Canoy Dexter, Bundred Peter
University of Oxford/Honorary Research Fellow at University of Manchester, Oxford/Manchester, UK.
BMJ Clin Evid. 2011 Apr 4;2011:0325.
Obesity is the result of long-term energy imbalances, where daily energy intake exceeds daily energy expenditure. Along with long-term health problems, obesity in children may also be associated with psychosocial problems, including social marginalisation, low self-esteem, and impaired quality of life. Most obese adolescents stay obese as adults. Obesity is increasing among children and adolescents, with 16.8% of boys and 15.2% of girls in the UK aged 2 to 15 years obese in 2008.
We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of lifestyle interventions for the treatment of childhood obesity? What are the effects of surgical interventions for the treatment of childhood obesity? We searched: Medline, Embase, The Cochrane Library, and other important databases up to January 2010 (Clinical Evidence reviews are updated periodically, please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA).
We found 14 systematic reviews and RCTs that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions.
In this systematic review we present information relating to the effectiveness and safety of the following lifestyle interventions: behavioural, diet, and multifactorial interventions; physical activity; and bariatric surgery.
肥胖是长期能量失衡的结果，即每日能量摄入超过每日能量消耗。除了长期健康问题外，儿童肥胖还可能与心理社会问题相关，包括社会边缘化、自卑和生活质量受损。大多数肥胖青少年成年后仍肥胖。儿童和青少年肥胖率正在上升，2008年英国2至15岁的男孩中有16.8%、女孩中有15.2%肥胖。
我们进行了一项系统评价，旨在回答以下临床问题：生活方式干预对儿童肥胖治疗有何效果？手术干预对儿童肥胖治疗有何效果？我们检索了：截至2010年1月的医学期刊数据库（Medline）、荷兰医学文摘数据库（Embase）、考克兰图书馆及其他重要数据库（临床证据综述会定期更新，请查看我们的网站获取本综述的最新版本）。我们纳入了来自美国食品药品监督管理局（FDA）和英国药品及医疗保健产品监管局（MHRA）等相关组织的危害警示。
我们发现14项符合我们纳入标准的系统评价和随机对照试验。我们对干预措施的证据质量进行了GRADE评估。
在本系统评价中，我们提供了以下生活方式干预措施的有效性和安全性相关信息：行为、饮食和多因素干预；体育活动；以及减肥手术。
