Braden Katherine W, Nigg Claudio R
Office of Public Health Studies, University of Hawai'i at Manoa, Honolulu, HI.
Hawaii J Med Public Health. 2016 Jun;75(6):162-71.
In the United States, obesity continues to be a major public health concern. Obesity disproportionately affects Native Hawaiian and Other Pacific Islanders (NHOPI) who demonstrate alarming rates of obesity and its related chronic conditions. However, little is known about the causes of obesity for this group. Given the modest effects of individual-level obesity treatments, identifying the most impactful determinants that can be modified to prevent or reduce obesity in NHOPI youth is critical to the development of interventions that best meet the needs of this population. A systematic review was conducted in PubMed, with additional expert-recommended articles identified through the Hawai'i Initiative for Childhood Obesity Research and Education (HICORE) research database, to evaluate the current body of research on modifiable determinants or correlates of obesity in NHOPI youth. Of an initial pool of 471 articles, 60 articles were read in full and 14 articles were selected for inclusion in the qualitative synthesis. Utilizing an ecological framework to identify gaps in the literature and suggest areas for future research, findings from this review indicate that early life and contextual factors-namely, infant-feeding mode, geographic location, and education-appear to play an important role in obesity in NHOPI youth. However, more research is needed, particularly pre-birth cohort studies evaluating the effects of prenatal and early life risk factors, studies on the sociocultural influences on obesity-related psychosocial factors and health behaviors, as well as the influence of environmental and policy-level variables.
在美国，肥胖仍然是一个主要的公共卫生问题。肥胖对夏威夷原住民和其他太平洋岛民（NHOPI）的影响尤为严重，他们的肥胖率及其相关慢性病发病率令人担忧。然而，对于这一群体肥胖的成因却知之甚少。鉴于个体层面肥胖治疗效果有限，确定最具影响力且可改变的决定因素，以预防或减少NHOPI青年的肥胖，对于制定最能满足该人群需求的干预措施至关重要。我们在PubMed上进行了一项系统综述，并通过夏威夷儿童肥胖研究与教育倡议（HICORE）研究数据库确定了其他专家推荐的文章，以评估当前关于NHOPI青年肥胖的可改变决定因素或相关因素的研究现状。在最初筛选出的471篇文章中，60篇文章被全文阅读，14篇文章被选入定性综合分析。利用生态框架来识别文献中的空白并提出未来研究方向，本次综述的结果表明，早期生活和环境因素，即婴儿喂养方式、地理位置和教育程度，似乎在NHOPI青年肥胖中起着重要作用。然而，仍需要更多研究，特别是评估产前和早期生活风险因素影响的出生前队列研究、关于社会文化对肥胖相关心理社会因素和健康行为影响的研究，以及环境和政策层面变量的影响。
