Moredich Cheryl A, Kessler Theresa A
J Midwifery Womens Health. 2014 Jul-Aug;59(4):380-7. doi: 10.1111/jmwh.12061. Epub 2013 Nov 20.
Obesity is epidemic in the United States and is considered a public health issue that disproportionally affects low-income women. Combating obesity among low-income women presents unique challenges that must be addressed if weight loss interventions are to be successful. The aim of this integrative review was to explore and synthesize the literature that addresses physical activity and nutrition interventions used to combat obesity in obese, low-income women.
A search for original research published between 2006 and 2011 was conducted in online databases. In addition, a hand search of references was performed, and one author was contacted to clarify outcome data. Articles that met inclusion criteria targeted obese, low-income adult women; focused on physical activity or nutrition behavior as an intervention; and measured change in weight as a primary outcome. Studies that focused on women who were postpartum or breastfeeding and those that used pharmacologic or surgical interventions to augment weight loss were excluded.
A total of 7 articles were chosen for critical appraisal. According to a synthesis of the current studies, specific weight loss interventions for physical activity and nutrition behavior change for obese, low-income women produced the desired outcome of weight loss. Participants among these studies voiced a preference for group interventions led by peers or medical professionals. Interventions led by peer educators were successful and had the advantage of lowering cost and increasing sustainability. Pragmatic nutrition education worked best, especially when cognizant of cost, food preferences, and culture. Even small increases in physical activity augmented weight loss; however, safety concerns prevented some low-income women from engaging in exercise.
According to this synthesis of the best-available evidence, customized weight loss interventions are effective in obese, low-income women. By incorporating these evidence-based interventions, clinicians can be instrumental in decreasing the burden of obesity in obese, low-income women.
肥胖在美国呈流行趋势，被视为一个对低收入女性影响尤为严重的公共卫生问题。要使减肥干预措施取得成功，应对低收入女性的肥胖问题面临着一些必须解决的独特挑战。本综合综述的目的是探讨并综合有关用于对抗肥胖的肥胖低收入女性体育活动和营养干预措施的文献。
在在线数据库中检索2006年至2011年间发表的原创研究。此外，还对手参考文献进行了人工检索，并联系了一位作者以澄清结果数据。符合纳入标准的文章针对肥胖的低收入成年女性；将体育活动或营养行为作为干预重点；并将体重变化作为主要结果进行测量。聚焦于产后或哺乳期女性的研究以及使用药物或手术干预来促进减肥的研究被排除。
共选择了7篇文章进行批判性评价。根据当前研究的综合情况，针对肥胖低收入女性体育活动和营养行为改变的特定减肥干预措施产生了预期的减肥效果。这些研究中的参与者表示更喜欢由同龄人或医学专业人员主导的小组干预。由同伴教育者主导的干预措施很成功，具有降低成本和提高可持续性的优势。实用的营养教育效果最佳，尤其是在考虑成本、食物偏好和文化时。即使体育活动的小幅增加也能促进减肥；然而，安全问题使一些低收入女性无法参与锻炼。
根据对现有最佳证据的综合情况，定制的减肥干预措施对肥胖低收入女性有效。通过纳入这些基于证据的干预措施，临床医生可有助于减轻肥胖低收入女性的肥胖负担。
