The University of Texas Medical Branch, Galveston, TX, USA.
J Racial Ethn Health Disparities. 2024 Aug;11(4):2338-2345. doi: 10.1007/s40615-023-01701-7. Epub 2023 Jul 13.
Childhood obesity prevalence in the USA continues to rise and the Hispanic American population is disproportionately affected. Obesity prevalence among Hispanic youth is 26.2%, the highest prevalence of any minority or non-minority group of children. Prevalence of related conditions including type 2 diabetes, heart disease, and stroke also are increased among Hispanic Americans. Physicians and other providers commonly utilize body mass index (BMI) to estimate percentage of bodily fat and risk of adverse health outcomes. BMI has been shown to track from childhood to adulthood, demonstrating necessity for early intervention. Interventions targeting the prevention and reversal of obesity among children are categorized as school-based or family-based. Interventions vary but may involve strategies such as meetings to discuss health-related curriculum, augmentation of physical activity, and/or improvement of nutritional quality of food. The aim of this article is to review the current literature to determine whether family-based or school-based interventions are more successful in the prevention and reversal of obesity among Hispanic youth. We reviewed twenty-eight studies describing these interventions and included ten (four school-based and six family-based) in our in-depth analysis. Inclusion criteria required trials were conducted among adequate population sizes of Hispanic youth within the age range of interest, analyzed the primary outcome of interest, and took place after the year 2000. Family-based interventions typically involved small population sizes, were dependent upon parent adherence, and were rarely effective. School-based interventions were more commonly effective and involved larger population sizes, allowing for greater generalizability and greater impact of the intervention. Of five family or school-based interventions which successfully reduced BMI among this population, four included a component involving structured physical activity. School-based interventions involving augmentation of physical activity with minimal limitations of study execution demonstrated efficacy in the prevention and reversal of obesity among Hispanic children.
美国儿童肥胖症的患病率持续上升，西班牙裔美国人的肥胖问题尤为严重。西班牙裔青少年的肥胖患病率为 26.2%，是所有少数族裔或非少数族裔儿童中最高的。与肥胖相关的疾病，包括 2 型糖尿病、心脏病和中风，在西班牙裔美国人中的发病率也有所上升。医生和其他医务人员通常使用身体质量指数（BMI）来估计体脂肪百分比和不良健康结果的风险。BMI 从儿童期到成年期都有跟踪记录，这表明需要早期干预。针对儿童肥胖预防和逆转的干预措施可分为以学校为基础或以家庭为基础的干预措施。干预措施各不相同，但可能涉及讨论健康相关课程的会议、增加身体活动和/或改善食物营养质量等策略。本文的目的是回顾现有文献，以确定以家庭为基础或以学校为基础的干预措施在预防和逆转西班牙裔青少年肥胖方面是否更成功。我们回顾了描述这些干预措施的 28 项研究，并对其中的 10 项（4 项以学校为基础，6 项以家庭为基础）进行了深入分析。纳入标准要求试验在西班牙裔青年的适当人群中进行，年龄在感兴趣的范围内，分析了主要的研究结果，并在 2000 年后进行。以家庭为基础的干预措施通常涉及较小的人群规模，依赖于家长的坚持，且很少有效。以学校为基础的干预措施更有效，涉及更大的人群规模，使干预措施具有更大的普遍性和更大的影响力。在这一人群中，有五项家庭或学校为基础的干预措施成功降低了 BMI，其中四项包括了涉及结构化身体活动的内容。涉及增加身体活动且对研究执行限制最小的以学校为基础的干预措施，在预防和逆转西班牙裔儿童肥胖方面显示出了疗效。
