Ministry of Health, Nuku'alofa, Tonga.
Obes Rev. 2011 Nov;12 Suppl 2:41-50. doi: 10.1111/j.1467-789X.2011.00923.x.
Tonga has a very high prevalence of obesity with steep increases during youth, making adolescence a critical time for obesity prevention. The Ma'alahi Youth Project, the Tongan arm of the Pacific Obesity Prevention in Communities project, was a 3-year, quasi-experimental study of community-based interventions among adolescents in three districts on Tonga's main island (Tongatapu) compared to the island of Vava'u. Interventions focused mainly on capacity building, social marketing, education and activities promoting physical activity and local fruit and vegetables. The evaluation used a longitudinal design (mean follow-up duration 2.4 years). Both intervention and comparison groups showed similar large increases in overweight and obesity prevalence (10.1% points, n = 815; 12.6% points, n = 897 respectively). Apart from a small relative decrease in percentage body fat in the intervention group (-1.5%, P < 0.0001), there were no differences in outcomes for any anthropometric variables between groups and behavioural changes did not follow a clear positive pattern. In conclusion, the Ma'alahi Youth Project had no impact on the large increase in prevalence of overweight and obesity among Tongan adolescents. Community-based interventions in such populations with high obesity prevalence may require more intensive or longer interventions, as well as specific strategies targeting the substantial socio-cultural barriers to achieving a healthy weight.
汤加的肥胖患病率非常高，且在青少年时期急剧上升，因此青少年时期是预防肥胖的关键时期。Ma'alahi 青年项目是太平洋肥胖预防社区项目在汤加的分支机构，该项目是一项为期 3 年的、针对汤加主要岛屿（汤加塔布）三个地区青少年的社区为基础的干预措施的准实验研究，与瓦瓦乌岛进行了比较。干预措施主要侧重于能力建设、社会营销、教育以及促进身体活动和当地水果和蔬菜的活动。该评估采用了纵向设计（平均随访时间为 2.4 年）。干预组和对照组的超重和肥胖患病率都显示出类似的大幅增加（10.1%，n=815；12.6%，n=897）。除了干预组的体脂百分比相对略有下降（-1.5%，P<0.0001）外，两组之间在任何人体测量变量的结果上均无差异，行为变化也没有呈现出明确的积极模式。总之，Ma'alahi 青年项目对汤加青少年超重和肥胖患病率的大幅增加没有影响。对于肥胖率较高的此类人群，社区为基础的干预措施可能需要更密集或更长时间的干预，以及针对实现健康体重的大量社会文化障碍的具体策略。
