兒童及青少年過重及肥胖防治

Prevention and Treatment of Overweight and Obesity among Children and Adolescent

台灣地區由於社會進步、經濟發展、營養狀況改善及交通建設發展使生活活動空間相對地減小；再加上國人飲食習慣改變， 過重或肥胖盛行有明顯增加趨勢。從1980年起， 學童平均體重上升幅度大於平均身高。兒童時期肥胖， 不但是有心臟血管疾病、糖尿病及高血壓等慢性病重要危險因子，對骨指肌肉、呼吸、內分泌及社交學習上也多有影響。研究指出，兒童或青少年時期的肥胖會隨著年齡的增加而導致成年時期肥胖的發生且可能直接或間接的增加成年後肥胖相關慢性病的致病率和死亡率，對人類健康產生重大的威脅。然而肥胖的致病機轉目前仍不是十分明確，家族遺傳因素及生活環境因素（如飲食、運動及生活作息）等仍是主要致病原因，因此，最近有許多致胖環境的假設與研究結果陸續提出。本文將針對兒童肥胖的成因及防治方法與策略進行整理介紹，並回顧國內外不同年齡層兒童及青少年實施介入計畫， 配合學校課程、及飲食運動計畫等，使兒童肥胖能更有效的達到控制。

Along with improvements in the social-economic status and life quality has evolved a change in eating habits. This change in eating habits is a significant factor underlying the prevalence of overweight and obesity among children and adolescents. Since 1980, the average weight gain of children has increased at a higher rate than average height. Childhood obesity is an important risk factor for chronic diseases, including cardiovascular disease, diabetes, hypertension, musculoskeletal, respiratory, and endocrine disorders as well as compromises in social learning among children and adolescents. Many studies have shown that children and adolescent obesity is the main factor that associated with the increases in obesityrelated chronic disease morbidity and mortality. However, the mechanisms underlying the development of obesity remains unclear. Family factors and environment factors, including diet, exercise and lifestyle, are thought to be the main causes of obesity. One of the most important mechanisms proposed in recentyears is the “obesogenic environment hypothesis”. In this paper,which focuses on strategies for preventing and treating childhood overweight and obesity, we review the different intervention programs implemented for children and adolescents, including school diet and physical activity and programs for different age groups.