Global Health Promotion Office, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, NE, MS K-40 Atlanta, GA 30341, USA.
J Sch Health. 2013 Sep;83(9):668-77. doi: 10.1111/josh.12080.
Rapidly rising childhood obesity rates constitute a public health priority in Latin America which makes it imperative to develop evidence-based strategies. Schools are a promising setting but to date it is unclear how many school-based obesity interventions have been documented in Latin America and what level of evidence can be gathered from such interventions.
We performed a systematic review of papers published between 1965 and December 2010. Interventions were considered eligible if they had a school-based component, were done in Latin America, evaluated an obesity related outcome (body mass index [BMI], weight, %body fat, waist circumference, BMI z-score), and compared youth exposed vs not exposed.
Ten studies were identified as having a school-based component. Most interventions had a sample of normal and overweight children. The most successful interventions focused on prevention rather than treatment, had longer follow-ups, a multidisciplinary team, and fewer limitations in execution. Three prevention and 2 treatment interventions found sufficient improvements in obesity-related outcomes.
We found sufficient evidence to recommend school-based interventions to prevent obesity among youth in Latin America. Evidence-based interventions in the school setting should be promoted as an important component for integrated programs, policies, and monitoring frameworks designed to reverse the childhood obesity in the region.
儿童肥胖率迅速上升，这是拉丁美洲的一个公共卫生重点，因此必须制定基于证据的策略。学校是一个有希望的环境，但迄今为止，尚不清楚在拉丁美洲有多少基于学校的肥胖干预措施已经记录在案，以及可以从这些干预措施中收集到何种程度的证据。
我们对 1965 年至 2010 年 12 月期间发表的论文进行了系统评价。如果干预措施具有基于学校的组成部分、在拉丁美洲进行、评估与肥胖相关的结果（体重指数 [BMI]、体重、%体脂肪、腰围、BMI z 分数），并比较暴露于非暴露于的年轻人，则认为干预措施符合条件。
确定了 10 项具有基于学校的组成部分的研究。大多数干预措施都有正常体重和超重儿童的样本。最成功的干预措施侧重于预防而不是治疗，随访时间更长，有一个多学科团队，并且在执行方面的限制较少。有 3 项预防和 2 项治疗干预措施发现肥胖相关结果有足够的改善。
我们发现有足够的证据推荐在拉丁美洲的青年中开展基于学校的干预措施以预防肥胖。应促进基于学校的循证干预措施，作为旨在扭转该地区儿童肥胖问题的综合方案、政策和监测框架的重要组成部分。
