Obesity in adolescence-from etiological variability to interventional efficacy in the school context

J. Tallon, Antonio J. Silva, Aldo M. Costa, A. Barros
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Abstract

Introduction: Our paper concern two fundamental pillars to face obesity in adolescence- nutrition education and the phenomenon of human variability, namely in the biological and behavior dimension. Objectives: Assessment of the impact of an innovate school-based nutrition education program (OBESIDATA); the multivariate study of the anthropometric profile and physical activity pattern of adolescents in Portugal; comparison between energy consumption and their energy needs; Evaluation of the accuracy of four commonly used basal metabolic rate prediction equations. Results: After a two weeks period of open interactive digital platform, 85.8% of students increased their nutritional knowledge; the overall prevalence of overweight and obesity in adolescents was 16.5% and 5.9%, respectively; just 38% of participants reported a level of physical activity in line with WHO recommendations; the RMR mean differences of six identified anthropometrics clusters vary from 1349 Kcalories to 1955 Kcalories; the mean reported energy intake was lower than the estimated energy requirements; from all predictive equations estimating energy requirements the relative accuracy, using indirect calorimetric evaluations, is just about 17%. Conclusions: School-based nutrition using technology may provide a practical, attractive and cost- effective strategy to improve nutrition knowledge and eating behaviors; the adolescent’s prevalence of overweight/obesity remains relatively high and physical activity was clear below the WHO recommendations; at average level adolescents REI seems to be lower than their EER, but REI reveals a great individual variability; the accuracy of RMR using predictive equations may have limited applicability; a new paradigma to prevent obesity is coming where genetic will have soon a practical central role.1,2
青少年肥胖——从病因变异到学校背景下的干预效果
引言:我们的论文关注两个基本支柱,以面对青少年肥胖-营养教育和人类变异性现象,即在生物和行为的维度。目的:评估一项创新的学校营养教育计划(OBESIDATA)的影响;葡萄牙青少年人体测量特征和身体活动模式的多变量研究;能源消耗与能源需求的比较;四种常用基础代谢率预测方程的准确性评价。结果:开放互动数字平台两周后,85.8%的学生营养知识有所增加;青少年超重和肥胖的总体患病率分别为16.5%和5.9%;只有38%的参与者报告的身体活动水平符合世卫组织的建议;六个已确定的人体测量簇的RMR平均差异从1349 k卡路里到1955 k卡路里不等;报告的平均能量摄入低于估计的能量需求;从所有估计能量需求的预测方程中,使用间接量热评估的相对精度仅为17%左右。结论:以学校为基础的营养利用技术可能为提高营养知识和饮食行为提供一种实用、有吸引力和具有成本效益的策略;青少年超重/肥胖患病率仍然相对较高,身体活动明显低于世卫组织的建议;在平均水平上,青少年REI似乎低于EER,但REI表现出较大的个体差异;使用预测方程的RMR的准确性可能具有有限的适用性;一种预防肥胖的新模式即将出现,基因将很快发挥实际的核心作用
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