Moscetti Craig W, Pronk Nicolaas P
Allina Health, 7590 Lyric Lane, Fridley, MN 55432, USA; HealthPartners, 8170 33 Ave S, Bloomington, MN 55425, USA.
HealthPartners, 8170 33 Ave S, Bloomington, MN 55425, USA; HealthPartners Institute for Education and Research, 8170 33 Ave S, Bloomington, MN 55425, USA.
Prev Med Rep. 2016 Nov 9;5:1-3. doi: 10.1016/j.pmedr.2016.11.006. eCollection 2017 Mar.
Progress in altering the current obesity epidemic among children and adolescents remains elusive. Evidence continues to underscore the challenges of altering weight status as children age. Further, weight loss interventions among children and adults alike tend to demonstrate efficacy in the short-term, however individuals tend to slowly revert back to their original weight status over time. New understanding of obesity's early origins suggests the need to rethink current approaches, particularly within healthcare. Instead of a predominant focus on "mid-flight course corrections," healthcare should consider the "take-off" time period for health trajectories. This means improved support and promotion of healthy behaviors before and after birth, and with both the mother and infant. To meet the challenge, greater continuity will be required across obstetrics and pediatrics, which often operate independently, focused on different clinical outcomes. Likewise, there is an urgent need to remedy a significant skills gap within both practices. Through its connection with almost every new mother, healthcare plays a unique and vital role in maternal and child health outcomes. A more seamless obstetrics-pediatrics care continuum could better address the early origins of obesity, factors that we are coming to learn have life-long consequences.
改变当前儿童和青少年肥胖流行趋势的进展仍然难以实现。证据不断强调随着儿童年龄增长改变体重状况所面临的挑战。此外,儿童和成人的减肥干预措施在短期内往往显示出效果,但随着时间的推移,个体往往会慢慢恢复到原来的体重状态。对肥胖早期起源的新认识表明有必要重新思考当前的方法,尤其是在医疗保健领域。医疗保健不应主要关注“飞行途中的航线修正”,而应考虑健康轨迹的“起飞”时间段。这意味着在出生前后以及母亲和婴儿双方都要加强对健康行为的支持和推广。为应对这一挑战,产科和儿科之间需要更大的连续性,因为它们通常独立运作,关注不同的临床结果。同样,迫切需要弥补这两种医疗实践中存在的重大技能差距。通过与几乎每一位新妈妈建立联系,医疗保健在母婴健康结果方面发挥着独特而重要的作用。更无缝的产科 - 儿科护理连续体可以更好地解决肥胖的早期起源问题,我们逐渐了解到这些因素会产生终身影响。