Budd Geraldine M, Hayman Laura L
College of Nursing and Health Professions, Drexel University, Philadelphia, PA, USA.
MCN Am J Matern Child Nurs. 2008 Mar-Apr;33(2):111-8, quiz 119-20. doi: 10.1097/01.NMC.0000313419.51495.ce.
The prevalence of childhood obesity is increasing in the United States and globally. Associated with numerous comorbid conditions, childhood obesity is also recognized as a risk factor for multiple chronic conditions and premature mortality in adult life. Children and adolescents, particularly those from ethnic minorities and rural low income populations, bear an excess burden of obesity and its attendant comorbidities. A major contributor to childhood obesity is a physical and social environment that promotes foods high in fat and calories and minimizes the opportunities for physical activity. Despite the strong environmental influences that encourage overeating and sedentary behavior, weight maintenance is viewed as a personal responsibility. Addressing the obesity crisis requires a paradigm shift away from blaming individuals for the lack of will power to control their eating and physical activity to one of recognizing the "toxic" or "obesigenic" environment as a primary determinant. This article addresses the obesity crisis from individual, family, local community, and public policy perspectives. Emphasis is placed on the role of nurses and nursing, acting to promote change with individuals and families and acting as advocates for multilevel policy initiatives, in reversing the epidemic and improving the health of future generations.
在美国及全球范围内，儿童肥胖的患病率正在上升。儿童肥胖与众多合并症相关，它也被视为成年后多种慢性疾病和过早死亡的一个风险因素。儿童和青少年，尤其是来自少数族裔和农村低收入人群的儿童和青少年，承受着肥胖及其相关合并症的额外负担。儿童肥胖的一个主要促成因素是这样一种物理和社会环境，它推崇高脂肪和高热量食物，并将身体活动的机会减到最少。尽管存在鼓励暴饮暴食和久坐行为的强大环境影响，但体重维持仍被视为个人责任。应对肥胖危机需要一种范式转变，即从指责个人缺乏控制饮食和身体活动的意志力，转变为认识到“有毒”或“致肥胖”环境是主要决定因素。本文从个人、家庭、当地社区和公共政策的角度探讨肥胖危机。重点强调护士和护理工作在促使个人和家庭做出改变以及作为多层次政策倡议倡导者方面所发挥的作用，以扭转这一流行趋势并改善后代的健康状况。
