儿童青少年肥胖的营养治疗策略

肥胖已成为世界性的公共健康问题,儿童青少年肥胖也越来越得到社会的关注。体质指数(BMI)是判定儿童超重及肥胖的指标。儿童青少年肥胖可累及全身多系统并出现相应的并发症,如糖耐量异常甚至2型糖尿病、血脂异常、高血压、非酒精性脂肪肝等。营养治疗是儿童青少年肥胖的主要治疗手段。建立健康饮食模式需在专业人员指导下,以家庭为基础,同时需社会、学校给予支持与协助。肥胖患儿的营养方案应个体化,能量达到患儿身高对应年龄的营养需求,保证三大营养素均衡(蛋白质供能占总能量的15%～20%,碳水化合物占55%～65%,脂肪占20%～25%),保证优质蛋白质,充足的膳食纤维及健康的油脂。体重控制目标为身高逐渐增长,体重不增或增长缓慢逐渐达到正常的BMI。在营养方案实施过程中,专业医师团队应监督患儿的实施,完成随访。运动也是减重过程中重要的组成部分。多位一体的关注与协助保证患儿身心健康成长。

Nutritional Therapy for Obesity in Children and Adolescent

Obesity has become a public health problem. Obesity in children and adolescents has obtained growing social attention. Body mass index (BMI) is widely used to identify overweight and obesity. Children and adolescent obesity can lead to multiple systemic complications, like abnormal glucose tolerance, type 2 diabetes, dyslipidemia, hypertension, nonalcoholic fatty liver disease, etc. Nutritional therapy is the primary therapy for obesity in children and adolescents. The establishment of a healthy eating pattern requires professional guidance, based on family and need assistance from the community and schools. Nutritional plans for obese children should be individualized. The energy must reach the nutritional requirements of the children''s height of corresponding age, ensure the balance of the three macronutrients (protein 15%-20%, carbohydrate 55%-65% and fat 20%-25%), and intake enough quality protein, dietary fiber, and healthy fats. The goal of weight control is gradually increase in height with slow or without weight gain. During the implementation of nutritional plan, a professional team should supervise the progress and complete the follow-up. Exercise is also an important part for weight loss. All of us should work together to ensure the physically and mentally healthy growth of children.