Tap chl Tai MQI Hpng Vijt Nam - Volume (58-14). N°2 - Apr, 2013
MOT SO YEU TO NGUY CO ROI LOAN LIPID MAU 0
TRE EM BEO PHI TlT 6-10 TUOI TAI MpT SO TRUCJNGTIEU HQC CUA HA NQI NAM 2012
Bid Thi Nhung*, Le Thi Hgp*, Nguyen Do Huy', Tran Quang Binh", Phgm Thi Tuyit Lan" , Vu Anh Linh"", Biii Nggc Hd ""
Nghien ciru tim hieu mot sd yeu to nguy co rdi logn lipid mdu(RLLM) d tre beo phi 6- 10 ludi tgi mgt so trudng tieu hoc tgi Hd Ngi ndm 2012. Thiet ke nghien ciru benh chimg tren 119 Ire beo phi 6-10 tuoi vd 121 Ire binh thudng Igi mgt so trudng lieu hgc thugc dia bdn thdnh phd Hd Ngi tii thdng 11 ndm 2011 den thdng 7 ndm 2012. Ket qua cho thdy:
Mgt sd yeu td nguy ca den roi logn lipid mdu a Ire em beo phi 6-10 tudi Id BMl trung binh Clia bd me; bo, me cd bieu hien thira cdn, beo phi; Tinh cdch dn udng hdu an, dn vgt, dn nhanh, dn nhieu, dn trudc khi di ngii ciia Ire beo phi; Sd thich dn udng thirc dn beo cita tre beo phi: Tre beo phi cd thdi gian ngii dem it hon nhung lai cd thdi gian ngii trua nhieu hem nhdm binh thudng.
Tirkhda: Cdc yeu td nguy ca RLLM, thira cdn beo phi, hgc sinh tieu hgc.
SUMMARY
SOME RICK FACTORS OF DYSLIPIDEMIA AMONG OBESITY SCHOOL CHILDREN FROM 6 TO 10 YEAR OLD AT SOME PRIMARY SCHOOLS OF HANOI CITY IN 2012
The research aimed to identify the some risk factors of dyslipidemia status of obesity school children from 6 to 10 year old at some primary schools in Hanoi city in 2012. A case- control study was conducted with involvement of 119 obesity school children and 121 normal school children of some primary schools of Hanoi City from November, 2011 to July, 2012. The results show that: Some risk factors of dyslipidemia of obesity school children fi-om 6 to 10 year old were: average EMI score of fathers, mothers; signs of overweight and obesity of fathers ,mothers; eating behavior of obesity children such as greedy. Junk food, over eating, carting before go to bed, and interests in fat food., and prevalence of less time of at night sleeping but more time of at noon sleeping in obesity children was higher than that in normal children.
Key words: risk factors of dyslipidemia status, obesity, school children.
khoang 24% tte em 6-9 tu6i bi thira can L D A T V A N D E hoac beo phi. Tai My, theo s6 lieu dua theo Theo bao cao cua To chiic Y Te The can nang va chieu cao tir National Health Gioi, tai chau Au nam 2007 trung binh co and Nutrition Examination Survey
' (NHANES) nam 2007-2008 cho thiy
• ViSn Dinh du9ng khoang 16,9% tre em va thanh thieu niSn tit
"viSnVe sinh Dich tS Tmng ucmg 2 dfa 19 tudi beo phi [1]. T6 chuc phong
;;; Tnicmg Dai hoc Y khoa Phan, Ngoc Thach ^ < ^^ ^ , x^ , / (,Q.pp) ^^ j j ^g Tmimg Dai hoc DUQC Hi Noi . s J- .^
" " ' Tniimg Dai hoc Jumonji, Nh|t I Nhjn bW 25.2. Duyet in 15.3.2013
.... " .: ^ „ivT-- cnong oeo pni quoc te yiKj I r) i^mi^ \^a ^uiiB - • • T X V T J Z ^ % B ^ "« ° l*a tu6i hpc duong hien nay co
85
Tgp chl Tai MQi Hgng Vi^t Nam - Volume (58-14). N°2 - Apr. 2013
khoang 155 trieu tre em (khoang 10%) bj thija can va b6o phi. Trong do co khoang 30-45 trieu, chiem 2-3% tong so tr6 em bj beo phi [2].
Tai Vigt Nam, b6o phi c6 xu hu6ng gia tang nhanh chong d mgi lira tuoi vji cdc vung mien, dac biet la a khu vuc thanh thj, trong do the h6o byng la thudng gap nhat.
Mgt so benh man tinh lien quan den dinh duQfng nhu dai thao duong, ting huyet ap,...
ciing ngay cang gia tSng [3]. Cac cugc dieu tra dich te hgc truoc nhung nam 1995 cho thay ty le thira can khong dang ke, beo phi hau nhu khong co, nhung tu nam 2005 ty Ig thira can da len toi 9,7% va beo phi dp 1 la 6,2% o lua tuoi 25 den 64 tuoi [4], Thira can, beo phi da tro thanh van de siic khoe cgng dong truoc het 6 cac do thi nhu Ha Ngi, Ho Chi Minh va Hai Phong. Beo phi gay nen nhijng anh hucmg tieu cue tdi sue khoe liic tre nho cung nhu khi truong thanh [5]. Beo phi lam tang nguy co mac benh tim mach, benh tang huyet ap, roi - loan lipid mau; roi loan dung n^p glucose, tang insulin mau va tang de khang voi insulin [6]. Hgi chung chuyen hoa duoc xem nhu la mgt trong nhihig yeu to nguy co tim mach thuong gap 6 nguoi Ion ciing da xuat hien 6 tre em va co lien quan voi tinh trang beo phi [7].
Do vay, de co them cac so lieu cap nhat ve cac yeu to lien quan 6 tre em tiiu hgc - doi tugmg can dugc uu tien trong cac chuong trinh can thiep ve sue khoe va dinh duong - dong thoi xuat phat tir nhu cku thuc tien, chiing toi tien hanh nghien cuu de tai: "M^/ so yeu to nguy ca roi logn lipid mdu d tre beo phi tir 6-10 tudi tgi mpt so trirffng tieu hpc cua thdnh phd Hd Ndi ndm 2012" nham xac dinh mgt s6 y6u t6 nguy CO den roi loan lipid mau 6 tre em beo phi 6-10 tu6i tai Ha Npi nam 2012.
2. fi6l TirgfNG VA PHU'ONG PHAP NGHIEN CUV
D6I twp^ng:
Trd 6 den 10 tuoi dugc xac dinh mac b^o phi bang ngudng phan loai quoc tk theo BMl rieng theo gioi v^ tuoi tu 6-10 tuoi, tuong img voi BMl > 30 kg/m^ 6 ngudi 18 tu6i[8] va dugc loai tru bdo phi do nguyen nhan ngi tiet, do khiem khuyet di truyen, do diing thuoc nhu dCmg Corticoid kdo dai hoac dang dieu tri roi loan lipid mau keo dai.
Cha me hoac ngudi cham soc true tiep Clia tre dugc chgn (khong bj tam than, khong bi roi loan tri nho va hgp tac va dong y tham gia nghien cuu).
Dja diemva thdi gian nghien cihi:
Nghien cuu dugc thuc hien tai mgt so trudng tieu hgc thugc cac quan huyen ngi, ngoai thanh ciia Ha Ngi: Hoan Kiem, Hoang Mai, Thanh Tri, Thanh Xuan, Tir Liem, Hai Ba Tnmg, Ddng Da, Dong Anh.
Thdi gian nghien cuu: tir thang 12/2011 dSn thang 7/2012.
Thiet ke nghien cihi: Nghien ciiu benh chung de tim cac yeu to nguy co cua roi loan lipid mau. Cong thirc tinh co mau [9] la:
(lTr3=.C r,(lnOR)-,p(l - p) OR = 3; p= O.J; a=0,OS vd p=0.2; C=
7.85; r = 1(1 benh 1 chimg); n = 104,uac 10% bd cugc, cd mdu Id 114 doi tugng cho mdi nhdm. Tren thuc ti cd 119 Ire beo phi cd RICH lipid, ldy loan bg s6 ndy vdo nghien ciru.
Thu th^p thong tin:
Tri tie 6-10 tudi: Xet nghi&n cholesterol toan phin, LDL-C, Triglycerid,
Tap chl Tai Mui Hpng Vifet Nam - Volume (58-14) N°2 - Apr, 2013
HDL-C mau dugc thuc hien bdi b?nh vien Medlatec. Tre dupe xac dinh co r6i loan chuyen hoa lipid mau khi co roi loan theo ngudng eao > 1 chi so lipid mau: cholesterol toan phan, LDL-C, Triglycerid, HDL-C.
Ngudng xac dinh rdi loan chuydn hoa lipid mau d tre em theo NCEP [10]
Cac yeu to lien quan dupe nghiSn cuu thdng qua sir dung phuong phap phong van vdi bp cau hdi thiet ke sin: Cac th6i quen an uong va sinh hoat cua tre, tien sii gia dinh va tien sir cua tre nhu tinh tr^g thira can, beo phi cua bo me, can nang luc sanh Clia tre, tien can suy dinh dudng. quan diem ciia cac cha me ve tinh trang dinh dudng cua tre, tinh trang kinh te cua gia dinh tre.
Phdn tfch vd xir ly sd lieu: Sii dung phan mem theo chuong trinh SPSS for window 14.0 vdi cac test thong k8 y hgc.
Danh gia moi lien quan giiia rdi loan lipid mau va yeu to nguy co dua vao ty suat chenh (OR). De so sanh giiia cac ty le dimg test X ^ de so sanh 2 nhom hoac 3 nhom vdi nhau, trong trudng hgp mlu nho hon 5 test chinh xac ciia Fisher dugc su dung. Sd lieu khong phan phoi theo luat chuan dugc sir diing test Krukal-Wallis va Mann-whitney.
Dfio dire nghien cihi: De tai da dugc th6ng qua h6i ddng y diic cua Vien Dinh dudng Quoc gia t4t ca hpc sinh tham gia nghien cuu va phu huynh cua cac em se dupe giai thich ro ve muc dich, npi dung thuc hien va quyin Igi khi tham gia nghien cim, d6ng thdi se ky gidy ddng y tham gia trudc khi tiSn hanh liy mau. Nhihig thdng tin ca nhan thu thap dugc se ma boa va bao mat tuyet ddi. Cac sd li^u thu thap dugc chi Sli dung cho muc tieu nghien cim, khong ph\ic vu cho muc dich nao khac.
3. KET QUA NGHIEN ClTU
BSng 3-1. Giei trj trung binh ciia mOt s6 chi tieu nghifen cCfu d cdc nh6m doi tugng di^u tra
giai do^n 2 Chi tiSu nghien
CLTU
can nang (kg) Chidu cao (cm) BMl {kglir?) Ving eo (cm) V6ng mdng (cm) Ty s6 vong eo/v6ng mong Du'ong huyet (mg/dl)
B6o phi c6 RLLM (n = 119) TB±SD 42,0 ± 9,4 131,2 ±10,0 24,0 ± 2,3 74,6 ± 7,6 79,0 ± 6,9 0,9*0,1 80,9 ± 5,6
Nh6m chu'ng (n = 121) TB±SD 25.6 ± 5,4 128,4 ±9,9 20,0 ± 4,5 64,6 ±11,9 71,4 ±10,0 0,9 ±0,1 81,9 ±8,2
P
<0,01
>0,05
Bang 3.1 cho thay nhom beo phi cd roi loan lipid mau co trung binh chieu cao, chi so BMl, vong eo, vong mong eao hon nhom chiing mpt each co y nghia thong ke (p < 0,01). Ty so vdng eo/vdng mong cua nhdm beo phi c6 roi loan lipid mau trung binh la 0,94, cao hon so vdi nhom chiing la 0,90 va sir khac biet nay co y nghia thdng ke (p < 0,01). Can nang trung binh cua nhom beo phi c6 roi loan lipid mau la 42,0 kg cao hon gip 1,5 lan so vdi nhom chung va su khac biet nay co y nghia thong ke (p
< 0,01). Tuy nhien, dudng huyet trung binh cua nhom beo phi co roi loan lipid mau va nhom chiing khong khac biet vdi p>0,05.
Bang 3 2 Nong 36 trung binh cua cSc thdnh ph^n lipid mdu cua 2 nh6m
Y4ut6 Cholesterol todn Dhan (mg/dl) HDL-C (mg/dl) LDL-C (mg/dl) Triglycerid (mg/dl)
Beo phi c6 RLLM (n = 119) T B ± S D 167,4 ±38,4 45,9 ±10,2 102,3 ±33,1 137,8 ±60,5
Nhom chu'ng (n = 121) T B ± S D 142,0±16,7
58,2 ± 8,7 81,3 ±13,2 66,5 ±11,7
P
<0,01
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Tgp chl Tai MQi Hgng Vi^t Nam - Volume (56-14). N°2 - Apr., 2013
Ket (jua cua bang 3.2 cho thay trh b^o phi cd rdi loan lipid mdu c6 trung binh triglycerid la 137,8 mg/dl cao hon gap doi so vdi nhom chung la 56,5 mg/dl (p< 0,001). Trung binh cua cholesterol toAn phan va LDL-C tuy khong d mure cao nhung cao hon nh6m chirng c6 y nghia thong ke (p < 0,001). Trung binh cua HDL- C d nh6m b^o phi cd roi loan lipid mdu 1^
45,9 mg/dl thap hon nhdm chimg la 58,2%
mgt each cd y nghia thdng ke (p < 0,001).
sang 3.3 M6i li^n quan giOa tinh trgng BMl cua cha m? va mifc chi cho Sn u6ng vdi r6i
logn lipid d tre
Tinh trang
BMl (trung
binh) Bo Me Mi>c chl Sn u6ng ngu'6'i/thang {tri$u donq)
B4o phi c6 RLLM ( n = 1 1 9 ) T B ± S D 23,2 ± 2,3 22,1 ± 1 , 9 4,0 ± 2 , 7
Nh6m chCrng (n = 121) T B ± S D 21,8 ± 2 , 1 20,9 ± 1 , 9 4,0 ± 2 , 7
P
< 0 , 0 1
< 0 , 0 1
> 0 , 0 5
Ket qua cua bang 3.3 cho thay mac dii mire chi phi cho viec an udng binh quan diu ngudi/thang cua cac gia dinh co tre beo plu cd roi loan lipid mau la khoang 4 trieu dong khong khac biet so vdi nhom chiing (p >
0,05) nhung BMl trung binh ciia bd va mg d nhom beo phi cd rdi loan lipid mau lan lugt la 23,2 va 22,! cao hon BMl tnmg bmh ciia bd va me d nhom chiing la 21,8 va 20,9 vdi su khac biet cd y nghia thdng ke (p < 0,001).
Bang 3 4. Moi lign quan gi&a thCra can, b^o phi cue cha mg vdi r6i logn lipid d tre Tinh ch^t
gia iTInh Cha thCra can BP,n(%) M$ thu-a can BP,n(%) Cha me thCra cdn BP,n(%)
B6o phi C6RLLM ( n = 1 1 9 ) 33(27,7) 32(26.9) 32(26,9)
Nh6m chCrng (n = 121)
34(29,9) 18(16,2)
6(5,0) OR
1,02 2,1 7,05
P
> 0 , 0 5
< 0 , 0 6
< 0 , 0 1
Bang tren cho thiy ty 1^ mp thira can b6o phi d nhdm b6o phi ed roi loan lipid mdu Ik gin 27% cao hon gap 1,5 lan so vdi nhdm chumg (p < 0,05). Rieng vdi ty le tre b^o phi cd r6i loan lipid mau co cha me deu thira can b^o phi la 26,9% cao hon gap 5 lan so vdi nh6m chiing, s\r khac bi^t nay co y nghia thong ke (p < 0,001).
Bang tren ciing cho thay tre c6 mp thiia can b^o phi sS cd nguy co bj bdo phi cd roi loan lipid mdu cao hon 2,1 Ian so vdi nhom chiing, tr^ c6 cA cha va me thira can beo phi thi se cd nguy eo eao hon 7,05 lan so vdi nhdm chiing.
Bang 3.5. M6i lidn quan giOa d$c di^m ban thdn, th6i quen vd sd thich dn udng cua tre vdi
tinh trgng roi logn lipid B6o phi Nhdm Tinh trang c6 RI.LM chipng OR p
(n=119) (n = 121) D|c diem ban
than cua tre CNSS2 4000q,n(%) Con mot,n(%) Con ut,n(%) Kinh te gia dinh giau,n(%) Thoi quen Sn uong
11(9,2) 15(12,6) 49(41,2) 84(70,6)
Hau an,n(%) 69(58,0) An vgt.n(%)
An nhanh,n(%) An nhl4u,n(%) An tru'6'C khi dl ngu,n(°/o) Sd> thich an u6ng cua tre Thich mu'c an b4o,n(%) Thich thirc an ngotn(%) Thich an tdm,cua, ca,n(%)
35(29,4) 68(48,7) 36(30,3) 20(16.8)
74(62,2) 85(71,4) 80(67.2)
5(4,1) 0,47 12(10,0) ' 0.76 53(43,8) 80(66,1)
13(10,7) 53(43,8) 12(9,9)
5(4.2) 43(35,5)
60(49,6) 85(70,2) 87(71,9)
1.11 0,79
>0,05
>0,05
>0,05
>0,05
11,46: <o,01 0.53 < 0,05 8,60 9,97 0.36
1,67 1,06 0,80
<0,01
<0,01
<0.01
<0,05
>0,05
>0,05
Tgp chl Tai MOi Hong Vi$t Nam - Volume (58-14) N°2 - Apr.. 2013
Bang 3.5 cho thiy m6i lien quan giiSa can n|ng so sinh, yeu td con mpt hay con lit vdi tinh trang beo phi cd rdi loan lipid mau cua tre chua dugc tim thiy.
Hau an la dac diem noi trpi cua iih6m tre beo phi cd rdi loan lipid mau (58%) trong khi dac diem nay d nhom binh thudng chi la 10,7%. Sv khac bipt nay cd y nghia thdng ke vdi p < 0,001, OR = 11,46.
Ty 1$ tre an nhieu trong nhdm b6o phi cd r6i l o ^ lipid mau chiem 30,3%, cao hon gip 7 lin so vdi tre nhdm chiing la 4,2% (p
< 0,001, OR = 9,97). Tre beo phi co rdi loan lipid mau an vat, an nhanh, an trudc khi di ngii nhieu hon ban so vdi nhom chimg vdi p < 0,05-0,001.
Bang tren cho thiy sd thich thuc an beo ciia nhom tre beo phi eo roi loan lipid mau chilm ty le 62,2% cao hon nhdm chiing la 49,6%, su khac biet nay cd y nghia thdng ke vdi p ^ 0,04. Tre co sd thich thiic an beo se CO nguy co bi beo phi co rdi loan lipid mau cao hon 1,67 lin so vdi nhdm chiing.
Sd thich d6i vdi cac thiic an khac khong co su khac biet giiia 2 nhom.
Bang 3.6. Tinh trang hogt dpng tTnh tgi cua 2 nh6m
Tinh trang hoat
Sd phot xem TV/nqay Choi dl$n tCr (Philt) Thdi gian ngu dem (qla) TTiol gian ngii tnia (phot) Ngoi choi CO, trd chuyen, ve tranh, dpc sach bao (philt) cac hoat dgng TDTT*
Beo phi cd RLLM (n = 119) (TB ± SD) 128,5 ±82.5
18,6 ±35,9 8,2 ±0,7 107,7 ±137,0
96,6 ± 59,3 n
66
%
55,5 Nh6m chi>ng (n= 121) (TB ± SD) 117,8 ±72.2
13,6 ±29,8 8.4 ± 0,6 78,8 ± 35,9
119.7 ±81,5 n
57
%
P
>0.05
>0,05
<0,01
<0,05
<0,05
47.1 |>0,05
"OR = 1,4
Qua kk qua a bang 3.6 cho thiy thai gian ngii trong dem va thai gian ngoi choi cua nhom b^o phi co roi loan lipid mau thap han nhom chung mgt each c6 y nghTa thong ke (p < 0,05). Tuy nhien, thcri gian ngii tnra trung binh ciia nhom beo phi co roi loan lipid mau cao han nhom chiing (p < 0,05).
Thoi gian danh cho hoat dpng giai tri nhu xem ti vi va choi di?n tu 6 2 nhom nhu nhau (p > 0,05).Ty 1? khong tham gia cac hoat dpng the due the thao a nhom beo phi CO roi loan lipid mau la 55,5% khong khac biet so voi nhom chiing (p > 0,05).
Qua nghien cmi ciia chiing toi con thay rang BMl trung binh cua b6 va me o nhom beo phi CO roi loan lipid mau lan lupt la 23,2 va 22,08 cao hon BMl trung binh cua b6 va me a nhom chiing la 21,8 va 20,9 (p
< 0,001). Mac dii miic chi phi cho viec an u6ng binh quan diu nguoi/thang ciia cac gia dinh co tre beo phi co roi loan lipid mau la khoang 4 trieu ddng khong khac biet so voi nhom chiing (p > 0,05), nhung ty le me thira can beo phi 6 nhom beo phi co roi loan lipid mau la gin 27% cao hon gip moi so voi nhom chiing voi 0R=2,1 (p < 0,05).
Rieng vcri ty le tre beo phi co r6i loan lipid mau CO cha me dSu thira can beo phi la 26,9% cao hon gip 5 lin nhom chiing, OR
= 7,05 (p < 0,001). Nghien cilu cua tac gia Novaes va cpng sir [11] ciing cho thay ty le beo phi a tre co thd giam dang kj nho vao su tang nhan thirc cua bo me v6 che dp dinh duong diy dii va hpp ly.
Mpt s6 nghien cilu khac cung cho thay ring tre beo phi co cha hoac me bi beo phi CO nguy CO cao bi r6i loan lipid mau dac
Tgp chl Tai MOi Hpng Vi$t Nam - Volume (58-14). N°2 - Apr., 2013
biet tang triglycerid va giam HDL- Cholesterol [12]. Tac gia Candido va cpng su nghien ciiu tren 780 doi tupng la hpc sinh tieu hpc cho thay tre b^o phi c6 nguy CO cao bj tang triglycerid va giam HDL- Cholesterol, dac bi?t d nhihig tre cd cha hoac mp bi beo phi [13].
Qua ket qua nghien ciiu cua chiing tdi cho thay "hau an" la dac diem noi trpi cua nhdm tre beo phi co roi loan lipid mau (58%) trong khi d5c diem nay d nhom binh thudng chi la 10,7% (p<0,001, 0R= 11,46).
Ty le tre an nhieu chiem 30,3%, cao hon gap 7 lan so vdi tre nhdm chiing la 4,2% (p
< 0,001, OR - 9,97). Cac thoi quen an vat, an nhanh, an trudc khi di ngu nhieu hon ban so vdi nhdm chiing vdi p < 0,05-0,001.
Ket qua nay phii hpp vdi nghien ciru cua Savitha cho thay tre em thira can, beo phi cd Idi sdng tTnh tai, it van ddng, cd thoi quen an vat, an nhieu chat beo cd ty le cao rdi loan lipid mau ( P <0,05) [14]. Nghien ciiu Clia tac gia Yamborisut ciing cho thay tang cholesterol mau d tre em liia tuoi hpc dudng cd lien quan den yeu to gia dinh, trpng lupng co the va che dp dinh dudng cua tre [15]. Trong nghien ciru ciia chung tdi, da so cac tre beo phi co roi loan lipid mau thich thiic an beo, chiem ty le 62,2%
cao hon nhom chiing la 49,6%, su khac biet nay co y nghia thong ke vdi p = 0,04. Tre CO sd thich thiic an beo se cd nguy co bi beo phi CO rdi loan lipid mau cao hon 1,67 lin so vdi nhom chiing. Ket qua nay tuong tu nhu ket qua nghien ciiu ciia cac tac gia khac [14].
K^TLUAN
Mpt sd yeu t6 nguy co den roi loan lipid mau d trd em b^o phi 6-10 tu6i la:
BMl trung binh ciia bo me B6, mp cd bieu hipn thira can, b^a phi
Tinh each an uong ciia tre beo phi:
hau an, an vSt, an nhanh, an nhilu, an trudc khi di ngii
Sd thich an uong cua tre beo phi:
thich thiic 5n beo.
Tre beo phi rdi loan lipid mau co thdi gian ngii dem it hon nhom binh thudng nhung lai co thdi gian ngu trua nhieu hon.
KHUYEN NGHI
Nen tuyen truyen cho cpng dong ve cac hau qua lam sang va c ^ lam sang ciia beo phi d tre em nhu rdi logn lipid mau, tang huyet ap,... de bd me cua tre nhan thuc dupe tam quan trpng cua dieu tri beo phi d tre em va khuyen khich hp thuc hanh che dp sinh boat, luyen tap va dinh dudng phii hpp cho tre.
Chiing toi c h ^ thanh cam on cac em hpc sinh, cha mp cac em va cac thay co giao cac trudng tieu hpc Ha Npi da nhiet tinh cpng tac vdi nhdm dieu tra. Nghien cuu dupe su tai trp ciia Sd Khoa hpc va Cdng Nghe Ha Ndi cho d^ tai "Nghien ciiu moi lien quan cua gen va loi sdng doi vdi nguy CO mic benh beo phi ciia tre em tieu hoc Ha Noi", ma sd OlC-08/05-2011-2.
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Tgp chl Tai MOi Hpng Vi$t Nam - Volume (58-14). N''2 - A p r , 2013
TAI LI£U THAM KHAO Cynthia Ogden, Margaret Carroll.
(2010), "Prevalence of Obesity Among Children and Adolescents: United States, Trends 1963-1965 Through 2007-2008", Division of Health and Nutrition Examination Surveys.
Lobstein, T., Baur, L., Uauy, R.
(2004), "Obesity in children and young people: a crisis in public health", Obes Rev, 5 Suppl 1,4-104.
Ha Huy Khdi, Nguyen Cdng Khan, Le Thi Hpp (2008), "Cac thanh td chinh ciia chien lupe dinh dudng du phong cac bpnh man tinh d Viet Nam", Tgp chi Dinh Duong vd Thuc Phdm, so 4(3-^4).
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