EMGO Institute for Health and Care Research and Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, The Netherlands.
Obes Rev. 2012 Mar;13 Suppl 1:56-74. doi: 10.1111/j.1467-789X.2011.00960.x.
The current review aimed to systematically identify dietary, physical activity and sedentary behaviours in preschool children (4-6 years of age) that are prospectively related to overweight or obesity later in childhood. Prospective studies published between January 1990 and June 2010 were selected from searches in PubMed, EMBASE, PsycINFO, CINAHL and Cochrane Library. Studies examining the prospective association between at least one relevant behaviour measured during preschool period (children aged 4-6 years at baseline) in relation to at least one anthropometric measurement at follow-up (age <18 years) were included. Harvest plots were used to summarize the results and draw conclusions from the evidence. Of the 8,718 retrieved papers, 23 papers reporting on 15 different study samples were included in this review. Strong evidence was found for an inverse association between total physical activity and overweight. Moderate evidence was observed for a positive association between television viewing and overweight. Because of the heterogeneity in the assessed dietary behaviours, insufficient evidence was found for an association between dietary intake or specific dietary behaviours and overweight. These results suggest that interventions aiming to prevent overweight among preschool children should focus on promotion of total physical activity and limitation of screen time and that further research is needed to establish whether and which dietary behaviours are important for obesity prevention in this age group. However, despite the lack of evidence for dietary behaviours from the present review, future interventions may already target specific dietary behaviours that are highly prevalent and for which there a clear rationale as well as preliminary evidence that these behaviours are associated with overweight.
本综述旨在系统地识别学前儿童（4-6 岁）的饮食、身体活动和久坐行为，这些行为与儿童后期超重或肥胖具有前瞻性关联。从 1990 年 1 月至 2010 年 6 月期间在 PubMed、EMBASE、PsycINFO、CINAHL 和 Cochrane Library 中进行了检索，选择了前瞻性研究。研究中至少有一项在学前期间（基线时儿童年龄为 4-6 岁）测量的相关行为与随访时至少一项人体测量学指标（年龄 <18 岁）之间存在前瞻性关联。使用“harvest plots”来总结结果并从证据中得出结论。在检索到的 8718 篇论文中，有 23 篇论文报道了 15 个不同的研究样本，纳入了本综述。有强有力的证据表明总身体活动与超重呈负相关。有中度证据表明看电视与超重呈正相关。由于评估的饮食行为存在异质性，因此饮食摄入或特定饮食行为与超重之间的关联证据不足。这些结果表明，旨在预防学前儿童超重的干预措施应侧重于促进总身体活动和限制屏幕时间，并且需要进一步研究以确定在该年龄段饮食行为是否以及哪些行为对肥胖预防很重要。但是，尽管本综述中缺乏饮食行为的证据，但未来的干预措施可能已经针对特定的饮食行为，这些行为具有很高的普遍性，并且有明确的理由以及初步证据表明这些行为与超重有关。
