Department of Pediatrics, Children's Hospital of Michigan, Detroit, MI, USA.
Indian J Pediatr. 2013 Mar;80 Suppl 1:S28-37. doi: 10.1007/s12098-012-0923-5. Epub 2013 Jan 20.
Rapidly changing dietary practices accompanied by an increasingly sedentary lifestyle predispose to nutrition-related non-communicable diseases, including childhood obesity. Over the last 5 y, reports from several developing countries indicate prevalence rates of obesity (inclusive of overweight) >15 % in children and adolescents aged 5-19 y; Mexico 41.8 %, Brazil 22.1 %, India 22.0 % and Argentina 19.3 %. Moreover, secular trends also indicate an alarming increase in obesity in developing countries; in Brazil from 4.1 % to 13.9 % between 1974 and 1997; in China from 6.4 % to 7.7 % between 1991 and 1997; and in India from 4.9 % to 6.6 % between 2003-04 to 2005-06. Other contributory factors to childhood obesity include: high socio-economic status, residence in metropolitan cities and female gender. Childhood obesity tracks into adulthood, thus increasing the risk for conditions like the metabolic syndrome, type 2 diabetes mellitus (T2DM), polycystic ovarian syndrome, hypertension, dyslipidemia and coronary artery disease later in life. Interestingly, prevalence of the metabolic syndrome was 35.2 % among overweight Chinese adolescents. Presence of central obesity (high waist-to-hip circumference ratio) along with hypertriglyceridemia and family history of T2DM increase the odds of T2DM by 112.1 in young Asian Indians (< 40 y). Therapeutic lifestyle changes and maintenance of regular physical activity are most important strategies for preventing childhood obesity. Effective health awareness educational programs for children should be immediately initiated in developing countries, following the successful model program in India (project 'MARG').
快速变化的饮食方式和日益增加的 sedentary lifestyle（久坐生活方式）促使营养相关的非传染性疾病（包括儿童肥胖）的发生。在过去的 5 年中，来自几个发展中国家的报告显示，5-19 岁儿童和青少年的肥胖（包括超重）患病率>15%；墨西哥为 41.8%，巴西为 22.1%，印度为 22.0%，阿根廷为 19.3%。此外，长期趋势也表明发展中国家肥胖症呈惊人增长；巴西从 1974 年到 1997 年肥胖率从 4.1%上升到 13.9%；中国从 1991 年到 1997 年从 6.4%上升到 7.7%；印度从 2003-04 年到 2005-06 年从 4.9%上升到 6.6%。儿童肥胖的其他促成因素包括：高社会经济地位、居住在大都市和女性性别。儿童肥胖会持续到成年期，从而增加代谢综合征、2 型糖尿病（T2DM）、多囊卵巢综合征、高血压、血脂异常和冠心病等疾病的风险。有趣的是，超重中国青少年中代谢综合征的患病率为 35.2%。中心性肥胖（高腰臀比）加上高三酰甘油血症和 T2DM 家族史使年轻的亚洲印度人（<40 岁）患 T2DM 的几率增加 112.1 倍。治疗性生活方式的改变和定期体育锻炼的维持是预防儿童肥胖的最重要策略。发展中国家应立即效仿印度（MARG 项目）成功的示范项目，为儿童启动有效的健康意识教育计划。
