Trivedi Shamita, Burton Amy, Oden Jon
Division of Pediatric Endocrinology, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX, 75390-9063, USA,
Indian J Pediatr. 2014 Feb;81(2):152-7. doi: 10.1007/s12098-013-1138-0. Epub 2013 Jul 28.
Over the last decades, pediatric obesity has become a global epidemic with worldwide estimates as high as 43 million children and adolescents affected, and this number is rising at an exponential rate. With pediatric obesity comes a host of co-morbidities including impaired glucose tolerance, dyslipidemia, hypertension, and impaired liver function. Treatment of this population has proven to be challenging for many reasons. For patients, a new baseline exists consisting of an increasingly sedentary lifestyle as well as a lack of availability of affordable healthy alternatives. In addition, there is an overwhelming presence of energy-dense foods. For physicians, there are many issues including lack of time, training, and reimbursement. The most efficacious and reliable way to treat this population and its co-morbidities is with a healthy, balanced lifestyle consisting of a realistic diet plan and exercise regimen. The is the cornerstone of therapy in the Center for Obesity And its Complications in Health (COACH) clinic which is Children's Medical Center's (Dallas, TX) strategy to combat and treat pediatric overweight and obesity. Lifestyle changes of diet and exercise plans are tailored to each individual's interests and metabolic needs in COACH which is a multi-disciplinary clinic. Additionally, co-morbidities are screened for and treated aggressively to help prevent long-term complications of overweight and obesity. If others do similar interventions in their communities, this global epidemic has the possibility of more positive outcomes than those currently projected.
在过去几十年里，儿童肥胖已成为一种全球流行病，据全球估计，受影响的儿童和青少年高达4300万，而且这个数字正以指数级速度增长。儿童肥胖会引发一系列合并症，包括糖耐量受损、血脂异常、高血压和肝功能受损。事实证明，治疗这一人群具有挑战性，原因有很多。对患者来说，一种新的基线状态存在了，其包括越来越久坐不动的生活方式以及缺乏负担得起的健康替代选择。此外，高能量密度食物大量存在。对医生来说，存在许多问题，包括时间不足、培训缺乏和报销问题。治疗这一人群及其合并症最有效、最可靠的方法是采用健康、均衡的生活方式，包括切实可行的饮食计划和锻炼方案。这是儿童医学中心（德克萨斯州达拉斯）肥胖及其健康并发症中心（COACH）诊所治疗的基石，该诊所是儿童医学中心对抗和治疗儿童超重与肥胖的策略。在COACH这个多学科诊所里，饮食和锻炼计划等生活方式的改变是根据每个人的兴趣和代谢需求量身定制的。此外，还会对合并症进行筛查并积极治疗，以帮助预防超重和肥胖的长期并发症。如果其他人在他们的社区进行类似干预，那么这场全球流行病有可能产生比目前预计更积极的结果。
