Gillman Matthew W
Obesity Prevention Program, Department of Ambulatory Care and Prevention, Harvard Medical School and Harvard Pilgrim Health Care, Boston, MA, USA.
Nestle Nutr Workshop Ser Pediatr Program. 2010;65:13-20; discussion 20-4. doi: 10.1159/000281141. Epub 2010 Feb 1.
The current obesity epidemic has affected even the youngest children in our societies, including those in the first months of life. Animal experiments suggest that the early postnatal period may be critical to development of healthful energy homeostasis and thus prevention of obesity. In humans, observational studies and follow-up of randomized feeding trials show that rapid weight gain in the first half of infancy predicts later obesity and higher blood pressure. Despite the mounting consistency of results, several questions remain to be answered before clinical or public health implications are clear. These include the need for body composition data in infancy and data from the developing world to identify modifiable determinants of gain in adiposity in the early weeks of life, to mount interventions to modify these determinants, to examine tradeoffs of more vs. less rapid weight gain for different outcomes, and to incorporate any interventions that prove to be efficacious into clinical and public health practice in a cost-effective manner.
当前的肥胖流行甚至已经影响到了我们社会中最年幼的儿童，包括那些出生头几个月的婴儿。动物实验表明，出生后早期阶段对于健康能量平衡的发展以及肥胖的预防可能至关重要。在人类中，观察性研究和随机喂养试验的随访表明，婴儿期上半年体重快速增加预示着日后肥胖和更高的血压。尽管结果越来越一致，但在临床或公共卫生影响明确之前，仍有几个问题有待解答。这些问题包括需要婴儿期的身体成分数据以及来自发展中世界的数据，以确定生命早期几周肥胖增加的可改变决定因素，开展干预措施来改变这些决定因素，研究不同结果下体重增加较快与较慢之间的权衡，并以具有成本效益的方式将任何被证明有效的干预措施纳入临床和公共卫生实践。
