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JAMA:多方位行为干预未能改善医疗条件不足的学龄前儿童肥胖

2018-08-09 聂少芳(武汉协和医院 ) 信诺医讯

肥胖的发病始于儿童期,在少数族裔中发病率最高。大量研究提示干预儿童的健康行为,如饮食,睡眠等,可治疗儿童期肥胖,但疗效甚微,且只能在短期内降低儿童的体重指数(BMI),其疗效的可持续性尚未知。

肥胖的发病始于儿童期,在少数族裔中发病率最高。大量研究提示干预儿童的健康行为,如饮食,睡眠等,可治疗儿童期肥胖,但疗效甚微,且只能在短期内降低儿童的体重指数(BMI),其疗效的可持续性尚未知。

因缺乏有效的治疗手段,儿童期肥胖的预防成为大家关注的焦点,尤其在肥胖发生率最高而医疗条件薄弱的少数族裔社群里。此项健康成长随机对照临床试验(GROW RCT)旨在评估36个月的多方位行为干预对有肥胖风险的学龄前儿童BMI改变的影响。

研究对象是来自医疗条件薄弱的田纳西州纳什维尔的610个亲子对,入组时儿童均有肥胖风险但不至肥胖,均接受为期36个月的入学预备课程,其中304对随机进入干预组额外接受行为干预。

行为干预包括家长技能建设, 儿童营养选择,体育活动习惯,利用家庭和社会环境养育子女,健康睡眠,减少媒体时间等。主要结局是36月内BMI的改变趋势。

结果显示,研究对象90%以上来自拉丁裔,平均年龄为4.3岁,一半以上为女孩,一半以上的家庭年收入在25000美元以下。36月时,干预组和对照组儿童BMI均值皆为17.8,且两组的主要结局无统计学差异(P =.39);干预组较对照组平均热量摄入更低(校正 P =.003),而社区活动的参与更多(校正 P = .006)。

研究显示,36个月的多方位行为干预未能改善田纳西州纳什维尔地区医疗条件不足的儿童BMI的增长趋势。采用其他形式的干预或在其他城市进行行为干预是否有效尚待进一步研究证实。

原始出处:Shari L. Barkin, MD, MSHS1; William J. Heerman, MD, MPH2; Evan C. Sommer, BS, BA2; et al. Effect of a Behavioral Intervention for Underserved Preschool-Age Children on Change in Body Mass Index : A Randomized Clinical Trial. JAMA. August 7, 2018

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  2. [GetPortalCommentsPageByObjectIdResponse(id=1981235, encodeId=ac871981235d3, content=<a href='/topic/show?id=8a344564298' target=_blank style='color:#2F92EE;'>#学龄前儿童#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=88, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=45642, encryptionId=8a344564298, topicName=学龄前儿童)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=仁心济世, createdTime=Thu May 16 15:05:00 CST 2019, time=2019-05-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=339362, encodeId=2806339362af, content=不错耶,学习啦, beContent=null, objectType=article, channel=null, level=null, likeNumber=104, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=3b2c1627329, createdName=owlhealth, createdTime=Sat Aug 18 15:43:33 CST 2018, time=2018-08-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1552864, encodeId=7662155286444, content=<a href='/topic/show?id=59d628408fa' target=_blank style='color:#2F92EE;'>#儿童肥胖#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=28408, encryptionId=59d628408fa, topicName=儿童肥胖)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f06814304969, createdName=windight, createdTime=Sat Aug 11 02:05:00 CST 2018, time=2018-08-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=337525, encodeId=762733e5254c, content=感谢小编为我们准备了如此丰盛的精神大餐,同时也向作者致谢!认真学习了,点赞!, beContent=null, objectType=article, channel=null, level=null, likeNumber=101, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=30251637888, createdName=lietome15, createdTime=Thu Aug 09 12:05:34 CST 2018, time=2018-08-09, status=1, ipAttribution=)]
    2018-08-18 owlhealth

    不错耶,学习啦

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  4. [GetPortalCommentsPageByObjectIdResponse(id=1981235, encodeId=ac871981235d3, content=<a href='/topic/show?id=8a344564298' target=_blank style='color:#2F92EE;'>#学龄前儿童#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=88, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=45642, encryptionId=8a344564298, topicName=学龄前儿童)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=仁心济世, createdTime=Thu May 16 15:05:00 CST 2019, time=2019-05-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=339362, encodeId=2806339362af, content=不错耶,学习啦, beContent=null, objectType=article, channel=null, level=null, likeNumber=104, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=3b2c1627329, createdName=owlhealth, createdTime=Sat Aug 18 15:43:33 CST 2018, time=2018-08-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1552864, encodeId=7662155286444, content=<a href='/topic/show?id=59d628408fa' target=_blank style='color:#2F92EE;'>#儿童肥胖#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=28408, encryptionId=59d628408fa, topicName=儿童肥胖)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f06814304969, createdName=windight, createdTime=Sat Aug 11 02:05:00 CST 2018, time=2018-08-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=337525, encodeId=762733e5254c, content=感谢小编为我们准备了如此丰盛的精神大餐,同时也向作者致谢!认真学习了,点赞!, beContent=null, objectType=article, channel=null, level=null, likeNumber=101, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=30251637888, createdName=lietome15, createdTime=Thu Aug 09 12:05:34 CST 2018, time=2018-08-09, status=1, ipAttribution=)]
    2018-08-09 lietome15

    感谢小编为我们准备了如此丰盛的精神大餐,同时也向作者致谢!认真学习了,点赞!

    0

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