Department of Pediatrics, Children’s Hospital of Michigan, Detroit, Michigan 48201, USA.
Endocr Rev. 2012 Feb;33(1):48-70. doi: 10.1210/er.2010-0028. Epub 2012 Jan 12.
Rapidly changing dietary practices and a sedentary lifestyle have led to increasing prevalence of childhood obesity (5-19 yr) in developing countries recently: 41.8% in Mexico, 22.1% in Brazil, 22.0% in India, and 19.3% in Argentina. Moreover, secular trends indicate increasing prevalence rates in these countries: 4.1 to 13.9% in Brazil during 1974-1997, 12.2 to 15.6% in Thailand during 1991-1993, and 9.8 to 11.7% in India during 2006-2009. Important determinants of childhood obesity include high socioeconomic status, residence in metropolitan cities, female gender, unawareness and false beliefs about nutrition, marketing by transnational food companies, increasing academic stress, and poor facilities for physical activity. Childhood obesity has been associated with type 2 diabetes mellitus, the early-onset metabolic syndrome, subclinical inflammation, dyslipidemia, coronary artery diseases, and adulthood obesity. Therapeutic lifestyle changes and maintenance of regular physical activity through parental initiative and social support interventions are the most important strategies in managing childhood obesity. Also, high-risk screening and effective health educational programs are urgently needed in developing countries.
近年来，快速变化的饮食方式和久坐不动的生活方式导致发展中国家儿童肥胖症（5-19 岁）的患病率不断上升：墨西哥为 41.8%，巴西为 22.1%，印度为 22.0%，阿根廷为 19.3%。此外，这些国家的流行趋势表明肥胖率呈上升趋势：1974-1997 年巴西上升了 4.1%至 13.9%，1991-1993 年泰国上升了 12.2%至 15.6%，2006-2009 年印度上升了 9.8%至 11.7%。儿童肥胖的重要决定因素包括高社会经济地位、居住在大都市、女性、对营养的无知和错误观念、跨国食品公司的营销、日益增加的学业压力以及缺乏体育锻炼设施。儿童肥胖与 2 型糖尿病、早发代谢综合征、亚临床炎症、血脂异常、冠心病和成年肥胖有关。通过父母的主动行动和社会支持干预，进行治疗性生活方式改变和保持有规律的体育锻炼，是管理儿童肥胖的最重要策略。此外，发展中国家迫切需要进行高风险筛查和有效的健康教育计划。
