营养失调与治疗杂志

抽象的

儿童营养 2019：古吉拉特邦艾哈迈达巴德市学童肥胖和超重的患病率及决定因素：一项横断面研究 - Nilesh Thakor - 古吉拉特邦大学

尼莱什·塔科尔

儿童肥胖本身就是成人肥胖的一个因素，其发病率和死亡率可能高于成人。由于成人肥胖的治疗困难以及儿童肥胖的诸多长期不良影响，预防儿童肥胖现已成为公共卫生的优先事项。

了解艾哈迈达巴德市学童肥胖的发生情况及其原因。

方法论：

2009 年 7 月至 2011 年 4 月，Dharmapuri-Patan 的 GMERS 医学院儿科和社区医学系在古吉拉特邦艾哈迈达巴德市随机选取 10 所学校开展横断面教育。在获得父母的书面知情同意后，使用预先设计、预先测试、半结构化的 Performa 对年龄在 10 至 15 岁之间的 2562 名儿童进行了观察。进行了体格测量并计算了 BMI。根据 IOTF（国际肥胖工作组）标准确定了超重和肥胖的患病率。通过采访儿童，考虑了肥胖和超重的许多决定因素。使用 SPSS 17（试用版）分析了收集的数据。

2562 名儿童中，男性占 54.09%，女性占 45.9%。肥胖和超重的患病率分别为 5.62% 和 9.99%。女性人口的总体肥胖患病率（6.8%）高于男性（4.62%）。15 岁年龄组的肥胖发病率最高（8.22%）。活动较少组的肥胖和​​超重患病率明显高于活动较多组（分别为 9.3% 和 13.95%）。每天在电视或电脑前花费 > 2 小时的儿童组的肥胖和​​超重患病率明显较高。每日摄入热量超过 RDA 的儿童组的肥胖和​​超重患病率明显高于另一组（分别为 18.57% 和 15.19%）。每周摄入垃圾食品少于或等于2次的儿童肥胖和超重患病率（分别为8.91%和13.36%）明显高于每周摄入垃圾食品少于或等于2次的儿童（分别为1.71%和5.98%），父母有肥胖史的儿童肥胖和超重患病率分别为46.15%和17.94%，明显高于无肥胖史的儿童（分别为4.34%和9.74%）。

This is particularly true in low and middle-income countries that form the major chunk of the global population. The emerging epidemics of obesity, cardiovascular disease, and diabetes form the crux of this phenomenal change. Among these units, obesity has become a colossal epidemic causing serious public health anxiety and contributes to 2.6 million deaths worldwide every year. The prevalence of obesity has improved worldwide in almost all country in all the age groups. The steep rise has prompted this development to be termed an epidemic and because it is worldwide a pandemic.

It has been estimated that worldwide over 22 million children below the age of 5 are obese, and one in 10 children is overweight. Globally the prevalence of childhood obesity varies from over 30% in the USA to less than 2% in Sub-Saharan Africa. Now, the occurrence of obese school children is 20% in the UK and Australia, 15.8% in Saudi Arabia, 15.6% in Thailand, 10% in Japan, and 7.8% in Iran. In China, the prevalence of obesity among children aged 7-9 years increased from 1-2% in 1985 to 17% among girls and 25% among boys in 2000.

Indian data about current trends in childhood obesity are developing. Available studies of Delhi and Chennai have shown a prevalence of 7.4% and 6.2% respectively. An education conducted among adolescent school children in South Karnataka has presented the prevalence of overweight and obesity to be 9.9% and 4.8% respectively. The present study was a cross-sectional study undertaken in 10 schools, which were selected randomly from a list of all schools in Ahmedabad city from September 2015 to December 2015 by the Department of Paediatrics and Community Medicine of GMERS Medical College, Dharmapuri-Patan, Gujarat, India. All children between the age group of 10 -15 were included after written informed consent of their parents. The sample size was calculated based on an estimated prevalence of obesity of 8% by a pilot study, with 80% power, 95% confidence, and 5% level of significance with an allowable error of 20% to obtain age and gender-specific representative sample of children. 2400 school going children of age group 10- 15 years were the calculated sample size of the study but since all the children, studying in class 5th to 10th, of the selected schools, belonging to the 10 -15-year age group were included in the study population, the final sample size was 2562 children.

Overall, the total number of obese children identified in the whole study population was 144 (5.62%) and the numbers of overweight children were 256 (9.99%). The overall prevalence of obesity was more among the female population (6.8%) as compared to that in males (4.62%). Though the prevalence of overweight was more among males (10.25%). Different categories of BMI and gender of the children were not significantly associated.

每周总体育运动时间≤2小时的儿童仅有430人，活动量较少组的肥胖和​​超重患病率（分别为9.3%和13.95%）显著高于活动量较多组的儿童。因任何目的在电视或电脑前花费超过2小时的儿童有556人（21.7%），在电视或电脑前花费时间较长的儿童肥胖和超重患病率（分别为14.38%和14.75%）显著高于每天在电视或电脑前花费时间≤2小时的儿童。每日热量摄入>RDA（推荐膳食供给量）的儿童有474人（22.7%），每日热量摄入高于RDA的儿童肥胖和超重患病率（分别为18.57%和15.19%）显著高于每周吃垃圾食品超过两次的儿童有1392人（54.33％）。

结论：

 学龄儿童肥胖和超重发生率较高，迫切需要通过教育和激励所有利益相关者来提高认识。

注：本研究部分成果于 2019 年 5 月 13 日至 14 日在法国巴黎举行的世界儿科营养与儿童健康大会上发表