Isganaitis Elvira, Levitsky Lynne L
Pediatric Endocrine Unit, Massachusetts General Hospital for Children, Boston, Massachusetts 02114, USA.
Curr Opin Endocrinol Diabetes Obes. 2008 Feb;15(1):1-8. doi: 10.1097/MED.0b013e3282f44a07.
This review critically examines recent publications on prevention of childhood obesity and places these publications within a biologic, epidemiologic, public health, and policy context. It should help practitioners advocate effective preventive strategies and develop effective plans of action for research and policy.
Risk factors for childhood obesity include low socioeconomic status, maternal obesity, rapid infancy weight gain, and decreased physical activity. Changes in food availability and activity levels during the past 30 years are well documented. Obesity prevention programs have had limited success but they demonstrate that changes in school and community environments can decrease childhood weight gain. Legislative approaches to the obesity epidemic have not led to changes in governmental agricultural policy or in the food and marketing industry.
Obesity in childhood is a major public health problem and contributes to significant morbidity in adulthood. It is the natural biologic outcome of an unprecedented increase of food availability and intake, coupled with decreased energy output. Present obesity prevention measures have been small scale and timid. Public policy measures to address the obesity epidemic have not yet been sufficiently strong to be effective. Suggestions are made to intensify public education and change national behaviors.
本综述批判性地审视了近期关于预防儿童肥胖的出版物，并将这些出版物置于生物学、流行病学、公共卫生和政策背景中。它应有助于从业者倡导有效的预防策略，并制定有效的研究和政策行动计划。
儿童肥胖的风险因素包括社会经济地位低下、母亲肥胖、婴儿期体重快速增加以及身体活动减少。过去30年中食物供应和活动水平的变化有充分记录。肥胖预防项目取得的成功有限，但它们表明学校和社区环境的改变可以减少儿童体重增加。针对肥胖流行的立法措施并未导致政府农业政策或食品及营销行业的改变。
儿童肥胖是一个主要的公共卫生问题，并导致成年期的显著发病率。它是食物供应和摄入量空前增加，同时能量输出减少的自然生物学结果。目前的肥胖预防措施规模较小且不够大胆。应对肥胖流行的公共政策措施尚未强大到足以产生效果。建议加强公众教育并改变国民行为。
