Power C, Lake J K, Cole T J
Department of Epidemiology & Biostatistics, Institute of Child Health, London, UK.
Int J Obes Relat Metab Disord. 1997 Jul;21(7):507-26. doi: 10.1038/sj.ijo.0800454.
This paper reviews child and adolescent adiposity measures and associated long-term health risks. The first section argues that anthropometric measures are practical for large scale epidemiological studies, particularly the body mass index. Limitations of this and other measures are presented. The second section summarises the evidence on the relationship between child and adolescent and adult adiposity. This is based on a search for relevant literature in the following computerised databases: Medline (1985-96), BIDS (EMBASE and Science Citation Index 1985-96). The literature search revealed that the child to adult adiposity relationship is now well-documented, although methodological differences hinder comparisons. Nonetheless, consistently elevated risks of adult obesity are evident for fatter children, although the prediction of adult obesity from child and adolescent adiposity measures is only moderate. Fewer studies could be identified in relation to long-term health risks of child and adolescent adiposity. It is therefore difficult to specify categories of risk associated with childhood adiposity without more information from long-term studies. Further evidence is also required to confirm the suggestion from some studies that adult disease risks are associated with a change in adiposity from normal weight in childhood to obesity in adulthood. However, on the basis of the evidence available, it is argued that population-based approaches to the prevention of obesity are likely to be more effective than approaches targeted as fat children. Population-based approaches are desirable, first because of the poor prediction of adult obesity from child and adolescent measures, and second, because of risks of adult mortality and morbidity may be elevated for individuals who become overweight after adolescence.
本文综述了儿童和青少年肥胖的测量方法以及相关的长期健康风险。第一部分指出，人体测量方法对于大规模流行病学研究很实用，尤其是体重指数。文中介绍了该方法及其他方法的局限性。第二部分总结了有关儿童、青少年肥胖与成人肥胖之间关系的证据。这部分内容基于在以下计算机化数据库中搜索相关文献：医学在线数据库（1985 - 1996年）、BIDS数据库（包含1985 - 1996年的EMBASE和科学引文索引）。文献检索表明，儿童与成人肥胖之间的关系现已得到充分记录，尽管方法上的差异妨碍了比较。尽管如此，较胖的儿童成年后肥胖风险持续升高，不过根据儿童和青少年肥胖测量结果预测成人肥胖的准确性一般。关于儿童和青少年肥胖的长期健康风险，能找到的研究较少。因此，在没有更多长期研究信息的情况下，很难明确与儿童肥胖相关的风险类别。还需要进一步的证据来证实一些研究提出的观点，即成人疾病风险与儿童期体重正常但成年后肥胖的肥胖程度变化有关。然而，根据现有证据，有人认为基于人群的肥胖预防方法可能比针对肥胖儿童的方法更有效。基于人群的方法是可取的，首先是因为根据儿童和青少年的测量结果对成人肥胖的预测效果不佳，其次是因为青春期后超重的个体成年后死亡和发病风险可能会升高。
