Parental experiences of adopting healthy lifestyles for children with disabilities living with overweight and obesity

BackgroundChildren with disabilities present with high obesity rates.ObjectiveThis study explored the parental experience of adopting healthy lifestyle choices, for children with disabilities, who received dietetic weight management advice.MethodsSemi-structured qualitative interviews were carried out with eight parents/carers in their own homes or healthcare setting in an inner London locality, or by telephone. Data was analyzed using an interpretative phenomenological analysis (IPA) approach.ResultsFive superordinate themes emerged: 1. Strategies to promote healthy lifestyles: encouraging physical activity, limiting access to food and taking a gradual approach to making lifestyle changes. 2. Challenges to adopting healthy lifestyles: selective eating patterns, the high cost of healthy foods and parental/carer lack of time. 3. The role of healthcare professionals (HCPs): revealed that not all parents/carers received advice or support, prior to dietetic referral, when managing their child's weight. Feeling reassured by HCPs was valued. Parents/carers reported a positive experience of seeing the dietitian, as they appreciated receiving practical and individualized advice. 4. Support needs: family support and support from families with children with disabilities was explored. 5. Parent/carer wellbeing: such as stress was found to have a detrimental impact on parents making healthy lifestyle changes.ConclusionsAdopting a healthy lifestyle involved a variety of strategies and challenges, some of which are specific to this population group and should be considered by HCPs, when having weight-related discussions and offering advice. Parental/carer support needs and wellbeing should also be taken into consideration when planning weight management services for this population group.     

营养干预对学生知识行为及超重肥胖的影响

目的 在“营养校园”试点学校进行为期一年的营养干预,分析评价干预效果。方法 在石家庄新华区选取一所小学和一所初中进行干预,从三、五、七年级中分别随机抽取2个班级的学生在干预前后进行调查。干预方法包括开展营养健康教育、促进身体活动、科学营养供餐支持等综合措施,通过问卷和体格测量调查学生干预前后的营养知识、饮食行为及超重肥胖变化情况。结果 干预后,营养知识题目的正确率显著提高（χ2=613.737,P<0.001）,总体正确率为59.8%。学生早餐食物种类（χ2=19.841,P<0.001）和早餐摄入频率（χ2=5.405,P<0.05）均有显著改善。总体超重肥胖率未见显著改善,按性别、年级分层分析发现,女生超重肥胖率降低（χ2=1.891,P<0.05）,5年级（χ2=4.923,P<0.05）和7年级（χ2=10.563,P<0.01）学生超重肥胖率降低,且高年级学生降幅更明显。结论 以校园为基础开展综合营养干预措施,可以提高学生的营养知识水平,并改善学生的不良饮食行为及超重肥胖现状。     

安徽省2010—2019年9～18岁中小学生超重与肥胖流行趋势分析

目的 了解安徽省 2010—2019年中小学生超重和肥胖的流行趋势,为制定有效的干预措施提供依据。方法 于2010年、2014年和2019年分别采用分层整群随机抽样的方法获取安徽省在校中小学生有效数据7459份、8789份和5821份,应用中国肥胖工作组(WGOC) “中国学龄儿童青少年超重、肥胖筛查BMI分类标准”进行筛查,比较超重和肥胖变化情况。结果 2019年安徽省9～18岁中小学生的超重、肥胖检出率分别为15.3%和10.0%,男生超重、肥胖检出率分别为18.4%和13.0%,女生超重、肥胖检出率分别为12.2%和7.1%;城市学生超重、肥胖检出率分别为 16.3%和12.3%,乡村学生超重、肥胖检出率分别为14.2%和7.7%。2010—2019 年安徽省 9～18 岁中小学生超重、肥胖检出率表现出持续增长的趋势。结论 2010—2019年安徽省9～18岁中小学生超重、肥胖检出率处于增长趋势,超重、肥胖检出率存在性别及城乡差异。     

石家庄市学龄儿童超重、肥胖与血压、血脂和血糖的关系

目的探讨城市学龄儿童超重、肥胖与血压、血脂和血糖等心血管疾病危险因素的聚集性。方法采用多阶段分层抽样，测定石家庄市区913名7～13岁儿童的身高、体重、收缩压（SBP）、舒张压（DBP）、总胆固醇（TC）、甘油三酯（TG）、高密度脂蛋白胆固醇（HDL-C）和空腹血糖水平。结果儿童超重和肥胖总检出率为29．24％（男34．98％，女24．23％）。与正常儿童相比，超重和肥胖儿童的SBP、DBP、TC和TG水平明显升高，HDL-C明显降低。超重和肥胖儿童的高血压、高TG、高TC、高血糖和低HDL-C检出率也明显高于正常儿童。校正年龄和性别后，超重和肥胖儿童的SBP、DBP、TC、TG、血糖升高和HDL-C降低的危险性分别为正常儿童的6．77、3．22、2．55、6．42、3．85和2．94倍（95％CI分别是4．15～11．04、1．38～7．49、1．59～4．11、3．46～11．92、1．69～8．78和1．83～4．73）；超重与肥胖儿童有任意1、2、3个所选心血管疾病危险因素的危险性分别是正常儿童的2．74、13．15和15．33倍（95％CI分别是1．92～3．92、6．69～25．87和4．17～56．39）。结论儿童期超重与肥胖增加儿童心血管疾病危险因素的聚集性以及儿童获得多个心血管疾病的危险性。控制儿童超重和肥胖有助于心血管疾病的早期预防。     

广东省2002年成人超重、肥胖流行病学特征分析

目的 了解广东省成年人超重肥胖的流行特征,确定预防控制的重点人群和地区。方法 运用多阶段随机整群抽样方法,抽取大城市、中小城市、2类农村各3个区(县)、1类农村4个县,每个县(区)抽取2个街道(乡)、6个居委,共540户,用面对面询问调查获得≥18岁居民个人基本情况,体检获取体重、身高数据。结果 共调查≥18岁成年人15 130人,体重指数均值为22.03±3.38,男性(22.06±3.37)与女性(21.98±3.40)比较差异无统计学意义,城市(23.06±3.53)与农村(21 08±2.94)比较差异有统计学意义。超重、肥胖的粗患病率分别为16 8％和1.8％,年龄标化患病率分别为15.0％和1 7％。超重粗患病率城市(24 8％)高于农村(9.4％),男性(17 5％)高于女性(16 2％);肥胖粗患病率城市(3.1％)明显高于农村(0 7％),男性(1 8％)与女性(1.7％)之间差异无统汁学意义。超重、肥胖的影响因素主要为体力活动、家庭收入、性别、年龄、吸烟与城乡。结论 广东省超过六分之一成年居民超重和肥胖,已经成为一个重要的公共卫生问题,必须采取平衡膳食、增加体力活动与健康教育等措施进行综合防治。     

Standardized Ultrasound Measurement of Subcutaneous Fat Patterning: High Reliability and Accuracy in Groups Ranging from Lean to Obese

A recently standardized ultrasound technique for measuring subcutaneous adipose tissue (SAT) was applied to normal-weight, overweight and obese persons. Eight measurement sites were used: upper abdomen, lower abdomen, erector spinae, distal triceps, brachioradialis, lateral thigh, front thigh and medial calf. Fat compression was avoided. Fat patterning in 38 participants (body mass index: 18.6–40.3 kgm^?2; SAT thickness sums from eight sites: 12–245 mm) was evaluated using a software specifically designed for semi-automatic multiple thickness measurements in SAT (sound speed: 1450 m/s) that also quantifies embedded fibrous structures. With respect to ultrasound intra-observer results, the correlation coefficient ρ = 0.999 (p < 0.01), standard error of the estimate = 1.1 mm and 95% of measurements were within ±2.2 mm. For the normal-weight subgroup, the median measurement deviation was 0.43 mm (1.1% of mean thickness), and for the obese/overweight subgroup it was 0.89 mm (0.5%). The eight sites used here are suggested to represent inter-individual differences in SAT patterning. High measurement accuracy and reliability can be obtained in all groups, from lean to overweight and obese, provided that measurers are trained appropriately.     

Weight gain in infancy and post‐bronchiolitis wheezing

Aim: Low birth weight, high birth weight and excessive weight gain after birth may be risk factors for asthma in childhood, but their associations with wheezing in early childhood are poorly studied. The aim of the study was to evaluate birth weight, weight gain in early infancy and overweight in infancy assessed by weight for length (WFL) as risk factors for wheezing after hospitalization for bronchiolitis in early infancy. Methods: In all, 127 full‐term infants hospitalized for bronchiolitis at age <6 months have been followed up until the mean age of 1.5 years. The weights and lengths of the infants were measured on admission to hospital and at the control visit. Birth weights were obtained from the hospital records. Results: Both occurrence and recurrence of post‐bronchiolitis wheezing were associated with birth weight >4000 g and the recurrence of post‐bronchiolitis wheezing with WFL >110% at age 1.5 years. The associations were robust to adjustments with gender and allergy. Higher weight gain from birth to hospitalization at age <6 months was associated with wheezing in the subgroup of children with birth weight >4000 g. Conclusion: High birth weight and the development of overweight may be associated with post‐bronchiolitis wheezing in infancy.