Yuan Changzheng, Dong Yanhui, Chen Hui, Ma Le, Jia Lihong, Luo Jiayou, Liu Qin, Hu Yifei, Ma Jun, Song Yi
School of Public Health, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Institute of Child, Adolescent Health and School of Public Health, Peking University and National Health Commission Key Laboratory of Reproductive Health, Beijing, China.
Lancet Public Health. 2024 Dec;9(12):e1115-e1124. doi: 10.1016/S2468-2667(24)00245-7. Epub 2024 Nov 20.
China is confronted with the challenge of increasing childhood obesity. Although interventions for childhood obesity have been developed, their effectiveness and implementation can vary considerably across nations. In this paper, we review and consolidate the evidence on childhood obesity intervention strategies aimed at multiple levels and components across life, in China. School-based interventions, primarily delivered with group-based dietary and physical education, have shown potential efficacy and can be enhanced by integrating food environment reform and family support. However, most interventional studies were done in eastern and urban areas of China, which highlights the need for attention in regions with insufficient health resources where policies and initiatives are less accessible. In addition, the sparse reporting on implementation design and delivery might hinder the scalability of potentially effective strategies. Amid rapid social and economic development over the past few decades, China faces unique challenges on urbanisation, physical inactivity, and nutritional transitions, necessitating an updated policy agenda for primary prevention of childhood obesity. Structural longitudinal evaluations of public initiatives led by the government and organisations along with inclusive and equitable interventions targeting children of different ages, urban-rural regions, and different ethnic and socioeconomic groups are warranted. Tackling childhood obesity in China needs a cohesive approach that integrates social, economic, cultural, and environmental strategies, combining school-based, family-based, and individual-based approaches, and concerted efforts from multiple sectors and entities within China.
中国正面临儿童肥胖率上升的挑战。尽管已经制定了针对儿童肥胖的干预措施，但其有效性和实施情况在不同国家可能有很大差异。在本文中，我们回顾并整合了中国针对贯穿一生的多个层面和要素的儿童肥胖干预策略的证据。以学校为基础的干预措施主要通过集体饮食和体育教育来实施，已显示出潜在效果，并且可以通过整合食物环境改革和家庭支持来加强。然而，大多数干预研究是在中国东部和城市地区进行的，这凸显了在卫生资源不足、政策和举措难以实施的地区需要予以关注。此外，关于实施设计和实施情况的报告稀少，可能会阻碍潜在有效策略的推广。在过去几十年快速的社会和经济发展过程中，中国在城市化、身体活动不足和营养转变方面面临独特挑战，因此需要更新预防儿童肥胖的初级政策议程。由政府和组织牵头的公共举措进行结构性纵向评估，以及针对不同年龄、城乡地区以及不同种族和社会经济群体儿童的包容性和公平性干预措施是必要的。在中国应对儿童肥胖问题需要一种综合方法，该方法整合社会、经济、文化和环境策略，结合基于学校、家庭和个人的方法，并需要中国多个部门和实体的共同努力。
