儿童肥胖:公共健康危机

A. Salama
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摘要

在过去三十年中,全球儿童肥胖患病率显著增加。这种肥胖流行病被认为是年轻人中2型糖尿病等疾病发病率上升的原因。对饥饿控制的遗传学和生理学的了解有了很大的进展,从而澄清了各种不同寻常的肥胖疾病的原因。父母消瘦的孩子在控制体重方面可能比父母肥胖的孩子做得更好。坚持运动可能是肥胖儿童的一个问题,运动计划的选择或设计应该考虑到这些坚持问题。儿童饮食的营养充分性应根据儿童所吃的食物和规定的饮食来评估。然而,对于如何预防或逆转这些罕见疾病导致的儿童肥胖,我们几乎一无所知。由于现代儿童久坐不动的生活方式,卡路里摄入量和活动建议需要在人口水平上重新评估和加强量化。鉴于人们对所谓的能量差距的理解日益加深,目前针对个人治疗的卡路里建议可能过于保守。尽管预防和治疗研究的质量有所提高,但仍需要高质量的多中心长期随访研究。在此期间,应通过预防和治疗措施,努力减少摄入,增加能量消耗。鉴于最近的数据表明,儿童肥胖患病率的螺旋式上升可能正在放缓,应在所有方面加大努力,以保持这一潜在的有希望的趋势。
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Childhood Obesity: A Public Health Crisis
Over the past three decades, pediatric obesity prevalence has significantly increased globally. This obesity epidemic is thought to be the cause of the rising incidence of illnesses like type 2 diabetes in youngsters. Understanding the genetics and physiology of hunger control has advanced greatly, and as a result, the reasons for various unusual obesity diseases have been clarified. Children of thin parents may do better in weight control than children of obese parents. Adherence to exercise is likely to be a problem with obese children, and the choice or design of an exercise program should take these adherence problems into account. The nutritional adequacy of the child's diet should be evaluated both in terms of what the child is eating as well as in terms of the prescribed diet. We have learned almost little about how to prevent or reverse childhood obesity from these rare illnesses, though. Due to the modern sedentary lives of children, calorie intake and activity recommendations require re-evaluation and enhanced quantification at the population level. Given the growing understanding of the so-called energy gap, the current calorie recommendations for individual treatment may be too conservative. High-quality multicentre studies with long-term follow-ups are required despite improvements in the quality of research into prevention and therapy. During this time, efforts should be made to reduce intake and enhance energy expenditure through preventative and therapeutic measures. Increased efforts should be undertaken on all fronts to maintain this potentially promising trend in light of recent data that suggest that the spiralling rise in pediatric obesity prevalence may be slowing.
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