健康教育对肥胖儿童认知、饮食结构及生活方式的影响

中国儿童保健杂志 ›› 2012, Vol. 20 ›› Issue (11): 966-970.

健康教育对肥胖儿童认知、饮食结构及生活方式的影响

王斐¹,陈梦莹¹,陈海燕¹,史晓燕²,李荣¹,李小妹¹,陈银花¹,李晓南^1,2

南京医科大学 1 附属南京儿童医院,2 儿科医学研究所,江苏南京 210008

收稿日期:2012-05-08 发布日期:2012-11-06 出版日期:2012-11-06
通讯作者: 李晓南,E-mail:xiaonan6189@yahoo.com
作者简介:王斐(1984- ),女,江苏人,硕士研究生,主要研究方向为儿童营养
基金资助:
国家自然科学基金(81273064);南京医学科技发展基金(YKK10051);江苏省营养学会(JYX201201)

Effects of health education on cognition,diet and lifestyle in obese children

WANG Fei¹,CHEN Meng-ying¹,CHEN Hai-yan¹,SHI Xiao-yan²,LI Rong¹,LI Xiao-mei¹,CHEN Yin-hua¹,LI Xiao-nan^1,2

Department of Children Health Care,Nanjing Children's Hospital;
2 Medical Institute of Pediatrics,Nanjing Medical University,Nanjing,Jiangsu 210008,China

Received:2012-05-08 Online:2012-11-06 Published:2012-11-06

摘要/Abstract

摘要： 【目的】探索单次和多次健康教育对肥胖儿童认知,饮食结构、生活方式及体重控制的影响,为儿童肥胖干预的实施提供有效措施。【方法】按照《中国0~18岁儿童青少年体块指数的生长曲线》超重和肥胖诊断标准筛查学龄儿童,对肥胖儿童发放调查问卷,评估肥胖认知、饮食结构及生活方式并分组给予单次或多次健康教育。健康教育的内容包括肥胖的判断和危害,科学的饮食结构、生活方式和心理支持等。6个月后再次进行评估。【结果】共有107名年龄6~13岁的肥胖儿童(男69人,女38人)纳入研究。资料完整90名,其中单次教育组44人,多次教育组46人。1)健康教育后两组儿童和家长对肥胖的认知水平均提高,但多次教育组儿童和家长认知水平显著高于单次教育组(P<0.01);2)干预后,多次教育组总能量及蛋白质、脂肪、碳水化合物摄入量及能量密度均降低(P<0.01),蔬菜份量增加(P<0.05),动物性食物及甜点、薯片的进食份额明显减少(P<0.01);单次教育组脂肪摄入减少(P<0.01),但总能量、食物份额量无明显改变;3)多次教育组在洋快餐、零食、看电视吃零食频率及看电视时间明显减少(P<0.01),但每日运动时间无明显变化;单次教育组生活方式无显著改变(P>0.05);4)干预后单次教育组BMI-SDS(body mass index-standard deviation score )无明显改变,多次教育组BMI-SDS降低(P<0.05)。【结论】对肥胖儿童和家长进行健康教育,尤其是多次教育有助于提高肥胖儿童和家长认知能力,降低儿童总能量摄入,改变饮食结构和生活方式,进而降低BMI。

关键词: 肥胖, 健康教育, 认知, 饮食, 生活方式, 儿童

Abstract: 【Objective】 To explore the impacts of single and repetitive health education on the cognition,diet,lifestyle and weight control in obese children,and provide effective measures to childhood obesity intervention. 【Methods】 According to "Body mass index growth curves for Chinese children adolescents aged 0 to 18 years "diagnostic criteria for screening obesity in school-age children.Obese children and their parents were distributed questionnaires to assess cognition of obesity,diet and lifestyle and then were assigned single or repetitive education.Six months later,the obese children and their parents were asked to complete the questionnaires again for evaluating health education effects on cognition,diet and lifestyle and weight control. 【Results】 107 obese children ( 6 to 13-year-old,69 boys,38 girls) were involved into the intervention study and 90 obese children were completed.There were 44 obese children in single education group and 46 obese children in repetitive education group.At 6 months' follow-up,1) Cognition:Both of children and parents in two groups on the cognitive had increased,particular in children (P=0.008) and parents (P=0.003) of repetitive education group.2) Dietary survey:total energy,protein,fat,carbohydrate intake,food energy density of the lunch and dinner,single meal size (lunch size and dinner size) were significantly decreased in repetitive education group (P<0.001),while the meal size was not any change in single education group (P>0.05).3) Lifestyles:had significantly decreased in high fat food,snacks,watching TV,snacking,watch TV time(P<0.001)in repetitive education group but not in single education group (P>0.05).4) Body Mass Index (BMI):During the follow-up,the mean BMI-Standard Deviation Score (BMI-SDS) was decreased in repetitive education group(P<0.01)but not in single education group(P>0.05). 【Conclusion】 Health education,especially repetitive education could change obese children on cognitive ability,total energy intake and lifestyle,thereby reducing BMI.

Key words: obesity, health education, cognition, diet and lifestyle,children

中图分类号:

R179

王斐,陈梦莹,陈海燕,史晓燕,李荣,李小妹,陈银花,李晓南. 健康教育对肥胖儿童认知、饮食结构及生活方式的影响[J]. 中国儿童保健杂志, 2012, 20(11): 966-970.

WANG Fei,CHEN Meng-ying,CHEN Hai-yan,SHI Xiao-yan,LI Rong,LI Xiao-mei,CHEN Yin-hua,LI Xiao-nan. Effects of health education on cognition,diet and lifestyle in obese children[J]. journal1, 2012, 20(11): 966-970.

参考文献

[1] Collins CE,Warren J,Neve M,et al.Measuring effectiveness of dietetic interventions in child obesity:a systematic review of randomized trials[J].Arch Pediatr Adolesc Med,2006,160(9):906-922.
[2] Rachel AJ,Anthony DO,Clare EC,et al.The HIKCUPS trial:a multi-site randomized controlled trial of a combined physical activity skill-development and dietary modification program in overweight and obese children[J].BMC Public Health,2007,7:15-22.
[3] Summerbell CD,Waters E,Edmunds LD,et al.Interventions for preventing obesity in children[J].Cochrane Database Syst Rev,2005,3:CD001871.
[4] 李辉,季成叶,宗心南,等.中国0~18岁儿童、青少年体块指数的生长曲线[J].中华儿科杂志,2009,47(7):493-498.
[5] Melin I,Reynisdottir S,Berglund L,et al.Conservative treatment of obesity in an academic obesity unit.Long-term outcome and drop-out[J].Eat Weight Disord,2006,11:22-30.
[6] Perri MG,Martin AD,Leermakers EA,et al.Effects of group-versus home-based exercise in the treatment of obesity[J].J Consult Clin Psychol,1997,65:278-285.
[7] Lillegaard IT,Overby NC,Andersen LF.Can children and adolescents use photographs of food to estimate portion sizes? [J].Eur J Clin Nutr,2005,59(4):611-617.
[8] 史晓燕,陈梦莹,王斐,等.单餐大份量进食是儿童单纯性肥胖的饮食危险因素[J].营养学报,2011,33(2):138-142.
[9] Baughcum AE,Chamberlin LA,Deeks CM,et al.Maternal perceptions of overweight preschool children[J].Pediatrics,2000,106(6):1380-1386.
[10] Adams AK,Quinn RA,Prince RJ.Low recognition of childhood overweight and disease risk among Native-American caregivers[J].Obes Res,2005,13(1):146-152.
[11] Lopez-Dicastillo O,Grande G,Callery P.Parents' contrasting views on diet versus activity of children:implications for health promotion and obesity prevention[J].Patient Educ Couns,2010,78(1):117-123.
[12] Katula JA,Vitolins MZ,Rosenberger EL,et al.Healthy living partnerships to prevent diabetes (HELP PD):design and methods[J].Contemp Clin Trials,2010,1(1):71-81.
[13] Savage JS,Fisher JO,Birch LL.Parental influence on eating behavior:conception to adolescence[J].J Law Med Ethics,2007,35(1):22-34.
[14] Ornelas IJ,Perreira KM,Ayala GX.Parental influences on adolescent physical activity:a longitudinal study[J].Int J Behav Nutr Phys Act,2007,4:3-12.
[15] Kamath CC,Vickers KS,Ehrlich A,et al.Clinical review:behavioral interventions to prevent childhood obesity:a systematic review and metaanalyses of randomized trials[J].J Clin Endocrinol Metab,2008,93(12):4606-4615.
[16] Munsch S,Roth B,Michael T,et al.Randomized controlled comparison of two cognitive behavioral therapies for obese children:Mother versus mother-child cognitive behavioral therapy[J].Psychotherapy and Psychosomatics,2008,77(4):235-246.
[17] Melin I,Reynisdottir S,Berglund L,et al.Conservative treatment of obesity in an academic obesity unit.Long-term outcome and drop-out[J].Eat Weight Disord,2006,11(1):22-30.
[18] Dishman RK,Darracott CR,Lambert LT.Failure to generalize determinants of self-reported physical activity to a motion sensor[J].Med Sci Sports Exerc,1992,24:904-910.
[19] Lewis S,Thomas SL,Hyde J,et al."I don't eat a hamburger and large chips every day!" A qualitative study of the impact of public health messages about obesity on obese adults[J].BMC Public Health,2010,10:309-317.