医学书籍－－节食（medical book for overweight）

The Evidence Report
September. 1998. NIH Publication: National Institute of Health,
National Heart, Lung and Blood Institute in cooperation with The National Institute of Diabetes and Digestive and Kidney Diseases Appendices

　

在1995年，（美国）国家肥胖教育控制委员会（隶属于NHLBI）联合NIDDK，召集一流的专家制定关于成人肥胖和超重的识别、评估、治疗临床指导原则，以便临床从业者得以在工作中施行。

推动此指导原则的施行的是全美国的肥胖和超重人数的增加和流行。而医生需要提醒病人一些的风险因素。

超重的人常合并高血压、高血脂、2型糖尿病、冠心病和别的一些健康问题。在美国，一年因肥胖而发生的医疗支出达1000亿美元。

肥胖与超重的诊疗原则

262页，1.4M。 PDF格式！

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Clinical Guidelines on the Identification, Evaluation, and Treatment
of Overweight and Obesity in Adults.

对识别、评估、治疗成人的超重和肥胖临床指导原则

Foreword
　

In 1995, the National Obesity Education Initiative of the National Heart, Lung, and Blood Institute (NHLBI), in cooperation with the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), convened the first Expert Panel on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults to develop clinical practice guidelines for primary care practitioners.

The impetus for these guidelines was the recognition that the prevalence of overweight and obesity in the United States is increasing, and that practitioners need to be alerted to the accompanying health risks. According to the latest statistics from the third National Health and Nutrition Examination Survey, 97 million Americans are overweight or obese. Excess weight is often accompanied by high blood pressure, high blood cholesterol, type 2 diabetes, coronary heart disease, and other health problems. The total costs attributable to obesity-related disease approach $100 billion annually in the United States.

The panel used the principles of evidence-based medicine, including an evidence model and evidence categories. It was the first time a panel thoroughly examined the scientific evidence for risks associated with overweight and obesity, and their treatments, and developed clinical practice recommendations based on their conclusions.

The panel was headed by Dr. F. Xavier Pi-Sunyer, of St. Luke's/Roosevelt Hospital Center in New York City. He and the other 23 panel members methodically and critically examined a vast amount of published scientific evidence. The panel also obtained scientific input from approximately 115 outside reviewers. The result was The Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults: The Evidence Report. Dr. David Schriger of the University of California at Los Angeles, who is a methodologist consultant in the area of evidence-based practice guidelines, and Dr. Elaine Chiquette of the San Antonio Cochrane Center in Texas, who developed the evidence tables, served as key advisors to the panel.

Evidence examined by the panel included: research on the relationship of overweight and obesity to high blood pressure, high blood cholesterol, type 2 diabetes, stroke, congestive heart failure, coronary heart disease, various cancers, osteoarthritis, and sleep apnea; risks associated with the distribution and amount of body fat; and various treatment strategies, including diet, physical activity, behavior therapy, pharmacotherapy, and surgery. The resulting guidelines document how different treatment strategies affect weight loss and how weight control affects the major risk factors for heart disease and stroke.

The guidelines have been reviewed and endorsed by many professional organizations. In fact, because of the associated risks between high blood pressure and high blood cholesterol and overweight and obesity, the document represents the first clinical practice guidelines to be reviewed and endorsed by members of the coordinating committees of both the National Cholesterol Education Program and the National High Blood Pressure Education Program which comprise approximately 52 professional societies, government agencies, and consumer organizations. Two additional groups endorsing the guidelines are the North American Association for the Study of Obesity and the NIDDK National Task force on the Prevention and Treatment of Obesity.

The report, the evidence model and its accompanying evidence tables, and a body mass index calculator are available on the NHLBI website at the following location: http://www.nhlbi.nih. gov./nhlbi/cardio/obes/prof/guidelns/ob_home. htm

An abbreviated version of the evidence report is being prepared and will be distributed to primary care physicians, nurses, registered dietitians and nutritionists, and other health care practitioners.

It is our hope that these clinical guidelines will not only help the health care practitioner understand the importance of weight management but also provide them with the tools to assess and treat their patients more effectively. Equally important, we hope that the guidelines lead to a greater public understanding of obesity and a greater appreciation for the persistent efforts of millions of people to lose weight.

Claude Lenfant, M.D.

Director

National Heart, Lung, and Blood Institute