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欧洲世界卫生组织成员国儿童肥胖防治。流行病学数据、医学社会层面及预防项目。

Fighting obesity in children from European World Health Organization member states. Epidemiological data, medical-social aspects, and prevention programs.

作者信息

Nittari G, Scuri S, Petrelli F, Pirillo I, di Luca N M, Grappasonni I

机构信息

Telemedicine and Telepharmacy Centre, University of Camerino, Italy.

School of Medicinal and Health Products Sciences, University of Camerino, Italy.

出版信息

Clin Ter. 2019 May-Jun;170(3):e223-e230. doi: 10.7417/CT.2019.2137.

Abstract

Childhood obesity is one of the most serious public health chal-lenges of this century. Overweight and obese children are likely to stay obese into adulthood and more likely to develop non-communicable diseases like diabetes and cardiovascular diseases at a younger age. In the WHO European Region one child out of 3, is overweight or obese. Over 60% of children who are overweight before puberty will be overweight in early adulthood. Children and adolescents, aged 5-19 have shown rising obesity rates in almost all nations, including where the situation was far from alarming 40 years ago. Several nations have seen the prevalence almost double: Israel has gone from 5.8% in 1975 to 11.9% in 2016, Andorra from 6.2% to 12.8%, and Malta from 7.4% to 13.4%. Analyzing overweight and obesity, we can see that they follow similar trends and patterns. In 1975 the majority of European countries had a prevalence less than 10% and obesity less than 5%, while no European country had overweight prevalence higher than 30% and obe-sity higher than 10%. In 2016 the trend reversed, showing a worrying increase in the number of European countries with a high prevalence of overweight (over 30%) and obesity (over 10%) (Fig. 1)(29). Starting from the analysis of epidemiological data on obesity in the WHO European Region, the paper analyzes the adopted prevention programs in order to assess their effectiveness and figure out the best strategies to reduce the prevalence of overweight and obesity. The WHO European Childhood Obesity Surveillance Initiative reported that children tend to overeat and not to do enough physical exercise. Different preventive programs have identified different areas of action and corresponding measures: consumption of healthy foods, physical exercise, care before conception and during pregnancy, early childhood, school age children, weight management, monitoring and evaluation. Primary prevention is essential to reduce obesity incidence: it is easier to act on the adoption of healthy eating habits than intervene with diets on children who already have weight issues. Working on pre-vention programs represents an investment for the future of children's health. By simply acting on prevention, particularly on body weight reduction, it could be possible to tackle the spreading of correlated di-seases. Therefore, prevention programs ought to be prioritized priority at a national and international level.

摘要

儿童肥胖是本世纪最严峻的公共卫生挑战之一。超重和肥胖的儿童成年后很可能仍肥胖,且更有可能在年轻时患上糖尿病和心血管疾病等非传染性疾病。在世卫组织欧洲区域,每3名儿童中就有1名超重或肥胖。青春期前超重的儿童中,超过60%在成年早期仍会超重。在几乎所有国家,5至19岁的儿童和青少年肥胖率都在上升,包括40年前情况还远未达到令人担忧程度的国家。有几个国家的肥胖率几乎翻了一番:以色列从1975年的5.8%升至2016年的11.9%,安道尔从6.2%升至12.8%,马耳他从7.4%升至13.4%。分析超重和肥胖情况可以发现,它们呈现出相似的趋势和模式。1975年,大多数欧洲国家超重率低于10%,肥胖率低于5%,没有一个欧洲国家超重率高于30%,肥胖率高于10%。2016年趋势逆转,超重(超过30%)和肥胖(超过10%)高患病率的欧洲国家数量令人担忧地增加(图1)(29)。本文从分析世卫组织欧洲区域肥胖的流行病学数据入手,分析了已采用的预防方案,以评估其有效性,并找出降低超重和肥胖患病率的最佳策略。世卫组织欧洲儿童肥胖监测倡议报告称,儿童往往暴饮暴食且体育锻炼不足。不同的预防方案确定了不同的行动领域和相应措施:健康食品消费、体育锻炼、孕前和孕期保健、幼儿期、学龄儿童、体重管理、监测与评估。一级预防对于降低肥胖发病率至关重要:培养健康的饮食习惯比干预已有体重问题的儿童的饮食更容易。开展预防方案是对儿童健康未来的一项投资。仅通过开展预防工作,特别是减轻体重,就有可能应对相关疾病的蔓延。因此,预防方案应在国家和国际层面被列为优先事项。

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