Systems-Oriented Global Childhood Obesity Intervention Program, Fisher Institute of Health and Well-being, College of Health, Ball State University, Muncie, IN, USA.
Department of Biomedical and Health Informatics, The Children's Hospital of Philadelphia, Philadelphia, PA, USA.
Adv Nutr. 2021 Jul 30;12(4):1137-1148. doi: 10.1093/advances/nmaa162.
For a comprehensive understanding of high-level obesity in the USA, we studied the trends of obesity prevalence since 2007, and related biological, behavioral, and sociocultural factors in obesity racial/ethnic disparities. We searched PubMed, Embase, and national data archives for the studies using national survey data and published in English from January 1, 2007 to September 11, 2020. Forty-seven studies met the inclusion criteria and were systematically reviewed. After a short leveling-off during 2009-2012, the US national prevalence of obesity has steadily increased. Although women had higher racial/ethnic disparities in obesity and severe obesity than men, it decreased due to the significant drop in non-Hispanic black (NHB) women in the last 10 y. However, obesity and severe obesity prevalence increased in Mexican-American (MA) men, MA boys, and MA girls and became similar to or surpassing NHB groups. Substantial racial/ethnic disparities remained in the past decade. Even at the same level of BMI, MAs and non-Hispanic Asians had a higher percent of body fat and metabolic syndrome than other ethnic/racial groups. NHB's cultural preference for a large body significantly associated weight misperception and lower weight control practices. In addition to socioeconomic status, health behaviors, neighborhood environments, and early childhood health factors explained substantial racial/ethnic differences in obesity. Differences in biological, behavioral, and sociocultural characteristics should be considered in future public health intervention efforts to combat obesity in the USA.
为了全面了解美国的肥胖问题，我们研究了自 2007 年以来肥胖流行率的趋势，以及肥胖在种族/族裔差异方面的相关生物学、行为和社会文化因素。我们在 PubMed、Embase 和国家数据档案中搜索了使用全国性调查数据且于 2007 年 1 月 1 日至 2020 年 9 月 11 日以英文发表的研究。有 47 项研究符合纳入标准，并进行了系统综述。在 2009-2012 年期间短暂稳定后，美国的全国肥胖流行率稳步上升。尽管女性在肥胖和重度肥胖方面的种族/族裔差异高于男性，但由于过去 10 年非西班牙裔黑人（NHB）女性的显著下降，这种差异有所减少。然而，墨西哥裔美国人（MA）男性、男孩和女孩的肥胖和重度肥胖流行率增加，并且与 NHB 群体相似或超过。在过去十年中，仍然存在着巨大的种族/族裔差异。即使 BMI 水平相同，MA 和非西班牙裔亚洲人的体脂肪和代谢综合征的比例也高于其他族裔/种族群体。NHB 对大身材的文化偏好与体重感知错误和较低的体重控制行为显著相关。除了社会经济地位、健康行为、社区环境和儿童早期健康因素外，肥胖的种族/族裔差异还可以用大量其他因素来解释。在未来的公共卫生干预工作中，应该考虑生物学、行为和社会文化特征方面的差异，以对抗美国的肥胖问题。
