单纯性超重肥胖儿童综合干预效果评价

了解单纯性超重肥胖儿童的各项体检指标干预前后变化,为探讨合理有效的干预措施提供依据.方法 分层随机整群抽取海淀区216名中小学生为研究对象,对其采用适宜的有氧运动、健康教育、合理营养、医务及家长监督、心理疏导等综合措施进行干预.结果 干预后,儿童超重、肥胖率明显下降,13.4%的超重肥胖儿童恢复正常体重,差异有统计学意义(x2=61.83,P<0.01).儿童形态、生理、生化指标改善明显,血糖、三酰甘油、胆固醇等多项指标降低,差异均有统计学意义(P值均<0.01).结论 健康教育,适宜的运动方式,家长、学校共同参与的综合干预措施是控制儿童肥胖有效、方便、无副作用的方案.     

广州市中学生超重肥胖健康教育干预效果评价

目的 探讨群体层面(健康教育讲座、公众号推送)和个人层面(个性化膳食指导意见)相结合的健康教育对广州市中学生超重肥胖的干预效果,为中学生超重肥胖的预防控制提供依据。方法 于2018年通过方便抽样的方法抽取广州市3所初中和3所高中,经体检筛查出1 457名超重肥胖的12～18岁学生。对超重肥胖学生通过公众号推送健康推文、举办健康教育讲座、下发《学生个性化膳食指导意见》手册等措施进行干预,干预时间为2018年9月至2019年12月。使用χ²检验比较干预前后的超重肥胖构成比,计算需治疗人数(NNT)评价干预效果。结果 干预前超重构成比为66.71%(972/1 457),干预后下降至59.92%(873/1 457);干预前肥胖构成比为33.29%(485/1 457),干预后下降至26.63%(388/1 457)。肥胖学生中NNT最小的是12～13岁女生组(NNT=2.6,95%CI=1.9～4.1),NNT最大的是14～18岁男生组(NNT=5.9,95%CI=4.7～8.1);超重学生中12～13岁女生组NNT最小(NNT=2.7,95%CI=2.2～3.5),...     

基于学校环境的重庆市中小学生超重肥胖干预效果评价

目的 探讨基于学校环境的学生超重肥胖综合干预效果,为预防和控制中小学生超重肥胖提供依据。方法 采用多阶段分层整群抽样方法抽取重庆市主城区12所中小学9 933名学生,随机分为6所干预校和6所对照校,对干预校采取学校环境政策干预、健康教育、体育活动指导结合的综合干预,干预前后进行体格检查和问卷调查。结果 干预后干预校超重率在原有基础上(12.9%)上升了0.2%,肥胖率(7.4%)未变化;对照校超重率、肥胖率分别在原有基础上(11.5%、7.7%)上升了0.5%、0.1%。干预前两组学校正常体重的学生在干预后BMI、腰围、臀围均升高(P<0.05),干预校超重肥胖的学生在干预后BMI、腰围均下降(P<0.05),对照校超重肥胖的学生在干预后臀围升高、腰围降低(P<0.05);干预校学生在干预后肥胖相关饮食问题正确率上升,不健康饮食行为报告率下降(P<0.05)。结论 基于学校环境的学生超重肥胖综合干预能控制肥胖相关指标的增长速度,改善中小学生的饮食行为。     

综合干预措施对哈尔滨市8~14岁中小学生超重肥胖的干预效果

探讨综合干预措施对哈尔滨市8~14岁中小学生超重肥胖的干预效果,为防控中小学生超重肥胖的流行提供依据.方法 采用分层整群随机抽样方法,选取哈尔滨市2个城区4所学校的830名中小学生开展为期1年的“学校—家庭”超重肥胖综合干预.结果 干预1年后,经配对t检验,干预组学生体质量指数(BMI)基线与干预后比较,差异有统计学意义(t=-3.17,P<0.01),对照组学生的差异无统计学意义(t=-1.67,P=0.10);干预组和对照组超重肥胖率(28.06%,29.30%)与干预前比较(29.98%,29.54%),差异均无统计学意义(P值均>0.05);干预组干预后,肥胖相关知识20项问题总正确率(87.95%)高于干预前(41.25%),健康饮食行为21项问题总正确率(74.66%)高于干预前(47.30%),健康运动行为4项问题总正确率(69.78%)高于干预前(34.17%),差异均有统计学意义(x2值分别为3 977.17,1 377.57,423.73,P值均<0.05).结论 “学校—家庭”超重肥胖综合干预取得了积极的效果,对缓解中小学生超重肥胖的发生可起到一定促进作用.     

超重和肥胖中小学生生活质量自评与家长评估的比较

探讨超重和肥胖儿童青少年生活质量自评与家长评估的差异,为实施儿童青少年肥胖干预提供依据.方法 2013年10月期间,采用两阶段分层整群抽样方法,选取盐城市8~18岁儿童青少年1 857名,先进行超重、肥胖筛查,再采用儿童生活质量普适性核心量表4.0进行自我评估与家长评估.结果 儿童组生活质量自评,超重、肥胖患儿躯体功能得分(87.2±2.5,83.5±3.3)低于正常儿童(92.5±3.2)(P值均<0.05).青少年组自评,超重、肥胖患儿总分(82.5±2.6,80.3±2.8)、躯体功能得分(85.7±2.8,81.6±2.3)均低于正常儿童(86.9±3.3,91.9±3.6);肥胖患儿社会心理维度得分(79.6±2.4)低于正常儿童(83.2±2.8).家长评估,超重、肥胖儿童青少年躯体功能得分(92.1±2.6,88.5±2.8)均低于正常儿童(95.3±2.5).超重、肥胖儿童青少年生活质量家长评估得分均高于患儿自评,差异均有统计学意义(P值均<0.05).结论 超重、肥胖儿童青少年生活质量存在不同程度下降,家长对患儿生活质量评估得分偏高.应重视提高家长对肥胖儿童青少年生活质量的关注.     

上海肥胖超重中小学生糖脂代谢异常干预效果评价

目的研究肥胖和超重学生糖、脂代谢有关的生化指标特点及肥胖项目干预后的变化,为探索有效的肥胖干预效果评价指标提供依据。方法在上海市健康示范学院抽取1所小学和1所初级中学,筛查出55名肥胖学生,在超重、正常学生中按肥胖学生的年龄、性别进行配对;然后在未开展健康示范的学校中按干预学校学生的年龄、性别分别确定肥胖、超重学生各55名。各组对象均用相同年龄、性别的1∶1配对t检验分析。检测生化指标包括谷丙转氨酶(ALT)、胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、空腹血糖(FG)、空腹胰岛素(F ins)、HOMA胰岛素抵抗指数(HOMA-IR)。结果干预前,肥胖、超重学生的ALT、TG、空腹胰岛素、HOMA-IR均明显高于正常学生。ALT在肥胖、超重、正常学生分别为32,24,15 U/L,TG分别为1.03,0.92,0.80mmol/L,空腹胰岛素分别为14.70,12.34,5.97 IU,HOMA-IR分别为2.97,2.49,1.20。干预后,干预学校肥胖、超重学生的ALT、TG、空腹胰岛素、HOMA-IR均明显下降,肥胖组分别为20 U/L,0.90 mmol/L,11.93 IU,2.42,超重组分别为13 U/L,0.85 mmol/L,10.30 IU,2.05。同期对照学校干预后与干预前,肥胖学生ALT、空腹胰岛素、HOMA-IR明显上升,分别为32 U/L和26 U/L,20.76 IU和12.77 IU,4.57和2.56。结论肥胖、超重学生中存在明显的糖、脂代谢紊乱。健康示范学校创建项目能有效改善糖、脂代谢紊乱。在减肥评估中,除体重指标外,可增加一些生化指标,如ALT、HOMA-IR。     

超重与肥胖儿童健康生活方式干预效果评价

目的探讨健康生活方式的干预对超重及肥胖儿童生长发育的影响,为儿童超重和肥胖的干预研究提供依据。方法采取整群抽样方法,对太原市小学三~五年级学生744名进行体检,以检出的超重及肥胖者81人作为研究对象,进行生理发育指标的测量。按班级分层,将每班的超重及肥胖儿童随机分为2组,再将每个班的2组学生随机分配为干预组和对照组。对干预组进行健康生活方式干预,对照组儿童不进行任何干预。结果干预后肥胖程度加重的趋势得到控制,BMI指数的增加得到减缓。干预组干预后的肺活量显著高于干预前(P<0.05),干预组干预前、后舒张压测量值差异无统计学意义(P>0.05);对照组干预后舒张压测量值显著高于干预前(P<0.05)。结论健康生活方式有效地控制了肥胖程度的增加,达到了缓解肥胖的效果。     

深圳市光明新区超重肥胖中学生生活质量调查

了解深圳市光明新区超重、肥胖中学生的生活质量情况及其潜在影响因素,为学生超重肥胖的干预措施制定提供依据.方法 2014年9-10月,采用多阶段随机整群抽样方法,在深圳市光明新区抽取5所中学,共对45个班级2 540名学生进行生活质量问卷调查.结果 正常体重学生生活质量评分平均值为(91.93±4.02)分,总分及自我、社会、环境3个维度得分均高于超重和肥胖学生(F值分别为33.94,28.33,31.78,36.62,P值均<0.05).广义线性模型分析结果显示,女生、高中生及外地户籍是潜在的影响超重/肥胖中学生生活质量的因素(β值分别为12.27,7.89,4.26,P值均<0.05).结论 深圳光明新区超重和肥胖中学生的生活质量明显低于体重正常的中学生.应对重点人群开展心理咨询和疏导,帮助肥胖者参加集体活动,改变不良的行为模式,保证身体健康发展.     

北京市中小学生超重肥胖与生活方式的关系

了解北京市学生超重肥胖与生活方式之间的关系,探寻超重肥胖干预的方法.方法 该组资料为2010年全国学生体质调研数据.采取整群分层随机抽样的原则,在北京市6个区的40所中小学随机监测了6 789名学生.结果 北京市2010年中小学生超重、肥胖检出率分别为12.49%,9.52%,其中小学生超重、肥胖检出率分别为11.94%,11.24%,中学生分别为12.94%,8.08%.肥胖率城男高于乡男,差异有统计学意义.超重、肥胖与每天是否吃早餐、每日做家庭作业时间长短及电子休闲时间长短等无显著相关,但在是否喜欢体育课、是否喜欢长跑、体育课后感觉、每天体育锻炼超过1h、做课间操是否认真等方面差异均存在统计学意义.结论 改变生活方式是短中期预防肥胖的有效方法,必须提高公共卫生策略的高度,对整个社会采取措施.     

5-2-1-1-0行为干预改善儿童青少年超重肥胖效果评价

探索“5-2-1-1-0”新型行为干预模式对儿童青少年超重肥胖的效果,为儿童肥胖的行为干预提供依据.方法 选取北京市某区10所中小学校796名肥胖学生作为研究对象,随机分为干预校和对照校各5所.干预校开展为期3个月的“5-2-1-1-0”行为日记和健康教育,同期开展1次家长健康讲座,并呼吁家长监督;对照校不改变日常安排.干预前后对研究对象进行体格检查和静脉采血.使用协方差分析干预效果.结果 干预校体质量指数(BMI)、腰围、臀围和腰围身高比的下降值高于对照校,调整组间均数差分别为-0.22 kg/m2,-0.59 cm,-0.64 cm和-0.006(P值均<0.05).干预校收缩压和舒张压的下降均多于对照校,调整组间均数差分别为-4.9 mmHg和-4.4 mmHg(P值均<0.01).干预校空腹血糖的上升少于对照校,调整组间均数差为-0.15 mmol/L(P<0.01).结论 “5-2-1-1-0”行为干预对儿童青少年超重肥胖及相关健康指标的改善效果较好.     

运动干预12周对超重/肥胖儿童内皮细胞功能的影响

探讨12周运动处方干预对超重/肥胖儿童内皮细胞功能的影响,为促进超重/肥胖儿童心血管健康水平提供有效方法.方法 将郑州市某小学69名超重/肥胖儿童随机分为对照组(35名)和运动组(34名),对照组仅参加学校组织的体育活动,运动组在对照组的基础上进行60 min/次、3次/周共12周的运动处方干预(有氧运动+抗阻训练).分别于实验前后利用流式细胞仪测定外周血CD34+(造血干细胞表面标志物)、CD133+(造血祖细胞表面标志物)以及CD34+CD133+(内皮祖细胞)表达量(用阳性细胞率表示),B超检测颈总动脉内膜中层厚度(cIMT),内皮功能—外周动脉张力测试仪测定反应性充血指数(RHI)作为血管内皮功能参数.结果 实验后,运动组CD34+(0.087%±0.044%),CD133+ (0.192%±0.076%)以及CD34+CD133+ (0.110%±0.034%)表达量均较实验前(0.043%±0.011%,0.077%±0.030%,0.062%±0.011%)升高(t值分别为-6.05,-8.72,-7.75,P值均<0.01),RHI升高[实验前(1.86±0.27),实验后(2.13±0.32),t=-3.70,P<0.05],cIMT下降[实验前(0.41±0.09) mm,实验后(0.34±0.11) mm,t=2.49,P<0.05];对照组各参数均无显著性变化(P值均>0.05).结论 12周运动干预可通过动员内皮祖细胞改善超重/肥胖儿童血管内皮细胞功能.     

The effect of weight loss on changes in health-related quality of life among overweight and obese women with urinary incontinence

Objective

To estimate the effect of change in weight and change in urinary incontinence (UI) frequency on changes in preference-based measures of health-related quality of life (HRQL) among overweight and obese women with UI participating in a weight loss trial.

Methods

We conducted a longitudinal cohort analysis of 338 overweight and obese women with UI enrolled in a randomized clinical trial comparing a behavioral weight loss intervention to an educational control condition. At baseline, 6, and 18?months, health utilities were estimated using the Health Utilities Index Mark 3 (HUI3), a transformation of the SF-36 to the preference-based SF-6D, and the estimated Quality of Well-Being (eQWB) score (a summary calculated from the SF-36 physical functioning, mental health, bodily pain, general health perceptions, and role limitations?Cphysical subscale scores). Potential predictors of changes in these outcomes were examined using generalized estimating equations.

Results

In adjusted multivariable models, weight loss was associated with improvement in HUI3, SF-6D, and eQWB at 6 and 18?months (P?<?0.05). Increases in physical activity also were independently associated with improvement in HUI3 (P?=?0.01) and SF-6D (P?=?0.006) scores at 18?months. In contrast, reduction in UI frequency did not predict improvements in HRQL at 6 or 18?months.

Conclusion

Weight loss and increased physical activity, but not reduction in UI frequency, were strongly associated with improvements in health utilities measured by the HUI3, SF-6D, and eQWB. These findings provide important information that can be used to inform cost?Cutility analyses of weight loss interventions.     

超重肥胖对儿童青少年运动素质和生活质量的影响

目的 了解儿童青少年超重、肥胖发生情况及其对运动素质和生活质量的影响,为采取有效措施提高儿童青少年体质健康与生活质量水平提供理论依据.方法 分层整群抽取哈尔滨、武汉、湘潭、广州4地区4 104名7 ～18岁儿童,比较肥胖、超重的检出率在性别及年龄上的分布差异,并进一步分析超重组、肥胖组儿童青少年和正常组儿童青少年在运动素质和生活质量上的差异.结果 各学段男生肥胖和超重检出率均高于女生,差异均有统计学意义(P值均＜0.05),且儿童青少年肥胖、超重检出率有随年龄上升而下降的趋势;超重组、肥胖组儿童青少年运动素质水平较体重正常组差,差异均有统计学意义(P值均＜0.05);超重、肥胖儿童青少年与体重正常儿童青少年相比,生活质量水平受损不明显(P值均＞0.05).结论 儿童青少年超重、肥胖的发生在性别及年龄上具有差异.超重、肥胖的出现会对身心健康产生一系列的影响.     

Impaired parent-reported health-related quality of life of underweight and obese children at elementary school entry

Purpose

Examine the health-related quality of life of 5–6-year-old underweight, overweight and obese children.

Methods

Our cross-sectional study included 3,227 parent–child dyads from the “Be active, eat right” study. Parents completed questionnaires regarding child and parental characteristics. Health-related quality of life of the child was measured using the Child Health Questionnaire Parent Form 28. Children were classified normal weight, overweight, obese, severely obese, and underweight according to the international age and gender BMI cutoff points. Bootstrap analyses were performed for general linear models corrected for potential confounding variables.

Results

Severely obese children (β, ?2.60; 95 % CI, ?4.80 to ?0.57, p < 0.01) and underweight children (β, ?1.11; 95 % CI, ?1.85 to ?0.39, p < 0.01) had lower parent-reported scores on the physical summary scale. On the physical functioning profile scale parents of overweight and severely obese children also reported statistically significant lower scores (p < 0.05 and p < 0.01, respectively).There were no significant differences regarding the psychosocial summary scale scores between the different weight categories.

Conclusion

Underweight and overweight children experience impaired health-related quality of life on the physical functioning domain. Physicians, teachers and parents should be aware of the possible negative impact on health-related quality of life in underweight and overweight 5–6-year-old children.     

Impact of a community-based lifestyle intervention program on health-related quality of life

Background

The presence of risk factors for type 2 diabetes and cardiovascular disease, or the conditions themselves, contributes to lower health-related quality of life (HRQoL) among adults. Although community-based lifestyle intervention programs have been shown to be effective for improving risk factors for these diseases, the impact of these interventions on HRQoL has rarely been described.

Purpose

To examine changes in HRQoL following participation in the Group Lifestyle Balance program, a community translation of the Diabetes Prevention Program lifestyle intervention for adults with prediabetes and/or the metabolic syndrome.

Methods

Participants enrolled in the 12-month, 22-session intervention program (N = 223) completed the EuroQol Health Questionnaire (EQ-5D-3L) at baseline, 6, and 12 months. Linear mixed-effects regression models determined change in EQ-5D-visual analog scale (VAS) and Index scores post-intervention.

Results

Mean EQ-5D-VAS was improved by +7.38 (SE = 1.03) at 6 months and by +6.73 (SE = 1.06) at 12 months post-intervention (both; p < 0.0001). Mean changes in EQ-5D index values were +0.00 (SE = 0.01; NS) and +0.01 (SE = 0.01; p < 0.05), respectively. Adjusted for age, baseline score, and achieving intervention goals, mean change in EQ-5D-VAS was +11.83 (SE = 1.61) at 6 months and +11.23 (SE = 1.54) at 12 months (both; p < 0.0001). Adjusted mean change in EQ-5D index value was +0.04 (SE = 0.01) at 6 months and +0.05 (SE = 0.01) at 12 months (both; p < 0.01).

Conclusion

Participation in a community lifestyle intervention program resulted in improved HRQoL among adults with prediabetes and/or the metabolic syndrome. These benefits to HRQoL, together with improved clinical and behavioral outcomes, should increase the appeal of such programs for improving health.

     

Health- and oral health-related quality of life among preschool children with cerebral palsy

Objectives  

To assess the health- and oral health-related quality of life of preschool children with cerebral palsy (CP) and to determine their inter-relationship between the two quality of life measures.     

Predictors of diet quality among overweight and obese postmenopausal women

Previous studies have shown that sociodemographic characteristics can be determinants of healthful eating. However, health characteristics such as smoking status have not been well studied. The objective of this research, therefore, was to determine predictors of diet quality in postmenopausal women. We included 164 overweight or obese postmenopausal women aged 50 to 75 years living in and around Seattle, WA, and intake, measured by food frequency questionnaire, was used to calculate scores for the Diet Quality Index and Healthy Eating Index. Information on sociodemographic factors and health behaviors was collected by self-administered questionnaire. Body mass index was computed using duplicate measures of height and weight. Percent body fat was measured by dual-energy x-ray absorptiometry. Following data collection, one-way analysis of variance, chi(2), and Pearson correlations were used to compare means of diet quality scores across participant characteristics. We found that predictors of better diet quality in this study population were higher education and former smoking history (compared to never-smokers); there was no evidence for a relationship with income level. Individuals with higher-quality diets were more likely to have lower body mass index or percent body fat. Based on the results of this study, education level and smoking history are predictors of diet quality among overweight and obese postmenopausal women. These findings add to the increasing evidence for targeting public health interventions to individuals with lower education because this group stands to benefit from improved dietary intake. In addition, these results suggest that the timing of smoking cessation is a possible teachable moment for food and nutrition professionals.