青岛市0～18岁儿童单纯肥胖症流行病学调查

目的:了解青岛市城区儿童单纯肥胖症流行特点,为相关政策及干预措施的制定提供依据。方法:采用随机整群抽样,抽取15 791例城区0~18岁儿童为调查对象,其中男8 062例(51.05%),女7 729例(48.95%)。测量身长(高)体重,根据美国卫生统计中心/疾病控制中心(NCHS/CDC)参照人群值,体重≥身高别体重的10%~19%为超重,≥20%为肥胖。结果:青岛市城区0~18岁儿童单纯肥胖症的总检出率为10.48%,男童为12.68%,女童为8.19%。超重总检出率为16.28%,总肥胖超重比为0.64。0~7岁儿童肥胖检出率为6.43%,超重检出率为17.54%;~13岁儿童肥胖检出率为16.64%,超重检出率为12.32%;~18岁儿童肥胖检出率为18.72%,超重检出率为15.73%。脂肪重聚年龄(AR)为3岁;脂肪重聚比ARR1男童为1.1、女童为1.7;ARR2男童为1.2、女童为1.7。结论:青岛市城区0~18岁儿童单纯肥胖和超重检出率较高,已成为影响青岛地区儿童健康的重要因素,有效防治单纯肥胖症是当今儿童保健工作的重要任务。     

辽宁省5岁以下小儿单纯性肥胖症及其影响因素调查

对辽宁省５市５岁以下小儿单纯性肥胖症的发生情况及部分影响因素进行调查，结果表明；总检出率为５．９％；农村检出率高于城市．添加辅食时间、喂养方式、出生体重、城乡、年龄与小儿肥胖症检出率有关。添加辅食时间越早，出生体重越重；年龄越小，肥胖症检出率越高；混合喂养、人工喂养肥胖定检出率分别是母乳喂养的１．１２倍和１．２５倍；家庭年人均收入、父母文化程度与肥胖症检出率未发现有明显关系。小儿１岁前、出生体重重是肥胖症的易发因素，人工喂养、过量和过早添加辅食也是促成小儿单纯性肥胖的重要因素。     

福州市6—12岁儿童生长发育状况的综合评价

福州市6～12岁儿童5858名按照《0～18岁儿童学生生长发育快速监测评价量图》进行体重/身高、体重/年龄、身长/年龄三项指标综合评价。结果:大部份为正常儿童(87.4％),肥胖儿童检出率高(7.05％),近年来单纯性肥胖症逐年增高趋势值得注意。同时对《量图》的实用性进行讨论。     

妊娠期母体因素对子代肥胖的影响与机理

近年来我国肥胖症的发病率呈上升趋势。虽然儿童单纯性肥胖症的发病率因诊断标准尚未统一,尚有出入,但流行病学调查表明,1986～1996年我国城市0～7岁儿童单纯性肥胖症检出率超高速增长,年平均增长率达9.1％。2000年苏州市城区调查表明,儿童单纯性肥胖症检出率为3.56％,其中轻度肥胖44.32％,中度36.36％,重度19.32％。与此同时,成人肥胖症的发生率也急剧上升。肥胖一旦形成,治疗极为困难;并且由于造成肥胖的生物学机制尚未阐明,预防的手段也十分有限,因此,肥胖症已成为一个严重影响健康和亟待解决的问题。除了遗传因素、外部环境因素外,越来越多的证据表明产前宫内环境的变化可能是子代肥胖的至关重要的因素。影响胎儿的宫内环境因素包括妊娠糖尿病、妊娠体重增加、母亲肥胖症和胎儿本身的发育等,本文综述此方面研究     

长春市小学生单纯性肥胖症的调查研究

长春市小学生单纯性肥胖症检出率为11.43％,男童14.38％,女童8.35％,性别差异显著。采用1:1配对Logistic回归模型对100名肥胖儿童的危险因素进行研究,发现肥胖出现时间、肥胖家族史及食糖量多为产生肥胖的危险因素。在1岁前及4岁后出现肥胖的2个高峰年龄中,其病因又有明显不同,前者与出生体重、喂养方式及母妊娠发胖有关,后者与饮食量大及食糖多有关。还发现肥胖儿童血压增高,心率增快,学习成绩下降。     

沈阳市小学生单纯肥胖症的调查研究

１９９２年对沈阳市４所小学校儿童单纯肥胖症的调查表明：７～１２岁儿童单纯肥胖症的检出率为８．３９％，其中男学生明显高于女学生，轻度肥胖约占７０％．应用Ｌｏｇｉｓｔｉｃ回归模型对６０对１１～１２岁肥胖儿童和对照儿童肥胖的影响因素进行研究，结果表明：每天看书写作业时期长、体育活动少、饮食习惯及婴儿时期过早引入固体食物是引起此年龄组儿童肥胖的主要危险因素．     

儿少卫生

”2494儿童单纯性肥胖症的产生及预防/韩永斌…//中围学校卫生一199卜,19(3)一174~175 总结我国1985~1995牛10牛术月。肝为里仄咫阶重情况可以看出,肥胖儿童及超体重儿童比率与10年相比,7~18岁男生从1985年的3.38%上升为7.18%,尤其是城市男生的超体重及肥胖率高达12.03%。儿童单纯肥胖症流行病学调查发现,生后。一3个月的婴儿出现了一个检出高峰,原因之一即是人工喂养过量,过早添加固体食物和断奶早。要预防婴儿肥胖症,首先从孕妇合理营养开始,婴儿出生后,以母乳喂养为优,断奶不宜过早。主食量和肉食量高,蔬菜和水果量低,室内活动量少是形单…     

深圳市0～6岁儿童单纯性肥胖症的流行学研究

[目的]探讨深圳市0～6岁儿童单纯性肥胖症的流行学调查特征. [方法]按照随机整群抽样的方法调查1I 454名0～6岁儿童,以WHO身高标准体重标准为肥胖的判断标准. [结果]总的肥胖检出率为4.2%,男童4.9%,女童3.4%,两者差异有显著性(χ2=14.749,P<0.001),总的超重检出率为10.2%,男童10.6%,女童9.8%.两者差异无显著性(χ2=1.954,P>0.05).0岁组超重及肥胖检出率高于1岁组,1～5岁儿童超重及肥胖检出率呈上升趋势,各年龄组之间的超重及肥胖检出率差异有显著性(χ2超重=65.937,χ2肥胖=121.402,P值均<0.001).特区内、外儿童超重及肥胖检出率差异无显著性(χ2超重=0.74,χ2肥胖=3.045,P值均>0.05).出生体重≥4 kg、父亲低学历、父亲肥胖、母亲肥胖、4个月前人工喂养为主、剖宫产、小儿经常看和食品有关的广告、小儿睡前1 h进食奶类、小儿食欲好、吃饭速度快、父亲鼓励小儿多吃、母亲鼓励小儿多吃、小儿每天运动时间<1 h等是儿童单纯性肥胖症的影响因素. [结论] 深圳市儿童单纯性肥胖症的发生率急剧上升,饮食行为、运动及遗传等是影响儿童肥胖的主要因素,应在全市采取统一的儿童单纯性肥胖症干预措施.     

宝安区0～6岁儿童单纯性肥胖症检出率及相关因素分析

【目的】了解宝安区0～6岁儿童单纯性肥胖症的发生及相关因素。【方法】随机抽取宝安区0～6岁且家庭在深圳市居住一年以上(包括流动人口)的2388名儿童为肥胖症调查对象,经体格测量筛查出的所有单纯性肥胖症儿童和非肥胖症儿童按照1∶2配对正常体重儿童,进行问卷调查。【结果】共检出肥胖症儿童107名,检出率为4.48%;男女儿童间差异无显著性(χ2=1.65,P>0.05)。不同年龄组肥胖症检出率差异有显著性(χ2=19.34,P<0.01)。肥胖症相关因素有儿童食欲、进餐速度、家长对儿童食量看法、体型看法、肥胖症的看法及父母亲体重、母亲孕前体重、母亲分娩前最后体重及出生体重等。【结论】导致儿童肥胖的原因不仅有遗传因素和饮食方式,家长行为观念影响也是极其重要的因素,因此应提高家长对肥胖症危害性的认识及对儿童健康成长的正确引导,早期建立健康的饮食习惯和生活方式并长期保持,以有效降低肥胖症发生率。     

沈阳市3~6岁儿童单纯性肥胖症相关因素分析

目的:探讨儿童单纯性肥胖症影响因素及相关干预措施。方法:对23所幼儿园4 350名儿童进行了身高、体重测量评价,对检出的233名肥胖儿及对照组儿童家长采用问卷调查。结果:肥胖组儿童高出生体重占55.81%,肥胖组儿童既往和目前食欲量大,进食速度快,喜油腻、高脂肪、肉类、甜食等食物比例明显高于对照组。肥胖组父母体重、父母BM I、母孕前、娩前体重明显高于对照组。结论:高出生体重,活动量少,不合理的饮食习惯与遗传因素等与肥胖症的发生有关。儿童肥胖的预防从胎儿期抓起,加强对家长的喂养指导,避免不良的生活和饮食习惯,降低儿童肥胖症的。     

小学生零食消费种类与肥胖及代谢异常的关系

目的了解零食消费种类与儿童肥胖及代谢异常之间的关系,为制定相应的干预措施提供依据。方法采用随机整群抽样法从哈尔滨、北京、济南、上海、重庆、广州6个城市抽取6～13岁小学生7 084名,使用问卷调查收集年龄、性别、家庭经济情况和零食消费情况等信息,按照标准程序测量身高、体重、腰围、血压,采集晨起空腹血测定血糖、总胆固醇、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇和三酰甘油等指标。结果常吃"可经常食用"、"适当食用"、"限量食用"3类零食的小学生肥胖检出率(OR值及OR值95%CI)依次为9.3%(参照组)、10.2%(1.09,0.88～1.35)、11.8%(1.25,1.05～1.50),腹型肥胖率依次为13.3%(参照组)、14.8%(1.14,0.95～1.37)、15.8%(1.25,1.07～1.46),高三酰甘油血症检出率依次为3.4%(参照组)、3.9%(1.13,0.81～1.58)、4.6%(1.34,1.02～1.77)。调整年龄、性别、出生体重、出生4个月内喂养方式、父母文化程度、家庭人均收入等混杂因素后,肥胖、腹型肥胖、高三酰甘油血症检出率在各组间差异仍有统计学意义。结论经常吃不健康零食会增加儿童患肥胖及代谢异常的风险,选择蔬菜、水果、奶及奶制品、豆及豆制品等食物作为零食有益于健康,对儿童进行营养健康教育具有重要意义。     

小学生午餐在外就餐与肥胖及代谢异常的关系

目的了解午餐在外就餐与儿童肥胖等代谢疾病发生率之间的关系,为制定相应的干预措施提供依据。方法采用随机整群抽样法,从哈尔滨、北京、济南、上海、重庆、广州6个城市抽取6～13岁小学生7 083名,使用问卷调查收集年龄、性别及家庭经济情况等信息。按照标准程序进行体格检查和血压测量以及空腹血糖、总胆固醇、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇和三酰甘油等指标的测试。结果经常在学校、家里及在外就餐的儿童肥胖率(OR值95%CI)依次为10.1%(参照组),11.2%(1.01,0.84～1.2),11.3%(1.06,0.89～1.34),腹型肥胖的发生率依次为13.5%(参照组),16.1%(1.05,0.89～1.23),17.2%(1.24,1.03～1.51),代谢综合征的发生率依次为0.8%(参照组),1.4%(1.34,0.79～2.26),1.6%(1.71,1.01～3.26)。调整年龄、性别、出生体重、出生4个月内喂养方式、父母文化程度、家庭人均收入等混杂因素后,腹型肥胖、代谢综合征的发生率在各组间差异仍有统计学意义。结论经常在外吃午餐可增加儿童患肥胖及代谢异常的危险;学校午餐可为儿童提供更加均衡的营养摄入,应大力推广学校营养午餐,以保证儿童健康成长。     

北京市儿童肥胖的生活行为因素和家庭聚集性

目的 探讨儿童肥胖与其生活行为因素、父母肥胖的关系,为制定儿童肥胖的防治政策提供依据.方法 整群随机选取北京市城郊21 198名2～18岁儿童进行横断面研究.问卷调查包括儿童肥胖的家庭环境因素及其父母的肥胖情况;体格测量主要为儿童的身高、体重.采用SPSS13.0软件进行统计学分析,包括一般性描述、趋势卡方检验和非条件logistic回归分析.结果采用国际肥胖工作组推荐的儿童肥胖参考值(IOTF参考值),21 198名2～18岁儿童肥胖率为5.6%.儿童吸烟、饮酒等行为因素及其肥胖状况存在家庭聚集性.父母均不吸烟、一方吸烟、双亲均吸烟的子女吸烟率分别为1.50%、2.93%和6.01%(χ2趋势=45.422,P<0.01);父母均不饮酒、一方饮酒、双亲均饮酒的子女饮酒率分别为5.85%、9.12%和13.96%(χ2趋势=107.009,P<0.01).根据双亲BMI状态分组,"父母正常"、"父亲肥胖"、"母亲肥胖"、"双亲肥胖"各组中儿童肥胖率分别为3.29%、11.48%、9.12%和27.01%(χ2趋势=293.404,P<0.01).控制性别、年龄后,体育锻炼、睡眠、吃禽类食物、看电视、饮酒可能是儿童肥胖的影响因素.控制年龄、性别、青春期等协变量,与父母体重正常相比,母亲肥胖对女儿肥胖的影响较大(OR=5.93,95% CI:3.57～9.84),而父亲肥胖对儿子肥胖的影响较大(OR=4.29,95% CI:3.21～5.72).父母同时肥胖对女儿肥胖产生的影响(OR=28.51,95%CI:15.13～53.72),远远大于其对儿子肥胖的影响(OR=7.21,95% CI:4.07～12.75);其对2～5岁、10～12岁儿童的影响(OR=18.67,95% CI.49～234.46;OR=22.25,95% CI:10.62～46.59),大于其对其他年龄组肥胖的影响.结论 父母肥胖可能是儿童肥胖的独立危险因素,且关联存在性别、年龄差异.父母生活行为对儿童具有重要影响,对儿童肥胖的预防或干预应重视家庭环境因素.     

Infant Obesity and Severe Obesity Growth Patterns in the First Two Years of Life

Distinguishing an obesity growth pattern that originates during infancy is clinically important. Infancy based obesity prevention interventions may be needed while precursors of later health are forming. Infant obesity and severe obesity growth patterns in the first 2-years are described and distinguished from a normal weight growth pattern. A retrospective chart review was conducted. Body mass index (BMI) growth patterns from birth to 2-years are described for children categorized at 5-years as normal weight (n = 61), overweight (n = 47), obese (n = 41) and severely obese (n = 72) cohorts using WHO reference standards. BMI values were calculated at birth, 1-week; 2-, 4-, 6-, 9-, 12-, 15-, 18-months; and 2- and 5-years. Graphs of the longitudinal Analysis of Variance of Means of BMI values identified the earliest significant divergence of a cohort’s average BMI pattern from other cohorts’ patterns. ANOVA and Pearson Product Moment correlations were also performed. Statistically significant differences in BMI values and differences in growth patterns between cohorts were evident as early as 2–6 months post-birth. Children who were obese or severely obese at 5-years demonstrated a BMI pattern that differed within the first 2-years of life from that of children who were normal weight at 5-years. The earliest significant correlation between early BMI values and 5-year BMI value was at 4-months post-birth. The study fills an important gap by demonstrating early onset of an infant obesity growth pattern in full-term children who were healthy throughout their first 5 years of life.     

Rapid Weight Gain During the First Year of Life Predicts Obesity in 2–3 Year Olds from a Low-income,Minority Population

As the prevalence of childhood obesity increases, researchers continue to attempt to identify factors contributing to obesity. The purpose of this study was to define the relationship between birth weight, rapid weight gain (RWG), and early childhood obesity in a low-income, inner-city minority population. In this retrospective chart review, researchers documented every medical encounter recorded in the chart from birth to 3 years for 203 3 year old minority children from low-income families living in an urban area. Based on Center for Disease Control and Prevention’s growth charts and tables, z-scores at birth, 4 months, and 1 year were calculated and RWG determined. Researchers determined Body Mass Index percentiles at 3 years of age using the last available weight and height between 24 and 38 months of age. Eight percent of children were underweight, 62% were normal weight, 12% were at overweight and 18% were obese. Children who experienced RWG during the first year of life were 9.24 (CI: 3.73–22.91) as likely to become obese as those who did not experience RWG. Neither low birth weight nor being male increased the odds of becoming obese. Low birth weight predicted underweight at 24–38 months. In this high-risk population, children experiencing RWG during the first year of life have a significantly increased risk of being obese during the preschool years. Future research should identify factors leading to RWG, including specific infant feeding practices.     

Obesity and life style in a population of male school children aged 6 to 10 years in Ariana (Tunisia)

The increase of the prevalence of the obesity in childhood puts in reason some factors of the environment and the way of life of the child that encourage the hold of weight at these topics of as much more that if they are exposed genetically. A prospective survey has been done close to 3148 school boy aged of 6 to 10 years and who were schooled in the gouvernorat of Ariana showed that the prevalence of the obesity is around 3.7%. A survey case/witness has been achieved in a second time on the way of life of the group of the obese matched to a group of children no obese. An intended questionnaire to parents of children of these 2 groups permitted to collect some informations concerning the weight and the present size of parents, habits of life of their children. The weight to the birth has been searched for in the school medical file or from the notebook of health of the child. The obesity of parents is one factor of risk of the child obesity. The short length of sleep (< 8 hours), the erosion between meals especially in the evening after the dinner, the daily consumption of sugary foods and sparkling drinks is the important risk factors exposing to the infantile obesity this group of age. These behaviours can be corrected by a strategy of prevention and nutritional education.     

中日两国幼儿肥胖及其影响因素调查

目的为了调查中日两国幼儿肥胖发病情况及影响因素.方法 对中国上海市和日本立川市的3～4岁各1000余名幼儿测定身高和体重,并进行了肥胖及其影响因素的调查.结果 中国上海市幼儿超重率和肥胖率分别为11 .7%和4.3%,已接近于日本立川市的幼儿超重率(14.6%)和肥胖率(5.0%).幼儿出生体重过重喜食肉类和乳制品、就餐时间无规律、活动过少等因素会增加肥胖程度;双亲肥胖家庭的幼儿容易发生肥胖.结论 幼儿肥胖受到遗传和环境因素的双重影响,中国上海市幼儿肥胖已成为一个值得重视的卫生问题.     

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.     

Associations of Feeding Practices in Early Life and Dietary Intake at School Age with Obesity in 10- to 12-Year-Old Arab Children

Understanding the role in pediatric obesity of early life feeding practices and dietary intake at school age is essential for early prevention. The study aimed to examine associations of early life feeding practices, environmental and health-related exposures, and dietary intake at school age as determinants of obesity in children aged 10–12 years. In an earlier study of 233 healthy infants in two Arab towns in northern Israel, neonatal history, feeding practices, and health information were obtained up to age 18 months. This follow-up study assessed dietary intake and anthropometric measurements at age 10–12 years using the 24 h recall method. Overall, 174 children participated in this study. Almost all (98%) the children were breastfed. The prevalence of obesity at school age was 42%. A multivariable model adjusted for energy intake and socioeconomic status showed positive associations of total fat intake and of weight-for-height z score, but not feeding practices in infancy, with obesity. Higher gestational age at birth was associated with lower odds of obesity at age 10–12 years. In conclusion, in a population with near universal breastfeeding, gestational age at birth, weight indicators but not feeding practices in infancy, and total fat intake at school age were associated with increased likelihood of obesity.     

Trends in obesity and arthritis among baby boomers and their predecessors, 1971-2002

OBJECTIVES: We examined trends in obesity and arthritis prevalence among the "baby boom" (born 1946-1965) and "silent" (born 1926-1945) generations. METHODS: We conducted birth cohort analyses using successive waves of the National Health and Nutrition Examination Survey (1971-2002). RESULTS: Obesity rates increased markedly, beginning earlier in life with each successive birth cohort. When the members of the silent generation were aged 35-44 years, 14%-18% were obese. At comparable ages, 28%-32% of the youngest baby boomers were obese. Differences in arthritis prevalence were not evident across birth cohorts. However, the relative risk of arthritis because of obesity increased over time; consequently, the percentage of arthritis cases attributable to obesity increased from 3% to 18% between 1971 and 2002. CONCLUSIONS: Our results showed that members of the baby boom generation were more obese, and became so at younger ages than their predecessors. Although differences in arthritis prevalence are not yet evident, findings suggest that obesity has contributed to more cases of arthritis in recent years than in previous decades.