运动、营养联合干预对肥胖儿童的效果观察

目的观察运动和营养疗法联合干预对于肥胖儿童的临床效果。方法将我院100例单纯性肥胖儿童患者随机的分为对照组和实验组两组,每组各50例。对照组肥胖儿童采取单纯的运动或者营养疗法进行干预;实验组肥胖儿童采取运动和营养疗法进行共同干预,观察两组肥胖儿童的临床治疗效果。结果实验组总有效率显著高于对照组有效率(P<0.05),差异具有统计学意义。结论运动和营养疗法共同干预对于肥胖儿童的体重与形态方面具有比较好的效果,值得推广应用开来。     

单纯性肥胖儿童血压与体重指数的关系

目的:探讨青春期单纯性肥胖儿童血压与体重指数(BMl)的关系。方法:选取13～14岁青春期单纯性肥胖儿童50名和体重正常儿童67名为研究对象,测量身高、体重、血压并计算BMI。结果:青春期单纯性肥胖组儿童高血压发生率(26.0%)明显高于对照组儿童(3.0%),肥胖组高血压发生的相对危险度为11.377。结论:单纯性肥胖儿童发生高血压的危险性明显高于体重正常儿童,肥胖儿童高血压的发生与BMI呈正相关。     

儿童单纯性肥胖症3+2减重方案疗效及影响疗效的相关因素分析

目的 研究3+2减重方案对儿童单纯性肥胖的疗效、安全性,以及影响疗效的因素,探索适合国内肥胖儿童的个体化减重方案。方法 以2011年5月-2013年1月在本院小儿内分泌专科门诊诊断的85例单纯性肥胖儿童作为干预组,同时期在西安市区中小学采用11配对方法抽取的85例单纯性肥胖儿童作为肥胖对照组及85例健康儿童作为正常对照组。对三组儿童体重身高随访、监测,并对影响影响疗效的因素进行统计分析。结果 肥胖干预组6月后体质指数(BMI)较前明显减少,差异有统计学意义;肥胖干预组身高增长高于对照组,差异有统计学意义(P0.05);母亲的文化程度高、每次运动大于半小时和饮食和运动方案联合执行是有效减重的影响因素。结论 3+2减重方案可有效控制7~18岁肥胖儿童体重增长,是安全、有效可行的个体化减重方案。     

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。     

单纯性肥胖儿童35例社区干预分析

目的:探讨单纯性肥胖(Simple obesity)儿童的社区干预措施,提高社区健康管理水平.方法:对35例单纯性肥胖儿童综合运用饮食管理、适量运动和健康教育等方法进行社区干预.结果:在观察期内,患儿体重控制效果满意.结论:儿童处于生长发育的关键时期,对预防干预措施比较敏感,积极探索单纯性肥胖儿童的社区干预措施对降低发病率具有重要意义.     

综合干预对儿童单纯性肥胖疗效的影响研究

目的帮助肥胖儿童减轻体重,并建立健康的生活方式。方法组织小胖子健康之旅夏令营,对肥胖儿童进行10～15d的全封闭式管理,采取营养干预、运动干预、健康干预、生活方式干预的综合干预措施。结果观察组512例肥胖儿童中98.83%体重有不同程度的降低,1.17%体重无变化,无体重增长的儿童。与对照组比较,差异有统计学意义。结论采取夏令营这种方式对儿童单纯性肥胖进行综合干预是有效可行的。     

运动疗法对单纯性儿童肥胖干预效果的Meta分析

目的采用Meta分析评价运动疗法对单纯性儿童肥胖的干预效果。方法以"儿童"、"单纯性肥胖"、"肥胖"、"运动"等为主题词和关键词计算机检索中国生物医学文献数据库(CBM)、中国期刊全文数据库(CNKI)、维普期刊全文数据库(VIP)、万方医药期刊数据库、Medline、PubMed以及EMBASE等数据库,并辅以文献追溯等方法,收集有关运动疗法治疗单纯性儿童肥胖的随机对照试验,检索时间均从建库至2013年5月;运用Review Manager 5.0对纳入文献进行定量评价。结果共纳入10篇研究文献。Meta分析结果显示:运动干预组与对照组相比较体质指数降低值的加权均数差(WMD)为-1.00,[95%可信区间为(-1.68~-0.32)]、体重降低值的WMD为-1.79,[95%可信区间为(-3.23~-0.35)]、脂肪质量减少值的WMD为-2.71,[95%可信区间为(-3.02~-2.40)]。结论运动疗法对肥胖儿童降低体质指数、体重、减少脂肪质量方面有较好的效果,可以推广运动疗法在单纯性肥胖儿童中的应用。     

学龄前儿童单纯性肥胖综合治疗效果观察

目的观察综合疗法治疗学龄前儿童单纯性肥胖症的可行性及治疗效果,为防治儿童单纯性肥胖提供依据.方法选择镇江市区12所幼儿园中的3～6岁单纯性肥胖儿童138例,随机分为2组.对实验组儿童进行3个月的饮食调整、运动处方、行为疗法等综合治疗,对照组不进行任何干预.每月给肥胖儿测一次身高、体重、皮脂厚度.结果治疗后,实验组体重减轻,皮脂厚度减薄,与对照组相比差异有显著性(P＜0.05).实验组肥胖儿治愈率为42.03%,治疗总有效率为92.75%,轻度肥胖治愈率明显高于中、重度肥胖治愈率(P＜0.05),3岁和4岁组肥胖儿治愈率高于5岁和6岁组(P＜0.05);对照组无治愈例数,仅1例有效.结论综合疗法治疗儿童单纯性肥胖症是一种可行、有效,并值得推广的方法,对肥胖儿童进行早期干预可降低治疗难度.     

儿童单纯性肥胖的环境影响因素

儿童单纯性肥胖在全世界范围内呈现上升趋势,对儿童乃至成人的健康构成了严重威胁.儿童单纯性肥胖是遗传和环境的多种因素交互作用的结果,但全世界短期内儿童单纯性肥胖的患病率上升,表明环境因素起着极其重要的作用,该文对目前国内外有关儿童单纯性肥胖的环境影响因素研究进展,进行了较为详细的综述.常见的儿童单纯性肥胖的环境影响因素有久坐行为、运动、饮食模式、双亲体重指数、父母的受教育程度、孕期营养及母乳喂养、父母亲的吸烟情况以及心理因素.     

喂养与生活方式对单纯性肥胖儿童的影响

目的:探讨喂养与生活方式对儿童单纯性肥胖的影响,为有效防治儿童肥胖提供科学依据。方法:在现况研究的基础上采用病例对照研究的方法,对筛查出的单纯性肥胖儿童(321名)与体重正常儿童(321名)进行现场问卷调查配对调查研究,分析儿童单纯性肥胖的影响因素。结果:两组儿童0.5~1岁以前添加辅食、6个月以后添加肉食、每餐主食量大、常吃油炸食品、不吃早餐、进食速度较快、有暴饮暴食习惯、经常不喝牛奶等饮食因素的百分率,及每餐用餐时间和户外活动时间等生活方式,肥胖儿童明显高于正常儿童,差异有统计学意义(P<0.05)。结论:儿童单纯性肥胖的发生与早期喂养方式及饮食和运动习惯等多种生活方式相关。     

营养干预结合有氧运动对单纯性肥胖患者体质指数的影响

[目的]探讨低能量膳食营养干预结合有氧运动的减肥方式对单纯性肥胖症患者体重和体质指数等的影响。[方法]40例营养咨询门诊就诊的单纯性肥胖症患者,未用任何减肥药物,在减肥治疗中采取低能量膳食营养干预结合有氧运动的减肥方式,比较在减肥治疗前后,患者体重(BW)、体质指数(BMI)、腰围(WC)、臀围(HC)、腰臀比(WHR)等的变化。[结果]所有患者经过3个月的减肥治疗,体重由(79.52±10.81)kg降至(68.95±9.50)kg(P﹤0.0001),体质指数由(29.72±2.11)kg/m2降至(25.77±1.84)kg/m2(P﹤0.0001),腰围由(94.82±8.14)cm降至(89.12±7.94)cm(P﹤0.0001),臀围由(92.82±6.24)cm降至(89.93±6.21)cm(P﹤0.0001),腰臀比由1.02±0.05降至0.99±0.06(P﹤0.0001),其差异具有统计学意义。[结论]单纯性肥胖症患者不使用减肥药物,通过低能量膳食营养干预结合有氧运动,即可获得明显的减肥效果。     

The effects of a 3-year obesity intervention in schoolchildren in Beijing

BACKGROUND: Childhood obesity has become a health problem in urban areas in China. Intervention to reduce childhood obesity should be of high priority. School-based intervention programmes are needed to deal with the growing prevalence of childhood obesity in China. METHODS: Five primary schools were selected randomly for this study in the Beijing urban area in China; two were allocated to the intervention group and three to the control group. A total of 2425 children (1029 children in intervention schools and 1396 children in control schools) took part in the study for 3 years. In the intervention group, children and their parents were involved in a programme of nutrition education and physical activity. Control school students followed their usual health and physical education curriculum with no extra intervention. RESULTS: After the 3-year intervention, the prevalence of overweight and obesity were significantly lower in the intervention schools than in the control schools (overweight: 9.8% vs. 14.4%, P < 0.01; obesity: 7.9% vs. 13.3%, P < 0.01). The prevalence of overweight and obesity decreased by 26.3% and 32.5% in intervention schools respectively after intervention. The prevalence of overweight and obesity increased in control schools. There was also significant difference in body mass index between intervention and control schools (18.2 +/- 2.6 vs. 20.3 +/- 3.4, P < 0.01) after intervention. More non-obese children became obese in the control schools (7.0%) than in the intervention schools (2.4%) at end line (P < 0.01). Among the children who were obese at baseline, 49.2% remained obese at end line in intervention schools while 61.9% remained obese in control schools (P < 0.01). CONCLUSIONS: Our study showed that an intervention programme could be feasible in schools in Beijing, China. The prevalence of overweight and obesity was reduced in schoolchildren in Beijing through an intervention focused on nutrition education and physical activity. Overweight and obesity children as well as normal weight children and their parents should be involved in such an intervention programme.     

Obesity management via diet and exercise intervention

To assess the effects of exercise and diet on obese prepubertal children, a group of subjects embarked upon a 16-week exercise programme designed to improve body composition parameters and physical fitness. This was complemented by dietary counselling and nutrition education. Subjects comprising the experimental group (n = 10) on average lost body weight, reduced the sum of four skinfold measures (P less than 0.001) and in addition, noticed a reduction in body circumference measures whilst preserving or increasing lean body mass. In contrast, there was an increase in all measures for the control group (n = 10). The present study highlights the effectiveness of an exercise programme initiated as a function of an obesity clinic in association with a home programme. An interrelated approach to weight control in obese children should include exercise, diet and behaviour modification with appropriate guidance and follow-up.     

营养健康教育对单纯性肥胖儿童营养知识-态度-行为的研究

目的:了解和提高肥胖儿童营养知识水平,培养肥胖儿童良好的饮食习惯。方法:将840例肥胖儿童分为扑克牌组和对照组各420例,扑克牌组根据研究制订的营养健康教育模型进行健康教育,对照组采用传统营养教育方法。结果:营养健康教育后,肥胖儿童营养知识得到提高,食物选择及饮食行为趋于合理。扑克牌组的营养知识明显高于对照组(P<0.05)。结论:对肥胖儿童进行扑克牌营养健康教育寓教于乐,有助于增加其营养知识,改善其营养态度及饮食行为,最终达到减少儿童肥胖症的目的,值得推广和普及。     

Kieler Adipositaspräventionsstudie (KOPS)

Today,overweight and obesity are endemic in western societies. Since the treatment of obesity has very limited success rates, obesity prevention is necessary. The Kiel Obesity Prevention Study (KOPS) aims at reducing the incidence of overweight and obesity in children and adolescents. In KOPS, the nutritional state, nutrition, socio-economic and familiar factors, as well as physical activity and inactivity,were assessed in a group of 4,997 5–7 year old children in Kiel. In addition, intervention and health promotion was performed each year in three schools for all children and their teachers (nutrition education and active school breaks) together with a family-oriented approach in families with obese and pre-obese children. For obese children, an exercise training was offered (twice a week for about 6 months). All children were followed for 8 years and were reinvestigated at 10 and 14 years. The first results from KOPS show that obesity prevention is possible and successful with respect to reducing the incidence of overweight.     

膳食替代营养干预对女性腹型肥胖患者治疗作用的研究

目的 采用随餐营养棒代替主食结合有氧运动方式对女性腹型肥胖患者的减重效果。方法 对46例营养门诊就诊的女性腹型肥胖患者随机分配法随机分为随餐营养棒代替主食结合有氧运动方式减重的治疗组和限能量平衡膳食结合有氧运动方式减重的对照组,分别对两组患者进行饮食及生活方式的干预,比较两组患者减重前后的体重、体质指数、腰臀比、体脂百分比、骨质、蛋白质和水分的变化程度以及两组间减重后身体各项指标的变化幅度。结果 46例患者经过1月减重干预后,体重、体质指数、腰臀比及脂肪百分比均下降(P＜0.001),而骨质、蛋白质及水分均升高(P＜0.001),差异有统计学意义。与限能量平衡膳食结合有氧运动相比,随餐营养棒代替主食结合有氧运动在体重、体质指数、腰臀比及体脂百分比下降更为显著,同时骨质、蛋白质及水分升高也更加明显(P＜0.001),具有统计学意义。结论 两组减重方式均有效,相对限能量平衡膳食结合有氧运动,随餐营养棒代替主食结合有氧运动方式减重效果更好。     

Nutritional education of obese adolescents aged 13-15 years

The aim of this study was the assessment of nutritional education of 13-15 year old adolescents with simple obesity in comparison to their normal weight peers. The studied group consisted of 25 obese and 31 normal weight children. The questionnaire method was used to collect the data. Obese adolescents, compared to the normal weight counterparts, showed higher level of education concerning principles of proper nutrition. Nevertheless, high level of obesity in this group of children indicates that they do not comply with these principles. The study results suggest that emphasis should be placed on the quantity of food in diet of overweight and obese adolescents.     

40例肥胖症儿童的合理营养干预

目的探讨科学的饮食及健康教育等综合干预措施对肥胖儿童体重及其不良饮食习惯和行为的影响。方法通过对40例肥胖儿童进行为期10天的营养干预,内容包括营养处方、健康行为处方、心理辅导等手段。结果通过综合干预,40例肥胖儿童中37例体重下降了0.5-5.0kg不等,1例体重无变化,2例增加0.5-1.0kg。不良饮食习惯和行为显著改善(p<0.05)。结论科学的饮食、适当的运动,辅以有目的、有计划的健康教育是减轻肥胖儿童的体重及纠正其不良饮食习惯和行为的重要措施。     

Medical nutrition therapy of overweight adolescents

The long-term goal of medical nutrition therapy for adolescents who are overweight or at risk for becoming overweight is to promote healthy lifestyle behaviors. These behaviors will, in turn, improve metabolic parameters and self-esteem while helping the adolescent achieve and maintain a desirable body weight. The identification of anthropometric, metabolic, nutritional, and environmental risk factors present in the child and family will help formulate the medical nutrition intervention. A well-balanced diet that supports growth and development, aerobic exercise, and cognitive behavioral strategies are essential components of an intervention program. Frequent and long-term monitoring by a registered dietitian and pediatrician will reinforce lifestyle changes and support the adolescent and family in achieving realistic goals of weight loss or weight maintenance. This article covers the assessment and interventions necessary for successful nutrition therapy for obese and superobese adolescents.