Obesity in South Africa: challenges for government and health professionals
Obesity in South Africa: challenges for government and health professionals
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DOI：
10.1079/phn2005785
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发表时间：
2005-08-01
影响因子：
3.2
通讯作者：
van der Merwe, MT
中科院分区：
文献类型：
--
作者：
Kruger, HS;Puoane, T;van der Merwe, MT
目的：审查关于南非肥胖症的流行、原因和健康后果的数据，并提出预防和治疗肥胖症及其相关后果的干预措施。方法：对现有文献中的数据进行了回顾，重点是饮食和活动模式的变化、文化因素、观念和信仰、城市化和全球化。还审查了关于南非人肥胖对健康的影响的研究结果。结果：饮食摄入和活动模式向高脂肪摄入和低体力活动的转变导致了肥胖的高患病率。很少有超重的黑人女性认为自己超重，有些人还把瘦和艾滋病联系在一起。与胰岛素抵抗相关的葡萄糖和脂质毒性在肥胖合并症的发病机制中发挥作用。黑人人群中游离脂肪酸升高使肥胖黑人患者易患2型糖尿病。结论和建议：肥胖预防和治疗应基于教育、行为改变、政治支持、部门间合作和社区参与、地方行动、广泛包容人口、资源充足的规划、现有举措的渗透、循证规划以及适当的监测和评估。干预措施应包括以下内容：合理的体重目标、健康饮食、身体活动和行为改变。应优先考虑影响肥胖合并症发展易感性的基因和突变以及肥胖发展的生命脆弱期。应在社区服务中管理预防工作，在初级保健服务中确定高危患者，在医院服务中治疗合并症。
Objectives: To review data on the prevalence, causes and health consequences of obesity in South Africa and propose interventions to prevent and treat obesity and related outcomes.Methods: Data from existing literature were reviewed with an emphasis on changing eating and activity patterns, cultural factors, perceptions and beliefs, urbanisation and globalisation. Results of studies on the health consequences of obesity in South Africans are also reviewed.Results: Shifts in dietary intakes and activity patterns to higher fat intakes and lower physical activity are contributing to a higher prevalence of obesity. Few overweight black women view themselves as overweight, and some associate thinness with HIV/AIDS. Glucose and lipid toxicity, associated with insulin resistance, play roles in the pathogenesis of the co-morbid diseases of obesity. Elevated free fatty acids in the black population predispose obese black patients to type 2 diabetes.Conclusion and recommendations: Obesity prevention and treatment should be based on education, behaviour change, political support, intersectoral collaboration and community participation, local actions, wide inclusion of the population, adequately resourced programmes, infiltration of existing initiatives, evidence-based planning, and proper monitoring and evaluation. Interventions should have the following components: reasonable weight goals, healthful eating, physical activity and behavioural change. Genes and mutations affecting susceptibility to the development of co-morbidities of obesity and vulnerable periods of life for the development of obesity should be prioritised. Prevention should be managed in community services, identification of high-risk patients in primary healthcare services and treatment of co-morbid diseases in hospital services.