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减少儿童早期肥胖:澳大利亚全社区干预项目 Romp & Chomp 的结果。

Reducing obesity in early childhood: results from Romp & Chomp, an Australian community-wide intervention program.

机构信息

WHO Collaborating Centre for Obesity Prevention Deakin University Geelong Australia.

出版信息

Am J Clin Nutr. 2010 Apr;91(4):831-40. doi: 10.3945/ajcn.2009.28826. Epub 2010 Feb 10.

Abstract

BACKGROUND

There is growing evidence that community-based interventions can reduce childhood obesity in older children.

OBJECTIVE

We aimed to determine the effectiveness of the Romp & Chomp intervention in reducing obesity and promoting healthy eating and active play in children aged 0-5 y.

DESIGN

Romp & Chomp was a community-wide, multisetting, multistrategy intervention conducted in Australia from 2004 to 2008. The intervention occurred in a large regional city (Geelong) with a target group of 12,000 children and focused on community capacity building and environmental (political, sociocultural, and physical) changes to increase healthy eating and active play in early-childhood care and educational settings. The evaluation was repeat cross-sectional with a quasiexperimental design and comparison sample. Main outcome measures were body mass index (BMI), standardized BMI (zBMI; according to the Centers for Disease Control and Prevention 2000 reference charts), and prevalence of overweight/obesity and obesity-related behaviors in children aged 2 and 3.5 y.

RESULTS

After the intervention there was a significantly lower mean weight, BMI, and zBMI in the 3.5-y-old subsample and a significantly lower prevalence of overweight/obesity in both the 2- and 3.5-y-old subsamples (by 2.5 and 3.4 percentage points, respectively) than in the comparison sample (a difference of 0.7 percentage points; P < 0.05) compared with baseline values. Intervention child-behavioral data showed a significantly lower intake of packaged snacks (by 0.23 serving), fruit juice (0.52 serving), and cordial (0.43 serving) than that in the comparison sample (all P < 0.05).

CONCLUSION

A community-wide multisetting, multistrategy intervention in early-childhood settings can reduce childhood obesity and improve young children's diets. This trial was registered with the Australian Clinical Trials Registry at anzctr.org.au as ACTRN12607000374460.

摘要

背景

越来越多的证据表明,基于社区的干预措施可以减少大龄儿童的肥胖问题。

目的

我们旨在确定 Romp & Chomp 干预措施在减少肥胖、促进 0-5 岁儿童健康饮食和积极玩耍方面的有效性。

设计

Romp & Chomp 是一项在澳大利亚于 2004 年至 2008 年开展的、基于社区的、多环境、多策略的干预措施。该干预措施在一个大型区域城市(吉朗)开展,目标人群为 12000 名儿童,重点是社区能力建设和环境(政治、社会文化和物理)变化,以增加幼儿保育和教育环境中的健康饮食和积极玩耍。评估采用重复横断面研究,采用准实验设计和对照样本。主要结局指标为体重指数(BMI)、标准化 BMI(zBMI;根据 2000 年美国疾病控制与预防中心参考图表)以及 2 岁和 3.5 岁儿童超重/肥胖和肥胖相关行为的流行率。

结果

干预后,3.5 岁儿童亚组的平均体重、BMI 和 zBMI 显著降低,2 岁和 3.5 岁儿童亚组的超重/肥胖流行率也显著降低(分别降低 2.5 和 3.4 个百分点),与对照样本相比(差异为 0.7 个百分点;P<0.05),与基线值相比。干预后儿童行为数据显示,包装零食(减少 0.23 份)、果汁(减少 0.52 份)和甜饮料(减少 0.43 份)的摄入量明显低于对照样本(均 P<0.05)。

结论

在幼儿环境中开展基于社区的多环境、多策略干预可以减少儿童肥胖,并改善幼儿的饮食。本试验在澳大利亚临床试验注册处 anzctr.org.au 注册,注册号为 ACTRN12607000374460。

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