The Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland.
Acta Paediatr. 2010 Jun;99(6):888-95. doi: 10.1111/j.1651-2227.2009.01636.x. Epub 2009 Dec 11.
The aim of this study was to evaluate the impact of individualised dietary and lifestyle counselling, primarily aimed to decrease serum low-density lipoprotein cholesterol, on the clustering of overweight-related cardiometabolic risk factors in children.
The 7-month-old study children were randomized either to counselling (n = 540) or control group (n = 522).
The 5- to 15-year-old participants who fulfilled the international criteria were classified as overweight. Being in the highest [lowest for high-density lipoprotein (HDL) cholesterol] age- and gender-specific quintile of body mass index (BMI), blood pressure, serum triglycerides, HDL cholesterol or glucose was considered a risk factor. A cluster was defined as having high BMI and > or = 2 other risk factors.
The counselling did not reduce the prevalence of overweight in 5- to 15-year-old participants. From age 7 onwards, the proportion of children with > or = 2 risk factors was lower in the intervention than in the control group (p = 0.005). At the age of 15 years, 13.0% of girls and 10.8% of boys in the intervention group and 17.5% of girls and 18.8% of boys in the control group had the risk factor cluster (p = 0.046 for main effect of the study group). Having even one risk factor at the age of 5 years predicted the clustering of risk factors at the age of 15 years (OR: 3.8, p < 0.001).
Repeated, individualized dietary and lifestyle counselling may reduce the clustering of overweight-related cardiometabolic risk factors in adolescents even though the counselling is not intense enough to prevent overweight.
本研究旨在评估个体化饮食和生活方式咨询的效果，主要目的是降低血清低密度脂蛋白胆固醇，以减少儿童超重相关心血管代谢危险因素的聚集。
7 个月大的研究儿童被随机分为咨询组（n=540）或对照组（n=522）。
符合国际标准的 5-15 岁参与者被归类为超重。处于体重指数（BMI）、血压、血清甘油三酯、高密度脂蛋白（HDL）胆固醇或血糖的最高（HDL 胆固醇最低）年龄和性别五分位的参与者被认为是一个危险因素。一个聚类被定义为具有高 BMI 和>或=2 个其他危险因素。
咨询并未降低 5-15 岁参与者超重的发生率。从 7 岁开始，干预组中具有>或=2 个危险因素的儿童比例低于对照组（p=0.005）。在 15 岁时，干预组中 13.0%的女孩和 10.8%的男孩以及对照组中 17.5%的女孩和 18.8%的男孩存在危险因素聚类（研究组的主要效应 p=0.046）。在 5 岁时存在一个危险因素预测了 15 岁时的危险因素聚类（OR：3.8，p<0.001）。
反复、个体化的饮食和生活方式咨询可能会减少青少年超重相关心血管代谢危险因素的聚集，尽管咨询的强度不足以预防超重。
