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Lyu J, Wan Z, Liu Z, Zhou S, Feng X, Gao A, Lin Y, Zhang F, Wang H. Effect of a Multifaceted Intervention on Children's Body Image and the Mediating Role of Body Image in Changes in Adiposity Indicators. Nutrients 2023; 15:3951. [PMID: 37764735 PMCID: PMC10534561 DOI: 10.3390/nu15183951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 09/04/2023] [Accepted: 09/07/2023] [Indexed: 09/29/2023] Open
Abstract
Besides genetic factors and energy-related behaviors, psycho-cultural factors are also important in obesity etiology. Previous studies have suggested that improving body image might be an effective method for managing body weight. Thus, this study aimed to evaluate the effects of a multifaceted intervention on the body image of children and explore whether body image played a mediating role in changes in adiposity indicators. This study was embedded in a cluster randomized controlled trial, involving 1287 children from 24 primary schools in three cities in China (Beijing, Changzhi and Urumqi). The 9-month multifaceted intervention on childhood obesity included five components (three targeted children and two targeted environments), and randomization was performed by an independent person who was blinded to the schools. Two indicators (body size perception and body size expectation) were chosen to characterize body image and were measured by Ma figural stimuli at baseline and the end of the trial. Changes in body image indicators were classified as conducive to weight loss or not. Other anthropometric measures and self-reported behaviors were also collected at both time points. Generalized linear mixed models were used in the analyses. Compared to the controls (n = 648), the proportion of body size perception conducive to weight loss increased in the intervention group (n = 639), with an odds ratio of 2.42 (95%CI: 1.70~3.45, p < 0.001). The proportion of body size expectation conducive to weight loss also increased more in the intervention group than in the controls (OR = 1.74, 95%CI: 1.14~2.66, p = 0.010). In children whose baseline nutritional status was "normal weight with higher BMI" or "overweight/obese", the improvements in body size perception and body size expectation partly mediated the association between the intervention and changes in BMI, BMI Z score, waist circumference and body fat percentage (p < 0.05). This multifaceted study effectively improved the body image of children, which, in turn, led to beneficial changes in adiposity indicators. For the first time, body size perception and body size expectation have been confirmed to be important factors associated with the beneficial effect of a childhood obesity intervention, suggesting that body image components should be generalized in the future.
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Affiliation(s)
- Jinlang Lyu
- Department of Maternal and Child Health, School of Public Health, Peking University, National Health Commission Key Laboratory of Reproductive Health, Beijing 046000, China; (J.L.); (Z.W.); (Z.L.); (S.Z.)
- Peking University Health Science Center-Weifang Joint Research Center for Maternal and Child Health, Weifang 261000, China
| | - Zhongshang Wan
- Department of Maternal and Child Health, School of Public Health, Peking University, National Health Commission Key Laboratory of Reproductive Health, Beijing 046000, China; (J.L.); (Z.W.); (Z.L.); (S.Z.)
| | - Zheng Liu
- Department of Maternal and Child Health, School of Public Health, Peking University, National Health Commission Key Laboratory of Reproductive Health, Beijing 046000, China; (J.L.); (Z.W.); (Z.L.); (S.Z.)
| | - Shuang Zhou
- Department of Maternal and Child Health, School of Public Health, Peking University, National Health Commission Key Laboratory of Reproductive Health, Beijing 046000, China; (J.L.); (Z.W.); (Z.L.); (S.Z.)
| | | | - Aiyu Gao
- Dongcheng Primary and Secondary School Health Care Center, Beijing 236499, China;
| | - Yi Lin
- Urumqi Primary and Secondary School Health Care Center, Urumqi 830003, China
| | - Fang Zhang
- Mentougou Primary and Secondary School Health Care Center, Beijing 102300, China;
| | - Haijun Wang
- Department of Maternal and Child Health, School of Public Health, Peking University, National Health Commission Key Laboratory of Reproductive Health, Beijing 046000, China; (J.L.); (Z.W.); (Z.L.); (S.Z.)
- Peking University Health Science Center-Weifang Joint Research Center for Maternal and Child Health, Weifang 261000, China
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Zhang Y, Huang L, Zhou X, Zhang X, Ke Z, Wang Z, Chen Q, Dong X, Du L, Fang J, Feng X, Fu J, He Z, Huang G, Huang S, Ju X, Gao L, Li L, Li T, Li Y, Liu G, Liu W, Luo X, Nong G, Pan J, Shen K, Song H, Sun J, Mu D, Wang T, Wang B, Xiang W, Yang C, Yang S, Zhao Z, Zhu H, Zhu Y, Zhang J, Little J, Hesketh T, Sun K. Characteristics and Workload of Pediatricians in China. Pediatrics 2019; 144:peds.2018-3532. [PMID: 31253739 DOI: 10.1542/peds.2018-3532] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/15/2019] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES Although it is widely believed that China is facing a major shortage of pediatricians, the real situation of the current national status of pediatric human resources and their working conditions has not been evaluated to date. METHODS We administered a survey to 54 214 hospitals from all 31 provinces in mainland China from 2015 to 2016. Hospital directors of all secondary and tertiary hospitals with pediatric services and a random sample (10%) of primary hospitals provided information on number of pediatricians and their educational levels, specialties, workloads, dropout rates, and other hospital characteristics. A data set of medical resources and socioeconomic information regarding each region (1997-2016) was constructed from the Chinese National Statistics Bureau. The Gini coefficient was used to describe the geographical distributions of pediatricians and hospitals. RESULTS There were 135 524 pediatricians in China or ∼4 pediatricians per 10 000 children. Pediatricians' average educational level was low, with ∼32% having only 3 years of junior college training after high school. The distribution of pediatricians was extremely skewed (Gini coefficient 0.61), and the imbalance of highly educated pediatricians was even more skewed (Gini coefficient 0.68). The dropout rate of pediatricians was 12.6%. Despite an increase in the Chinese government's financial investment in health over the last decade, physicians have been burdened with a greater workload. CONCLUSIONS Uneven development of the pediatric care system, inadequately trained pediatricians, low job satisfaction, and unmet demand for pediatric care are the major challenges facing China's pediatric health care system.
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Affiliation(s)
- Yongjun Zhang
- Department of Pediatrics.,Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Lisu Huang
- Department of Pediatrics.,Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | | | | | - Zheng Ke
- Shanghai MedSci Medical Institute, Shanghai, China
| | - Zhaoxi Wang
- Harvard Medical School, Harvard University and Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - Qiang Chen
- Department of Pediatrics, Jiangxi Provincial Children's Hospital, Nanchang, China
| | - Xiangyu Dong
- Department of Pediatrics, Lanzhou University Second Hospital, Lanzhou, China
| | - Lizhong Du
- Department of Pediatrics, The Children's Hospital and School of Medicine and
| | - Jianpei Fang
- Department of Pediatrics, Second Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Xing Feng
- Department of Pediatrics, Soochow University Affiliated Children's Hospital, Suzhou, China
| | - Jianhua Fu
- Department of Pediatrics, ShengJing Hospital of China Medical University, Shenyang, China
| | - Zhixu He
- Department of Pediatrics, The Affiliated Hospital of Guizhou Medical University, Guiyang, China
| | - Guoying Huang
- Department of Pediatrics, Children's Hospital of Fudan University, Shanghai, China
| | - Songming Huang
- Department of Pediatrics, Children's Hospital of Nanjing Medical University, Nanjing, China
| | - Xiuli Ju
- Department of Pediatrics, Qilu Hospital of Shandong University, Jinan, China
| | - Li Gao
- Department of Pediatrics, Henan Province People's Hospital, Zhengzhou, China
| | - Li Li
- Department of Pediatrics, First People's Hospital of Yunnan Province, Kunming University of Science and Technology, Kunming, China
| | - Tingyu Li
- Department of Pediatrics, Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Yarui Li
- Department of Pediatrics, Shanxi Children's Hospital and Shanxi Medical University, Taiyuan, China
| | - Geli Liu
- Department of Pediatrics, Tianjin Medical University General Hospital, Tianjin, China
| | - Wenjun Liu
- Department of Pediatrics, Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Xiaoping Luo
- Department of Pediatrics, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Guangming Nong
- Department of Pediatrics, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Jiahua Pan
- Department of Pediatrics, The First Affiliated Hospital of University of Science and Technology of China, Hefei, China
| | - Kunling Shen
- Department of Pediatrics, Beijing Children's Hospital at Capital Medical University, Beijing, China
| | - Hongmei Song
- Department of Pediatrics, Peking Union Medical College Hospital, Beijing, China
| | - Jinghui Sun
- Department of Pediatrics, The First Hospital of Jilin University, Changchun, China
| | - Dezhi Mu
- Department of Pediatrics, West China Women's and Children's Hospital, Chengdu, China
| | - Tianyou Wang
- Department of Pediatrics, Beijing Children's Hospital at Capital Medical University, Beijing, China
| | - Baoxi Wang
- Department of Pediatrics, Tangdu Hospital of the Fourth Military Medical University, Xian, China
| | - Wei Xiang
- Department of Pediatrics, Maternal and Child Health Care Hospital of Hainan Province, Haikou, China
| | - Changyi Yang
- Department of Pediatrics, Fujian Provincial Maternity and Children's Hospital of Fujian Medical University, Fuzhou, China
| | - Shufen Yang
- Department of Pediatrics, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Zhengyan Zhao
- Department of Pediatrics, The Children's Hospital and School of Medicine and
| | - Hua Zhu
- Department of Pediatrics, Inner Mongolia Autonomous Region People's Hospital, Hohhot, China
| | - Yimin Zhu
- Department of Pediatrics, Hunan Province People's Hospital, Changsha, China
| | - Jun Zhang
- Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Julian Little
- School of Epidemiology, Public Health, and Preventive Medicine, University of Ottawa, Ottawa, Canada; and
| | - Therese Hesketh
- Institute for Global Health, Zhejiang University, Hangzhou, China.,Institute for Global Health, University College London, London, United Kingdom
| | - Kun Sun
- Department of Pediatrics, .,Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
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Cai L, Dai M, Lin L, Yang W, Chen Y, Ma J, Jing J. Incidence of childhood overweight and obesity and its association with weight-related attitudes and behaviors in China: a national longitudinal study. Int J Behav Nutr Phys Act 2018; 15:108. [PMID: 30390717 PMCID: PMC6215687 DOI: 10.1186/s12966-018-0737-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Accepted: 10/16/2018] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Childhood obesity is a major public health challenge. We aimed to investigate the incidence of overweight/obesity among Chinese children; and prospectively examine the associations of weight-change intention with risk of overweight/obesity and behavioral changes in initially normal-weight children. METHODS A national sample of 21,796 children aged 6-17 years were investigated in September 2013 and followed up nine months later, of which 19,887 (91%) were normal weight and 1909 (9%) were underweight at baseline. Weight and height were objectively measured. Weight perception, weight-change intention, weight control practices, weight-related behaviors, and demographic information were obtained by questionnaires. RESULTS Among children with underweight or normal-weight, the cumulative incidence of overweight/obesity was 2.77% (95% CI 2.55-2.99). Among normal-weight children, those who overestimated their weight had higher baseline BMI z-scores and an increased relative risk (RR) of overweight/obesity (RR 1.51, 95% CI 1.15-1.99). Children who misperceived themselves as underweight or overweight had stronger weight-change intention than their counterparts. However, children with weight-change intention did not develop greater changes in dietary intakes, physical activities, or sedentary behaviors than those without intention. There was no significant association between weight-change intention and incidence after adjusting for BMI z-scores at baseline. Self-reported improving diet, increasing physical activity, and dieting were associated with certain actual behavioral improvements and smaller increase in BMI z-score, but not associated with decreased risk of overweight/obesity. CONCLUSION The 9-months cumulative incidence of overweight/obesity was 2.77% among Chinese children. Weight-change intention was not associated with incidence of overweight/obesity in normal-weight children, regardless of their weight perception. More importantly, children's weight-change intention was insufficient in achieving desirable behavioral changes. Future overweight and obesity prevention programs should directly target on promoting children's actual behavioral changes.
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Affiliation(s)
- Li Cai
- Department of Maternal and Child Health, School of Public Health, Sun Yat-Sen University, Guangzhou, China
| | - Meixia Dai
- Department of Maternal and Child Health, School of Public Health, Sun Yat-Sen University, Guangzhou, China
| | - Lizi Lin
- School of Public Health, Peking University, Beijing, China
| | - Wenhan Yang
- Department of Maternal and Child Health, School of Public Health, Sun Yat-Sen University, Guangzhou, China
| | - Yajun Chen
- Department of Maternal and Child Health, School of Public Health, Sun Yat-Sen University, Guangzhou, China
| | - Jun Ma
- School of Public Health, Peking University, Beijing, China
| | - Jin Jing
- Department of Maternal and Child Health, School of Public Health, Sun Yat-Sen University, Guangzhou, China
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Zeng X, Cai L, Ma J, Ma Y, Jing J, Chen Y. Eating fast is positively associated with general and abdominal obesity among Chinese children: A national survey. Sci Rep 2018; 8:14362. [PMID: 30254301 PMCID: PMC6156407 DOI: 10.1038/s41598-018-32498-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Accepted: 09/10/2018] [Indexed: 01/08/2023] Open
Abstract
Eating faster is related to more energy intake, but less is known about the relationships between children's eating speed, food intake and adiposity, especially in high school children. This study aimed to investigate the associations of eating speed with general and abdominal obesity among Chinese children basing on a national survey. A total of 50,037 children aged 7-17 years were enrolled from 7 provinces in China in 2013. Anthropometric indices were objectively measured. Data on eating speed were collected by questionnaires. Increasing trends across the slow, medium, and fast eating speed group were observed in the prevalence of general obesity (7.2%, 10.0% and 15.9%), abdominal obesity (16.1%, 21.8%, and 29.4%) and waist-to-height ratio (WHtR) ≥ 0.5 (11.1%, 14.8%, and 22.0%). Compared with medium eating speed, fast eating speed was positively associated with obesity, abdominal obesity, and WHtR ≥ 0.5 (odds ratios [ORs]: 1.51~1.61), while slow eating speed was negatively associated with these outcomes (ORs: 0.65~0.75). Increased trends of consumption of fruits, meat/meat conducts, sugar-sweetened beverages, fried food, and fast food were observed in pace with increasing eating speed (P < 0.05). Our findings suggest that eating speed is positively associated with childhood general and abdominal obesity, which may be an important, modifiable factor to prevent childhood obesity.
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Affiliation(s)
- Xia Zeng
- Department of Maternal and Child Health, School of Public Health, Sun Yat-Sen University, Guangdong, People's Republic of China
| | - Li Cai
- Department of Maternal and Child Health, School of Public Health, Sun Yat-Sen University, Guangdong, People's Republic of China
| | - Jun Ma
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, People's Republic of China
| | - Yinghua Ma
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, People's Republic of China
| | - Jin Jing
- Department of Maternal and Child Health, School of Public Health, Sun Yat-Sen University, Guangdong, People's Republic of China.
| | - Yajun Chen
- Department of Maternal and Child Health, School of Public Health, Sun Yat-Sen University, Guangdong, People's Republic of China.
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Prevalence of severe obesity and its association with elevated blood pressure among children and adolescents in Shandong, China. Blood Press Monit 2018; 22:345-350. [PMID: 28926364 DOI: 10.1097/mbp.0000000000000292] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND Childhood obesity has increased markedly during the past decades; however, data on the prevalence of severe obesity in children and adolescents are limited. The present study examined the prevalence of severe obesity and its association with elevated blood pressure (BP) among children and adolescents in Shandong, China. PATIENTS AND METHODS A total of 44 630 (22 404 boys and 22 226 girls) students aged 7-18 years participated in the study. BMI cut-off points recommended by the International Obesity Task Force were used to define class I-III obesity. Relatively high BP status was defined as systolic BP and/or diastolic BP of at least 95th percentile for age and sex. RESULTS The prevalence rates of class I, class II, and class III obesity were 6.67, 1.47, and 0.42% for boys and 2.88, 0.64, and 0.18% for girls, respectively; boys had a higher prevalence than girls (P<0.01). Substantial urban-rural disparities exist in childhood obesity; urban boys and girls had a higher prevalence of class I and class II obesity than their rural peers (P<0.05). Severe obesity is associated with elevated BP; the prevalence of relatively high BP increased from 39.93% (boys) and 39.53% (girls) in the class I obese group to 50.54% (boys) and 53.66% (girls) in the class III obese group (P<0.05). CONCLUSION Although the current prevalence of severe obesity was at a relatively low level, but we should not relax our vigilance to the obesity epidemic. Our findings also emphasize the importance of the prevention of severe obesity to prevent future-related problems such as hypertension in children and adolescents.
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A retrospective study on association between obesity and cardiovascular risk diseases with aging in Chinese adults. Sci Rep 2018; 8:5806. [PMID: 29643416 PMCID: PMC5895579 DOI: 10.1038/s41598-018-24161-0] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Accepted: 03/26/2018] [Indexed: 01/14/2023] Open
Abstract
This study aimed to investigate the prevalence of overweight and obesity and its relationship with cardiovascular risk diseases among different sex and age groups in an urban Chinese adult population. A retrospective analysis was performed on 384,061 Chinese adults aged 20 years and older in Nanjing. The age-standardized prevalence of overweight and obesity was 42.8% and 13.2% in men and 23.9% and 6.6% in women. A gradually increasing trend was observed in the prevalence of overweight and obesity from 2008 to 2016, especially in individuals aged 20~39 years. Overweight and obesity were significantly associated with increased risks of dyslipidemia, diabetes mellitus, hypertension, and hyperuricemia. Age weakened such relationship for both genders, which spiked in individuals aged 20~39 years. For men and women aged 20~39 years, the OR (95% CI) of obesity reached 4.23 (4.01–4.47) and 5.29 (4.63–6.04) for dyslipidemia, 3.70 (2.97–4.60) and 6.38 (3.86–10.55) for diabetes mellitus, 6.19 (5.76–6.64) and 9.36 (7.86–11.13) for hypertension, and 3.66 (3.45–3.88) and 6.65 (5.70–7.74) for hyperuricemia, respectively. The increasing trend in the epidemic of overweight and obesity is a risk factor for cardiovascular risk diseases in Chinese adults, especially in individuals aged 20~39 years.
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Zhang YX, Chu ZH, Li SY, Zhao JS, Zhou JY. Trends in the Prevalence of Morbid Obesity among Children and Adolescents in Shandong, China, 1995-2014. J Trop Pediatr 2018; 64:60-66. [PMID: 28419373 DOI: 10.1093/tropej/fmx030] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Childhood obesity has increased dramatically during the past decades; however, data on the prevalence of morbid obesity is limited. The present study examined the prevalent trends in morbid obesity among children and adolescents during the past 19 years (1995-2014) in Shandong, China. METHODS Data for this study were obtained from five cross-sectional surveys (1995, 2000, 2005, 2010 and 2014) of schoolchildren in Shandong Province, China. A total of 41 500 students aged 7-18 years were included in this study. Body mass index cutoffs recommended by the International Obesity Task Force were used to define morbid obesity. RESULTS The prevalence of morbid obesity was increasing continuously during the past 19 years (1995-2014), from 0.25% for boys and 0.11% for girls in 1995 to 2.73% for boys and 1.29% for girls in 2014. Boys had higher prevalence of morbid obesity than girls (p<0.01). Regional socioeconomic status (SES) inequalities in morbid obesity were observed; children and adolescents from high SES district had a rapid increase in the prevalence of morbid obesity than their counterparts from moderate SES and low SES districts in the past 19 years. CONCLUSION Although the current prevalence of morbid obesity was at a relatively low level, a continuous increasing trend was observed between 1995 and 2014. We should not relax our vigilance, and policymakers and experts should pay more attention to the monitoring and prevention of morbid obesity among children and adolescents in the future decades.
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Affiliation(s)
- Ying-Xiu Zhang
- Shandong Center for Disease Control and Prevention, Shandong University Institute of Preventive Medicine, Shandong 250014, China
| | - Zun-Hua Chu
- Shandong Center for Disease Control and Prevention, Shandong University Institute of Preventive Medicine, Shandong 250014, China
| | - Su-Yun Li
- Shandong Center for Disease Control and Prevention, Shandong University Institute of Preventive Medicine, Shandong 250014, China
| | - Jin-Shan Zhao
- Shandong Center for Disease Control and Prevention, Shandong University Institute of Preventive Medicine, Shandong 250014, China
| | - Jing-Yang Zhou
- Shandong Center for Disease Control and Prevention, Shandong University Institute of Preventive Medicine, Shandong 250014, China
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Zhang YX, Wang SR, Zhao JS, Chu ZH. Truncal pattern of subcutaneous fat distribution is associated with obesity and elevated blood pressure among children and adolescents. Blood Press 2017; 27:25-31. [DOI: 10.1080/08037051.2017.1369000] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Ying-Xiu Zhang
- Shandong Center for Disease Control and Prevention, Shandong University Institute of Preventive Medicine, Jinan, Shandong, China
| | | | - Jin-Shan Zhao
- Shandong Center for Disease Control and Prevention, Shandong University Institute of Preventive Medicine, Jinan, Shandong, China
| | - Zun-Hua Chu
- Shandong Center for Disease Control and Prevention, Shandong University Institute of Preventive Medicine, Jinan, Shandong, China
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Zhang Y, Zhao J, Chu Z, Zhou J. Increasing prevalence of childhood overweight and obesity in a coastal province in China. Pediatr Obes 2016; 11:e22-e26. [PMID: 26403644 DOI: 10.1111/ijpo.12070] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2015] [Revised: 08/15/2015] [Accepted: 08/19/2015] [Indexed: 11/28/2022]
Abstract
BACKGROUND The increasing prevalence of childhood obesity constitutes a serious public health problem in both developed and developing countries. OBJECTIVES The present study examined the prevalent trends in overweight and obesity among children and adolescents in Shandong, China spanning 29 years (1985-2014). METHODS Data for this study were obtained from four cross-sectional surveys of schoolchildren carried out in 1985, 1995, 2005 and 2014 in Shandong Province, China. A total of 39 943 students aged 7-18 years were included in this study (14 458 in 1985, 7 198 in 1995, 8 568 in 2005 and 9 719 in 2014). RESULTS Using IOTF criteria, the prevalence of overweight and obesity increased from 1.73% and 0.05% for boys, 1.67% and 0.04% for girls in 1985 to 20.83% and 10.39% for boys, 15.81% and 4.35% for girls in 2014; Using World Health Organization criteria, the prevalence of overweight and obesity increased from 2.76% and 0.45% for boys, 2.46% and 0.11% for girls in 1985 to 20.30% and 18.16% for boys, 18.89% and 6.58% for girls in 2014, respectively. CONCLUSION Childhood overweight and obesity has entered the extensively epidemic stage in this region at present. Comprehensive strategies of intervention should include periodical monitoring, education on pattern of nutrition, oxygen-consuming physical exercises and healthy dietary behaviour.
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Affiliation(s)
- Y Zhang
- Shandong Center for Disease Control and Prevention, Shandong University Institute of Preventive Medicine, Jinan, Shandong, China
| | - J Zhao
- Shandong Center for Disease Control and Prevention, Shandong University Institute of Preventive Medicine, Jinan, Shandong, China
| | - Z Chu
- Shandong Center for Disease Control and Prevention, Shandong University Institute of Preventive Medicine, Jinan, Shandong, China
| | - J Zhou
- Shandong Center for Disease Control and Prevention, Shandong University Institute of Preventive Medicine, Jinan, Shandong, China
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Prevalence of overweight and central obesity and their relationship with blood pressure among college students in Shandong, China. Blood Press Monit 2016; 21:251-4. [DOI: 10.1097/mbp.0000000000000189] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Zhang YX, Wang ZX, Zhao JS, Chu ZH. Prevalence of Overweight and Obesity among Children and Adolescents in Shandong, China: Urban-Rural Disparity. J Trop Pediatr 2016; 62:293-300. [PMID: 26966244 DOI: 10.1093/tropej/fmw011] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
BACKGROUND The pattern of urban-rural disparity in childhood obesity varies across countries. The present study examined the change trend of urban-rural disparity in childhood overweight and obesity from 1985 to 2014 in Shandong, China. METHODS Data for this study were obtained from four cross-sectional surveys of school children carried out in 1985, 1995, 2005 and 2014 in Shandong Province, China. In this study, 39 943 students aged 7-18 years were included (14 458 in 1985, 7198 in 1995, 8568 in 2005 and 9719 in 2014). Height and weight of all subjects were measured; body mass index (BMI) was calculated from their height and weight. The BMI cutoff points recommended by the International Obesity Task Force were used to define overweight and obesity. RESULTS The prevalence of overweight and obesity was increasing continuously both in urban and rural areas over the past 29 years (1985-2014). The prevalence of combined overweight and obesity was significantly higher in urban than in rural children and adolescents in 1985, 1995 and 2005 (p < 0.01). However, a rapid increase in the prevalence of combined overweight and obesity was observed in rural areas after 2005; as a result, the urban-rural disparity was getting narrower, and no significant urban-rural disparity was observed in 2014 (p > 0.05). CONCLUSION The change trend of urban-rural disparity should be concerned in the future; policies and interventions focused on childhood overweight and obesity should pay attention to rural areas.
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Affiliation(s)
- Ying-Xiu Zhang
- Shandong Center for Disease Control and Prevention, Shandong University Institute of Preventive Medicine, Shandong, China
| | - Zhao-Xia Wang
- Yantai Center for Disease Control and Prevention, Shandong, China
| | - Jin-Shan Zhao
- Shandong Center for Disease Control and Prevention, Shandong University Institute of Preventive Medicine, Shandong, China
| | - Zun-Hua Chu
- Shandong Center for Disease Control and Prevention, Shandong University Institute of Preventive Medicine, Shandong, China
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Abstract
OBJECTIVE Nutritional status during childhood plays an important role in the human life cycle. The present study examined the prevalence trends in different grades of nutritional status (thinness, normal weight, overweight and obesity) among children and adolescents in Shandong, China. DESIGN Data for the study were obtained from six cross-sectional surveys of schoolchildren carried out in 1985, 1995, 2000, 2005, 2010 and 2014. Height and weight of all children were measured; BMI was calculated from their height and weight. International BMI cut-offs were used to define thinness, overweight and obesity. SETTING Shandong Province, China. SUBJECTS A total of 56 045 students aged 7-18 years were included in the current analysis. RESULTS In the past 29 years, the prevalence of thinness decreased from 18·22 % and 23·45 % in 1985 to 7·18 % and 9·49 % in 2014 for boys and girls, respectively. Conversely, the prevalence of combined overweight and obesity increased from 1·79 % and 1·66 % in 1985 to 31·12 % and 20·11 % in 2014 for boys and girls, respectively. CONCLUSIONS The nutritional profile of Shandong children and adolescents had an obvious change over the past 29 years. Special attention should be paid to controlling the rapid rise of childhood overweight and obesity.
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Zhang YX, Wang ZX, Zhao JS, Chu ZH. Trends in overweight and obesity among rural children and adolescents from 1985 to 2014 in Shandong, China. Eur J Prev Cardiol 2016; 23:1314-20. [DOI: 10.1177/2047487316643830] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2016] [Accepted: 03/19/2016] [Indexed: 01/06/2023]
Affiliation(s)
- Ying-xiu Zhang
- Shandong Center for Disease Control and Prevention, Shandong University Institute of Preventive Medicine, China
| | - Zhao-xia Wang
- Yantai Center for Disease Control and Prevention, China
| | - Jin-shan Zhao
- Shandong Center for Disease Control and Prevention, Shandong University Institute of Preventive Medicine, China
| | - Zun-hua Chu
- Shandong Center for Disease Control and Prevention, Shandong University Institute of Preventive Medicine, China
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Zhang YX, Yan P, Chu ZH. Shifts in the distribution of body mass index among children and adolescents in Shandong, China, 1985–2014. Int J Cardiol 2016; 203:126-7. [DOI: 10.1016/j.ijcard.2015.10.164] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2015] [Accepted: 10/18/2015] [Indexed: 10/22/2022]
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15
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Zhang YX, Wang SR. Distribution of subcutaneous fat and the relationship with blood pressure in obese children and adolescents in Shandong, China. Paediatr Perinat Epidemiol 2015; 29:156-61. [PMID: 25683056 DOI: 10.1111/ppe.12178] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND The association between elevated blood pressure (BP) and childhood obesity has been documented in several studies. However, the association between BP and body fat distribution in obese children remains poorly understood. We examined the distribution of subcutaneous fat and its association with BP in obese children and adolescents. METHODS Data for this study were obtained from a large cross-sectional survey of school children. A total of 38,873 students (19,485 boys and 19,388 girls) aged 7-17 years participated in this study. Height, weight, BP, subscapular and triceps skinfold thicknesses (SFT) of all subjects were measured. Obesity was defined by using body mass index (BMI) criteria recommended by the Working Group on Obesity in China. A total of 3,579 obese children and adolescents (2,367 boys and 1,212 girls) were examined. RESULTS Most of the obese children and adolescents had high subcutaneous fat. However, a small number of the obese individuals had a lower SFT levels. Obese children and adolescents with high SFT and central distribution had higher BP levels than those with low SFT and peripheral distribution. CONCLUSION Obese children and adolescents assessed by BMI might not necessarily have a high SFT level. The BP level of obese individuals is associated with the level and distribution pattern of SFT. Additional measurement of SFT is better than BMI alone to help identify high BP risks.
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Affiliation(s)
- Ying-xiu Zhang
- Shandong Center for Disease Control and Prevention, Shandong University Institute of Preventive Medicine, Jinan, Shandong, China
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Zhang YX, Zhao JS, Chu ZH. Prevalence of overweight and obesity among children and adolescents is associated with urbanization in Shandong, China. Int J Cardiol 2014; 176:1212-3. [PMID: 25129279 DOI: 10.1016/j.ijcard.2014.07.222] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2014] [Accepted: 07/27/2014] [Indexed: 10/25/2022]
Affiliation(s)
- Ying-xiu Zhang
- Shandong Center for Disease Control and Prevention, Shandong University Institute of Preventive Medicine, Shandong, China.
| | - Jin-shan Zhao
- Shandong Center for Disease Control and Prevention, Shandong University Institute of Preventive Medicine, Shandong, China
| | - Zun-hua Chu
- Shandong Center for Disease Control and Prevention, Shandong University Institute of Preventive Medicine, Shandong, China
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Zhang YX, Zhou JY, Zhao JS. Synchronous prevalence of obesity and elevated blood pressure among children and adolescents in Shandong, China. Int J Cardiol 2014; 174:462-3. [PMID: 24768382 DOI: 10.1016/j.ijcard.2014.04.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2014] [Accepted: 04/02/2014] [Indexed: 11/25/2022]
Affiliation(s)
- Ying-Xiu Zhang
- Shandong Center for Disease Control and Prevention, Shandong University Institute of Preventive Medicine, Shandong, China.
| | - Jing-Yang Zhou
- Shandong Center for Disease Control and Prevention, Shandong University Institute of Preventive Medicine, Shandong, China
| | - Jin-Shan Zhao
- Shandong Center for Disease Control and Prevention, Shandong University Institute of Preventive Medicine, Shandong, China
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