学龄前儿童超重肥胖的调查和影响因素分析

目的：调查北京市学龄前儿童超重肥胖流行现状并分析其影响因素,为制定防制策略提供科学依据。方法：选择842例3~5岁健康查体的学龄前儿童为研究对象,测量身高、体重并计算体质量指数（BMI）。向儿童主要养护人进行问卷调查,获得母亲孕期、儿童早期喂养、身体活动和行为习惯、家庭情况和膳食情况等与儿童超重肥胖的相关信息。以儿童是否超重肥胖为因变量,影响儿童超重肥胖的23个因素为自变量,进行单因素和多因素Logistic 回归分析。结果：学龄前儿童超重率为10.69%、肥胖率为11.28%;多因素Logistic回归分析显示,孕期增重、出生6月内喂养方式、屏幕暴露时长、谷薯类食物食用频率4个变量差异有统计学意义（P＜0.05）,孕期增重过多、出生6月内人工喂养、每日屏幕暴露时长≥1 h、每周食用谷薯类食物是儿童超重肥胖的危险因素。结论：北京市学龄前儿童超重肥胖率处于较高水平,儿童超重肥胖受多种因素的共同影响。     

8～10岁超重肥胖儿童HOMA-IR指数分布及与人体成分的相关性研究

目的：探讨8～10岁超重肥胖儿童稳态胰岛素评估模型胰岛素抵抗（HOMA IR）指数的分布及与人体成分等测量指标的关系。方法：以2018年北京市某小学8～10岁超重肥胖儿童为研究对象,采集人体测量指标（体质量、身高、体质量指数、腰臀比）、人体成分指标（肌肉量、去脂体重量、体脂肪、体脂百分比、内脏脂肪面积、基础代谢率）,检测血液空腹血糖、胰岛素水平,采用HOMA IR指数评估胰岛素抵抗。结果：共收集149名儿童,其中超重57名、肥胖92名;肥胖者体质量指数、腰臀比、体脂肪、体脂百分比、空腹胰岛素、内脏脂肪面积、HOMA IR指数均显著高于超重者,两者空腹血糖比较无显著差异（P=0.108）。男生（109例）在肌肉量、去脂体重、基础代谢率方面大于女生（40例）（P＜0.05）。48例（32.2%）儿童存在胰岛素抵抗状态（IR＞4）,且各检测指标均显著升高（P＜0.001）。体质量指数、腰臀比、体脂肪、体脂百分比、内脏脂肪面积均与HOMA IR指数呈显著正相关（P＜0.001）,其中腰臀比相关性最大（r=0.472）。结论：超重肥胖儿童HOMA IR指数普遍偏高。HOMA IR指数大于4时,体重、BMI、体脂肪、体脂百分比、内脏脂肪面积等显著增加。人体成分分析可用于超重肥胖儿童体格评估。     

黎族人的瘦体与脂肪质量指数

2014年11月在海南省五指山市5个黎族村寨测量了607例(男为308例,女为299例)黎族人体质量、身高等6项体成分指标值,计算了黎族人的体脂率(P_(bf))、瘦体质量(m_l)、脂肪质量(m_f)、瘦体质量指数(I_(lm))、脂肪质量指数(I_(fm))。研究发现,女性体脂率、脂肪质量、脂肪质量指数都明显大于男性,瘦体质量、瘦体质量指数均明显小于男性。随年龄增长,黎族人身高、瘦体质量逐渐减小,体脂率、脂肪质量、脂肪质量指数逐渐增大。受试者特征曲线显示身体质量指数、脂肪质量指数都可以适宜评价黎族人的体脂率,而且脂肪质量指数对体脂率的估算准确性比身体质量指数更高。这也提示脂肪质量指数是比身体质量指数评价肥胖更好的指标。     

体质测量在超重和肥胖研究中的应用

本文通过查阅文献,对体质测量在评估超重、肥胖和预测健康风险中的应用进行了回顾性调查、总结和分析,并对体质量指数、体脂肪指数和内脏脂肪指数等测量指标的优势和局限性进行了分析和讨论.由于预测结果受多种因素的影响,因而预测评价时应根据不同地域的不同的研究对象和不同的预测风险,选用不同的测量指标和不同的测量工具.为同行们今后应...     

学校身体活动环境与儿童肥胖的定性循证研究

目的：系统评价学校身体活动环境与儿童超重肥胖的关系，为相关指南和政策的制定提供循证证据。方法：检索1998—2020年公开发表的相关中英文文献，中文数据库为中国生物医学文献数据库（CBM）、中国知网（CNKI）、万方数据知识服务平台，英文数据库为Cochrane Library、PubMed、EMbase等。结果：共检索出3 846篇文献，其中中文3 080篇、英文766篇。经过文献筛选，共有8篇英文文献纳入本次系统评价，包括1项队列研究、1项横断面研究、2项干预研究、4项系统综述。结果显示，学校体育运动场所与儿童青少年身体活动水平有关，身体活动水平的增强可有效降低肥胖发生的风险。学校身体活动可以有效预防儿童青少年超重肥胖或延缓超重肥胖率上升速度，尤其对超重肥胖相关指标的改善更有效。结论：学校身体活动环境与儿童超重肥胖可能有关，还需要更多高质量研究设计的证据支持。     

天津籍汉族大学生的人体组成成分研究

通过对天津籍汉族大学生身体成分的研究,对天津籍汉族大学生的肥胖程度有直观的科学评价,为天津市汉族大学生的营养平衡、身体锻炼、体质发育提供科学参考。测量了天津籍汉族大学生22项身体成分指标,除体脂肪率、皮下脂肪含量、浮肿指数之外,其他体成分指标男性均高于女性。男性浮肿指数与年龄存在着显著的正相关。女性腰围、臀围、基础代谢和总能量代谢与年龄存在着显著的负相关。根据BMI指数男性体重正常占52.54%,而女性则为73.60%,体重正常率明显多于男性。结果表明:天津籍汉族大学生的肥胖度大都在正常范围内,但男性的肥胖度明显严重于女性,这是由生活习惯、饮食习惯和塑身观念造成的,应多关注天津籍男性汉族大学生的身体肥胖情况。     

大学生运动员体型与胰岛素敏感度相关性研究

为了了解大学生运动员体型与胰岛素敏感度的相关性,我们招募了320名大学生运动员与300名非运动员为受试对象,测量了其身高、体重、BIA体脂肪率,计算身体质量指数(body mass index,BMI),并检测理论空腹血糖、血清胰岛素、稳态模型评估(homeostasis model assessment,HOMA)值、糖化血红蛋白以及胆固醇数值。我们比较了大学生运动员和非运动员胰岛素敏感度与代谢指标,并推测了其关联性。研究发现,运动员的体重、身体质量指数与BIA脂肪率均显著的高于非运动员;运动员的空腹胰岛素以及HOMA都显著的高于非运动员。另以皮尔逊积差相关以及偏相关探讨与胰岛素相关的因子,发现无论有没有经过性别与年龄的校正,运动员或非运动员的肥胖指标(体重,身体质量指数与脂肪率)都与胰岛素敏感度指标(胰岛素,HOMA)呈显著正相关,说明大学生运动员具有较低的胰岛素敏感度,并且胰岛素敏感度随着肥胖指标的升高而下降。本研究结果为揭示运动员体型与胰岛素敏感度的相关性提供了一定的帮助。     

绿地与居民超重肥胖之间关系的Meta分析

已有研究表明,绿地与周边人群超重和肥胖风险存在潜在关联,然而其具体效应有待测定。采用Meta分析(meta-analysis)方法对69篇绿地与居民超重肥胖关系的研究结果进行统计分析,并探究了不同研究设计、绿地指标、样本年龄和不同尺度地理分析单元等亚组的研究结果差异,发现：(1)总体上,绿地与居民超重或肥胖风险、身体质量指数(body mass index, BMI)和腰围呈负相关关系,但不同研究设计类型(横截面研究和队列研究)之间的研究结果具有较大差异。(2)对于不同的绿地指标,其与居民超重肥胖的关系也存在一定差异。(3)相较于儿童和青少年,绿地与成年人超重肥胖的关联性更显著。(4)两者之间的关系具有明显的尺度效应。Meta分析结果显示,绿地与居民超重肥胖关系在各亚组中存在混杂,意味着它们的关系可能更加复杂,这对未来研究起到一定启示作用：应增加纵向研究以更深入探讨两者之间的因果关系和作用机理;构建完善的绿地测度指标体系,考虑多尺度地理分析单元的影响差异;同时,不应忽视来自样本多方面混杂因素的影响,从而使未来相关领域研究得出更明晰的结论,为城市绿地系统规划及相关政策制定提供科学依据。     

维吾尔族大学生身体成分与身体形态指标的关系

目的 了解维吾尔族大学生体成分及身体形态指标的关系,为维吾尔族大学生肥胖干预以及学生营养教育、科学参与体育锻炼提供理论依据.方法 随机抽取新疆师范大学14个班的在校维吾尔族大学生659名,采用人体成分分析仪及《国家学生体质健康标准》规定的项目和测试要求进行测试,比较不同体成分大学生间身体形态指标.结果 维吾尔族男女大学生肥胖组BMI指数均高于正常组,超重组的腰臀比均高于正常组,差异均有统计学意义(P值均＜0.01);正常、超重、肥胖3组的上臂皮褶厚度差异无统计学意义(P＞0.05).结论 维吾尔族大学生的脂肪主要堆积于腹部.应在控制高热量饮食的基础上进行科学的体育锻炼,加强营养知识的宣传和普及,倡导平衡膳食合理营养.     

中国九省（区）农民超重肥胖的变化趋势及人口经济因素的影响

目的：分析1991—2015年我国18~64岁成年农民超重肥胖的变化趋势,并探讨人口经济因素对其的影响。方法：利用“中国健康与营养调查”1991—2015年间9轮队列研究的基本信息、社会经济因素和体格测量数据,选择18~64岁职业为“农民、渔民或猎人（以下简称农民）”的成年人作为研究对象。采用《中国成人超重和肥胖症预防控制指南》中的体质指数（BMI）切点值判定肥胖程度。应用多因素Logistic模型分析人口经济因素对肥胖发生危险性的影响。结果：1991—2015年间,我国农民超重和肥胖率均呈逐渐上升趋势,超重率从11.42%上升至35.80%,肥胖率从1.37%上升至13.92%。多因素Logistics分析结果显示,女性超重肥胖危险性高于男性。随着年龄的增加,农民超重肥胖危险性明显增加,35~49岁、50~64岁年龄组肥胖危险性高于18~34岁年龄组。北方及中部地区农民超重肥胖危险性高于南方地区。高收入水平的农民超重肥胖危险性高于低收入水平的农民。高中及以上文化程度的农民超重肥胖危险性高于小学及以下组。结论：性别、年龄、收入水平、地理位置是农民超重肥胖的重要影响因素。建议根据分布特征,将优质资源集中到中部、北方地区,并加强对中老年人进行营养知识和健康生活方式的宣教。同时也要关注高收入地区及男性农民的超重肥胖问题。     

Genetics of obesity in adult adoptees and their biological siblings.

An adoption study of genetic effects on obesity in adulthood was carried out in which adoptees separated from their natural parents very early in life were compared with their biological full and half siblings reared by their natural parents. The adoptees represented four groups who by sampling from a larger population were categorised as either thin, medium weight, overweight, or obese. Weight and height were obtained for 115 full siblings of 57 adoptees and for 850 half siblings of 341 adoptees. In full siblings body mass index (kg/m2) significantly increased with weight of the adoptees. Body mass index of the half siblings showed a steady but weaker increase across the four weight groups of adoptees. There were no significant interactions with sex of the adoptees, sex of the siblings, or (for the half siblings) sex of the common parent. In contrast with the findings in half siblings and (previously) the natural parents there was a striking, significant increase in body mass index between full siblings of overweight and obese adoptees. The degree of fatness in adults living in the same environment appears to be influenced by genetic factors independent of sex, which may include polygenic as well as major gene effects on obesity.     

Human Body Composition and the Epidemiology of Chronic Disease

Obesity and body fat distribution (FD) are established risk factors for chronic diseases. The body mass index (BMI) and the waist/hip circumference ratio (WHR) are used conventionally as indices of obesity and FD in epidemiological studies. Although some general limitations of these indices are recognized, others that affect their use in relative risks for disease are not well recognized. These include effects of sex, ethnicity, and especially age on the relationships between these indices and body composition, which can result in substantial misclassification of obesity and FD. There is considerable variability in body composition for any BMI, and some individuals with low BMIs have as much fat as those with high BMIs. This results in poor sensitivity for classifying levels of body fatness (e.g., too many “false negatives,” or overweight individuals classified as not overweight), and relative risks are attenuated across all categories of BMI. A more serious problem, however, is that at different ages the same levels of BMI correspond to different amounts of fat and fat-free mass. Data from the Rosetta Study and the New Mexico Aging Process Study show that older adults have, on average, more fat than younger adults at any BMI, due to the loss of muscle mass with age. As a result, the sensitivity of BMI cutpoints with respect to body fatness decreases with age, and the use of a fixed cutpoint for all ages results in “differential mis-classification bias.” Taken together, these issues sug- gest that the increases with age in the prevalences of overweight and obesity, and in the risks for chronic diseases, may be mis-estimated using BMI. Similar issues may affect the use of WHR for estimating prevalences and associated risks of FD. New field methods for estimating body composition are available that can be applied in large, epidemiologic follow-up studies of chronic diseases. These methods will allow epidemiologists to consider, for example, whether it is increased fat, or the replacement of fat-free mass with fat, with age that is associated with risk for chronic disease.     

Education,Health Behaviors,and the Black-White Difference in Waist-to-Hip Ratio

Few epidemiologic studies have investigated the impact of body mass index, low educational attainment, cigarette smoking, and physical activity on the considerable black-white difference in waist-to-hip ratio. These relationships were assessed with multi-variable linear regression among 3,094 adults (24% black) who were examined in 1987 in South Carolina. The unadjusted mean waist-to-hip ratio was lower for black men than for white men (-0.03 units) and higher for black women than for white women (+0.03 units). After adjustment for age, body mass index, education, smoking, and physical activity, the black-white difference in mean waist-to-hip ratio was ?0.02 units (p<0.001) among men and +0.01 units (p<0.01) among women. Although differing distributions of age, body mass index, and educational attainment accounted for a 59% reduction in the black-white difference among women, these factors did not explain the difference among men. Thus, these results suggest that other environmental or biologic factors may also play an important role in the marked variation in body fat distribution between the two ethnic groups. The results also support the importance of the prevention of cigarette smoking and overweight in potentially preventing abdominal obesity in both black adults and white adults.     

Implications of childhood obesity for adult health: findings from thousand families cohort study

ObjectiveTo determine whether being overweight in childhood increases adult obesity and risk of disease.DesignProspective cohort study.SettingCity of Newcastle upon Tyne.Participants932 members of thousand families 1947 birth cohort, of whom 412 attended for clinical examination age 50.ResultsBody mass index at age 9 years was significantly correlated with body mass index age 50 (r=0.24, P<0.001) but not with percentage body fat age 50 (r=0.10, P=0.07). After adult body mass index had been adjusted for, body mass index at age 9 showed a significant inverse association with measures of lipid and glucose metabolism in both sexes and with blood pressure in women. However, after adjustment for adult percentage fat instead of body mass index, only the inverse associations with triglycerides (regression coefficient= −0.21, P<0.01) and total cholesterol (−0.17, P<0.05) in women remained significant.ConclusionsLittle tracking from childhood overweight to adulthood obesity was found when using a measure of fatness that was independent of build. Only children who were obese at 13 showed an increased risk of obesity as adults. No excess adult health risk from childhood or teenage overweight was found. Being thin in childhood offered no protection against adult fatness, and the thinnest children tended to have the highest adult risk at every level of adult obesity.

What is already known on this topic

Many studies have found that body mass index in childhood is significantly correlated with body mass index in adulthoodObese children have been found to have higher all cause mortality as adults

What this study adds

No excess health risk from childhood overweight was foundChildhood body mass index was linked to adulthood body mass index but not percentage body fatOnly children who were obese at 13 showed a significant increased risk of obesity as adultsPeople who were thinnest as children and fattest as adults tended to have the highest adult risk     

Impaired endothelium-dependent vasodilation in overweight and obese adult humans is not limited to muscarinic receptor agonists

Muscarinic receptor agonists have primarily been used to characterize endothelium-dependent vasodilator dysfunction with overweight/obesity. Reliance on a single class of agonist, however, yields limited, and potentially misleading, information regarding endothelial vasodilator capacity. The aims of this study were to determine 1) whether the overweight/obesity-related reduction in endothelium-dependent vasodilation extends beyond muscarinic receptor agonists and 2) whether the contribution of nitric oxide (NO) to endothelium-dependent vasodilation is reduced in overweight/obese adults. Eighty-six middle-aged and older adults were studied: 42 normal-weight (54 +/- 1 yr, 21 men and 21 women, body mass index = 23.4 +/- 0.3 kg/m(2)) and 44 overweight/obese (54 +/- 1 yr, 28 men and 16 women, body mass index = 30.3 +/- 0.6 kg/m(2)) subjects. Forearm blood flow (FBF) responses to intra-arterial infusions of acetylcholine in the absence and presence of the endothelial NO synthase inhibitor N(G)-monomethyl-l-arginine, methacholine, bradykinin, substance P, isoproterenol, and sodium nitroprusside were measured by strain-gauge plethysmography. FBF responses to each endothelial agonist were significantly blunted in the overweight/obese adults. Total FBF (area under the curve) to acetylcholine (50 +/- 5 vs. 79 +/- 4 ml/100 ml tissue), methacholine (55 +/- 4 vs. 86 +/- 5 ml/100 ml tissue), bradykinin (62 +/- 5 vs. 85 +/- 4 ml/100 ml tissue), substance P (37 +/- 4 vs. 57 +/- 5 ml/100 ml tissue), and isoproterenol (62 +/- 4 vs. 82 +/- 6 ml/100 ml tissue) were 30%-40% lower in the overweight/obese than normal-weight adults. N(G)-monomethyl-l-arginine significantly reduced the FBF response to acetylcholine to the same extent in both groups. There were no differences between the groups in the FBF responses to sodium nitroprusside. These results indicate that agonist-stimulated endothelium-dependent vasodilation is universally impaired with overweight/obesity. Moreover, this impairment appears to be independent of NO.     

To be an immigrant: a risk factor for developing overweight and obesity during childhood and adolescence?

Childhood overweight and obesity, especially among migrant children, are current health problems in several European countries. In the present study the prevalence of overweight and obesity among migrant children from Turkey and the former Yugoslavia was documented and compared with that of Austrian children in Vienna. Anthropometric data from 1,786 children were collected at the ages of 6, 10 and 15 years. Body mass was estimated by means of the body mass index and percentile curves were used to determine weight status. The prevalence of overweight and obesity was found to be significantly higher among migrant children. Children and adolescents from the former Yugoslavia and Turkish girls exhibited especially high rates of overweight and obesity. Biosocial and cultural factors are discussed as causes of these observations.     

Growth and Body Mass Index of Brazilians Ages 9 Through 17 Years

Obesity during adolescence is considered a strong predictor of adult obesity, and obesity and overweight have been increasing among Brazilian adults. To gauge the relative frequency of overweight among adolescents in Brazil, we compared the distributions of body mass index (kg/m²) and stature in national population based samples of the U.S. and Brazil. U.S. adolescents were on average about 10 cm taller than Brazilians, although growth spurts occurred at the same age for both populations. Brazilian adolescents were leaner than their U.S. counterparts. This difference was reduced among girls in the postpubertal period. At age 17 years, U.S. boys were about 10 kg heavier than Brazilian boys, but the difference among girls was only 2 kg. In families above the poverty level in the more developed South region, body mass index distribution for boys was closer to that of the U.S., and older girls tended to have higher body mass index than U.S. girls. Within Brazil, body mass index varied by ethnicity with Mulattos, but not Blacks, of both sexes having lower body mass index than Whites of the same age. Urban adolescents had higher body mass index than those living in rural areas. In general, the patterns seen among Brazilian adults were found among children. Among girls, in particular, overweight has become an identifiable problem during adolescence.     

Overweight and obesity in Slovenian schoolgirls, 1991-2006

The proportion of overweight children and adults has been growing rapidly in the last few years in many European and other countries. Certain consequences of overweight are already manifested in youth; in adulthood they are one of the main causes of death and several diseases. The study examined the proportion of overweight and obese Slovenian girls aged 7 to 18 with the use of an annually repeated cross-sectional study. The study lasted from 1991 to 2006 and was based on the body mass index according to IOTF norms. The results show that in this period the proportion of overweight girls increased by almost 30% (from 13.5% to 18.8%), whereas the proportion of obese girls doubled (from 2.3% to 4.6%). The prevalence of overweight and obesity is highest in childhood and early adolescence where it is around two to three times higher than at the age of 18.     

Aging, Obesity, and Mortality: Misplaced Concern About Obese Older People?

Although there is widespread agreement that obesity (body mass index [BMI] ≥ 30 kg/m(2)) raises health risks, debate has ensued on whether obese older adults are also at greater risk. This study examines the effect of obesity on mortality for younger and older adults to determine whether the risk of obesity is lessened in later life. Data from a 20-year follow-up of a national sample of adults were used to examine the risk of obesity on mortality (N = 6,767). Cox models reveal that obesity raises mortality risk for adults of all ages, but this relationship is nearly twice as strong for persons younger than 50 years of age. Being slightly overweight in later life is associated with lower mortality risk, but obesity raises mortality risk, especially for ischemic heart disease. Obesity in middle age is a grave public health concern, but obesity in later life also merits attention.     

Obesity, weight status and employability: Empirical evidence from a French national survey

We investigate the relationship between employability and obesity, particularly how obesity and overweight are associated with the percentage of working years spent unemployed and the ability to regain employment. Data for adults who responded to the 2003 Decennial Health Survey collected by the French National Institute of Statistics and Economic Studies revealed that the percentage of time spent unemployed during working years is significantly higher for each kg/m2 deviation from the mean body mass index (BMI) attained at age 20 and that the probability of regaining employment after a period of unemployment is much lower.