摘要：Objectives. This study determined the prevalence of Minnesota urban youths reaching the Healthy People 2010 objectives for obesity and intake of fat, calcium, fruits, vegetables, and grains and compared prevalence rates across sociodemographic characteristics. Methods. The study sample included 4746 adolescents (aged 11–18 years) from the Minneapolis/St. Paul area who completed dietary surveys and participated in anthropometric measurements as part of a school-based population study. Results. Considerable gaps were seen between the existing prevalence rates for obesity and nutrient and food patterns and the targeted Healthy People 2010 prevalence rates. For example, 12.5% of the girls and 16.6% of the boys had body mass index values at or greater than the 95th percentile (target = 5%). Only 29.5% of the girls and 42.5% of the boys were meeting the daily recommended intakes for calcium (target = 75%). Similarly, percentages of youths consuming the recommended amounts of fat, fruits, vegetables, and grains were lower than the targeted percentages. There were large sociodemographic disparities in obesity and eating patterns, particularly across race/ethnicity and socioeconomic status. Conclusions. Concerted public health efforts are needed to achieve the Healthy People 2010 objectives for obesity and nutrition and to reduce racial/ethnic and socioeconomic disparities. Dietary patterns developed during adolescence may contribute to obesity and eating disorders and may increase the risk for several important chronic diseases later in life. 1 Being overweight as an adolescent is associated with being overweight as an adult. 2 Fat intake during childhood and adolescence is associated with increased risk for coronary heart disease in adulthood. 2 Low dietary calcium intake has been shown to lead to low bone density in adolescents and possibly to osteoporosis later in life. 3 Furthermore, nutritional intake is of particular importance in adolescence because of rapid growth and development during this period. 2, 4, 5 Despite the importance of nutrition during adolescence, not enough is known about the eating behaviors of young people. Healthy People 2010 is a comprehensive, nationwide health promotion and disease prevention agenda that includes 467 objectives in 28 focus areas. 6 It was developed by the US Department of Health and Human Services as a 10-year strategy for improving the health of the nation. Healthy People 2010 aims to achieve 2 overarching goals: (1) increase quality and years of healthy life and (2) eliminate health disparities. In light of the high prevalence of nutrition-related conditions and the strong potential for the prevention of these conditions, “nutrition and overweight” is one of the focus areas addressed. 6 Healthy People 2010 objectives with particular relevance to the nutritional health of adolescents target levels of obesity, fat intake, intake of calcium-rich foods, and intake of fruits, vegetables, and grains (Table 1 ▶ ). In planning effectively for the achievement of the Healthy People 2010 objectives, an assessment of current eating patterns among youths is essential. Furthermore, in working toward decreasing disparities across racial/ethnic, socioeconomic, and other sociodemographic characteristics, baseline prevalence rates within different subgroups of the population need to be assessed. TABLE 1— Healthy People 2010 Objectives for Overweight and Nutritional Health of Relevance to Youths Who Were Examined in This Study Overweight status Reduce the proportion of children and adolescents who are overweight or obese (target: 5% at ≥95th percentile). Dietary fat Increase the proportion of persons 2 years and older who consume less than 10% of calories from saturated fat (target: 75%). Calcium Increase the proportion of persons 2 years and older who meet dietary recommendations for calcium (target: 75% consuming ≥1300 mg/day). Fruits Increase the proportion of persons 2 years and older who consume at least 2 daily servings of fruit (target: 75%). Vegetables Increase the proportion of persons 2 years and older who consume at least 3 daily servings of vegetables, with at least one third being dark green or deep yellow vegetables (target: 50%). Grains Increase the proportion of persons 2 years and older who consume at least 6 daily servings of grain products, with at least 3 being whole grains (target: 50%). Open in a separate window Population-based studies of adolescent health have tended to be of a comprehensive nature with limited numbers of questions on eating behaviors. For example, the Youth Risk Behavior Survey, the Connecticut Youth Survey, the Commonwealth Fund Study, and the Minnesota Adolescent Health Survey have provided important information on eating behaviors among large and diverse adolescent populations, but questions assessing eating behaviors have been limited in scope and have not been adequately tested for reliability and validity. 7– 10 Furthermore, these larger studies relied on self-reported heights and weights; actual anthropometric measurements were not taken. Studies with more comprehensive assessments of nutritional intake typically have not included large numbers of adolescents, 11 have not focused on identifying psychosocial and behavioral correlates of eating behaviors, 12– 15 and have been narrowly focused (e.g., calcium intake only). 16 Even the Continuing Survey of Food Intakes by Individuals, which provided 2-day dietary intake data on a large representative sample of individuals within the United States, included only 1300 adolescents (aged 12–19 years), thus making comparisons across sociodemographic characteristics such as race/ethnicity somewhat difficult. 17, 18 Data for the current study were drawn from Project EAT (Eating Among Teens), a comprehensive study of adolescent eating patterns and weight concerns that was designed to address the limitations of previous studies on adolescent eating behaviors. The current study aimed to assess the prevalence of obesity and the eating behaviors targeted in Healthy People 2010 among a large populationbased sample of Minnesota urban youths. Percentages of adolescents reaching the Year 2010 objectives for obesity and intake of total fat, saturated fat, calcium, fruits, vegetables, and grains were examined and compared across sex, school level, race/ethnicity, and socioeconomic status (SES).
