祖辈带养对学龄前儿童饮食行为、身体活动和超重肥胖的影响

目的 探究祖辈带养对学龄前儿童饮食行为、身体活动和超重肥胖的影响。方法 采用文献研究法,检索中国知网、万方数据库、维普数据库和PubMed 数据库中近5年发表的祖辈带养对学龄前儿童饮食行为、身体活动和超重肥胖影响的文献,进行描述性统计分析。结果 最终纳入16篇文献。文献研究结果表明,祖辈带养可能是学龄前儿童超重肥胖的危险因素,可能的原因主要为祖辈带养导致学龄前儿童不健康的饮食行为和身体活动减少。结论 祖辈带养对学龄前儿童饮食行为、身体活动和超重肥胖有影响,对祖辈进行营养健康教育可能对学龄前儿童超重肥胖的防控有着重要作用。     

学龄儿童不良饮食行为对超重和肥胖的影响

目的了解全国9地区学龄儿童超重和肥胖的现状及饮食行为因素对其的影响。方法采用多阶段整群抽样,选取7~12岁儿童814人,进行问卷调查和体格测量,依据中国肥胖问题工作组推荐标准分组,并用单因素和多因素Logistic回归分析不良饮食习惯对超重和肥胖的影响。结果学龄儿童超重和肥胖率分别为22.88%和9.90%,城市地区最为严重,且二线城市不亚于一线城市。多因素分析结果显示不吃早餐为危险因素(OR=1.65,P0.05;OR=2.22,P0.01),挑食与超重、肥胖成负相关(OR=0.43,P0.01;OR=0.32,P0.01),快餐和碳酸饮料均在分析中被排除。结论儿童超重和肥胖问题日益严重,与遗传、环境、饮食行为等多种因素密切相关。不良饮食行为可能是超重和肥胖的危险因素,有必要实施早期干预,促使儿童养成良好的饮食习惯。     

儿童睡眠不足与肥胖发生的相关性研究概述

儿童超重/肥胖已发展为威胁儿童健康的重要公共卫生问题,相关危险因素的探讨受到学术界的广泛关注,近年来越来越多的研究显示睡眠不足是超重/肥胖的另一个危险因素。本文综述了不同年龄阶段儿童睡眠不足与超重/肥胖相关性的流行病学研究;回顾了睡眠不足对神经内分泌系统等的影响,初步阐述了睡眠不足引起超重/肥胖的可能机制;并简述了现有研究的局限性及以后研究的方向。     

儿童青少年肥胖与母亲孕期邻苯二甲酸酯暴露

世界卫生组织定义肥胖为一种具有潜在不良健康后果的全球性疾病,且异常或过度的脂肪积累对健康构成威胁. 在美国、英国和澳大利亚等高收入国家,儿童超重和肥胖的比例为20%~35%,且儿童肥胖与成年后的心血管疾病、胰岛素抵抗、2型糖尿病、非酒精性脂肪肝、阻塞性睡眠呼吸暂停等多种不良结局密切相关[1]. 在中低收入国家,儿童青少年超重的总体患病率为17.3%,肥胖患病率为8.6%[2]. 中国儿童青少年肥胖在20世纪呈现低流行状况,但2014年7~18岁儿童青少年的超重和肥胖患病率达19. 4%[3].肥胖的病因复杂,近年来有研究发现,环境内分泌干扰物邻苯二甲酸酯( phthalic acid esters, PAEs)是一种新的致肥因子( obesogen) ,而母亲孕期PAEs暴露是儿童童年期肥胖的危险因素[4] ,丰富了人们对肥胖病因的新认识.     

南京市秦淮区学龄前儿童超重和肥胖情况

目的了解学龄前儿童超重和肥胖情况及其影响因素。方法 2012年对南京市秦淮区22所托幼机构6 878名学龄前儿童进行体格测量评价,以检出的超重/肥胖儿童为研究组,以1∶1配对正常体重儿童为对照组进行病例对照研究,筛选学龄前儿童超重肥胖的危险因素。结果秦淮区学龄前儿童超重率为20.63%,肥胖率7.36%,男童超重率和肥胖率均高于女童(P值均0.05)。随着年龄的增长,儿童肥胖率呈上升趋势,差异有统计学意义(P0.05)。多因素条件logistic回归分析结果显示,父母肥胖、出生体重异常、进食量大和每日户外活动时间2h是学龄前儿童肥胖超重的危险因素(P值均0.05),母乳喂养是保护因素(P0.05)。结论该地区学龄前儿童超重肥胖率较高,超重和肥胖的发生是遗传和环境等多种因素共同作用的结果。     

母亲养育实践与婴幼儿饮食行为对儿童超重肥胖影响的研究

目的 本研究探讨母亲养育实践与婴幼儿饮食行为对儿童超重肥胖的影响。方法 采用目的抽样法,选取徐州市2所医院及2个社区卫生服务中心的6 ~ 24月龄婴幼儿及其母亲为研究对象,母亲完成婴幼儿喂养类型和饮食行为问卷。根据儿童身长和体重,计算年龄别体质指数Z值（body mass index - for age z - score,BMIZ）,BMIZ + 2为儿童超重肥胖。采用二元logistic回归分析母亲养育实践与婴幼儿饮食行为对儿童超重肥胖的影响。结果 本研究共回收882份有效问卷,儿童超重肥胖发生率为15.65%。二元logistic回归结果表明,敏感型养育（OR = 0.234,95%CI:0.159 ~ 0.344）,饱腹反应（OR = 0.467,95%CI:0.336 ~ 0.649）和进食缓慢的饮食行为（OR = 0.737,95%CI:0.552 ~ 0.984）是儿童超重肥胖的保护因素;食物反应的饮食行为（OR = 2.369,95%CI:1.797 ~ 3.122）,限制（OR = 2.359,95%CI:1.530 ~ 3.640）和纵容型养育（OR = 1.743,95%CI:1.250 ~ 2.431）是儿童超重肥胖的危险因素。结论 敏感型养育,饱腹反应和进食缓慢的饮食行为降低儿童超重肥胖的发生风险;食物反应的饮食行为,限制和纵容型养育增加儿童超重肥胖的发生风险。     

儿童肥胖综合干预效果研究进展

近年来,中国儿童肥胖流行趋势日益严重.2005年全国学生体质与健康调研结果显示,我国学龄儿童中超重与肥胖检出率继续增加[1].超重肥胖已成为影响我国儿童身心自健康的重要问题.目前关于儿童肥胖的干预研究很多,多采用包括饮食、运动和行为的综合干预模式.     

上海市部分学龄儿童营养与健康状况分析

随着经济的发展,生活水平的提高,儿童营养得到了明显的改善。然而,随着生活方式和社会环境的改变,各种疾病和外在因素的影响导致儿童血脂异常的比例逐渐增加。血脂异常是导致儿童肥胖的主要原因之一。1997年世界卫生组织（WHO）肥胖顾问委员会重申肥胖是一类疾病,并指出是当今全球侵害人类健康的流行疾病之一。很多研究已经表明,血脂异常是超重和肥胖的危险因素,儿童期超重和肥胖又是预测成年期肥胖及其相关健康危险的重要指标,儿童期超重和肥胖已成为我国大中城市一个主要的公共卫生问题,严重威胁人类健康和生命安全。[第一段]     

零食、体力活动和静坐行为与超重、肥胖及社会人口学特征的相关性研究

目的探讨零食习惯、体力活动、静坐行为以及社会人口学特征与宁夏南部农村地区儿童青少年超重和肥胖的关系。方法采用分层整群抽样的方法,选取宁夏南部5个地区3～9年级2 355名学生为调查对象,进行问卷调查和体格检查。采用方差分析、非条件Logistic回归分析研究超重肥胖的危险因素。结果宁夏南部农村地区儿童青少年超重/肥胖率为5. 1%;零食摄入频率高、体力活动频率低与女性儿童青少年超重肥胖患病率有关(P0. 05),静坐时间长与男性儿童青少年超重肥胖有关(P0. 05); Logistic回归分析显示,零食和体力活动是儿童青少年超重肥胖的危险因素(OR=4. 31,95%=1. 34～13. 88;OR=0. 66,95%=0. 44～0. 98);儿童青少年体力活动和静坐时间与家庭经济状况有关(OR=1. 39,95%=1. 02～1. 91; OR=0. 54,95%=0. 36～0. 82)。结论零食、体力活动和静坐行为是宁夏南部农村地区儿童超重和肥胖的影响因素,且与家庭经济状况有关。     

上海市闵行区中小学生肥胖相关健康意识行为

了解中小学生群体中肥胖相关健康意识和行为情况,为探讨儿童青少年肥胖健康干预策略提供参考.方法 采用整群随机抽样的方法,对上海市闵行区某社区卫生服务中心所辖全部中小学生共5 048名进行问卷调查,问卷内容主要包括肥胖相关健康意识、行为和家庭环境影响.结果 5 048名学生对基本的肥胖相关知识掌握较好,平均7.5分,其中中学生得分高于小学生(t=-3.797,P<0.05).但中小学生每次运动应持续的时间、肥胖的危险因素知晓率均不高,且超重组学生对自身体重的感知度不高,有57.3%的学生不觉得自己超重.而学生在肥胖相关行为方面的表现落后于健康意识,平均6.4分,但睡觉前0.5 h经常加餐、晚饭前后吃零食等不利于健康的行为却在超重或肥胖组中所占比例低于正常组(P值均<0.05).结论 未来学生肥胖干预应进一步关注提高行为转变的动机和保证行为转变的可持续性.     

Explorations on risk profiles for overweight and obesity in 9501 preschool-aged children

BackgroundChildhood obesity places a major burden on global public health. We aimed to identify and characterize potential factors, both individually and jointly, in association with overweight and obesity in Chinese preschool-aged children.MethodsWe cross-sectionally recruited 9501 preschool-aged children from 30 kindergartens in Beijing and Tangshan. Overweight and obesity are defined according to the World Health Organization (WHO), International Obesity Task Force (IOTF), and China criteria.ResultsAfter multivariable adjustment, eating speed, sleep duration, birthweight, and paternal body mass index (BMI) were consistently and significantly associated with childhood overweight and obesity under three growth criteria at a significance level of 5%. Additional fast food intake frequency, maternal BMI, gestational weight gain (GWG) and maternal pre-pregnancy BMI were significant factors for overweight (WHO criteria) and obesity (both IOTF and China criteria). Importantly, there were significant interactions between parental obesity and eating speed for childhood obesity. Finally, for practical reasons, risk nomogram models were constructed for childhood overweight and obesity based on significant factors under each criterion, with good prediction accuracy.ConclusionOur findings indicated a synergistic association of lifestyle, fetal and neonatal, and family-related factors with the risk of experiencing overweight and obesity among preschool-aged children.     

Exploring U.S. Hispanic parents’ length of time in the United States: Influences on obesity outcomes among U.S. Hispanic children

The 2009 California Health Interview Survey was used to examine effects of Hispanic immigrant parents’ length of stay (less or more than 10 years) in the United States on the overweight and obesity outcomes among their children (N = 956, aged 6–11). The socio-ecological model of health was used to conceptualize health risk behaviors and associations with overweight/obesity outcomes among children. Weight (using body mass index) among children was influenced by parents’ length of stay, country of origin, income, and urban/rural residence. Future directions for social work professionals working with obese Hispanic children and their families are discussed.     

Understanding the Early Signs of Chronic Disease by Investigating the Overlap of Mental Health Needs and Adolescent Obesity

ObjectiveChildhood obesity has reached epidemic proportions with two to three-fold increases in prevalence in the past three decades. Sedentary lifestyles and nutrition have been linked to these increases though little is known about mental health illnesses in children and teens which may be precursors to negative modifiable health risk factors. The objective of this study was to investigate for a potentially more clinically practical indicator of depression over a multi-item screen in respect to reporting of overweight and obesity in adolescents. This study further investigated modifiers to this association and stability of association.MethodThis cross-sectional study aggregated 2007/2009 California Health Interview Survey data (n = 6,917 adolescents). Univariate analyses of population characteristics and modifiable behaviors with obesity/overweight and depression are presented. Multivariable weighted logistic regression was used to compare the adjusted odds of overweight and obesity for those children with reported depression.ResultsAfter controlling for gender, race/ethnicity, age, and modifiable behaviors, there was a statistically significant relationship between reported depression and overweight/obesity (OR = 1.24; 95% CI = 1.04, 1.49). This effect size was consistent in hierarchical models overall and stratified by gender.ConclusionsOverweight and obesity in adolescents should be understood clinically in the context of depression and other mental health illness. This study highlights a routine primary care or parental screening assessment that could indicate tendencies in adolescent boys and girls which may be precursors to overweight or obesity. Further research should be conducted to identify ways for integrating adolescent mental health screens into primary care.     

祖辈喂养与儿童超重肥胖关系的研究进展

儿童超重肥胖已成为十分严峻的公共卫生问题。家庭作为儿童主要的成长环境，与其体质健康密切相关。随着社会经济不断发展，祖辈逐渐参与到家庭喂养中并成为儿童的主要喂养者，是不容忽视的社会现象与趋势。本文从祖辈的喂养观念、喂养行为、喂养方式、喂养环境选择因素对儿童超重肥胖的影响进行综述，以期为提高祖辈喂养水平和减少儿童超重肥胖发生率提供依据。     

Adolescents' health behaviors and obesity: Does race affect this epidemic?

This study explores the influence of health behaviors and individual attributes on adolescent overweight and obesity using data from Wave II (Add Health). Structural equation model/path analysis using maximum likelihood estimation was utilized to analyze the relationships of health behaviors and attributes with obesity. Results of the model reveal that the causal paths (adolescents'' attributes and health behaviors) for overweight and obesity were different for African American and Caucasian adolescents. Generally, African Americans were more susceptible to overweight and obesity than Caucasians. Although increasing levels of vigorous physical activities lowers the risk for obesity among African American and Caucasian adolescents alike, low family SES and being sedentary were associated with overweight and obesity among Caucasians. No significant associations were found among African Americans. Increased hours of sleep at night relate positively with obesity among African Americans. These findings suggest important elements in the consideration of race in developing effective intervention and prevention approaches for curbing the obesity epidemic among U.S. adolescents.     

儿童生长发育与营养

我国儿童生长发育与营养面临着营养不良和超重肥胖的双重负担。2005-2014年全国7～18岁儿童青少年的营养不良检出率呈持续下降趋势,但总体检出率仍然较高。儿童青少年超重肥胖呈现新的流行趋势,2005年乡村学生超重肥胖检出率年均增长值超过城市,2014年部分地区乡村学生肥胖检出率开始接近或超过城市。儿童青少年身体素质持续下降,其中耐力素质下降尤为显著。儿童青少年慢性非传染性疾病患病率明显增加。在营养改善和经济投入的同时,应加强健康教育,促进儿童青少年养成合理的膳食习惯和生活方式。     

北京市小学生进食行为与超重肥胖的关系

分析北京市三~五年级小学生进食行为与超重肥胖的关系,为儿童超重肥胖预防和控制提供依据.方法 采取整群抽样的方法,选取北京市某城区12所小学三~五年级的学生1 788名,测量身高、体重,计算身体质量指数(BMI),通过问卷调查了解学生的进食行为、膳食摄入频率、身体活动情况,分析进食行为与超重肥胖之间的关系.结果男生的超重肥胖率为47.8%,女生为25.6%,差异有统计学意义(x2=94.54,P<0.01);男生在家吃饭时用碗大小和进食速度分布与女生的差异均有统计学意义(x2值分别为6.75,57.33,P值均<0.01).在Logistic回归模型中,控制年龄、性别、膳食评分、身体活动能量消耗值因素后,在家吃饭时用碗比大人小、吃饭速度比同班同性别的同学快是儿童超重肥胖的危险因素(OR值分别为1.55,2.50,95%CI=1.14~2.11,1.51~4.16).结论 小学生的用碗大小和吃饭速度快慢可能与超重肥胖有关.为预防和控制儿童超重肥胖,应提倡小学生和家长使用一样大小的碗,并减慢进食速度.     

母亲孕前BMI和孕期增重与学龄前儿童超重肥胖的相关性研究

目的探讨母亲孕前体质量指数(BMI)和孕期增重与学龄前儿童超重肥胖的相关性。方法选取2019年1月至2020年1月于余姚市妇幼保健院儿童保健科进行儿童保健咨询的3~5岁儿童共300例为研究对象,回顾性收集母亲孕前BMI和孕期增重情况,采用多因素Logistic回归模型进行相关性分析。结果儿童超重肥胖的发生率为35例(11.67%),在校正性别、年龄等混杂因素后,母亲孕前低体重的儿童出现超重肥胖的风险降低,母亲孕前超重肥胖的儿童出现超重肥胖的风险增加,其OR值及95%CI分别为0.602(0.413~0.755)、1.822(1.370~2.424),均P<0.05;母亲孕期增重过度的儿童出现超重肥胖的风险增加,其OR值及95%CI为1.298(1.009~1.669),P<0.05,但是母亲孕期增重不足并不会降低儿童出现超重肥胖的风险(P>0.05);母亲孕前超重肥胖且孕期增重过度的儿童出现超重肥胖的风险显著增加,母亲孕前低体重且孕期增重不足或孕期增重正常的儿童出现超重肥胖的风险显著降低,其OR值及95%CI分别为1.575(1.031~2.411)、0.556(0.343~0.872)、0.411(0.233~0.719),均P<0.05。结论母亲孕前BMI超重和孕期增重过度均是学龄前儿童发生超重肥胖的影响因素,并且母亲孕前BMI的影响更加严重。