Избыточный вес у детей 3-12 лет: причины, эффекты, профилактика. Часть 1. Образ жизни и питание

Аннотация

Введение. Избыточный вес демонстрирует катастрофическое распространение по всем экономически развитым странам мира, несмотря на всемирные усилия по его профилактике. Целью работы был анализ предикторов избыточного веса, последствий его формирования и подходов к профилактике у детей.

Материалы и методы. Для анализа современного состояния изучения избыточного веса у детей 3-12 лет были использованы материалы из 168 зарубежных источников литературы из международной базы данных PubMed. Критерием включения источника в рассмотрение были репрезентативные выборки и наличие количественных данных по детям в возрастном интервале от 3 до 12 лет, характеризующих тот или иной аспект проблемы избыточного веса. Поиск информации проводился по следующим направлениям: «дети дошкольного и младшего школьного возраста», «избыточный вес и/или ожирение», «рацион питания», «экранное время», «сидячий образ жизни», «качество сна», «физическая (мышечная) работоспособность», «двигательная подготовленность», «физическая (двигательная) активность», «влияние окружающей среды».

Результаты и обсуждение. В Части 1 систематизированы сведения о роли низкой двигательной активности, распределения времени на разные виды активности, неправильного рациона питания, пищевого поведения, структуры и регулярности питания.

Заключение. Материалы, рассмотренные в Части 1, демонстрируют распределение избыточного веса и ожирения в мире, а также отражают важную роль низкой двигательной активности в формировании условий для развития избыточного веса и метаболического синдрома в детском возрасте. Даже небольшое перераспределение времени в течение суток с условием всего лишь 10%-ного увеличения времени активных движений, способно снять остроту проблемы и предотвратить формирование избыточного веса у значительных контингентов детского населения. Вносит свой немалый вклад в формирование избыточного веса и неправильный рацион питания, особенно регулярное использование детьми подслащенных напитков. Другие аспекты проблемы избыточного веса у детей, включая роль окружающей среды, семьи, социо-экономических факторов, будут рассмотрены в Части 2.

Благодарности. Данная статья выполнена в рамках государственного задания № 073-00070-25-03 от 29.05.2025.

Литература

Руднев С.Г., Соболева Н.П., Стерликов С.А., Николаев Д.В., Старунова О.А. с соавт. Биоимпедансное исследование состава тела населения России. М.: РИО ЦНИИОИЗ. 2014.

Ara I., Moreno L.A., Leiva M.T., Gutin B., Casajús J.A. Adiposity, physical activity, and physical fitness among children from Aragón, Spain. Obesity (Silver Spring), 2007, 15 (8), pp. 1918-24. https://doi.org/10.1038/oby.2007.228

Blaes A., Baquet G., Fabre C., Van Praagh E., Berthoin S. Is there any relationship between physical activity level and patterns, and physical performance in children? Int. J. Behav. Nutr. Phys. Act, 2011, 8, pp. 122. https://doi.org/10.1186/1479-5868-8-122

Champion S.L., Rumbold A.R., Steele E.J., Giles L.C., Davies M.J., et al. Parental work schedules and child overweight and obesity. Int. J. Obes. (Lond), 2012, 36 (4), pp. 573-80. https://doi.org/10.1038/ijo.2011.252

Chaput J.P., Lambert M., Mathieu M.E., Tremblay M.S., O'Loughlin J., et al. Physical activity vs. sedentary time: independent associations with adiposity in children. Pediatr Obes, 2012, 7 (3), pp. 251-258. https://doi.org/10.1111/j.2047-6310.2011.00028.x

Chen H., Wang L.J., Xin F., Liang G., Zhou Y.L. Associations between 24-h movement behaviours and BMI in Chinese primary- and middle-school students. J. Exerc. Sci Fit., 2023, 21 (2), pp. 186-192. https://doi.org/10.1016/j.jesf.2023.01.002

Cleland V., Crawford D., Baur L.A., Hume C., Timperio A., et al. A prospective examination of children's time spent outdoors, objectively measured physical activity and overweight. Int. J. Obes. (Lond), 2008, 32 (11), pp. 1685-1693. https://doi.org/10.1038/ijo.2008.171

Colley R.C., Garriguet D., Janssen I., Wong S.L., Saunders T.J., et al. The association between accelerometer-measured patterns of sedentary time and health risk in children and youth: results from the Canadian Health Measures Survey. BMC Public Health, 2013, 13, pp. 200. https://doi.org/10.1186/1471-2458-13-200

Dalene K.E., Anderssen S.A., Andersen L.B., Steene-Johannessen J., Ekelund U., et al. Cross-sectional and prospective associations between physical activity, body mass index and waist circumference in children and adolescents. Obes. Sci Pract., 2017, 3 (3), pp. 249-257. https://doi.org/10.1002/osp4.114

Dorsey K.B., Herrin J., Krumholz H.M. Patterns of moderate and vigorous physical activity in obese and overweight compared with non-overweight children. Int. J. Pediatr. Obes., 2011, 6 (2), pp. e547-e555. https://doi.org/10.3109/17477166.2010.490586

Drenowatz C., Steiner R.P., Brandstetter S., Klenk J., Wabitsch M., et al. Organized sports, overweight, and physical fitness in primary school children in Germany. J. Obes., 2013, pp. 935245. https://doi.org/10.1155/2013/935245

Fairclough S.J., Dumuid D., Mackintosh K.A., Stone G., Dagger R., et al. Adiposity, fitness, health-related quality of life and the reallocation of time between children's school day activity behaviours: A compositional data analysis. Prev. Med. Rep., 2018, 11, pp. 254-261. https://doi.org/10.1016/j.pmedr.2018.07.011

Fayet-Moore F., McConnell A., Cassettari T., Tuck K., Petocz P., et al. Vegetable intake in Australian children and adolescents: the importance of consumption frequency, eating occasion and its association with dietary and sociodemographic factors. Public Health Nutr., 2020, 23 (3), pp. 474-487. https://doi.org/10.1017/S136898001900209X

Fulton J.E., Dai S., Steffen L.M., Grunbaum J.A., Shah S.M., et al. Physical activity, energy intake, sedentary behavior, and adiposity in youth. Am. J. Prev. Med., 2009, 37 (1), pp. S40-S49. https://doi.org/10.1016/j.amepre.2009.04.010

Gibson S., Boyd A. Associations between added sugars and micronutrient intakes and status: further analysis of data from the National Diet and Nutrition Survey of Young People aged 4 to 18 years. Br. J. Nutr., 2009, 101 (1), pp. 100-107. https://doi.org/10.1017/S0007114508981484

Guo Q., Wang B., Cao S., Jia C., Zhao L., et al. Patterns and sociodemographic determinants of water intake by children in China: results from the first national population-based survey. Eur. J. Nutr., 2020, 59 (2), pp. 529-538. https://doi.org/10.1007/s00394-019-01921-w

Henry C.J., Lightowler H.J., Strik C.M. Effects of long-term intervention with low- and high-glycaemic-index breakfasts on food intake in children aged 8-11 years. Br. J. Nutr., 2007, 98 (3), pp. 636-640. https://doi.org/10.1017/S0007114507727459

Hjorth M.F., Chaput J.P., Ritz C., Dalskov S.M., Andersen R., Astrup A., Tetens I., Michaelsen K.F., Sjödin A. Fatness predicts decreased physical activity and increased sedentary time, but not vice versa: supp.ort from a longitudinal study in 8- to 11-year-old children. Int. J. Obes. (Lond), 2014, 38 (7), pp. 959-65. https://doi.org/10.1038/ijo.2013.229

Hosseini S.H, Papanikolaou Y., Isalm N., Rashmi P., Shamloo A., et al. Consumption Patterns of Grain-Based Foods among Children and Adolescents in Canada: Evidence from Canadian Community Health Survey-Nutrition 2015. Nutrients, 2019, 11 (3), pp. 623. https://doi.org/10.3390/nu11030623

Hubbard K., Economos C.D., Bakun P., Boulos R., Chui K., et al. Disparities in moderate-to-vigorous physical activity among girls and overweight and obese schoolchildren during school- and out-of-school time. Int. J. Behav. Nutr. Phys. Act., 2016, 13, pp. 39. https://doi.org/10.1186/s12966-016-0358-x

Jabbour G., Lambert M., O'Loughlin J., Tremblay A., Mathieu M.E. Mechanical efficiency during a cycling test is not lower in children with excess body weight and low aerobic fitness. Obesity (Silver Spring), 2013, 21 (1), pp. 107-114. https://doi.org/10.1002/oby.20241

Jansen W., Mackenbach J.P., Joosten-van Zwanenburg E., Brug J. Weight status, energy-balance behaviours and intentions in 9-12-year-old inner-city children. J. Hum. Nutr. Diet., 2010, 23 (1), pp. 85-96. https://doi.org/10.1111/j.1365-277X.2009.01027.x

Jiang H., Zhao A., Zhao W., Tan S., Zhang J., et al. Do Chinese Preschool Children Eat a Sufficiently Diverse Diet? A Cross-Sectional Study in China. Nutrients, 2018, 10 (6), pp. 794. https://doi.org/10.3390/nu10060794

Keane E., Layte R., Harrington J., Kearney P.M., Perry I.J. Measured parental weight status and familial socio-economic status correlates with childhood overweight and obesity at age 9. PLoS One, 2012, 7 (8), pp. e43503. https://doi.org/10.1371/journal.pone.0043503

Keane E., Li X., Harrington J.M., Fitzgerald A.P., Perry I.J., et al. Physical Activity, Sedentary Behavior and the Risk of Overweight and Obesity in School-Aged Children. Pediatr. Exerc. Sci, 2017, 29 (3), pp. 408-418. https://doi.org/10.1123/pes.2016-0234

Kwabla M.P., Gyan C., Zotor F. Nutritional status of in-school children and its associated factors in Denkyembour District, eastern region, Ghana: comparing schools with feeding and non-school feeding policies. Nutr. J., 2018, 17 (1), 8. https://doi.org/10.1186/s12937-018-0321-6

Lätt E., Mäestu J., Ortega F.B., Rääsk T., Jürimäe T., et al. Vigorous physical activity rather than sedentary behaviour predicts overweight and obesity in pubertal boys: a 2-year follow-up study. Scand. J. Public Health, 2015, 43 (3), pp. 276-282. https://doi.org/10.1177/1403494815569867

Learmonth Y.C., Hebert J.J., Fairchild T.J., Møller N.C., Klakk H., et al. Physical education and leisure-time sport reduce overweight and obesity: a number needed to treat analysis. Int. J. Obes. (Lond), 2019, 43 (10), pp. 2076-2084. https://doi.org/10.1038/s41366-018-0300-1

LeBlanc A.G., Broyles S.T., Chaput J.P., Leduc G., Boyer C., et al. Correlates of objectively measured sedentary time and self-reported screen time in Canadian children. Int. J. Behav. Nutr. Phys. Act., 2015, 12, pp. 38. https://doi.org/10.1186/s12966-015-0197-1

Lee S.T., Wong J.E., Shanita S.N., Ismail M.N., Deurenberg P., et al. Daily physical activity and screen time, but not other sedentary activities, are associated with measures of obesity during childhood. Int J Environ Res Public Health, 2014, 12 (1), pp. 146-161. https://doi.org/10.3390/ijerph120100146

Li L., Shen T., Wen L.M., Wu M., He P., Wang Y., Qu W., Tan H., He G. Lifestyle factors associated with childhood obesity: a cross-sectional study in Shanghai, China. BMC Res Notes, 2015, 8, pp. 6. https://doi.org/10.1186/s13104-014-0958-y

Li N., Zhao P., Diao C., Qiao Y., Katzmarzyk P.T., et al. Joint associations between weekday and weekend physical activity or sedentary time and childhood obesity. Int. J. Obes. (Lond), 2019, 43 (4), pp. 691-700. https://doi.org/10.1038/s41366-019-0329-9

Liao J., Cao C., Hur J., Cohen J., Chen W., et al. Association of sedentary patterns with body fat distribution among US children and adolescents: a population-based study. Int. J. Obes. (Lond), 2021, 45 (9), pp. 2048-2057. https://doi.org/10.1038/s41366-021-00874-7

Lopes V.P., Malina R.M., Maia J.A.R., Rodrigues L.P. Body mass index and motor coordination: Non-linear relationships in children 6-10 years. Child Care Health Dev., 2018, 44 (3), pp. 443-451. https://doi.org/10.1111/cch.12557

López-Sobaler A.M., Aparicio A., González-Rodríguez L.G., Cuadrado-Soto E., Rubio J., et al. Adequacy of Usual Vitamin and Mineral Intake in Spanish Children and Adolescents: ENALIA Study. Nutrients, 2017, 9 (2), pp. 131. https://doi.org/10.3390/nu9020131

López-Sobaler A.M., Aparicio A., Rubio J., Marcos V., Sanchidrián R., et al. Adequacy of usual macronutrient intake and macronutrient distribution in children and adolescents in Spain: A National Dietary Survey on the Child and Adolescent Population, ENALIA 2013-2014. Eur. J. Nutr., 2019, 58 (2), pp. 705-719. https://doi.org/10.1007/s00394-018-1676-3

Louie J.C., Moshtaghian H., Rangan A.M., Flood V.M., Gill T.P. Intake and sources of added sugars among Australian children and adolescents. Eur. J. Nutr., 2016, 55 (8), pp. 2347-2355. https://doi.org/10.1007/s00394-015-1041-8

Ma F.F., Luo D.M. Relationships between physical activity, fundamental motor skills, and body mass index in preschool children. Front Public Health, 2023, 11, pp. 1094168. https://doi.org/10.3389/fpubh.2023.1094168

Magriplis E., Michas G., Petridi E., Chrousos G.P., Roma E., et al. Dietary Sugar Intake and Its Association with Obesity in Children and Adolescents. Children (Basel), 2021, 8 (8), pp. 676. https://doi.org/10.3390/children8080676

Martinho D.V., Gouveia É.R., França C., Lopes H., Ihle A., Marques A., Rodrigues A., Alves R., Sarmento H. Body Composition and Physical Fitness in Madeira Youth. Children (Basel), 2022, 9 (12), pp. 1833. https://doi.org/10.3390/children9121833

Mitchell J.A., Pate R.R., España-Romero V., O'Neill J.R., Dowda M., et al. Moderate-to-vigorous physical activity is associated with decreases in body mass index from ages 9 to 15 years. Obesity (Silver Spring), 2013, 21 (3), pp. E280-E293. https://doi.org/10.1002/oby.20118

Nasreddine L., Hwalla N., Al Zahraa Chokor F., Naja F., O'Neill L., et al. Food and nutrient intake of school-aged children in Lebanon and their adherence to dietary guidelines and recommendations. BMC Public Health, 2022, 22 (1), pp. 922. https://doi.org/10.1186/s12889-022-13186-w

Nilsen B.B., Yngve A., Monteagudo C., Tellström R., Scander H., Werner B. Reported habitual intake of breakfast and selected foods in relation to overweight status among seven- to nine-year-old Swedish children. Scand. J. Public Health, 2017, 45 (8), pp. 886-894. https://doi.org/10.1177/1403494817724951

Nogueira H., Costeira E., Pereira M.M., Costa D., Gama A., Machado-Rodrigues A., Silva M.R., Marques V.R., Padez C.M. The environment contribution to gender differences in childhood obesity and organized sports engagement. Am. J. Hum. Biol, 2020, 32 (2), pp. e23322. https://doi.org/10.1002/ajhb.23322

Ortega F.B., Ruiz J.R., Sjöström M. Physical activity, overweight and central adiposity in Swedish children and adolescents: the European Youth Heart Study. Int. J. Behav. Nutr. Phys. Act., 2007, 4, p. 61. https://doi.org/10.1186/1479-5868-4-61

Ostojic S.M., Stojanovic M.D., Stojanovic V., Maric J., Njaradi N. Correlation between fitness and fatness in 6-14-year old Serbian school children. J. Health Popul. Nutr., 2011, 29 (1), pp. 53-60. https://doi.org/10.3329/jhpn.v29i1.7566

Perry C.P., Keane E., Layte R., Fitzgerald A.P., Perry I.J., et al. The use of a dietary quality score as a predictor of childhood overweight and obesity. BMC Public Health, 2015, 15, pp. 581. https://doi.org/10.1186/s12889-015-1907-y

Riso E.M., Kull M., Mooses K., Hannus A., Jürimäe J. Objectively measured physical activity levels and sedentary time in 7-9-year-old Estonian schoolchildren: independent associations with body composition parameters. BMC Public Health, 2016, 16, pp. 346. https://doi.org/10.1186/s12889-016-3000-6

Sagbo H., Kpodji P. Dietary diversity and associated factors among school-aged children and adolescents in Lokossa district of southern Benin: a cross-sectional study. BMJ Open, 2023, 13 (10), pp. e066309. https://doi.org/10.1136/bmjopen-2022-066309

Silva-Santos S., Santos A., Vale S., Mota J. Motor fitness and preschooler children obesity status. J. Sports Sci., 2017, 35(17), pp. 1704-1708. https://doi.org/10.1080/02640414.2016.1232486

Smirk E., Mazahery H., Conlon C.A., Beck K.L., Gammon C., et al. Sugar-sweetened beverages consumption among New Zealand children aged 8-12 years: a cross sectional study of sources and associates/correlates of consumption. BMC Public Health, 2021, 21 (1), pp. 2277. https://doi.org/10.1186/s12889-021-12345-9

Söğüt M., Clemente F.M., Clark C.C.T., Nikolaidis P.T., Rosemann T., Knechtle B. Variations in Central Adiposity, Cardiovascular Fitness, and Objectively Measured Physical Activity According to Weight Status in Children (9-11 Years). Front. Physiol., 2019, 10, pp. 936. https://doi.org/10.3389/fphys.2019.00936

Stigman S., Rintala P., Kukkonen-Harjula K., Kujala U., Rinne M., Fogelholm M. Eight-year-old children with high cardiorespiratory fitness have lower overall and abdominal fatness. Int. J. Pediatr. Obes., 2009, 4 (2), pp. 98-105. https://doi.org/10.1080/17477160802221101

Stival C., Lugo A., Barone L., Fattore G., Odone A., Salvatore S., et al. Prevalence and Correlates of Overweight, Obesity and Physical Activity in Italian Children and Adolescents from Lombardy, Italy. Nutrients, 2022, 14 (11), pp. 2258. https://doi.org/10.3390/nu14112258

Talarico R., Janssen I. Compositional associations of time spent in sleep, sedentary behavior and physical activity with obesity measures in children. Int. J. Obes. (Lond), 2018, 42 (8), pp. 1508-1514. https://doi.org/10.1038/s41366-018-0053-x

Thibault H., Carriere C., Langevin C., Kossi Déti E., Barberger-Gateau P., Maurice S. Prevalence and factors associated with overweight and obesity in French primary-school children. Public Health Nutr., 2013, 16 (2), pp. 193-201. https://doi.org/10.1017/S136898001200359X

Thumann B.F., Buck C., De Henauw S., Hadjigeorgiou C., Hebestreit A., et al.. Cross-sectional associations between objectively measured sleep characteristics and body mass index in European children and adolescents. Sleep Med., 2021, 84, pp. 32-39. https://doi.org/10.1016/j.sleep.2021.05.004

Umeokonkwo A.A., Ibekwe M.U., Umeokonkwo C.D., Okike C.O., Ezeanosike O.B., Ibe B.C. Nutritional status of school age children in Abakaliki metropolis, Ebonyi State, Nigeria. BMC Pediatr., 2020,20 (1), p. 114. https://doi.org/10.1186/s12887-020-1994-5

Vieux F., Maillot M., Constant F., Drewnowski A. Water and beverage consumption patterns among 4 to 13-year-old children in the United Kingdom. BMC Public Health, 2017, 17 (1), pp. 479. https://doi.org/10.1186/s12889-017-4400-y

Vieux F., Maillot M., Rehm C.D., Barrios P., Drewnowski A. Trends in tap and bottled water consumption among children and adults in the United States: analyses of NHANES 2011-16 data. Nutr. J., 2020, 19 (1), pp. 10. https://doi.org/ 10.1186/s12937-020-0523-6

Warren J.M., Henry C.J., Simonite V. Low glycemic index breakfasts and reduced food intake in preadolescent children. Pediatrics, 2003, 112 (5), pp. e414. https://doi.org/10.1542/peds.112.5.e414

WHO guidelines on physical activity and sedentary behaviour. Geneve: World Helth Organization; 2021 г. License: CC BY-NC-SA 3.0 IGO.

Wilkie H.J., Standage M., Gillison F.B., Cumming S.P., Katzmarzyk P.T. Correlates of intensity-specific physical activity in children aged 9-11 years: a multilevel analysis of UK data from the International Study of Childhood Obesity, Lifestyle and the Environment. BMJ Open, 2018, 8 (2), pp. e018373. https://doi.org/10.1136/bmjopen-2017-018373

Yamaguchi M., Kondo N., Hashimoto H. Universal school lunch programme closes a socioeconomic gap in fruit and vegetable intakes among school children in Japan. Eur. J. Public Health, 2018, 28 (4), pp. 636-641. https://doi.org/10.1093/eurpub/cky041

Yan R., Gong E., Li X., Zheng L., Liao W., et al. Impact of Obesogenic Environments on Sugar-Sweetened Beverage Consumption among Preschoolers: Findings from a Cross-Sectional Survey in Beijing. Nutrients, 2022, 14 (14), pp. 2860. https://doi.org/10.3390/nu14142860

Zhang T., Cai L., Ma L., Jing J., Chen Y., et al. The prevalence of obesity and influence of early life and behavioral factors on obesity in Chinese children in Guangzhou. BMC Public Health, 2016, 16 (1), p. 954. https://doi.org/10.1186/s12889-016-3599-3

Zheng M., Rangan A., Olsen N.J., Andersen L.B., Wedderkopp N., et al. Substituting sugar-sweetened beverages with water or milk is inversely associated with body fatness development from childhood to adolescence. Nutrition, 2015, 31 (1), pp. 38-44. https://doi.org/10.1016/j.nut.2014.04.017