Franco Manuel, Sanz Belén, Otero Laura, Domínguez-Vila Adrián, Caballero Benjamín
Departamento de Epidemiología, Centro Nacional de Investigación Cardiovascular (CNIC), Madrid, España.
Gac Sanit. 2010 Dec;24 Suppl 1:49-55. doi: 10.1016/j.gaceta.2010.09.014. Epub 2010 Nov 12.
Obesity is currently a global public health problem. Obesity in early life increases the risk of long-term energy imbalance and adult obesity and its comorbidities, type 2 diabetes, and cardiovascular disease. Since infancy and childhood are critical periods for the adoption of food preferences and physical activity, prevention strategies must intervene in these early periods to promote healthy habits and reduce risk behaviors. Trends in the prevalence of childhood obesity and overweight in Spain have continuously increased in the last three decades. Obesity and overweight currently affect 15 and 20% of Spanish children, respectively, and these percentages are among the highest in Europe. Childhood obesity is determined by social and economic factors pertaining to sectors other than the health system, such as advertising, the built environment, education and the school environment, transportation and the food environment. Following the Health in All Policies (HiAP) approach, the authors identified a series of multisector policy changes that may help to prevent and control the current rising trend of childhood obesity in Spain. The HiAP approach acknowledges that social factors including socioeconomic status, gender differences and the work-life balance are important to develop effective policy changes in the prevention of childhood obesity. A key to success in the prevention of childhood obesity in Spain through policy changes will depend on the ability to establish a policy with the explicit and primary goal of improving health outcomes, despite the anticipated resistance from various sectors and stakeholders.
肥胖目前是一个全球性的公共卫生问题。儿童期肥胖会增加长期能量失衡、成人肥胖及其合并症、2型糖尿病和心血管疾病的风险。由于婴儿期和儿童期是养成食物偏好和身体活动习惯的关键时期，预防策略必须在这些早期阶段进行干预，以促进健康习惯并减少风险行为。在过去三十年中，西班牙儿童肥胖和超重的患病率呈持续上升趋势。肥胖和超重目前分别影响15%和20%的西班牙儿童，这些比例在欧洲位居前列。儿童肥胖由卫生系统以外其他部门的社会和经济因素决定，如广告、建筑环境、教育和学校环境、交通以及食品环境。遵循“健康融入所有政策”（HiAP）方法，作者确定了一系列多部门政策变革，这些变革可能有助于预防和控制西班牙目前儿童肥胖率不断上升的趋势。HiAP方法承认，包括社会经济地位、性别差异和工作与生活平衡在内的社会因素对于制定预防儿童肥胖的有效政策变革很重要。通过政策变革在西班牙预防儿童肥胖取得成功的关键将取决于能否制定一项明确以改善健康结果为首要目标的政策，尽管预计会受到各部门和利益相关者的抵制。
