Wiegand S, Bau A-M, Babitsch B
Interdisziplinäres Sozialpädiatrisches Zentrum der Charité-Kinderklinik, Universitätsmedizin Berlin, Deutschland.
Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2011 May;54(5):533-40. doi: 10.1007/s00103-011-1266-5.
The prevalence of obesity and associated comorbidities among children and adolescents has risen worldwide throughout the past 3 decades. To break this trend, population-based activities in health promotion/prevention and health care are necessary. Studies showed that long-term eating behavior improvement with the cooperation of the patient's family together with child-friendly organization support both individual therapeutic improvements as well as a relevant reduction of obesity prevalence. A significant BMI reduction can be achieved with a normal varied diet, whose energetic value is 300-400 kcal/day below the patient's daily energetic needs, due to the lower consumption of fat and sugar. This requires, however, that the entire family be willing to change their unhealthy eating behaviors (e.g., soft drinks and fast food) and to introduce regular meals into their daily routine. Sensibly, most therapies combine diet therapy with increased physical activity and parental training. Controlled media consumption, active leisure-time behavior, and a structured daily routine are further conditions for successful weight reduction. The high-risk groups for pediatric obesity, i.e., families with migration background and/or low socioeconomic status, have been poorly reached by established programs.
在过去三十年里，全球儿童和青少年肥胖及相关合并症的患病率呈上升趋势。为了打破这一趋势，开展基于人群的健康促进/预防和医疗保健活动十分必要。研究表明，在患者家庭的配合以及儿童友好型组织的支持下，长期改善饮食行为不仅有助于个体治疗效果的提升，还能显著降低肥胖患病率。通过正常的多样化饮食，由于脂肪和糖的摄入量减少，能量值比患者每日能量需求低300 - 400千卡/天，体重指数（BMI）可显著降低。然而，这需要整个家庭愿意改变不健康的饮食行为（如饮用软饮料和食用快餐），并将规律用餐纳入日常生活。明智的做法是，大多数治疗方法将饮食疗法与增加体育活动及家长培训相结合。控制媒体使用、保持积极的休闲行为以及建立规律的日常生活习惯是成功减重的其他条件。既定项目对小儿肥胖的高危群体，即有移民背景和/或社会经济地位较低的家庭，覆盖不足。
