Lipek Tobias, Igel Ulrike, Gausche Ruth, Kiess Wieland, Grande Gesine
J Pediatr Endocrinol Metab. 2015 May;28(5-6):485-95. doi: 10.1515/jpem-2015-0127.
Childhood obesity is a major concern for public health. There are multiple factors (e.g., genetic, social, and environmental) that contribute to unhealthy weight gain. Drawing from findings on "obesogenic environments" and core principles of preventive strategies to reduce health inequalities, this paper gives an overview of recent childhood prevention programs that target aspects of the physical environment ("environmental changes"). Out of the ten reviews we screened (including more than 300 studies), we identified very few that addressed aspects of the environment. We focus here on 14 programs that follow different approaches to environmental changes (e.g., access to/quality of playgrounds, changes in school cafeterias). Altering the environment offers opportunities for healthier behaviors and seems to be an effective strategy to prevent childhood obesity. However, the evaluation of those (mostly) multidimensional interventions does not allow drawing firm conclusions about the single effect of environmental changes. We conclude that obesity prevention programs should combine person-based and environmental approaches.
儿童肥胖是公共卫生领域的一个主要关切问题。有多种因素（如遗传、社会和环境因素）导致不健康的体重增加。借鉴关于“致胖环境”的研究结果以及减少健康不平等的预防策略的核心原则，本文概述了近期针对物理环境方面（“环境变化”）的儿童预防项目。在我们筛选的十篇综述（包括300多项研究）中，我们发现很少有涉及环境方面的内容。我们在此重点关注14个采用不同环境变化方法的项目（如操场的使用/质量、学校食堂的变化）。改变环境为更健康的行为提供了机会，似乎是预防儿童肥胖的有效策略。然而，对那些（大多）多维度干预措施的评估无法就环境变化的单一效果得出确凿结论。我们得出结论，肥胖预防项目应将基于个体的方法和环境方法结合起来。
