婴儿期增重与5岁以下儿童单纯性肥胖的相关性研究

目的探讨婴儿期增重与5岁以下儿童单纯性肥胖的相关性。方法选取2006年至2011年在中山市博爱医院出生的6746例婴儿进行随访登记,统计相关数据,从中筛选出单纯性肥胖的567例儿童设为肥胖组,并按年龄、性别匹配原则1：1配对者设为对照组,进行父母文化程度、婴儿出生体重、喂养等方面的单因素分析,并进行影响儿童单纯性肥胖的多因素logistics回归分析。结果多因素logistics回归分析显示：与儿童单纯性肥胖显著相关的变量为婴儿出生时的体重（OR=1．94,95％CI=1．56,2．32）、婴儿期前6个月平均增重量（OR=2．17,95％CI=2．11,2．36）及婴儿期后6个月的平均增重量（OR=1．90,95％CI=1．61,2．19）,均P〈0．05。结论与儿童单纯性肥胖密切相关的影响因素为：婴儿出生时的体重、婴儿期前6个月及添加辅食后6个月的平均增重量。     

学龄前儿童肥胖危险因素分析

[目的]研究儿童肥胖的危险因素,为肥胖高危人群的行为干预提供依据. [方法] 采用病例对照研究,将超重肥胖儿童作为病例,正常体重儿童作为对照.对研究对象进行问卷调查和体格检查.收集出生资料、饮食行为习惯等,分析进餐速度与儿童期肥胖的关系. [结果]平均每顿用餐时间、性别、出生体重、母亲糖尿病史及孕前高体质指数和吃西式快餐的频率与儿童期肥胖有关.进餐时间与肥胖的OR值为0.951(95%CI:0.927～0.976),吃西式快餐与肥胖的OR值为1.189(95%CI:1.005～1.407).高出生体重的OR值为1.278(95%CI:1.030～2.000). [结论]适当延长进餐时间可降低肥胖风险,巨大儿、母亲糖尿病及吃西式快餐是儿童期肥胖的危险因素.     

巨大儿在婴儿期发生单纯性肥胖症的调查

目的 了解巨大儿在婴儿期发生单纯性肥胖症的情况,以便制定切实有效的干预措施.方法 对管辖社区2002-2007年出生的巨大儿79例与出生体重正常儿643例在婴儿期发生单纯性肥胖症的情况进行调查.结果 巨大儿在婴儿期身长、体重都超过同年龄同性别均值加上2个标准差者有22例(27.8%);发生单纯性肥胖症21例(26.6%),与出生体重正常儿比较,差异均有统计学意义.结论 巨大儿在婴儿期身长、体重超标,易发生单纯性肥胖症,对儿童单纯性肥胖症的干预,应从减少出生巨大儿,降低婴儿期肥胖开始.     

中国儿童单纯性肥胖与出生体重关系的Meta分析

目的系统评价我国儿童单纯性肥胖与出生体重的相关性,为控制和预防儿童单纯性肥胖提供理论依据。方法计算机检索PubMed、EMbase、Web of science、CNKI、CBM、VIP和WanFang Data,收集关于中国儿童单纯性肥胖与出生体重关系的病例-对照研究,检索时限2000年1月-2014年11月。采用RevMan5.1软件进行Meta分析。结果最终纳入18个研究,共17 442例研究对象。Meta分析结果显示:与正常体重组相比,高出生体重儿童发生单纯性肥胖的危险性较高,差异有统计学意义[OR=2.09,95%CI:1.90~2.30,P0.000 01];儿童单纯性肥胖在低出生体重方面差异无统计学意义[OR=0.92,95%CI:0.41~2.06,P=0.84]。结论高出生体重是儿童单纯性肥胖的危险因素;低出生体重与儿童单纯性肥胖无关联。     

巨大儿在婴儿期发生单纯性肥胖症的调查

目的了解巨大儿在婴儿期发生单纯性肥胖症的情况,以便制定切实有效的干预措施。方法对管辖社区2002—2007年出生的巨大儿79例与出生体重正常儿643例在婴儿期发生单纯性肥胖症的情况进行调查。结果巨大儿在婴儿期身长、体重都超过同年龄同性别均值加上2个标准差者有22例（27．8％）;发生单纯性肥胖症21例（26．6％）,与出生体重正常儿比较,差异均有统计学意义。结论巨大儿在婴儿期身长、体重超标,易发生单纯性肥胖症,对儿童单纯性肥胖症的干预,应从减少出生巨大儿,降低婴儿期肥胖开始。     

江苏地区4～7岁儿童肥胖和超重与出生体重关系的研究

目的 了解江苏省4～7岁儿童肥胖和超重与出生体重之间的关系,为预防和减少儿童期肥胖提供科学依据.方法 对江苏省覆盖13个市区20 488名儿童进行体格检查,并结合孕妇妊娠结局卡资料分析儿童超重、肥胖与出生体重的关系.结果 随着出生体重的幅度增加儿童肥胖和超重的发生与出生体重的发生比例呈上升趋势;低出生体重组（LBW〈2 500 g）、正常出生体重组（NBW=2 500～3 999 g）和高出生体重组（HBW≥4 000 g）肥胖和超重的发生比例分别为13.0%、20.5%和55.1%.结论 新生儿的出生体重对儿童发生超重和肥胖影响显著,应从母亲怀孕期间就开始预防儿童期肥胖和超重,避免高体重儿童出生.     

0—6岁单纯性肥胖儿童肥胖因素研究

目的 探讨儿童单纯性肥胖症的危险因素。 方法 采用１：１配对法对１６０例０￣６岁肥胖儿童进行了研究。 结果 ①小儿肥胖的发生与父母超重、婴儿出生体重过大、摄食量过多有关,但与４个月内喂养方式、睡眠及运动时间无关;②家长对肥胖的认识与儿童肥胖的发生有关;③肥胖儿童血压明显高于正常儿童。 结论 儿童期肥胖与遗传、家庭因素和食物摄入过多有关,儿童期肥胖有引起高血压的危险。     

低出生体重儿学龄前期发生肥胖或营养不良的影响因素

[目的]探讨低出生体重儿婴幼儿期膳食、气质、家庭环境与其学龄前期发生肥胖、营养不良的相关性,为预防低出生体重儿学龄前期肥胖、营养不良的发生提供依据。[方法]在上海市普陀区妇幼保健院儿保门诊选取定期检查的低出生体重儿66人,在同区域长寿社区卫生服务中心儿保门诊选取正常儿童33人,采用喂养指数问卷、膳食问卷、Carey《3~7岁婴儿气质问卷》(家长问卷)与《家庭环境问卷》进行测评,以Logistic回归法与单因素分析法进行分析。[结果]儿童气质、家庭环境与学龄前期儿童肥胖的发生有关。6个月喂养指数、添肝泥时间及家庭环境因子的"知识性"对学龄前期儿童营养不良的发生有显著影响。[结论]6个月喂养指数、气质、家庭环境与低体重儿学龄前期肥胖、营养不良的发生有关。对低出生体重儿进行6个月喂养指数测评、幼儿气质评定、家庭环境评估有临床使用价值。     

高出生体重与儿童单纯性肥胖关系的Meta分析

目的 探讨高出生体重与儿童单纯性肥胖的关系.方法 计算机检索1996至2012年中国期刊全文数据库(CNKI)、中文科技期刊全文数据库(VIP-维普)、万方-数字化期刊全文库,并辅以文献追溯的方法,收集国内公开发表的有关出生体重与儿童单纯性肥胖关系的病例对照研究相关文献.应用Rev Man 4.2.10软件进行Meta分析.结果 将10个研究结果加权合并,累计儿童单纯性肥胖病例4 486例,其中高出生体重799例,占17.8％;累计对照7 740例,其中高出生体重706例,占9.1％;合并OR=1.99(95％ CI:1.78～2.22).结论 国内研究显示高出生体重与儿童单纯性肥胖发生有显著关联.     

出生体重与儿童单纯性肥胖关系

目的探讨出生体重与儿童单纯性肥胖的关系,为预防和减少儿童单纯性肥胖提供科学依据。方法采用1∶1匹配的病例对照研究方法,对筛查出的肥胖儿童和匹配的正常儿童进行现场问卷调查,对出生体重与儿童单纯性肥胖关系进行分析。结果配对χ2检验结果表明,高出生体重儿肥胖发生的危险是正常出生体重儿的2.29倍（P〈0.01）;低出生体重儿肥胖发生的危险是正常出生体重儿的2.00倍（P〉0.05）。曲线拟合分析结果表明,儿童体质指数（BMI）与出生体重之间呈现“U”形分布（P〈0.05）。结论高出生体重与低出生体重均为儿童单纯性肥胖发生的危险因素。     

The National Weight Control Registry: a critique

This article is a critique of the claim that the National Weight Control Registry provides data showing that a significant number of adults in the United States have achieved permanent weight loss. We believe that promoting calorie-restricted dieting for the purpose of weight loss is misleading and futile. We advocate the adoption of a health-at-every-size (HAES) approach to weight management, focusing on the achievement and maintenance of lifestyle changes that improve metabolic indicators of health.     

Smoking,weight standards and “ideal” weight

DIET AND DOMESTIC LIFE IN SOCIETY. Anne Sharman, Janet Theophano, Karen Curtis and Ellen Messer, Eds. Temple University Press, Philadelphia, 1991, viii +287 pp., $34.85

WITH BITTER HERBS THEY SHALL EAT IT: Chemical Ecology and the Origins of Human Diet and Medicine by Timothy Johns. Arizona Studies in Human Ecology, University of Arizona Press, Tucson, Arizona 85719, USA. US$40.00 clothbound, 356 pages.

MALARIA VACCINE DEVELOPMENT: Pre‐erythrocytic stages. S.L. Hoffmann and L.J. Martinez Eds. Proceedings of a conference held in Bethesda, Maryland, USA. Supplement to Bulletin of the World Health Organization, Vol. 68, 1990. 196 pages, English only. Sw.fr.35.‐/US$31.50. In developing countries Sw.fr.24.50.

STOP THE NONSENSE: HEALTH WITHOUT FADS Ezra Sohar, M.D. Shapolsky Publishers, Inc., New York, 159 pps. $16.95     

博山地区4780名成年人身高、体重调查及体重指数、肥胖发生率的统计分析(人群肥胖症研究之一)

作者采用较准确的方法,对博山地区20岁以上不同职业的4780人(男3216,女1564),进行了年龄、身高和体重的调查,并对调查结果作了性别、年龄、身高与体重之问关系的相关、回归分析,得出推算标准体重的回归方程式、“正常成年男女身高与体重表”。按公式计算出体重指数,并拟定了20岁以上男女体重指数的正常范围(男0.1933～0.2525,女0.1951～0.2563)和体重超重、肥胖的体重指数界限值。按这个体重指数标准,本次调查结果男性属超重者占7.71％,肥胖占5.22％;女性超重占6.96％,肥胖占4.73％。本调查资料所载博山地区20岁以上人群年龄、身高与体重之间的关系及推算标准体重的方法,对国内其它地区也会有一定参考价值。     

Maternal anthropometric measurements and other factors: relation with birth weight of neonates

The objective of this study was to examine the influence of anthropometric measurements of pregnant women, gestational weight gain, fundal height, and maternal factors, namely age, education, family income, parity along with maternal hemoglobin, on birth weight of neonates. A cross sectional study was performed in Khoy City in north west of Iran. Four hundred and fifty healthy pregnant women in the age between 16-40 years were selected for this study from seven health urban centers and one referral hospital. Findings showed that the mean age, height, fundal height, maternal weight, and gestational weight gain during pregnancy were 26.1 years, 159.1 cm, 32.9 cm, 72.0 kg, 11.8 kg respectively. The mean birth weight of neonates was 3.2 kg and 11% of neonates showed low birth weight. Age, family income, maternal height, weight, gestational weight gain and fundal height were significantly associated with birth weight of neonates. Using binary logistic regression analysis, fundal height, maternal hemoglobin, family income and gestational weight gain of pregnant women could be considered as predictive factors of birth weight of neonates.     

An exploration of the experiences and perceptions of people who have maintained weight loss

Background: In clinical weight‐loss trials, the majority of those who lose weight will regain almost all of it within 5 years, yet there is limited evidence about effective strategies to support weight maintenance. The present study aimed to increase understanding of the experiences of those who have been successful at weight maintenance. Methods: This qualitative study used a phenomenological approach. Semi‐structured interviews were undertaken with a purposive sample of 10 participants who had maintained a minimum of 10% weight loss for at least 1 year. Interviews were transcribed and then analysed using a foundational thematic approach based on the Colaizzi method. Results: Participants believed that a more relaxed approach to weight management with realistic, long‐term goals was more appropriate for long‐term control. They had a strong reason to lose weight often with a medical trigger and had elicited support to help them. Most described the presence of saboteurs. Participants took personal responsibility for their weight management and were in tune with their nutrition and activity needs. Self‐monitoring was a strategy commonly used to support this. They described the lack of positive reinforcement in the maintenance phase as a major difficulty. Conclusions: This small‐scale study provides evidence to suggest the importance of a medical prompt to lose weight; planning for how to manage saboteurs and identifying methods of minimising the impact of a reduction in positive reinforcement. It reinforces the importance of many of the strategies known to support the weight‐loss phase.     

Postpartum Weight Change in Relation to Pre-Pregnancy Weight and Gestational Weight Gain in Women in Low-Income Setting: Data from the KITE Cohort in the Northern Part of Ethiopia

(1) Background: Postpartum weight may increase compared to pre-pregnancy due to weight retention or decrease due to weight loss. Both changes could pose deleterious effects on maternal health and subsequent pregnancy outcomes. Therefore, this study aimed to assess postpartum weight change and its associated factors. (2) Methods: A total of 585 women from the KIlte-Awlaelo Tigray Ethiopia (KITE) cohort were included in the analysis. (3) Results: The mean pre-pregnancy body mass index and weight gain during pregnancy were 19.7 kg/m² and 10.8 kg, respectively. At 18 to 24 months postpartum, the weight change ranged from −3.2 to 5.5 kg (mean = 0.42 kg [SD = 1.5]). In addition, 17.8% of women shifted to normal weight and 5.1% to underweight compared to the pre-pregnancy period. A unit increase in weight during pregnancy was associated with higher weight change (β = 0.56 kg, 95% CI [0.52, 0.60]) and increased probability to achieve normal weight (AOR = 1.65, 95% CI [1.37, 2.00]). Food insecurity (AOR = 5.26, 95% CI [1.68, 16.50]), however, was associated with a shift to underweight postpartum. Interestingly, high symptoms of distress (AOR = 0.13, 95% CI [0.03, 0.48]) also negatively impacted a change in weight category. (4) Conclusions: In low-income settings such as northern Ethiopia, higher weight gain and better mental health during pregnancy may help women achieve a better nutritional status after pregnancy and before a possible subsequent pregnancy.     

664例低出生体重儿分析

本文分析１２６２５围产儿中６６４例低出生体重儿（ＬｏｗＢｉｒｔｈＷｅｉｇｈｔＩｎｆａｎｔ，ＬＢＷＩ）的出生体重及产妇情况。     

Self-reported weight and height: implications for obesity research

BACKGROUND: Self-reported weight and height are under- and over-reported, respectively, in epidemiologic studies. This tendency, which may adversely affect study operations, has not been evaluated among subjects being enrolled into a weight-loss program. METHODS: Self-reported weight, height, and body mass index (BMI) were compared to measured values in 97 overweight or obese (BMI>27.3) women being enrolled into a randomized, controlled trial of two behavioral interventions for weight loss. The effects of demographic factors, baseline weight, baseline height, and baseline BMI on weight and height reporting were assessed. RESULTS: There was a significant difference between measured and reported weight (mean difference=-3.75 lb, p=0.0001) and height (mean difference=+0.35 in., p=0.0007). The mean difference between measured and reported BMI was -1.14 kg/m(2) (p=0.0001). Unemployed, retired, or disabled women were more likely to under-report their BMI than employed women (p=0.001). Six percent of subjects who were initially considered eligible for the study on the basis of the self-report were eventually excluded from the study because they did not meet the inclusion criterion for BMI. CONCLUSIONS: Obese women who seek weight-loss assistance tend to under-report their weight and over-report their height, suggesting that self-reported data are likely to be inaccurate. Misreporting is apparently influenced by employment and disability and has the potential to complicate recruitment of subjects for research studies.     

Pregnancy-Associated Obesity in Black Women in New York City

Objective: To determine weight gain during pregnancy and weight changes postpartum in first-time mothers delivering at or near term. Methods: At about 2 weeks after delivery, 47 adult, Black and Hispanic women provided information on their prepregnancy weight and height and maximum pregnancy weight. Women reinterviewed at 2 and 6 months after delivery reported their most recent weight measurement and the date of that measurement. This information was used to compute each woman's prepregnancy body mass index, pregnancy weight gain, and weight loss postpartum. Information on infant feeding was also collected at each postpartum visit. Results: About 2/3 of the women and 100% of the overweight and obese women gained excessive weight during pregnancy. Weight gain was most marked in women who started pregnancy overweight or obese. At 2 months postpartum, women were on average almost 18 lb above their prepregnancy weight. No additional maternal weight was lost by 6 months postpartum. Most infants were started on formula by 2 weeks of age. At 2 months of age, 85% were fed formula only and 91% of the infants were on WIC. Conclusions: Our results demonstrate a need for interventions to help women avoid obesity by regulating their pregnancy weight gain, losing weight for a longer period postpartum, and initiating and maintaining exclusive breast-feeding.     

Objectively Assessed Weight Change and All-Cause Mortality among Community-Dwelling Older People

Later life changes in body weight may be associated with an increased risk of mortality in older adults. The objective of this study was to examine whether weight change over four years was associated with a 17-year mortality risk in older adults. Participants were 1664 community-dwelling adults aged ≥65 years in the longitudinal Enquete de Sante’ Psychologique-Risques, Incidence et Traitement (ESPRIT) study. Outcomes were all-cause mortality, cardiovascular disease (CVD) and cancer mortality. Weight change was defined as difference between weight at baseline and 4 years, categorised into: weight stable (±<5% weight change), weight loss (≥5%) and weight gain (≥5%). Association between weight change and mortality risk was evaluated using Cox proportional hazards models. Over 17 years of follow-up (median 15 years), 565 participants died. Compared to stable weight participants, those with ≥ 5% weight loss had an increased risk of all-cause mortality (HR: 1.24, 95% CI: 1.00–1.56, p = 0.05) and CVD mortality (HR: 1.53, 95% CI: 1.10–2.14, p = 0.01), but not cancer mortality (HR: 0.83, 95% CI: 0.50–1.39, p = 0.49). Weight gain of ≥5% was not associated with increased mortality (HR: 1.05, 95% CI: 0.76–1.45, p = 0.74). Weight monitoring in older adults could help identify weight loss at its early stages to better target interventions to maintain nutritional reserve and prevent premature mortality.