Obes Facts. 2018;11(3):263-276. doi: 10.1159/000486512. Epub 2018 Jul 4.
Current guidelines for prevention of obesity in childhood and adolescence are discussed.
A literature search was performed in Medline via PubMed, and appropriate studies were analyzed.
Programs to prevent childhood obesity have so far remained mainly school-based and effects have been limited. Analyses by age group show that prevention programs have the best results in younger children (<12 years). Evidence-based recommendations for pre-school- and early school-aged children indicate the need for interventions that address parents and teachers alike. During adolescence, school-based interventions proved most effective when adolescents were addressed directly. To date, obesity prevention programs have mainly focused on behavior-oriented prevention. Recommendations for community- or environment-based prevention have been suggested by the German Alliance of Noncommunicable Diseases and include a minimum of 1 h of physical activity at school, promotion of healthy food choices by taxing unhealthy foods, mandatory standards for meals at kindergartens and schools as well as a ban on unhealthy food advertisement aimed at children.
Behavior-oriented prevention programs showed only limited long-term effects. Certain groups at risk for the development of obesity are not reached effectively by current programs. Although universally valid conclusions cannot be drawn given the heterogeneity of available studies, clearly combining behavior-based programs with community-based prevention to counteract an 'obesogenic environment' is crucial for sustainable success of future obesity prevention programs.
讨论当前儿童和青少年肥胖预防指南。
通过 PubMed 在 Medline 上进行文献检索,并分析了相关研究。
迄今为止,预防儿童肥胖的项目主要还是以学校为基础的,效果有限。按年龄组进行的分析表明,预防计划在年龄较小的儿童(<12 岁)中效果最好。针对学前和学龄初期儿童的循证建议表明,需要针对家长和教师采取干预措施。在青春期,直接针对青少年的学校干预措施效果最为显著。迄今为止,肥胖预防计划主要侧重于以行为为导向的预防。德国非传染性疾病联盟提出了基于社区或环境的预防建议,包括在学校至少进行 1 小时的体育活动,通过对不健康食品征税来促进健康食品的选择,对幼儿园和学校的膳食制定强制性标准,以及禁止针对儿童的不健康食品广告。
以行为为导向的预防计划仅显示出有限的长期效果。某些易患肥胖症的特定群体并未被当前的项目有效覆盖。鉴于现有研究的异质性,无法得出普遍适用的结论,但显然将基于行为的计划与基于社区的预防相结合,以对抗“肥胖环境”,对于未来肥胖预防计划的可持续成功至关重要。