究も多数なされている（Freedmanら，1987；角田ら，1994；Menghettiら，1995；大見ら，1995）。小児肥満の要因としては遺伝が関与しているが，環境の影響も無視できない（伊津野，1999）。また，小学生の期間には幼児期から引き継がれた肥満が解消することはほとんどないといわれている（大見ら，1995）。そして，小児肥満はそのまま放置されると，70〜80％が成人の肥満につながるともいわれている（楠，1974）。しかし，乳幼児期から学童期や思春期に至るまで，成長過程を継続して追跡した研究は少ないため，小児肥満の形成時期やそれに関係する要因については明確ではない。

　そこで，本研究は6歳の児童の成長の経過について，出生時期までさかのぼることで，小児肥満がいつ頃，どのような要因が関与して形成されるのかを探り，適切な地域看護的介入について考察することを目的としている。

　The purpose of this study was to find out the factors for childhood obesity and obtain the ways of suitable community health nursing intervention.

　The sample were 537 six-year-old school children who were in Fukui Prefecture in 1997. Thirty seven obese children were in the sample. Two of the same sex, height and weight at the birth time were applied to each obese child to make a matched-pair. Their height and weight at birth time, one month old, four months old, 18 months old, three years old, and six years old time were analyzed. The factors relating to childhood obesity such as family, past and present eating habits were also analyzed.

　It was found that the obese children had eaten baby food more, ate more and faster at six year of age than the controlled ones. It was also found that obese children were tendentious to be the only child or the last one in the family, and did not fond of exercise. The trend of childhood obesity began at their baby age and continued till six years old. There seems to increase the rate of obese children in their later life because of eating habits.

　The community health nurses would be able to advise the mothers at the baby or infant clinic or at the health education to prevent childhood obesity.