Obesity Prevention Program, Department of Population Medicine, Harvard Medical School, Boston, MA 02215, USA.
Child Obes. 2012 Feb;8(1):23-7. doi: 10.1089/chi.2011.0109.
Childhood obesity is prevalent, is of consequence, and disproportionately affects racial/ethnic minority populations. By the preschool years, racial/ethnic disparities in obesity prevalence and substantial differences in many risk factors for obesity are already present, suggesting that disparities in obesity prevalence have their origins in the earliest stages of life. The reasons for racial/ethnic variation in obesity are complex and may include differences in cultural beliefs and practices, level of acculturation, ethnicity-based differences in body image, and perceptions of media, sleep, and physical activity. In addition, racial/ethnic differences in obesity may evolve as a consequence of the socio- and environmental context in which families live. The primary care setting offers unique opportunities to intervene and alter the subsequent course of health and disease for children at risk for obesity. Regular visits during childhood allow both detection of elevated weight status and offer opportunities for prevention and treatment. Greater awareness of the behavioral, social–cultural, and environmental determinants of obesity among ethnic minority populations could assist clinicians in the treatment of obesity among diverse pediatric populations. Specific strategies include beginning prevention efforts early in life before obesity is present and recognizing and querying about ethnic- and culturally specific beliefs and practices, the role of the extended family in the household, and parents' beliefs of the causative factors related to their child's obesity. Efforts to provide culturally and linguistically appropriate care, family-based treatment programs, and support services that aim to uncouple socioeconomic factors from adverse health outcomes could improve obesity care for racial/ethnic minority children.
儿童肥胖症普遍存在，后果严重，且不成比例地影响着少数族裔群体。在学前阶段，肥胖症的种族/民族差异和肥胖症的许多风险因素的显著差异已经存在，这表明肥胖症的差异起源于生命的早期阶段。肥胖症的种族/民族差异的原因很复杂，可能包括文化信仰和实践的差异、文化适应程度、基于种族的身体形象差异以及对媒体、睡眠和身体活动的看法。此外，肥胖症的种族/民族差异可能会随着家庭所处的社会和环境背景而演变。初级保健机构提供了独特的机会，可以干预和改变处于肥胖风险中的儿童的后续健康和疾病进程。儿童时期的定期就诊不仅可以发现体重增加，还为预防和治疗提供了机会。提高少数民族群体对肥胖行为、社会文化和环境决定因素的认识，有助于临床医生治疗不同种族的儿科肥胖症患者。具体策略包括在肥胖出现之前尽早在生命早期开始预防工作，并认识和询问与种族和文化相关的特定信仰和实践、大家庭在家庭中的作用以及父母对与孩子肥胖相关的致病因素的看法。努力提供文化和语言上合适的护理、以家庭为基础的治疗计划和支持服务，旨在将社会经济因素与不良健康结果脱钩，这可能会改善少数族裔儿童的肥胖症护理。
