Epidemiology and Biostatistics Unit, Institute for Maternal and Child Health IRCCS Burlo Garofolo, Trieste, Italy.
Obes Rev. 2010 Oct;11(10):695-708. doi: 10.1111/j.1467-789X.2010.00735.x.
The aim of this paper was to review the evidence for early-life (from conception to 5 years of age) determinants of obesity. The design is review of published systematic reviews. Data sources included Medline, Embase, Web of Science, Cochrane Library, CINAHL, PsycINFO. Identification of 22 eligible reviews from a database of 12,021 independent publications. Quality of selected reviews assessed using the Assessment of Multiple Systematic Reviews score. Articles published after the reviews were used to confirm results. No review was classified as high quality, 11 as moderate and 11 as low. Factors associated with later overweight and obesity: maternal diabetes, maternal smoking, rapid infant growth, no or short breastfeeding, obesity in infancy, short sleep duration, <30 min of daily physical activity, consumption of sugar-sweetened beverages. Other factors were identified as potentially relevant, although the size of their effect is difficult to estimate. Maternal smoking, breastfeeding, infant size and growth, short sleep duration and television viewing are supported by better-quality reviews. It is difficult to establish a causal association between possible determinants and obesity, and the relative importance of each determinant. Future research should focus on early-life interventions to confirm the role of protective and risk factors and to tackle the high burden obesity represents for present and future generations.
本文旨在综述生命早期（从受孕到 5 岁）肥胖决定因素的证据。设计为已发表的系统评价综述。资料来源包括 Medline、Embase、Web of Science、Cochrane 图书馆、CINAHL、PsycINFO。从 12021 篇独立文献的数据库中确定了 22 篇合格的综述。使用多系统评价评估量表评估选定综述的质量。使用综述发表后的文章来确认结果。没有一篇综述被归类为高质量，11 篇为中等质量，11 篇为低质量。与超重和肥胖相关的因素：母亲糖尿病、母亲吸烟、婴儿快速生长、无母乳喂养或母乳喂养时间短、婴儿肥胖、睡眠持续时间短、每日体力活动<30 分钟、摄入含糖饮料。其他因素被认为可能相关，但很难估计其影响的大小。母亲吸烟、母乳喂养、婴儿大小和生长、睡眠持续时间短和看电视的情况得到了质量更高的综述的支持。很难在可能的决定因素和肥胖之间建立因果关系，也很难确定每个决定因素的相对重要性。未来的研究应侧重于生命早期的干预措施，以确认保护和风险因素的作用，并解决肥胖给当前和未来几代人带来的高负担。
