Oreskovic Nicolas M, Goodman Elizabeth, Robinson Alyssa I, Perrin Eliana M, Perrin James M
1 Center for Child & Adolescent Health Research and Policy, Massachusetts General Hospital , Boston, MA.
Child Obes. 2014 Apr;10(2):107-13. doi: 10.1089/chi.2013.0131. Epub 2014 Mar 11.
Physician counseling on lifestyle factors has been recommended as one way to help combat the obesity epidemic in the United States. The aim of this study was to examine the frequency of lifestyle counseling among healthy weight, overweight, and obese adolescents and determine the contributions of adolescent weight and physical activity.
Self-reported surveys on dietary and physical activity counseling, along with measured height, weight, and physical activity data by accelerometry were collected on 76 adolescents ages 11-14 years. General linear models tested for associations of reported lifestyle counseling by weight category, adjusting for physical activity, age, gender, race/ethnicity, and parent education.
Half (47%) of the subjects were overweight or obese. Frequency of lifestyle counseling varied by weight category, with obese adolescents reporting greater amounts of lifestyle counseling across all topics than their peers. Obese adolescents received more dietary (β = 0.88; standard error [SE] = 0.25; p = 0.001) and physical activity (β = 0.80; SE = 0.28; p = 0.006) counseling than healthy weight youth, as well as being told to increase their physical activity more often (β = 0.96; SE = 0.29; p = 0.001). There were no differences in lifestyle counseling between overweight and healthy weight subjects. Adolescents with greater daily moderate-to-vigorous physical activity reported less physical activity counseling (β = -0.02; SE = 0.008; p = 0.05).
Despite universal recommendations to counsel adolescents on lifestyle, only obese adolescents consistently report receiving such counseling. Given known difficulties in reversing obesity after onset, efforts should ensure that all adolescents receive lifestyle counseling.
在美国,医生就生活方式因素提供咨询被认为是帮助应对肥胖流行的一种方式。本研究的目的是调查健康体重、超重和肥胖青少年接受生活方式咨询的频率,并确定青少年体重和身体活动的影响因素。
收集了76名11至14岁青少年的自我报告饮食和身体活动咨询调查问卷,以及通过加速度计测量的身高、体重和身体活动数据。使用一般线性模型测试按体重类别报告的生活方式咨询的相关性,并对身体活动、年龄、性别、种族/族裔和父母教育进行调整。
一半(47%)的受试者超重或肥胖。生活方式咨询的频率因体重类别而异,肥胖青少年在所有主题上报告接受的生活方式咨询比同龄人更多。与健康体重的青少年相比,肥胖青少年接受了更多的饮食咨询(β = 0.88;标准误[SE] = 0.25;p = 0.001)和身体活动咨询(β = 0.80;SE = 0.28;p = 0.006),并且更常被告知增加身体活动(β = 0.96;SE = 0.29;p = 0.001)。超重和健康体重的受试者在生活方式咨询方面没有差异。日常中度至剧烈身体活动较多的青少年报告接受的身体活动咨询较少(β = -0.02;SE = 0.008;p = 0.05)。
尽管普遍建议为青少年提供生活方式咨询,但只有肥胖青少年一直报告接受此类咨询。鉴于肥胖发病后逆转存在已知困难,应努力确保所有青少年都能接受生活方式咨询。