生命早期营养关注和防控儿童肥胖的研究进展

Research progress of nutrition concern in early life and prevention and control of childhood obesity

儿童肥胖与成年慢性病密切相关。3岁前是人体脂肪聚集的第一关键期,儿童生长发育快速增长期是0~1岁。从怀孕至出生后1 000 d的营养关注和干预可获得最高效益,以关键期和快速增长期为切入点对控制儿童超重、肥胖发生与发展具有重要意义。本文阐述了营养膳食与生命早期发育的表观遗传学作用,生命早期营养关注的几个重要阶段及其导致儿童肥胖的暴露因素。应将防控对策聚焦于母儿生长模式和膳食结构,细化生命早期孕妇婴幼儿生长发育模式,使母儿体重适宜性生长。准确的体重增长监测与科学的膳食营养指导,是实现儿童肥胖零级预防的重要环节。预防儿童肥胖强调社会、环境、母亲、医生均是母儿体重增长决定因素,并要求人们适应需求、创新服务模式、优化体重营养管理内涵,落实高危母儿无缝衔接和全局追访,探索多方面生命早期进程的社区-家庭-母儿综合干预的有效工作模式。

Obesity in children is closely related to chronic diseases in adults. The first critical period of fat accumulation is before 3 years old,and the rapid growth period of children’s growth and development is 0-1 year old. Nutrition care and intervention from pregnancy to 1 000 days after birth can obtain the highest benefit. Taking the critical period and rapid growth period as the starting point is of great significance to control the occurrence and development of overweight and obesity in children. This paper expounds the epigenetic function of nutritional diet and early life development,several important stages of nutrition concern in early life and the exposed factors of obesity in children. The prevention and control measures should focus on the growth mode and dietary structure of mothers and infants,refine the growth and development mode of pregnant women and infants in early life,and make the weight of mothers and infants grow appropriately. Accurate weight gain monitoring and scientific dietary nutrition guidance are important elements to realize zero level prevention of childhood obesity. The prevention of childhood obesity emphasizes that society,environment,mothers and doctors are the determinants of mother and child weight growth,and requires personnel in the community to adapt to the needs,innovate service mode,optimize the connotation of weight nutrition management,implement seamless connection and overall follow-up of high-risk mothers and children,and explore the effective working mode of community-family-mother and child comprehensive intervention in the early process of life.