Prevalence and Characteristics of Overweight and Obesity in Indigenous Australian Children: A Systematic Review

Evidence-based profiling of obesity and overweight in Indigenous Australian children has been poor. This study systematically reviewed evidence of the prevalence and patterns of obesity/overweight, with respect to gender, age, remoteness and birth weight, in Indigenous Australian children, 0–18 years (PROSPERO CRD42014007626). Study quality and risk of bias were assessed. 25 publications (21 studies) met inclusion criteria, with large variations in prevalence for obesity or overweight (11% to 54%) reported. A high degree of heterogeneity in study design was observed, few studies (6/21) were representative of the target population, and few appropriately recruited Indigenous children (8/21). Variability in study design, conduct and small sample sizes mean that it is not possible to derive a single estimate for prevalence although two high-quality studies indicate at least one in four Indigenous Australian children are overweight or obese. Four of six studies reporting on gender, found overweight/obesity higher in girls and eight studies reporting on overweight/obesity by age suggest prevalence increases with age with one high quality large national study reporting total overweight/obesity as 22.4% of children aged 2–4 years, 27.5% of those aged 5–9, 38.5% aged 10–14 and 36.3% aged 15–17. Three of four studies, reporting obesity/overweight by region, found lower rates for children living in more remote areas than urban areas.

针对澳大利亚原住民儿童肥胖与超重状况的循证特征分析一直较为匮乏。本研究针对0至18岁的澳大利亚原住民儿童，系统梳理了肥胖与超重的患病率及其在性别、年龄、地域偏远程度和出生体重维度下的分布特征（PROSPERO注册号：CRD42014007626）。研究对纳入文献的质量及偏倚风险进行了评估。最终有25篇文献（对应21项研究）符合纳入标准，报告的肥胖或超重患病率差异显著，区间为11%至54%。研究设计存在高度异质性，仅少数研究（6/21）能代表目标人群，且仅有少量研究（8/21）恰当招募了原住民儿童参与。由于研究设计、实施过程存在差异且样本量普遍偏小，尽管两项高质量研究显示，至少四分之一的澳大利亚原住民儿童存在超重或肥胖问题，但无法得出统一的患病率估算值。在6项针对性别维度的研究中，有4项发现女童的超重/肥胖率更高；另有8项按年龄分组的超重/肥胖研究显示，患病率随年龄增长而上升——其中一项高质量的大型全国性研究表明，2~4岁儿童的超重/肥胖总患病率为22.4%，5~9岁为27.5%，10~14岁为38.5%，15~17岁为36.3%。在4项按地域分组的超重/肥胖研究中，有3项发现居住在偏远程度更高地区的儿童，其患病率低于城市地区儿童。