Broussard B A, Sugarman J R, Bachman-Carter K, Booth K, Stephenson L, Strauss K, Gohdes D
Indian Health Service Diabetes Program, Albuquerque, NM 87110, USA.
Obes Res. 1995 Sep;3 Suppl 2:289s-297s. doi: 10.1002/j.1550-8528.1995.tb00476.x.
Obesity is a particularly important challenge to the health status of Native Americans. This challenge is manifest in the increasing rates of non-insulin-dependent diabetes mellitus among Native Americans. Most studies of Native American infants, preschool children, schoolchildren, and adults have confirmed a high prevalence of overweight. Historical studies suggest that for many Native American communities the high rates of obesity are a relatively recent phenomenon. The specific reasons for the increase in obesity among Native Americans have not been determined, although it has been hypothesized that Native Americans have a genetic predisposition to overweight in a "westernized" environment of abundant food and decreased energy expenditure. Few detailed studies of diet or of physical activity levels of contemporary Native Americans have been published. Community-based interventions to modify diet and activity levels to prevent obesity in Native American communities are needed. Preliminary evidence from two formative school-based programs in the Southwest suggest that Native American communities are receptive to school-based interventions, and that such programs may be able to slow the rate of excess weight gain and to improve fitness in school children. Because of the cultural diversity among Native Americans, future studies should focus on collecting community- and region-specific data, and should emphasize the need for obesity prevention through culturally appropriate community- and school-based behavioral interventions.
肥胖对美国原住民的健康状况构成了尤为严峻的挑战。这一挑战体现在美国原住民中非胰岛素依赖型糖尿病发病率不断上升。大多数针对美国原住民婴儿、学龄前儿童、学龄儿童及成年人的研究均证实超重现象普遍存在。历史研究表明，对于许多美国原住民社区而言，肥胖率居高是相对较新的现象。尽管有人推测，在食物丰富且能量消耗减少的“西方化”环境中，美国原住民具有超重的遗传倾向，但美国原住民肥胖率上升的具体原因尚未确定。关于当代美国原住民饮食或身体活动水平的详细研究鲜有发表。需要开展基于社区的干预措施，以改变饮食和活动水平，预防美国原住民社区的肥胖问题。来自西南部两个初步的校内项目的证据表明，美国原住民社区愿意接受校内干预措施，而且此类项目或许能够减缓超重率上升，并提高学童的健康水平。鉴于美国原住民文化的多样性，未来的研究应侧重于收集特定社区和地区的数据，并应强调通过适合文化背景的社区及校内行为干预措施预防肥胖的必要性。
