我国婴儿超重和肥胖现状及影响的研究进展

Current status, determinants and health implications of infant overweight and obesity in China

摘要

近年来,我国学龄儿童和青少年的肥胖发生率逐渐升高,引发了国家与社会的高度关注。然而,大多数家长对婴儿肥胖却不以为意,甚至视其为健康的表现。由于我国既往研究中婴儿超重和肥胖的判断标准不一致,目前全国的检出率仍无准确数据,但是多项研究均提示我国婴儿超重和肥胖的检出率处于较高水平。婴儿超重和肥胖是遗传与环境因素共同作用所致,可能对个体的终身健康产生深远而持久的影响。家长和临床医务人员从婴儿期开始重视超重和肥胖的问题,及时调整养育方式,能有效降低其在学龄期及成年后发生肥胖与代谢并发症的风险,这体现了“关口前移”的健康管理理念。

Abstract

In recent years, the increasing prevalence of obesity among school-aged children and adolescents in China has attracted considerable attention from both the government and society. However, obesity in infancy remains underrecognized by many parents and is sometimes even regarded as a sign of good health. Because previous studies in China have used inconsistent criteria for defining infant overweight and obesity, accurate nationwide prevalence data are not yet available. Nevertheless, multiple studies have suggested that the detection rates of infant overweight and obesity in China are relatively high. Infant overweight and obesity result from the combined effects of genetic and environmental factors, and studies have shown that these conditions may lead to adverse consequences for health throughout the life course. Greater attention to overweight and obesity beginning in infancy among parents and clinical healthcare professionals, together with timely adjustments to nurturing and feeding practices, may effectively reduce the risk of obesity and metabolic complications during school age and adulthood. This reflects the health management philosophy of early intervention and proactive prevention.

关键词

婴儿超重和肥胖 / 定义 / 分型 / 流行现状 / 健康影响

Key words

infant overweight and obesity / definition / classification / epidemiological prevalence / health impacts

[1] Yuan C, Dong Y, Chen H, et al. Determinants of childhood obesity in China[J].Lancet Public Health, 2024, 9(12): e1105-e1114.
[2] Moreno-Mendez E, Quintero-Fabian S, Fernandez-Mejia C, et al. Early-life programming of adipose tissue[J]. Nutr Res Rev, 2020, 33(2): 244-259.
[3] Hill KB, Mullen GP, Nagareddy PR, et al. Key questions and gaps in understanding adipose tissue macrophages and early-life metabolic programming[J]. Am J Physiol Endocrinol Metab, 2024, 327(4):E478-E497.
[4] Bonet ML, Ribot J, Sánchez J, et al. Early life programming of adipose tissue remodeling and browning capacity by micronutrients and bioactive compounds as a potential anti-obesity strategy[J]. Cells, 2024, 13(10): 870.
[5] 中华医学会儿科学分会内分泌遗传代谢学组,中华医学会儿科学分会儿童保健学组,中华医学会儿科学分会临床营养学组,等.中国儿童肥胖诊断评估与管理专家共识[J].中华儿科杂志, 2022, 60(6):507-515.
The Subspecialty Group of Endocrinologic, Hereditary and Metabolic Diseases, the Society of Pediatrics, et al. Expert consensus on diagnosis, assessment, and management of obesity in Chinese children[J]. Chin J Pediatr, 2022, 60(6):507-515. (in Chinese)
[6] 国家卫生健康委员会. 7岁以下儿童生长标准: WS/T 423—2022[S]. 北京: 中国标准出版社,2022.
[7] 黄国英, 孙锟, 罗小平. 儿科学[M]. 10版. 北京: 人民卫生出版社, 2024.
[8] 首都儿科研究所,九市儿童体格发育调查协作组.2016年中国九城市七岁以下儿童单纯性肥胖流行病学调查[J].中华儿科杂志, 2018,56(1):745-752.
Capital Institute of Pediatrics, The Coordinating Study Group of Nine Cities on the Physical Growth and Development of Children. A national epidemiological survey on obesity of children under seven years of age in nine cities of China in 2016[J]. Chin J Pediatr, 2018, 56(1):745-752. (in Chinese)
[9] 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.
Li H, Ji CY, Zong XN, et al. Body mass index growth curves for Chinese children and adolescents aged 0 to 18 years[J]. Chin J Pediatr, 2009, 47(7): 493-498. (in Chinese)
[10] Aris IM, Bernard JY, Chen LW, et al. Infant body mass index peak and early childhood cardio-metabolic risk markers in a multi-ethnic Asian birth cohort[J]. Int J Epidemiol, 2017, 46(2):513-525.
[11] 于冬梅,琚腊红,赵丽云,等.中国0～5岁儿童超重肥胖分布特征[J].中华流行病学杂志, 2018, 39(6):710-714.
Yu DM, Ju LH, Zhao LY, et al. Prevalence and characteristics of overweight and obesity in Chinese children aged 0-5 years[J]. Chin J Epidemiol, 2018, 39(6):710-714. (in Chinese)
[12] 胡蝶, 王雅伶. 北京市顺义区0～2岁婴幼儿超重和肥胖的流行病学特征分析[J]. 中国妇幼保健, 2023, 38(1): 52-55.
[13] 骆明佳, 庞学红, 姜珊, 等. 2019—2021年中国6～71月龄儿童超重肥胖和贫血双重营养不良现状及相关因素[J]. 卫生研究, 2025, 54(3): 397-404.
Luo MJ, Pang XH, Jiang S, et al. Prevalence and associated factors for double burden of overweight/obesity and Anemia malnutrition among children aged 6-71 months in China in 2019-2021[J]. Journal of Hygine Research, 2025, 54(3): 397-404. (in Chinese)
[14] 霍言言,刘钟泠,马玲,等.真实世界2岁以下儿童不同体型匀称度现况及风险因素[J].中国儿童保健杂志, 2023, 31(7):718-723.
Huo YY, Liu ZL, Ma L, et al. Status quo and risk factors for different body proportions of children under 2 years old in the real world[J]. Chin J Child Health Care, 2023, 31(7):718-723. (in Chinese)
[15] 洪鑫, 林英英, 李国波, 等. 福建省2012—2022年85 159例5岁以下儿童营养状况分析[J]. 中国当代医药, 2024, 31(24): 127-130, 134.
Hong X, Lin YY, Li GB, et al. Analysis of nutritional status of 85 159 children under 5 years of age in Fujian Province from 2012 to 2022[J]. China Mod Med, 2024, 31(24): 127-130, 134. (in Chinese)
[16] 李莉华, 李归雁, 秦锐, 等. 江苏10市0～5岁儿童肥胖现状及影响因素分析[J]. 中国儿童保健杂志, 2024, 32(11): 1271-1276.
Li LH, Li GY, Qin R, et al. Status quo of obesity and its influencing factors among children aged 0-5 in 10 cities in Jiangsu Province[J]. Chin J Child Health Care, 2024, 32(11): 1271-1276. (in Chinese)
[17] Kumar S, Kelly AS. Review of childhood obesity: From epidemiology, etiology, and comorbidities to clinical assessment and treatment[J]. Mayo Clin Proc, 2017, 92(2):251-265.
[18] Littleton SH, Berkowitz RI, Grant SFA. Genetic determinants of childhood obesity[J]. Mol Diagn Ther, 2020, 24(6):653-663.
[19] Khusainova R, Minniakhmetov I, Vasyukova O, et al. Genetic landscape of obesity in children: Research advances and prospects[J].J Obes, 2025, 2025: 9186826.
[20] Umano GR, Bellone S, Buganza R, et al. Early roots of childhood obesity: Risk factors, mechanisms, and prevention strategies[J]. Int J Mol Sci, 2025, 26(15):7388.
[21] Carnell S, Thapaliya G, Jansen E, et al. Biobehavioral susceptibility for obesity in childhood: Behavioral, genetic and neuroimaging studies of appetite[J]. Physiol Behav, 2023, 271:114313.
[22] Khandelwal R, Meshram RJ, Patel A, et al. Maternal weight and gestational diabetes impacts on child health: A narrative review[J]. Cureus,2024, 16(9):e70192.
[23] Lokossou GAG, Kouakanou L, Schumacher A, et al. Human breast milk: From food to active immune response with disease protection in infants and mothers[J]. Front Immunol, 2022, 13:849012.
[24] Pomi AL, Pepe G, Aversa T, et al. Early adiposity rebound:Predictors and outcomes[J]. Ital J Pediatr, 2024, 50(1): 98.
[25] Dewey KG, Güngör D, Donovan SM, et al. Breastfeeding and risk of overweight in childhood and beyond:A systematic review with emphasis on sibling-pair and intervention studies[J]. Am J Clin Nutr, 2021, 114(5): 1774-1790.
[26] Quarta A, Quarta MT, Mastromauro C, et al. Influence of nutrition on growth and development of metabolic syndrome in children[J]. Nutrients, 2024, 16(22):3801.
[27] Eichner-Seitz N, Pate RR, Paul IM. Physical activity in infancy and early childhood:A narrative review of interventions for prevention of obesity and associated health outcomes[J]. Front Endocrinol, 2023, 14: 1155925.
[28] Spill MK, Callahan EH, Shapiro MJ, et al. Caregiver feeding practices and child weight outcomes:A systematic review[J]. Am J Clin Nutr, 2019, 109(Suppl): 990-1002.
[29] Ruzicka EB, Darling KE, Sato AF. Controlling child feeding practices and child weight: A systematic review and meta-analysis[J]. Obes Rev, 2021, 22(3):e13135.
[30] Hui H, Jenatabadi HS. The role of parental health knowledge and practices in mitigating obesity risks among preschool children[J].Sci Rep, 2025, 15: 31163.
[31] Jiang Y, Hu J, Chen F, et al. Comprehensive systematic review and meta-analysis of risk factors for childhood obesity in China and future intervention strategies[J]. Lancet Reg Health West Pac, 2025, 58:101553.
[32] Hunter KE, Nguyen D, Libesman S, et al. Parent-focused behavioural interventions for the prevention of early childhood obesity (TOPCHILD):A systematic review and individual participant data meta-analysis[J]. Lancet, 2025, 406(10509): 1235-1254.
[33] Jebeile H, Kelly AS, O'Malley G, et al. Obesity in children and adolescents: Epidemiology, causes, assessment, and management[J]. Lancet Diabetes Endocrinol, 2022, 10(5): 351-365.
[34] Doñate CL, Guillén SC, Iglesia AI, et al. Rapid growth between 0 and 2 years old in healthy infants born at term and its relationship with later obesity: A systematic review and meta-analysis of evidence[J]. Nutrients, 2024, 16(17):2939.
[35] Aris IM, Rifas-Shiman SL, Li LJ, et al. Patterns of body mass index milestones in early life and cardiometabolic risk in early adolescence[J]. Int J Epidemiol, 2019, 48(1):157-167.
[36] Perng W, Rahman ML, ArisIM, et al. Metabolite profiles of the relationship between body mass index (BMI) milestones and metabolic risk during early adolescence[J]. Metabolites, 2020, 10(8): 316.
[37] 李小真, 严双琴, 樊诗琦, 等. 婴儿期BMI峰值与6岁儿童超重/肥胖关联的出生队列研究[J]. 现代预防医学, 2022, 49(23): 4306-4310.
Li XZ, Yan SQ, Fan SQ, et al. Association of infant BMI peak and age with overweight/obesity in 6-year-old children: A birth cohort study[J]. Mod Prev Med, 2022, 49(23): 4306-4310. (in Chinese)
[38] Shan J, Feng H, Li X, et al. Four methods to identify sensitive periods of infant weight gain associated with adolescent BMI in a Chinese birth cohort[J].Sci Rep, 2025, 15: 24348.
[39] Luo L, Tao FB. Impact of age on cardiometabolic health in children at adiposity rebound: The role of genetic mechanisms[J]. World J Pediatr, 2025, 21(3):252-265.
[40] Gonçalves R, Wiertsema CJ, Silva CCV, et al. Associations of fetal and infant growth patterns with early markers of arterial health in school-aged children[J]. JAMA Netw Open, 2022, 5(6):e2219225.
[41] Nummela SR, Salo P, Pahkala K, et al. Weight gain in infancy and markers of cardiometabolic health in young adulthood[J]. Acta Paediatr, 2022, 111(8):1603-1611.

基金资助

南京医科大学科技发展基金(NMUB20210032)