婴幼儿肥胖社区管理初探

Community-based intervention for obesity in infants and preschool children

目的:通过对肥胖婴幼儿的社区管理,探讨能够在基层使用的、实用性及可行性较强的婴幼儿肥胖的干预方法。方法:2003年1月1日～2007年12月31日对辖区内0～3岁的婴幼儿7 539人进行健康体检,共筛出超重及肥胖儿童359人,其中187名儿童经家长知情同意后作为干预组接受肥胖儿管理(干预组),逐月随访,为期半年;另172名肥胖儿童仅接受常规保健,作为对照组。干预方法采用健康教育和一对一管理相结合的方式,通过帮助家长树立正确的喂养观念,建立良好的家庭食物环境(The family food environment,FFE),培养正确的喂养行为,避免过度喂养和过度进食。结果:通过社区管理,辖区内超重及肥胖儿童发病率呈下降趋势,2007年超重及肥胖儿童发病率(1.6%,0.8%)均较2003年(5.3%,2.9%)明显下降(P<0.001);经过改变肥胖儿童的家庭食物环境,干预组儿童体重转为正常或肥胖度减轻者(77.5%)明显多于对照组(45.3%,P<0.001),且1岁以内出现肥胖的儿童干预效果较1岁以后为好(P<0.01)。结论:以建立良好的家庭食物环境为主的婴幼儿肥胖社区干预方法简单、实用,值得在基层推广。

Objective：To explore the pragmatic and suitable methods of community-based intervention for obesity in infants and preschool children,and to evaluate the effects of them. Methods：7 539 infants and preschool children aged 0～3 years were examined from Jan 1,2003 to Dec 31,2007,and 359 of them were diagnosed as overweight or obesity,within which 187 were divided into intervention group with their parents′permission,and a monthly follow-up visit were made within half a year,172 were divided into control group.The intervention method adopted characterized in the combination of health education and individual administration through creating correct feeding concept,establishing favorable family food environment,cultivating perfect feeding behavior and avoiding excess feeding and eating. Results：The occurrence rate of obesity decreased through Community-based intervention.The occurrence rate of obesity in 2007（1.6%,0.8%） decreased significantly compared to that of 2003（5.3%,2.9%）（P〈0.001）.Children that recovered from the intervention group（77.5%） outnumbered that of from the control group（45.3%）（P〈0.01）,especially for those under 1 year old. Conclusion：Community-based intervention method based on favorable family food environment is both simple and useful,and is well worth for generalization.