Moreno Luis A, Rodríguez Gerardo
University School of Health Sciences, and Department of Pediatrics, University of Zaragoza, C/Domingo Miral s/n, 50009 Zaragoza, Spain.
Curr Opin Clin Nutr Metab Care. 2007 May;10(3):336-41. doi: 10.1097/MCO.0b013e3280a94f59.
Controversial information exists on the contribution of several dietary factors for overweight development in childhood, but there is no doubt that obesity prevalence is increasing. We review the most up-to-date information in order to clarify the evidence-based dietary aspects influencing obesity development in children and adolescents.
Longitudinal studies are the preferred method for analysing the relationship between dietary factors and obesity development. With the exception of infants, there are no conclusive associations between energy intake or diet composition and later overweight development in children. Among formula or mixed-fed infants, the increase in energy intake has been associated with an increased risk of being overweight during childhood. Breastfeeding seems to be a protective factor for later obesity development. In terms of food intake, longitudinal studies have only found a clear and positive association between obesity development and sugar-sweetened beverage consumption; this is not the case with snacking, fast food or food portion sizes. Cross-sectional studies have found correlations between being overweight in childhood and buying lunch at school, eating supper while watching television or without family supervision, consuming less energy at breakfast or more at dinner, and missing breakfast.
Results from longitudinal studies must be taken into account in order to design preventive strategies to counteract the increased prevalence of obesity and its consequences in children. Lack of breastfeeding, high early energy intake and high intake of sugar-sweetened beverages seem to be the main dietary factors contributing to obesity development.
关于多种饮食因素对儿童超重发展的影响存在有争议的信息,但肥胖患病率无疑正在上升。我们回顾最新信息,以阐明影响儿童和青少年肥胖发展的循证饮食方面。
纵向研究是分析饮食因素与肥胖发展之间关系的首选方法。除婴儿外,能量摄入或饮食组成与儿童后期超重发展之间没有确凿的关联。在配方奶喂养或混合喂养的婴儿中,能量摄入增加与儿童期超重风险增加有关。母乳喂养似乎是后期肥胖发展的一个保护因素。在食物摄入方面,纵向研究仅发现肥胖发展与含糖饮料消费之间存在明确的正相关;零食、快餐或食物份量则并非如此。横断面研究发现儿童期超重与在学校购买午餐、边看电视或无人监督时吃晚餐、早餐摄入能量较少或晚餐摄入能量较多以及不吃早餐之间存在相关性。
为了设计预防策略以应对儿童肥胖患病率上升及其后果,必须考虑纵向研究的结果。缺乏母乳喂养、早期能量摄入高以及含糖饮料摄入量高似乎是导致肥胖发展的主要饮食因素。