Obesity reduction within a generation: the dual roles of prevention and treatment.

Obesity reduction within a generation: the dual roles of prevention and treatment.
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DOI:
10.1038/oby.2011.199
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发表时间:
2011-10
期刊:
影响因子:
6.9
通讯作者:
Lee, Hedwig
Lee, Hedwig
中科院分区:
医学2区
文献类型:
--
作者:
Lee, Joyce M.;Lee, Hedwig

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2010年,白宫儿童肥胖工作组制定了减少儿童肥胖的基准目标。我们评估了在 2015 年、2020 年和 2030 年基准年实现工作组目标所需的预防和治疗平衡。我们创建了 2008-2030 年出生的美国出生队列(2-19 岁)的模拟。对于每一年,我们假设“旧”出生队列(之前基准肥胖估计的一部分)将受益于肥胖治疗策略,而“新”出生队列将受益于肥胖预防策略。我们评估了肥胖患病率,必须在不同的治疗效果假设下通过预防策略来实现。当我们假设通过治疗将患病率绝对降低1%时,我们发现预防策略需要在2015年之前实现肥胖患病率12%,在2020年之前达到8%,在2030年之前达到0.3%。由于少数民族儿童的肥胖患病率较高,预防策略需要在2030年之前实现肥胖率负增长,这是难以置信的。在对治疗效果更慷慨的假设下,估计值变得积极,但仍然很低。每个基准年工作组的目标都更难实现。政策必须侧重于肥胖治疗干预措施,特别是针对少数种族/族裔儿童的干预措施,以在遏制这一流行病方面取得进展。
In 2010, the White House Task Force on Childhood Obesity provided benchmark goals for reducing childhood obesity. We evaluated the balance of prevention and treatment required for achieving Task Force goals in benchmark years 2015, 2020, and 2030. We created a simulation of US birth cohorts (2–19 years) born 2008–2030. For each year, we assumed “old” birth cohorts (part of previous benchmark obesity estimates) would benefit from obesity treatment strategies, and “new” birth cohorts would benefit from obesity prevention strategies. We assessed obesity prevalence that must be achieved through prevention strategies, under varying assumptions of treatment effectiveness. When we assumed a 1% absolute reduction in prevalence through treatment, we found that prevention strategies would need to achieve an obesity prevalence of 12% by 2015, 8% by 2020, and 0.3% by 2030. Because of higher obesity prevalence among minority children, prevention strategies would need to achieve a negative prevalence by 2030, which is implausible. Under more generous assumptions of treatment effectiveness, estimates became positive but remained low. Task Force goals are more difficult to achieve with each benchmark year. Policies must focus on obesity treatment interventions, particularly targeted to racial/ethnic minority children, to make progress in stemming the epidemic.
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