Department of Pediatrics I, Martin-Luther-University Halle-Wittenberg, Halle, Germany.
Department of Prevention and Care of Diabetes, Technical University Dresden, Germany; German Center for Diabetes Research (DZD), Paul Langerhans Institute Dresden, Germany.
Metabolism. 2019 Mar;92:147-152. doi: 10.1016/j.metabol.2018.12.001. Epub 2018 Dec 5.
Prevalence of childhood obesity has worldwide more than doubled since 1980. Underlying factors are complex and are far from completely understood. Strategies to prevent childhood obesity have mainly focused on behavioral intervention; and obesity therapy was mainly based on lifestyle modification to date. However, effects for both have been quite limited so far and no country has succeeded in fighting the obesity epidemy we are facing. Normalization of body weight before onset of puberty is crucial for several reasons: First, obese children and adolescents frequently stay obese until adulthood. Second, obesity during adolescence is significantly associated with increased risk for cardiovascular and metabolic disease such as type 2 diabetes in adulthood. And third, recent data have shown a strong association between higher body mass index (BMI) during adolescence and increased risk for several malignancies such as leukemia, Hodgkin's disease, colorectal cancer, breast cancer and others in adulthood. This review summarizes our current understanding of epidemiology, underlying factors, concomitant disease, as well as available intervention strategies and gives an overview of what has been reached so far and what measures should be undertaken to counteract the obesogenic environment.
自 1980 年以来,全球儿童肥胖的患病率增加了一倍以上。其根本原因复杂,远未被完全了解。预防儿童肥胖的策略主要集中在行为干预上;迄今为止,肥胖症的治疗主要基于生活方式的改变。然而,到目前为止,这两种方法的效果都相当有限,没有一个国家成功地对抗我们所面临的肥胖症流行。在青春期前使体重正常化是至关重要的,原因有几个:第一,肥胖的儿童和青少年经常会一直肥胖到成年。第二,青春期肥胖与成年后患心血管和代谢疾病(如 2 型糖尿病)的风险显著增加有关。第三,最近的数据显示,青春期的体重指数(BMI)较高与成年后患几种恶性肿瘤(如白血病、霍奇金病、结直肠癌、乳腺癌等)的风险增加之间存在很强的关联。这篇综述总结了我们目前对流行病学、根本原因、并存疾病以及现有的干预策略的理解,并概述了迄今为止所取得的成就,以及应该采取哪些措施来对抗肥胖环境。