Heerman William J, Kenney Erica, Block Jason P, Fiechtner Lauren, McMahon Ellen, Kruse Lauren, Sharifi Mona, Edmondson Emma K, Virudachalam Senbagam
Department of Pediatrics, Vanderbilt University Medical Center, Nashville, USA.
Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, USA.
Curr Obes Rep. 2024 Mar;13(1):87-97. doi: 10.1007/s13679-023-00550-z. Epub 2024 Jan 3.
Public health interventions that intervene on macrolevel systems hold the promise of reducing childhood obesity at the population level through prevention. The purpose of this review is to highlight some of the recent and best scientific evidence related to public health interventions for the prevention of childhood obesity. We provide a narrative review of scientific evidence for six categories of public health interventions and their impact on childhood obesity: federal nutrition assistance programs, programs implemented in early care and education centers, interventions to support healthy nutrition and physical activity in schools, community-based programs and policies, labeling policies and marketing to children, and taxes on sugar sweetened beverages (SSB).
Federal nutrition assistance programs have the strongest evidence to support reduction in childhood obesity and serve populations with the highest prevalence of childhood obesity. Other interventions including SSB taxes, community-wide interventions, and interventions at schools and early care and education centers also show significant improvements in child weight status. Overall public health interventions have strong evidence to support widespread implementation in service of reducing childhood obesity rates at the population level. To effectively address the recalcitrant childhood obesity epidemic, multi-pronged solutions are needed. The current evidence for public health obesity interventions is consistent with the paradigm that recognizes the importance of macrolevel systems influences on childhood obesity: interventions that are most effective intervene at macrolevels.
对宏观层面系统进行干预的公共卫生措施有望通过预防在人群层面降低儿童肥胖率。本综述的目的是突出一些与预防儿童肥胖的公共卫生干预措施相关的最新且最佳科学证据。我们对六类公共卫生干预措施及其对儿童肥胖的影响的科学证据进行了叙述性综述:联邦营养援助计划、在早期护理和教育中心实施的计划、支持学校健康营养和体育活动的干预措施、基于社区的计划和政策、标签政策以及针对儿童的营销,以及对含糖饮料征税。
联邦营养援助计划有最有力的证据支持降低儿童肥胖率,且服务于儿童肥胖患病率最高的人群。其他干预措施,包括对含糖饮料征税、全社区干预措施以及在学校和早期护理及教育中心的干预措施,也显示出儿童体重状况有显著改善。总体而言,公共卫生干预措施有充分证据支持在人群层面广泛实施以降低儿童肥胖率。为有效应对顽固的儿童肥胖流行问题,需要多管齐下的解决方案。目前关于公共卫生肥胖干预措施的证据与认识到宏观层面系统对儿童肥胖影响重要性的范式一致:最有效的干预措施是在宏观层面进行干预。