3.Research progresses on interventions of obesity in children and adolescents.
Chinese Journal of Preventive Medicine 2023;57(5):760-765
		                        		
		                        			
		                        			Childhood and adolescent obesity has become a global epidemic. The interventions mainly include lifestyle intervention, medication treatment and bariatric surgery. Among them, lifestyle intervention, especially intensive lifestyle intervention with participation of family members, is the first-line treatment for obesity in children and adolescents. Both medication and bariatric surgery are adjuvant treatments for severely obese children and adolescents. Currently, metformin is the most widely used drug for the treatment of obesity in children and adolescents in both China and other countries; orlistat and liraglutide are also the drugs that are safe and often used in other countries; other drugs are not recommended. As a tertiary prevention and treatment strategy for obesity, bariatric surgery should be carried out on the basis of good compliance from both the children and their family members, with the cooperation of multiple disciplines. Sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB) are the most common types of procedure performed. Meanwhile, as a new treatment method, intra-gastric balloon procedure needs to be paid more attention to its efficacy and safety.
		                        		
		                        		
		                        		
		                        			Adolescent
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Child
		                        			;
		                        		
		                        			Pediatric Obesity/prevention & control*
		                        			;
		                        		
		                        			Obesity, Morbid/surgery*
		                        			;
		                        		
		                        			Gastric Bypass/methods*
		                        			;
		                        		
		                        			Metformin
		                        			;
		                        		
		                        			Gastrectomy/methods*
		                        			;
		                        		
		                        			Treatment Outcome
		                        			;
		                        		
		                        			Retrospective Studies
		                        			
		                        		
		                        	
4.Causes and Countermeasures of Complications After Bariatric Surgery.
Hong-Bin SHI ; Yong DAI ; Xiao-Feng LI ; Meng-Fan YANG ; Jian-Li GAO ; Jin DONG
Acta Academiae Medicinae Sinicae 2023;45(5):833-839
		                        		
		                        			
		                        			Roux-en-Y gastric bypass and laparoscopic sleeve gastrectomy characterized by simple operation and few postoperative complications have gradually become the two most commonly used surgical methods in clinical practice.A series of complications often occur after bariatric surgery,including gallstone disease,anemia,malnutrition,gastroesophageal reflux disease,kidney stones,and birth defects in offspring of women of childbearing age.There are controversies regarding the causes and countermeasures of these complications.This article mainly reviews the risk factors and countermeasures for the complications after bariatric surgery.
		                        		
		                        		
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Female
		                        			;
		                        		
		                        			Bariatric Surgery/methods*
		                        			;
		                        		
		                        			Gastric Bypass/methods*
		                        			;
		                        		
		                        			Gastroesophageal Reflux/surgery*
		                        			;
		                        		
		                        			Postoperative Complications/prevention & control*
		                        			;
		                        		
		                        			Risk Factors
		                        			;
		                        		
		                        			Gastrectomy/methods*
		                        			;
		                        		
		                        			Laparoscopy/methods*
		                        			;
		                        		
		                        			Obesity, Morbid/surgery*
		                        			;
		                        		
		                        			Retrospective Studies
		                        			
		                        		
		                        	
5.Sharing Chinese experience in obesity prevention and treatment with African countries.
Chinese Journal of Preventive Medicine 2022;56(8):1136-1141
		                        		
		                        			
		                        			Obesity has become a global public health problem that seriously threatens population health. The Chinese government has attached great importance to prevent and control the negative impacts of obesity on individuals, families and society. China has established a policy system for obesity, and made certain achievements in behavioral intervention, drug treatment, traditional Chinese medicine treatment, and surgical treatment. This study summarizes the prevention and treatment experience of obesity in China in order to provide reference for African countries to better formulate prevention and treatment strategies for obesity in line with their local context.
		                        		
		                        		
		                        		
		                        			Asian People
		                        			;
		                        		
		                        			China/epidemiology*
		                        			;
		                        		
		                        			Government
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Obesity/prevention & control*
		                        			;
		                        		
		                        			Public Health
		                        			
		                        		
		                        	
6.A clinical challenge of evaluation and management in children with genetic obesity.
Shu Min ZHAN ; Guan Ping DONG ; Jun Fen FU
Chinese Journal of Preventive Medicine 2022;56(9):1196-1202
		                        		
		                        			
		                        			Obesity is a growing global public health problem, while 40%-70% of obesity is determined by genetic factors. This article focuses on the classification, disease characteristics, diagnosis and progressive treatment of childhood genetic obesity. The prevention and control of childhood genetic obesity requires early detection of obese individuals and early screening of obesity causes. At the same time, clinicians are advised to propose individualized therapy and intervention measures based on multi-disciplinary opinions to improve the health of genetic obese children.
		                        		
		                        		
		                        		
		                        			Child
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Mass Screening
		                        			;
		                        		
		                        			Pediatric Obesity/prevention & control*
		                        			;
		                        		
		                        			Public Health
		                        			
		                        		
		                        	
7.Effectiveness of different screening strategies for type 2 diabete on preventing cardiovascular diseases in a community-based Chinese population using a decision-analytic Markov model.
Jia Min WANG ; Qiu Ping LIU ; Ming Lu ZHANG ; Chao GONG ; Shu Dan LIU ; Wei Ye CHEN ; Peng SHEN ; Hong Bo LIN ; Pei GAO ; Xun TANG
Journal of Peking University(Health Sciences) 2022;54(3):450-457
		                        		
		                        			OBJECTIVE:
		                        			To evaluate the effectiveness of different screening strategies for type 2 diabetes to prevent cardiovascular disease in a community-based Chinese population from economically developed areas based on the Chinese electronic health records research in Yinzhou (CHERRY) study.
		                        		
		                        			METHODS:
		                        			A Markov model was used to simulate different systematic diabetes screening strategies, including: (1) screening among Chinese adults aged 40-70 years recommended by the 2020 Chinese Guideline for the prevention and Treatment of Type 2 Diabetes (Strategy 1); (2) screening among Chinese adults aged 35 to 70 years recommended by the 2022 American Diabetes Association Standard of Medical Care in Diabetes (Strategy 2); and (3) screening among Chinese adults aged 35-70 years with overweight or obesity recommended by the 2021 United States Preventive Services Task Force Recommendation Statement on Screening for Prediabetes and Type 2 Diabetes (Strategy 3). According to the guidelines, individuals who were screened positively (fasting plasma glucose ≥ 7.0 mmol/L) would be introduced to intensive glycemic targets management (glycated hemoglobin < 7.0%).The Markov model simulated different screening scenarios for ten years (cycles) with parameters mainly from the CHERRY study or published literature. Number of cardiovascular disease events or deaths could be prevented and number needed to screen (NNS) were calculated to compare the effectiveness of the different strategies. One-way sensitivity analysis on the sensitivity of screening methods and probabilistic sensitivity analysis on uncertainties of diabetes incidence, the sensitivity of screening methods, and intensive glycemic management effects were conducted.
		                        		
		                        			RESULTS:
		                        			Totally 289 245 Chinese adults aged 35-70 years without cardiovascular diseases or diagnosed diabetes at baseline were enrolled. In terms of the number of cardiovascular disease events could be prevented, Strategy 1 for systematic diabetes screening among the adults aged 35-70 years was 222 (95%UI: 180-264), Strategy 2 for systematic diabetes screening among the adults aged 40-70 years was 227 (95%UI: 185-271), and Strategy 3 for systematic diabetes screening among the adults aged 35-70 years with obesity or overweight (body mass index ≥ 24 kg/m2) was 131 (95%UI: 98-164), compared with opportunistic screening. NNS per cardiovascular disease event for the strategies 1, 2 and 3 were 1 184 (95%UI: 994-1 456), 1 274 (95%UI: 1 067-1 564) and 814 (95%UI: 649-1 091), respectively. Compared with Strategy 1, NNS per cardiovascular disease event for Strategy 2 increased by 90 (95%UI: -197-381) with similar effectiveness of cardiovascular prevention; however, NNS per cardiovascular disease event for Strategy 3 was reduced by 460 (95%UI: 185-724) in contrast to the Strategy 2, suggesting that the Strategy 3 was more efficient. The results were consistent in multiple sensitivity analyses.
		                        		
		                        			CONCLUSION
		                        			Systematic screening for diabetes based on the latest guidelines in economically developed areas of China can reduce cardiovascular events and deaths. However, merely lowering the starting age of screening from 40 to 35 years seems ineffective for preventing cardiovascular disease, while screening strategy for Chinese adults aged 35-70 years with overweight or obesity is recommended to improve efficiency.
		                        		
		                        		
		                        		
		                        			Adult
		                        			;
		                        		
		                        			Cardiovascular Diseases/prevention & control*
		                        			;
		                        		
		                        			China/epidemiology*
		                        			;
		                        		
		                        			Cost-Benefit Analysis
		                        			;
		                        		
		                        			Diabetes Mellitus, Type 2/prevention & control*
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Mass Screening/methods*
		                        			;
		                        		
		                        			Obesity
		                        			;
		                        		
		                        			Overweight
		                        			;
		                        		
		                        			United States
		                        			
		                        		
		                        	
8.New understanding and research opportunities of metabolically healthy obesity.
Chen Fang WANG ; Hui Qiong XU ; Xiao Yan WU ; Fang Biao TAO
Chinese Journal of Preventive Medicine 2022;56(1):69-74
		                        		
		                        			
		                        			The paradox of obesity and metabolically healthy obesity are being challenged. More and more studies have disputed the potential mechanism and prognostic value of metabolically healthy obesity. The study of metabolically healthy obesity is helpful to clarify the potential causes of obesity paradox and the potential mechanism of different degrees of obesity harm to the population. From the perspective of evidence-based medicine, combined with the relevant literature at home and abroad, this study reviewed the new understanding of metabolically healthy obesity, lifestyle factors, the impact of fat factors on metabolically healthy obesity, and the new opportunities of metabolically healthy obesity research, in order to explore whether metabolically healthy obesity can maintain and gradually reduce weight for a long time, so as to improve cardiovascular disease In order to achieve the purpose of primary prevention of related diseases.
		                        		
		                        		
		                        		
		                        			Cardiovascular Diseases
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Life Style
		                        			;
		                        		
		                        			Obesity/prevention & control*
		                        			;
		                        		
		                        			Obesity, Metabolically Benign
		                        			
		                        		
		                        	
9.Current status and progress of precision nutritional weight management guided by single nucleotide polymorphism.
Chinese Journal of Preventive Medicine 2022;56(2):132-138
		                        		
		                        			
		                        			The incidence of obesity in our country is increasing year by year. Diet and lifestyle interventions are the most commonly used weight loss measures, but their intervention effects are affected by individual genetics, environment and other factors. Genome-wide association analysis has found many SNPs related to weight loss, and explored the interaction between these loci and diet, intestinal flora and other environmental factors. This article summarizes the study of single nucleotide polymorphisms, the analysis of gene-environment interactions related to diet interventions for weight loss, and the multi-loci analysis and prediction models such as genetic risk scores and machine learning modeling in weight loss, which provides reference for the further application and development of the precise nutrition in medical weight loss.
		                        		
		                        		
		                        		
		                        			Gene-Environment Interaction
		                        			;
		                        		
		                        			Genome-Wide Association Study
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Life Style
		                        			;
		                        		
		                        			Obesity/prevention & control*
		                        			;
		                        		
		                        			Polymorphism, Single Nucleotide
		                        			
		                        		
		                        	
10.Epidemiological research progress on the relationship between children's dietary patterns and health.
Meng Xue CHEN ; Jing Yuan XIONG ; Li ZHAO ; Guo CHENG ; Qian ZHANG ; Gangqiang DING
Chinese Journal of Preventive Medicine 2022;56(2):139-145
		                        		
		                        			
		                        			As food preferences and eating habits form early in life, the development of healthy eating habits in early childhood is a way to prevent diet-related diseases. The dietary pattern approach examines the effect of an overall diet on health outcomes, instead of individual foods or nutrients, thereby presenting a comprehensive evaluation of children's dietary intake. This article reviews the current literature to summarize the main methods for assessing dietary patterns and explore relationships between children's dietary patterns and obesity, puberty onset, cardiovascular diseases, and neurodevelopment. The purpose of this review is to provide evidence-based support for reducing the risk of diet-related diseases in children and recommendations for future research directions.
		                        		
		                        		
		                        		
		                        			Child
		                        			;
		                        		
		                        			Child, Preschool
		                        			;
		                        		
		                        			Diet
		                        			;
		                        		
		                        			Eating
		                        			;
		                        		
		                        			Feeding Behavior
		                        			;
		                        		
		                        			Food Preferences
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Obesity/prevention & control*
		                        			
		                        		
		                        	
            
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