Department of Health Policy and Management, Columbia Mailman School of Public Health, New York, New York 10032, USA.
Am J Prev Med. 2012 May;42(5):437-44. doi: 10.1016/j.amepre.2012.01.018.
The federal government has set measurable goals for reducing childhood obesity to 5% by 2010 (Healthy People 2010), and 10% lower than 2005-2008 levels by 2020 (Healthy People 2020). However, population-level estimates of the changes in daily energy balance needed to reach these goals are lacking.
To estimate needed per capita reductions in youths' daily "energy gap" (calories consumed over calories expended) to achieve Healthy People goals by 2020.
Analyses were conducted in 2010 to fit multivariate models using National Health and Nutrition Examination Surveys 1971-2008 (N=46,164) to extrapolate past trends in obesity prevalence, weight, and BMI among youth aged 2-19 years. Differences in average daily energy requirements between the extrapolated 2020 levels and Healthy People scenarios were estimated.
During 1971-2008, mean BMI and weight among U.S. youth increased by 0.55 kg/m(2) and by 1.54 kg per decade, respectively. Extrapolating from these trends to 2020, the average weight among youth in 2020 would increase by ∼1.8 kg from 2007-2008 levels. Averting this increase will require an average reduction of 41 kcal/day in youth's daily energy gap. An additional reduction of 120 kcal/day and 23 kcal/day would be needed to reach Healthy People 2010 and Healthy People 2020 goals, respectively. Larger reductions are needed among adolescents and racial/ethnic minority youth.
Aggressive efforts are needed to reverse the positive energy imbalance underlying the childhood obesity epidemic. The energy-gap metric provides a useful tool for goal setting, intervention planning, and charting progress.
联邦政府设定了可衡量的目标，即到 2010 年将儿童肥胖率降低 5%（《健康人 2010》），到 2020 年比 2005-2008 年的水平降低 10%（《健康人 2020》）。然而，目前还缺乏实现这些目标所需的人群层面上的日常能量平衡变化的估计值。
估计为实现 2020 年的《健康人》目标，青少年每日“能量缺口”（摄入的卡路里超过消耗的卡路里）所需的人均减少量。
2010 年进行了分析，使用 1971-2008 年全国健康和营养调查（N=46164）建立多元模型，以推断 2-19 岁青少年肥胖率、体重和 BMI 的过去趋势。估计了从 2020 年的预测水平到《健康人》方案之间的平均每日能量需求差异。
在 1971-2008 年间，美国青少年的平均 BMI 和体重每十年分别增加 0.55 公斤/平方米和 1.54 公斤。从这些趋势推断到 2020 年，2020 年青少年的平均体重将比 2007-2008 年的水平增加约 1.8 公斤。要避免这种增长，青少年的日常能量缺口需要平均减少 41 卡路里/天。要达到《健康人 2010》和《健康人 2020》的目标，还需要每天再减少 120 卡路里和 23 卡路里。在青少年和少数族裔青少年中，需要更大的减少。
需要采取积极的措施来扭转儿童肥胖流行背后的正能能量失衡。能量缺口指标为设定目标、规划干预措施和衡量进展提供了一个有用的工具。
