儿童肥胖的现状与预防.docx

儿童肥胖的现状与预防【摘要】 随着生活水平的提高和生活方式的变更，儿童肥胖率日渐增高，严重影响儿童的身心健康。肥胖是一种由多种因素导致的慢性疾病，其发生机制尚未明确。本文就儿童肥胖的流行现状，肥胖形成的主要影响因素及干预儿童肥胖的策略等方面进行全面综述。【关键词】 肥胖；儿童；预防Abstract： he prevalence of childhood obesity has reached the epidemic level in most countries with the improvement and the chang of lifeand obesity in childhood have the adverse impacts on both physical and psychologicalmechanism of obesity development is not fully understood and it is believed to be a chronic disorder with multiplearticle summarizes prevalence,cause,and prevention of childhood obesity. Key words:obesity；childhood；prevention 1 儿童肥胖的流行现状 根据国际肥胖专家工作组提供的数据，目前全球儿童超重率接近10%，肥胖率为2%3%,虽然不同国家所用的标准不尽相同，地区之间差异也比较大，但总体上各地区都呈现明显上升趋势。 发达国家自1971年起，儿童的肥胖人数一直在增加。美国是面临肥胖问题最严重的发达国家之一。在美国，有11%25%的儿童超重或者肥胖，大约70%的肥胖儿童成年后仍然肥胖。 体育锻炼 Stone等43统计了14个学校在体育锻炼知识和行为上的干预作用，大多数的结果有明显的正向作用。美国的交叉学科干预工程提出了一种基于课程学习的方法用于影响68岁儿童的饮食行为和久坐行为，并增强他们的体育锻炼。执行两年后发现，相对参照，女孩的肥胖个数明显下降，不过男生中作用不明显。看电视次数的减少对女生和男生都有明显的影响。参与体育锻炼的增加需要学校和教育部的政策支持。同样，选择更有利于减肥的交通工具上学也需要学校、政府、家长及社会各方面的支持。部分社会中，这样的政策已经被贯彻，如设计专门的步行和自行车路线35。 看电视习惯 看电视的时候少吃零食和增加体育锻炼同样重要，通过限制或减少看电视的次数可达到预防儿童肥胖的目的41。快餐食品是电视的主要广告产品，儿童是快餐食品的主要市场。减少儿童接触高能量的食品，饮料及快餐店，特别是避免强大的电视媒体对儿童的冲击，是一个值得提倡的潜在预防肥胖的策略。在瑞典，从十年前商业电视出现时就禁止向12岁以下的儿童进行电视广告。丹麦、挪威、奥地利、爱尔兰、澳大利亚和希腊都有相同的电视广告禁令35。 食物部分 食物的价格受到市场需求和食物所含营养成分的影响43。对高热量低营养的食品，如果政府干预增加一点税收就可以降低他们的销售，目前美国和加拿大已经在实行这种政策44。此外，食物的营养标签也可以帮助消费者在购物时作更健康的选择。比如，在澳大利亚和新西兰就在实行国家心脏基金推出的“Pick the Tick”的标签工程45。“Pick the Tick”可帮助消费者更容易选择健康的食物。此外，食物营养标准的规定可促使制造商制造更合理健康的食品。 5 预防方法的效果 研究显示，如果是为防止肥胖儿童继续肥胖，那么鼓励其多玩和减少他久坐比单纯的多运动和少吃更有效46。最近有一种新的肥胖预防策略，是学校主动出示健康报告让家长了解其孩子体重的问题，这种健康报告可帮助对儿童肥胖的预防。波斯顿区的调查表明，收到学校健康报告的家长比起没有收到报告的家长更能清楚自己小孩的体重超标问题，并更能及时地对其小孩的体重进行控制47。 6 小结 肥胖是一种由多种原因造成，与生活方式密切相关,以身体脂肪含量过度增生的慢性疾病。孩童时期的肥胖和超重对小孩的心理和生理健康都有重要的影响。它不仅使机体衰弱,而且会危害生命。肥胖的小儿容易得下呼吸道感染、睡眠呼吸暂停、重度者易患皮肤感染如疥疮、湿疹和黑色棘皮症等,承重骨关节的发育异常如学步推迟,膝内、外翻畸形,扁平足;青春期易患股骨骺端滑脱等关节损伤以及心理损害，如抑郁症。此外，超重的儿童比正常儿童在成年时期更容易得心血管和消化方面的疾病。 显然，初级和次级的肥胖预防工作对现在的肥胖流行的控制非常重要，对儿童的预防效果比对成人更明显。预防儿童肥胖有许多有效且可执行的措施，包括居住环境的选择，加强体育锻炼和饮食控制。这些措施在家里、幼儿园、学校等许多天然场所都可以分开被执行。一个健康合适的居住环境对在住的所有人都有益。当然，下一步的研究还需要知道什么才是预防，干涉和治疗肥胖的最有效措施。这些措施可能包括出于文化，种族，以及人类社会经济方面的考虑。 【参考文献】 1Parsons TJ,Power C,Logan S,et al. 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