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Fan L, Wang Z, Zhao Y, Ma Y. Urban-Rural Disparities in Knowledge, Use and Perceived Benefits of Nutrition Labels in China: Evidence from 10 Provinces. Nutrients 2023; 15:nu15051171. [PMID: 36904170 PMCID: PMC10004821 DOI: 10.3390/nu15051171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 02/24/2023] [Accepted: 02/24/2023] [Indexed: 03/03/2023] Open
Abstract
There exist significant gaps in nutritional status between urban and rural populations in China. The previous literature has shown that more knowledge and usage of nutrition labels are instrumental in improving diet quality and health. The aim of the study is to analyze: (1) Are there urban-rural disparities in consumer knowledge, use and perceived benefits of nutrition labels in China; (2) If so, what are the magnitudes of the disparities; (3) What can explain the disparities, and how can the disparities be reduced? The Oaxaca-Blinder (O-B) decomposition is utilized to analyze the predictors of urban-rural disparities in nutrition labels based on a self-conducted study of Chinese individuals. The information from a total of 1635 individuals (aged 11-81 years) across China in 2016 was collected in the survey. We find that rural respondents have less knowledge, lower usage and perceived benefits of nutrition labels than their urban counterparts. Demographics, focus on food safety, frequent shopping locations and income jointly explain 98.9% of the disparity in the knowledge of nutrition labels. Nutrition label knowledge is the predictor which contributes most to urban-rural disparity in label use-accounting for 29.6% of the disparity. Nutrition label knowledge and use are the two biggest predictors of disparities in perceived benefits-accounting for 29.7% and 22.8% of the disparity in perceived benefits, respectively. Our study suggests that policies aiming to improve income and education, as well as raising awareness of food safety in rural areas, are promising in closing the urban-rural disparities in nutrition labels knowledge, use, diet quality and health in China.
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Affiliation(s)
- Linlin Fan
- Department of Agricultural Economics, Sociology and Education, The Pennsylvania State University, State College, PA 16801, USA
| | - Zhigang Wang
- School of Agricultural Economics and Development, Renmin University of China, Beijing 100872, China
- Correspondence:
| | - Yiwen Zhao
- Department of Agricultural Economics, Sociology and Education, The Pennsylvania State University, State College, PA 16801, USA
| | - Ye Ma
- Information Center, Ministry of Agriculture and Rural Affairs, Beijing 100125, China
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Yu L, Zhou H, Zheng F, Song J, Lu Y, Yu X, Zhao C. Sugar Is the Key Cause of Overweight/Obesity in Sugar-Sweetened Beverages (SSB). Front Nutr 2022; 9:885704. [PMID: 35836588 PMCID: PMC9274200 DOI: 10.3389/fnut.2022.885704] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 06/06/2022] [Indexed: 11/13/2022] Open
Abstract
To evaluate association between overweight/obesity and sugar-sweetened beverages (SSB) types, SSB sugar, among children and adolescents. A total of 1,068 children and 751 adolescents were identified from a provincial survey conducted in Shandong, China. χ2 tests, logistic regression, restricted cubic spline (RCS), mediation analysis, pathway analysis, and ordinary least square (OLS) regression were applied to test association among overweight/obesity, SSB sugar, SSB types, and a set of factors. The mean daily SSB intake for children and adolescents was 210.7 and 208 ml, respectively. The threshold of SSB sugar consumption causing overweight/obesity was around 25 g/day and verified by RCS based on logistic regression. Approximately, 44.8% of the study subjects consumed more than 25 g/day of SSB sugar. SSB sugar intake above 25 g/day resulted in higher risk of overweight/obesity (OR = 1.391, 95% CI, 1.115–1.734). The effects of all types of SSBs on overweight/obesity were fully mediated by SSB sugar (p < 0.05), except for milk. Consumption of any types of SSBs had a positive impact on SSB sugar intake in both children and adolescents. Any type of SSB intake was a risk factor in excessive intake of SSB sugar (OR > 1, p < 0.05). In particular, milk powder, tea, and tea-flavored drinks, and carbonated have greater ORs for excessive intake of SSB sugar (OR = 76.08, 8.879, 4.355, p < 0.05, respectively). It was found that the effect of SSB on overweight/obesity was mediated by the intake of SSB sugar, and the effects of various SSBs were different according to multiple linear regression and pathway analysis (p < 0.05, respectively).
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Affiliation(s)
- Lianlong Yu
- Shandong Center for Disease Control and Prevention, Jinan, China
| | - Han Zhou
- Shandong Center for Disease Control and Prevention, Jinan, China
| | - Fengjia Zheng
- Shandong Center for Disease Control and Prevention, Jinan, China
| | - Jian Song
- Shandong Center for Disease Control and Prevention, Jinan, China
| | - Yutong Lu
- Queen Mary School, Nanchang University, Nanchang, China
| | - Xiao Yu
- Department of Nutriology, The Second Hospital of Shandong University, Jinan, China
| | - Changsheng Zhao
- Department of Nutriology, The Second Hospital of Shandong University, Jinan, China
- *Correspondence: Changsheng Zhao,
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Robatsch J, Voitl P, Diesner-Treiber SC. A cross-sectional, exploratory survey on health-relevant free-time activities and body mass index in preschool children in urban and rural settings of Austria. BMC Pediatr 2021; 21:495. [PMID: 34742276 PMCID: PMC8571826 DOI: 10.1186/s12887-021-02972-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Accepted: 10/25/2021] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND The increasing prevalence of obesity is among the most relevant healthcare issues in Europe. The number of overweight people rises due to lifestyle changes, increased sitting activities, and less physical activity. Prevention in early childhood is paramount to stop this alarming trend. AIM This study primarily aimed to evaluate the average time children (3-5 years) from rural and urban Austrian regions spent engaging in physical activity and sedentary behaviors in their free-time. Additionally, we investigated the potential correlation between duration and habits of free-time activity or place of residence and age- and sex-specific body mass index (BMI). The potential impact of socio-economic factors on BMI was examined. METHODS Urban (Vienna) and rural (Carinthia) regions of Austria were chosen for this observational cross-sectional study. Preschool children (n=130) attending nurseries in these regions were included. Weight and height were measured and BMI calculated. Free-time activity and socio-economic data were asked using a self-administered questionnaire. Data on sedentary behavior time (sedentary activity and media consumption) and physical activity time (defined as organized or spontaneous exercise) were analyzed using non-parametric tests. RESULTS Preschool children spent approximately as many hours of their free-time engaged in physical activity as in sedentary behaviors. Time trend in media consumption amounts to one-third of the cumulative time spent engaging in sedentary behaviors. Preschoolers from the urban area spent fewer hours practicing organized exercise and more in sedentary behaviors than peers in the rural area. In the selected areas, 7 % of preschoolers were overweight, 3.9 % were obese. BMI was not associated with free-time activities but showed a trendwise negative correlation with organized exercise. A positive correlation of age and organized exercise was observed but not with physical activity per se. CONCLUSIONS Our results confirm the necessity of preventive interventions among Austrian preschoolers and lead to a better understanding of their free-time activities. Further investigations with larger study populations are needed to promote effective childhood obesity prevention and examine the differences regarding obesity prevalence and leisure-time activity between rural and urban areas.
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Affiliation(s)
- J. Robatsch
- First Vienna Pediatric Medical Center, Donau-City Strasse 1, 1220 Vienna, Austria
| | - P. Voitl
- First Vienna Pediatric Medical Center, Donau-City Strasse 1, 1220 Vienna, Austria
- Sigmund Freud University Vienna, Donau-City Strasse 1, 1220 Vienna, Austria
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Zhang Y, Mei H, Xu K, Li C, Xia Z, Tan Y, Yang S, Zhang J. Association and potential mediators between socioeconomic status and childhood overweight/obesity. Prev Med 2021; 146:106451. [PMID: 33617865 DOI: 10.1016/j.ypmed.2021.106451] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 12/03/2020] [Accepted: 02/02/2021] [Indexed: 11/25/2022]
Abstract
The associations between socioeconomic status and childhood overweight/obesity are inconsistent, and potential underlying factors are unclear. In China, Hukou status is an important attribute of individual's socioeconomic circumstances, but previously received less consideration as a socioeconomic indicator. This study aimed to investigate the association between comprehensive socioeconomic status and childhood overweight/obesity. Using data from Wuhan Maternal and Child Health Management Information System (2009-2018, N = 209,500), clustering analysis was used to create comprehensive socioeconomic groups with indicator components such as parental education level, occupation, and maternal Hukou. The associations between the determined socioeconomic status and childhood overweight/obesity at age 1 and 2 were examined by log-binomial model. Parallel and serial mediation analyses were performed to test the indirect effects of potential mediators, including maternal pre-pregnancy body mass index, gestational weight gain, and infant birth weight, in the association between socioeconomic status and childhood overweight/obesity. Four clusters, defined as low, low-medium, medium-high, and high socioeconomic groups, were identified through clustering analysis. Hukou, among five socioeconomic components, contributed the most to the development of childhood overweight/obesity. Children in the low-medium socioeconomic group have a greater risk of overweight/obesity than the low socioeconomic group. Indirect effects of maternal pre-pregnancy body mass index, gestational weight gain, and infant birth weight were identified for the association. In conclusion, socioeconomic status may impact childhood obesity through maternal pre-pregnancy body mass index, gestational weight gain, and infant birth weight. Hukou should be considered in the evaluation of socioeconomic status in China.
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Affiliation(s)
- Yuanyuan Zhang
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Hong Mei
- Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China
| | - Ke Xu
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Chunan Li
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zhiguo Xia
- Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China
| | - Yafei Tan
- Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China
| | - Shaoping Yang
- Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China.
| | - Jianduan Zhang
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
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Cairo SMC, Teixeira CSS, da Silva TO, da Silva EKP, Martins PC, Bezerra VM, de Medeiros DS. Overweight in Rural Quilombola and Non-quilombola Adolescents From the Northeast of Brazil. Front Nutr 2021; 7:593929. [PMID: 33634159 PMCID: PMC7900433 DOI: 10.3389/fnut.2020.593929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Accepted: 12/29/2020] [Indexed: 11/26/2022] Open
Abstract
Introduction: Overweight is an emerging problem among children and adolescents that leads to the development of several morbidities and health risks. Overweight occurs differently in different populations, especially in vulnerable groups like the rural and quilombola communities (an African-descendant population). This study aimed to estimate the prevalence of overweight and to investigate the possible associated factors in rural adolescents living in both quilombola and non-quilombola communities in Northeast Brazil. Methods: This study is a population-based cross-sectional study with a household approach carried out in 2015 with 390 adolescents (age 10–19 years) living in rural quilombola and non-quilombola communities. The nutritional status was gauged using z-scores calculated for body mass index (BMI) and varies with gender and age. Prevalence ratios (PRs) and 95% confidence intervals (95% CIs) were used to establish associations between the results and explained variables. The multivariate analysis followed a model with a hierarchical entry of covariables controlled by gender and age. Results: The study showed that 18.5% of rural adolescents were overweight, of which 17.9% were quilombolas and 19.0% were non-quilombolas. A significant difference in overweight between the samples was not found. In the multivariate-adjusted model, age ≥16 years (PR: 0.51; 95% CI: 0.28–0.95), the habit of having regular breakfast (PR: 0.58; 95% CI: 0.35–0.98), and process of attending school (PR: 0.35; 95% CI: 0.17–0.71) were associated with a lower prevalence of overweight. Stationary screen time, in contrast, was associated with a higher prevalence (PR: 1.61; 95% CI: 1.05–2.46). The process of attending school was associated with a lower prevalence of overweight (PR: 0.26; 95% CI: 0.09–0.69), even for the quilombolas. Conclusions: A low prevalence of overweight was identified in rural adolescents. Overweight was significantly associated with the habit of having regular breakfast, older age, stationary screen time, and the process of attending school. The results reveal that school is a potential space for health promotion interventions, specifically in the most vulnerable rural regions, such as the quilombola communities. Besides, the study emphasizes the importance of adopting a healthy lifestyle early in life, including cultivating the habit of having regular breakfast and reducing stationary screen time.
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Affiliation(s)
- Stefanie M C Cairo
- Program of Post-Graduation in Collective Health, Multidisciplinary Institute of Health, Federal University of Bahia, Vitória da Conquista, Brazil
| | - Camila S S Teixeira
- Program of Post-Graduation in Public Health, Institute of Collective Health, Federal University of Bahia, Salvador, Brazil
| | - Tainan O da Silva
- Program of Post-Graduation in Collective Health, Multidisciplinary Institute of Health, Federal University of Bahia, Vitória da Conquista, Brazil
| | - Etna K P da Silva
- Program of Post-Graduation in Public Health, Faculty of Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Poliana C Martins
- Program of Post-Graduation in Collective Health, Multidisciplinary Institute of Health, Federal University of Bahia, Vitória da Conquista, Brazil
| | - Vanessa M Bezerra
- Program of Post-Graduation in Collective Health, Multidisciplinary Institute of Health, Federal University of Bahia, Vitória da Conquista, Brazil
| | - Danielle S de Medeiros
- Program of Post-Graduation in Collective Health, Multidisciplinary Institute of Health, Federal University of Bahia, Vitória da Conquista, Brazil
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Overweight and obesity in Eastern Morocco: Prevalence and associated risk factors among high school students. Rev Epidemiol Sante Publique 2020; 68:295-301. [PMID: 32896444 DOI: 10.1016/j.respe.2020.06.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Revised: 05/28/2020] [Accepted: 06/19/2020] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Overweight and obesity in children and adolescents have become a major public health problem affecting most countries worldwide. The purpose of the study was to assess the prevalence and risk factors of overweight and obesity among public high school students in Eastern Morocco. METHODS A cross-sectional survey was conducted between February and May 2014 among a sample of 2271 students (1086 girls and 1185 boys). References from the International Obesity Task Force (IOTF) were used to determine the prevalence of overweight and obesity. RESULTS The prevalence of overweight and obesity reached 12.2% (14.2% in girls vs 10.4% in boys, P<0.01) and 3.0% (3.1% in girls vs 2.8% in boys), respectively. Risk factors associated with overweight and obesity were urban residence (OR=1.76; [1.18-2.63]; P<0.01), father's income≥5000MAD (OR=1.32; [1.02-1.70]; P<0.05), father's overweight (including obesity) (OR=1.87; [1.38-2.54]; P<0.001) and female sex (OR=1.31; [1.02-1.68]; P<0.05). CONCLUSION The prevalence of overweight/obesity has reached an alarming rate among high school students in the Eastern region of Morocco. The findings of the present study suggest an urgent need to set up a strategy to prevent and combat this epidemic.
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Musić Milanović S, Lang Morović M, Bukal D, Križan H, Buoncristiano M, Breda J. Regional and sociodemographic determinants of the prevalence of overweight and obesity in children aged 7-9 years in Croatia. Acta Clin Croat 2020; 59:303-311. [PMID: 33456118 PMCID: PMC7808219 DOI: 10.20471/acc.2020.59.02.14] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
The aim of this study was to determine the prevalence and analyze the determinants of overweight and obesity among Croatian schoolchildren aged 7-9 years in relation to sociodemographic factors. This study used data that were gathered as part of the WHO Europe Childhood Obesity Surveillance Initiative in 2015/2016. The sample for the study was nationally representative. Anthropometric measurements of 5591 children, 2811 boys and 2780 girls, were collected during 8 weeks using standardized equipment. Studied variables included child’s anthropometric measurements and demographics, maternal education and employment status. The results showed a 35.9% prevalence of overweight and obesity in Croatian 7-9-year-old children. Overweight and obesity were more frequent in boys in comparison to girls, especially among boys from the Adriatic region (42.1%). The risk of overweight and obesity was increased in boys living in the Adriatic region (ORadj=1.33; 95% CI 1.03-1.71) and in girls with high-school educated mothers (ORadj=1.36; 95% CI 1.11-1.66). Girls with unemployed mothers had a lower risk of overweight and obesity (ORadj=0.73; 95% CI 0.58-0.92). The observed prevalence of childhood overweight and obesity warrants national and local time-bound targets for reduction of childhood obesity, accompanied by detailed action plans and monitoring mechanisms.
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Affiliation(s)
| | - Maja Lang Morović
- 1Health Promotion Division, Croatian Institute of Public Health, Zagreb, Croatia; 2Andrija Štampar School of Public Health, School of Medicine, University of Zagreb, Zagreb, Croatia; 3European Office for Prevention and Control of Noncommunicable Diseases, World Health Organization, Moscow, Russia
| | - Dora Bukal
- 1Health Promotion Division, Croatian Institute of Public Health, Zagreb, Croatia; 2Andrija Štampar School of Public Health, School of Medicine, University of Zagreb, Zagreb, Croatia; 3European Office for Prevention and Control of Noncommunicable Diseases, World Health Organization, Moscow, Russia
| | - Helena Križan
- 1Health Promotion Division, Croatian Institute of Public Health, Zagreb, Croatia; 2Andrija Štampar School of Public Health, School of Medicine, University of Zagreb, Zagreb, Croatia; 3European Office for Prevention and Control of Noncommunicable Diseases, World Health Organization, Moscow, Russia
| | - Marta Buoncristiano
- 1Health Promotion Division, Croatian Institute of Public Health, Zagreb, Croatia; 2Andrija Štampar School of Public Health, School of Medicine, University of Zagreb, Zagreb, Croatia; 3European Office for Prevention and Control of Noncommunicable Diseases, World Health Organization, Moscow, Russia
| | - João Breda
- 1Health Promotion Division, Croatian Institute of Public Health, Zagreb, Croatia; 2Andrija Štampar School of Public Health, School of Medicine, University of Zagreb, Zagreb, Croatia; 3European Office for Prevention and Control of Noncommunicable Diseases, World Health Organization, Moscow, Russia
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Ivanovitch K, Keolangsy S, Homkham N. Overweight and Obesity Coexist with Thinness among Lao's Urban Area Adolescents. J Obes 2020; 2020:5610834. [PMID: 32864170 PMCID: PMC7444367 DOI: 10.1155/2020/5610834] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 07/09/2020] [Accepted: 07/23/2020] [Indexed: 01/22/2023] Open
Abstract
INTRODUCTION In recent decades, the developing countries of Southeast Asia, including the Lao People's Democratic Republic (Lao PDR), have experienced a rapid growth of their urban population. Partly as a result of that, issues of undernutrition and overnutrition became a significant public health problem. OBJECTIVE To examine the prevalence of overweight and obesity and their related factors, among the school-attending adolescents in the Lao capital of Vientiane. METHODS A cross-sectional data on 300 adolescents aged 15-19 were collected during the months of March, April, and May 2018 by means of a self-administrated questionnaire. Anthropometric measurements were used to obtain data on height and weight. Pearson's chi-squared test, Fisher exact tests, and univariable and multivariable logistic regressions were applied in the course of the statistical analysis. RESULTS The study found a high prevalence of overweight/obesity (23.3%) and thinness (10.3%). Poor eating habits were noted in 67.0% of adolescents, even though 78.0% of them had a good knowledge of nutrition. Factors significantly associated with the overweight/obesity were low physical activities (aOR = 18.3; 95% CI: 5.51-60.66) and adolescents living with their guardians (aOR = 0.25; 95% CI: 0.08-0.79). Results also indicated that, in 47.3% of the cases, teachers, acting as a source of health and nutrition information, can prevent the risk of adolescents' overweight/obesity (aOR = 2.05, 95% CI = 1.11-3.80) but not their thinness (aOR = 0.4, 95% CI = 0.17-0.88). CONCLUSIONS Laotian adolescents are facing the spectrum of malnutrition in urban areas. To improve adolescents' nutritional status, there is a need for a collaborative approach of public health agencies that would address the issues of an effective food and nutrition policy. The school curricula should also include programs on nutrition and physical education.
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Affiliation(s)
- Katiya Ivanovitch
- Faculty of Public Health, Thammasat University (Rangsit Campus), Klong Luang District, Patumthani 12120, Thailand
| | - Sonemany Keolangsy
- Faculty of Public Health, Thammasat University (Rangsit Campus), Klong Luang District, Patumthani 12120, Thailand
| | - Nontiya Homkham
- Faculty of Public Health, Thammasat University (Rangsit Campus), Klong Luang District, Patumthani 12120, Thailand
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Zhou S, Ye B, Fu P, Li S, Yuan P, Yang L, Zhan X, Chao F, Zhang S, Wang MQ, Yan A. Double Burden of Malnutrition: Examining the Growth Profile and Coexistence of Undernutrition, Overweight, and Obesity among School-Aged Children and Adolescents in Urban and Rural Counties in Henan Province, China. J Obes 2020; 2020:2962138. [PMID: 32148952 PMCID: PMC7054782 DOI: 10.1155/2020/2962138] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Revised: 12/18/2019] [Accepted: 02/05/2020] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVE To examine the gender, age, and region of residence in the anthropometric and nutritional profiles of children and adolescents aged 6-18 in Henan Province, China's third most populous province. DESIGN This cross-sectional study of the China National Nutrition and Health survey (2010-2013) used a multistage cluster sampling technique. The sample included Chinese schoolchildren and adolescents aged 6 to 18 years (1,660 boys and 1,561 girls). Multiple logistic regression models were used to estimate the associations between sociodemographic correlates and overweight or obesity and stunting. Setting. Nine districts/counties in Henan Province. Participants. 3,221 subjects completed the questionnaire. Sociodemographic information was obtained. Body weight and height were measured. RESULTS There were statistically significant regional differences in average height and weight for boys in all age groups. Girls followed the same trends except for height when 15-18 years old. The urban-rural residence differences were found in relation to prevalence of stunting and weight status. Subjects in poor rural areas (15.43%) and ordinary rural areas (15.34%) had higher rates of stunting compared to their urban counterparts. Prevalence of overweight or obesity was highest in big city areas (15.71%) and lowest in ordinary rural areas (6.37%). Being a boy (OR = 1.69, 95% CI = 1.314-2.143), living in a big city (OR = 2.10, 95% CI = 1.431-3.073), or in a small-medium city (OR = 2.28, CI = 1.606-3.247), or being in a younger age group was associated with being overweight or obese. In addition, being a boy, living in a big city, or in a small-medium city, or being younger in age meant they were less likely to be stunted. CONCLUSIONS A substantial dual burden of malnutrition among children and adolescents in Henan Province was revealed. The urban-rural differences in nutritional status were found. Stunting was more prevalent in rural areas than in urban. In contrast, while the rising problem of childhood and adolescent obesity still exists in the big city, we also found a great spike in obesity in small-medium cities. Evidence also indicated that boys were more likely to be overweight or obese. Our findings suggest that nutrition education, as well as environmental and policy interventions, is needed to target specific geographic regions.
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Affiliation(s)
- Shengsheng Zhou
- Public Health Institute, Henan Center Disease Control and Prevention, No. 105, Nongye South Road, Zhengdong New District, Zhengzhou, Henan Province, China
| | - Bing Ye
- Public Health Institute, Henan Center Disease Control and Prevention, No. 105, Nongye South Road, Zhengdong New District, Zhengzhou, Henan Province, China
| | - Pengyu Fu
- Public Health Institute, Henan Center Disease Control and Prevention, No. 105, Nongye South Road, Zhengdong New District, Zhengzhou, Henan Province, China
| | - Shan Li
- Public Health Institute, Henan Center Disease Control and Prevention, No. 105, Nongye South Road, Zhengdong New District, Zhengzhou, Henan Province, China
| | - Pu Yuan
- Public Health Institute, Henan Center Disease Control and Prevention, No. 105, Nongye South Road, Zhengdong New District, Zhengzhou, Henan Province, China
| | - Li Yang
- Public Health Institute, Henan Center Disease Control and Prevention, No. 105, Nongye South Road, Zhengdong New District, Zhengzhou, Henan Province, China
| | - Xuan Zhan
- Public Health Institute, Henan Center Disease Control and Prevention, No. 105, Nongye South Road, Zhengdong New District, Zhengzhou, Henan Province, China
| | - Feng Chao
- Public Health Institute, Henan Center Disease Control and Prevention, No. 105, Nongye South Road, Zhengdong New District, Zhengzhou, Henan Province, China
| | - Shufang Zhang
- Public Health Institute, Henan Center Disease Control and Prevention, No. 105, Nongye South Road, Zhengdong New District, Zhengzhou, Henan Province, China
| | - Min Qi Wang
- School of Public Health, University of Maryland College Park, College Park, MD 20742, USA
| | - Alice Yan
- Joseph J. Zilber School of Public Health, University of Wisconsin Milwaukee, Milwaukee, WI 53201, USA
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Butler ÉM, Suhag A, Hong Y, Liang L, Gong C, Xiong F, Luo F, Liu G, Chen S, Taylor RW, Cutfield WS, Fu J, Derraik JGB. Parental Perceptions of Obesity in School Children and Subsequent Action. Child Obes 2019; 15:459-467. [PMID: 31408357 DOI: 10.1089/chi.2018.0338] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Background: Despite perceiving their child as being above a healthy weight, many parents do not intervene. Little is known about the factors influencing parental action. We assessed parental perception of child's weight status, the prevalence of mitigating parental action, and the underlying factors. Methods: We studied 20,242 children and adolescents from 6 centers across China. Anthropometry was measured by research nurses. Parents answered questionnaires, including their perception of their child's weight status, and any subsequent weight treatment. Results: A total of 3254 children had obesity (16.1%), with 63.0% correctly perceived as overweight by their parents. These children were more likely to be older (≥8 years; p < 0.0001), have severe obesity [adjusted relative risk (aRR) 1.41; p < 0.0001], and have mothers with overweight/obesity (aRR 1.15; p < 0.0001). In particular, parents of children aged <8 years were over five times more likely to perceive their child with overweight/obesity as "thin" than parents of teenagers. Conversely, girls, older children/adolescents, and urban youth were more likely to be wrongly perceived by parents as having an overweight issue. Only one in four children (27.8%) with available information received treatment for their perceived weight problem. Children with severe obesity were more likely to be treated (aRR 1.34; p < 0.0001), as were children of mothers with overweight/obesity (aRR 1.18; p = 0.002). Conclusions: Only one in four Chinese children perceived as overweight by their parents received treatment for their weight problem. Given that overweight/obesity in childhood tracks into adulthood and many parents did not intervene despite perceiving an overweight problem in their child, interventions for childhood obesity need to extend beyond parental perception of children's weight status.
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Affiliation(s)
- Éadaoin M Butler
- Liggins Institute, University of Auckland, Auckland, New Zealand.,A Better Start-National Science Challenge, New Zealand
| | - Alisha Suhag
- Liggins Institute, University of Auckland, Auckland, New Zealand.,Department of Experimental Psychology, University of Bristol, Bristol, United Kingdom
| | - Ye Hong
- Department of Endocrinology, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Li Liang
- First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Chunxiu Gong
- Beijing Children's Hospital of Capital Medical University, Beijing, China
| | - Feng Xiong
- Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Feihong Luo
- Department of Endocrinology, Children's Hospital of Shanghai Fudan University, Shanghai, China
| | - Geli Liu
- General Hospital of Tianjin Medical University, Tianjin, China
| | - Shaoke Chen
- Maternal and Children Health Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Rachael W Taylor
- A Better Start-National Science Challenge, New Zealand.,Department of Medicine, University of Otago, Dunedin, New Zealand
| | - Wayne S Cutfield
- Liggins Institute, University of Auckland, Auckland, New Zealand.,A Better Start-National Science Challenge, New Zealand
| | - JunFen Fu
- Department of Endocrinology, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - José G B Derraik
- Department of Endocrinology, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China.,Liggins Institute, University of Auckland, Auckland, New Zealand.,A Better Start-National Science Challenge, New Zealand.,Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
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11
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Emamian MH, Hashemi H, Fotouhi A. Obesity and underweight: Serious health problems in Iranian primary school children. Pediatr Int 2019; 61:1030-1035. [PMID: 31325396 DOI: 10.1111/ped.13978] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2018] [Revised: 05/12/2019] [Accepted: 07/11/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND Childhood obesity is increasing around the world. Compared with developed countries, the rate of increase is 30% higher in developing countries, where the monitoring of obesity and overweight is essential. This study investigated the prevalence of obesity, overweight, thinness, and stunting in primary school students in Shahroud, Iran. METHODS A total of 5,620 primary students were enrolled during 2015. In rural areas all students were invited to participate, while cluster sampling was used in urban areas and 200 classrooms were selected randomly as clusters. Height, weight and body mass index Z-scores for age (HAZ, WAZ and BAZ) were calculated based on World Health Organization standard. The mean indices and prevalence of obesity, overweight, thinness, and stunting were calculated by education level, gender, and place of residence. Prevalence of obesity and overweight was estimated also by international obesity task force definition. RESULTS The mean WAZ, HAZ, and BAZ were 0.050 ± 1.25, 0.005 ± 0.98, and 0.076 ± 1.35, respectively. These indices in rural areas were significantly lower than those in urban areas (P < 0.001). Overall, 25.7% of children in urban areas (95%CI: 24.1-27.4) and 14.8% in rural areas (95%CI: 12.3-17.3) were overweight or obese, and 5.1% of rural girls (95%CI: 3.1-7.0) were stunted. CONCLUSIONS Compared with previous studies, obesity and overweight are still rising in Iranian school children, thus more serious interventions are needed. These interventions must also deal with underweight and stunting, particularly in rural areas.
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Affiliation(s)
- Mohammad Hassan Emamian
- Ophthalmic Epidemiology Research Center, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Hassan Hashemi
- Noor Research Center for Ophthalmic Epidemiology, Noor Eye Hospital, Tehran, Iran
| | - Akbar Fotouhi
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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12
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Zhang XY, Yang WY, Yang J, Wang Y, Xiang Y, Gao LW, Zhang FY, Zhou YL. Epidemiological characteristics of childhood obesity in eastern China, 2017-2019. World J Pediatr 2019; 15:412-414. [PMID: 31407142 DOI: 10.1007/s12519-019-00298-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2019] [Accepted: 07/23/2019] [Indexed: 12/11/2022]
Affiliation(s)
- Xi-Yan Zhang
- Department of Child and Adolescent Health Promotion, Jiangsu Provincial Center for Disease Control and Prevention, No. 172 Jiangsu Road, Nanjing, 210009, China.,Public Health Research Institute of Jiangsu Province, Nanjing, China
| | - Wen-Yi Yang
- Department of Child and Adolescent Health Promotion, Jiangsu Provincial Center for Disease Control and Prevention, No. 172 Jiangsu Road, Nanjing, 210009, China.,Public Health Research Institute of Jiangsu Province, Nanjing, China.,School of Public Health, Southeast University, Nanjing, China
| | - Jie Yang
- Department of Child and Adolescent Health Promotion, Jiangsu Provincial Center for Disease Control and Prevention, No. 172 Jiangsu Road, Nanjing, 210009, China.,Public Health Research Institute of Jiangsu Province, Nanjing, China
| | - Yan Wang
- Department of Child and Adolescent Health Promotion, Jiangsu Provincial Center for Disease Control and Prevention, No. 172 Jiangsu Road, Nanjing, 210009, China.,Public Health Research Institute of Jiangsu Province, Nanjing, China
| | - Yao Xiang
- Department of Child and Adolescent Health Promotion, Jiangsu Provincial Center for Disease Control and Prevention, No. 172 Jiangsu Road, Nanjing, 210009, China.,Public Health Research Institute of Jiangsu Province, Nanjing, China
| | - Liu-Wei Gao
- Department of Child and Adolescent Health Promotion, Jiangsu Provincial Center for Disease Control and Prevention, No. 172 Jiangsu Road, Nanjing, 210009, China.,Public Health Research Institute of Jiangsu Province, Nanjing, China.,School of Public Health, Southeast University, Nanjing, China
| | - Feng-Yun Zhang
- Department of Child and Adolescent Health Promotion, Jiangsu Provincial Center for Disease Control and Prevention, No. 172 Jiangsu Road, Nanjing, 210009, China.,Public Health Research Institute of Jiangsu Province, Nanjing, China
| | - Yong-Lin Zhou
- Department of Child and Adolescent Health Promotion, Jiangsu Provincial Center for Disease Control and Prevention, No. 172 Jiangsu Road, Nanjing, 210009, China. .,Public Health Research Institute of Jiangsu Province, Nanjing, China.
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13
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Abstract
BACKGROUND Childhood obesity is growing globally as an epidemic. It is the most common metabolic disease identified in children. OBJECTIVE To assess the nutritional status of school going children in Poonamallee, Tamil Nadu and to compare the nutritional status between urban and rural school children. METHODS A retrospective review of the school health records over a period of 9 months was done with Institutional Ethics Committee (IEC) approval for a total of 1,803 children aged 5 to 18 years (916- rural, 887-urban). Revised IAP growth charts (2015) were used to classify their nutrition status. RESULTS The overall prevalence of overweight/obesity and thinness/severe thinness in our study was 20% and 9.4%, respectively. In the rural schools, the prevalence of overweight/obesity and thinness was 16.2% and 12.2%, respectively, whereas in the urban schools, it was 24% and 6.4%, respectively. The rural school children had lower mean Z scores of weight for age, height for age, and BMI for age compared to urban children (P < 0.001). CONCLUSION Among rural school children overweight/obesity is more prevalent than undernutrition. There is an urgent need for nutrition education for the school children and community.
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Affiliation(s)
- Sarala Premkumar
- Associate Professor, Department of Pediatrics, Sri Ramachandra Institute of Higher Education and Research, Porur, Chennai, India
| | - Padmasani Venkat Ramanan
- Professor, Department of Pediatrics, Sri Ramachandra Institute of Higher Education and Research, Porur, Chennai, India
| | - J Dhivya lakshmi
- Assistant Professor, Department of Pediatrics, Sri Ramachandra Institute of Higher Education and Research, Porur, Chennai, India
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14
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He H, Pan L, Du J, Liu F, Jin Y, Ma J, Wang L, Jia P, Hu Z, Shan G. Muscle fitness and its association with body mass index in children and adolescents aged 7-18 years in China: a cross-sectional study. BMC Pediatr 2019; 19:101. [PMID: 30971224 PMCID: PMC6456985 DOI: 10.1186/s12887-019-1477-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Accepted: 03/31/2019] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND The present study was the first one aimed to investigate the current muscle fitness and its associated factors among children and adolescents in mainland China. METHODS From Nov 2013 to Jul 2014, 2283 children and adolescents aged 7-18 were recruited in Hainan and Shaanxi Provinces in China by cross-sectional design. Information on anthropometry and muscle fitness, measured by hand grip strength (GS), vertical jump (VJ) and sit-and-reach (SR), were collected. Analysis of covariance was performed by using general linear regression models to identify the association between BMI and muscle fitness. RESULTS The means of GS, VJ and SR in boys were 22.30 ± 11.55 kg, 22.93 ± 6.80 cm and 3.58 ± 7.31 cm, respectively, and in girls were 16.61 ± 6.87 kg, 18.11 ± 4.08 cm and 7.18 ± 5.72 cm, respectively. GS (from 8.26 kg in the 7-8-year-old group to 27.91 kg in the 17-18 group) and SR (from 1.75 cm in the-8-year-old group to 10.12 cm in the 17-18 group) increased with age (both p for trend < 0.001). Boys had higher GS and VJ, but significantly lower SR than girls in each age group (p < 0.001). After adjusting for age, sex, residential areas and study regions, GS increased with elevated BMI (compared with normal weight group, the regression coefficient for thinness and overweight/obesity were - 2.997(95%CI: -3.693 to - 2.301) and 1.220 (95%CI: 0.285 to 2.155), respectively. With the p values less than 0.001 and 0.011, respectively). For VJ, there was no difference found between normal weight group and overweight/obesity group (p = 0.550), but the thinness group had the lowest performance (regression coefficient = - 2.681, 95%CI from - 3.965 to - 1.397, p < 0.001). For SR, compared with normal weight group, the regression coefficients for thinness and overweight/obesity were - 1.313(95%CI: -2.228 to - 0.399) and - 1.623(95%CI: -3.216 to - 0.030) respectively, both p < 0.05. CONCLUSIONS Increased body weight may have a positive association with isometric muscle strength measured by grip strength, but a negative one with strength of lifting the body. Sex difference was also found in the performance of flexibility.
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Affiliation(s)
- Huijing He
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, 5 Dongdansantiao, Dongcheng District, Beijing, 100005, China.,Department of Epidemiology and Statistics, School of Basic Medicine, Peking Union Medical College, 5 Dongdansantiao, Dongcheng District, Beijing, 100005, China
| | - Li Pan
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, 5 Dongdansantiao, Dongcheng District, Beijing, 100005, China.,Department of Epidemiology and Statistics, School of Basic Medicine, Peking Union Medical College, 5 Dongdansantiao, Dongcheng District, Beijing, 100005, China
| | - Jianwei Du
- Hainan Provincial Center for Disease Control and Prevention, Haikou, 570203, Hainan Province, China
| | - Feng Liu
- Shaanxi Provincial Center for Disease Control and Prevention, Xi'an, 710054, Shaanxi Province, China
| | - Yuming Jin
- Hainan Provincial Center for Disease Control and Prevention, Haikou, 570203, Hainan Province, China
| | - Jingang Ma
- Shaanxi Provincial Center for Disease Control and Prevention, Xi'an, 710054, Shaanxi Province, China
| | - Li Wang
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, 5 Dongdansantiao, Dongcheng District, Beijing, 100005, China.,Department of Epidemiology and Statistics, School of Basic Medicine, Peking Union Medical College, 5 Dongdansantiao, Dongcheng District, Beijing, 100005, China
| | - Pengben Jia
- Hainan Provincial Center for Disease Control and Prevention, Haikou, 570203, Hainan Province, China
| | - Zhiping Hu
- Shaanxi Provincial Center for Disease Control and Prevention, Xi'an, 710054, Shaanxi Province, China
| | - Guangliang Shan
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, 5 Dongdansantiao, Dongcheng District, Beijing, 100005, China. .,Department of Epidemiology and Statistics, School of Basic Medicine, Peking Union Medical College, 5 Dongdansantiao, Dongcheng District, Beijing, 100005, China.
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15
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Linet MS, Wang L, Wang N, Berry RJ, Chao A, Hao L, Li Z, Fang L, Yin P, Potischman N, Sun X, Meng F, Yang R, Cong S, Fan J, Kitahara CM, Liang X, Liu F, Lu X, Lv F, Mu C, Sampson J, Tang Y, Wan W, Wang B, Wang H, Zhang L, Wang Y. Prospective investigation of folic acid supplements before and during early pregnancy and paediatric and adult cancers in the Chinese children and families cohort: a pilot study in a sample of rural and urban families. BMJ Open 2018; 8:e022394. [PMID: 30061446 PMCID: PMC6067353 DOI: 10.1136/bmjopen-2018-022394] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Revised: 05/08/2018] [Accepted: 06/21/2018] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE To determine the feasibility of long-term prospective follow-up and ascertainment of cancer in offspring and mothers from the 1993-1995 Chinese Community Intervention Program that provided folic acid supplements before and during early pregnancy to reduce neural tube defects. DESIGN Feasibility pilot study for a prospective cohort study. SETTING Families residing during 2012-2013 in one rural and one urban county from 21 counties in 3 provinces in China included in the Community Intervention Program campaign. PARTICIPANTS The feasibility study targeted 560 families, including 280 from the rural and 280 from the urban county included in the large original study; about half of mothers in each group had taken and half had not taken folic acid supplements. INTERVENTION The planned new study is observational. PRIMARY AND SECONDARY OUTCOME MEASURES Primary: incidence of paediatric cancers in offspring; secondary: other chronic diseases in offspring and chronic diseases in mothers RESULTS: Only 3.4% of pilot study families could not be found, 3.9% had moved out of the study area and 8.8% refused to participate. Interviews were completed by 82% of mothers, 79% of fathers and 83% of offspring in the 560 families. Almost all mothers and offspring who were interviewed also participated in anthropometric measurements. We found notable urban-rural differences in sociodemographic and lifestyle characteristics of the parents, but fewer differences among the offspring. In eight catchment area hospitals, we identified a broad range of paediatric cancers diagnosed during 1994-2013, although paediatric brain tumours, lymphomas and rarer cancers were likely under-represented. CONCLUSIONS Overall, 20 years after the original Community Intervention Program, the pilot study achieved high levels of follow-up and family member interview participation, and identified substantial numbers of paediatric malignancies during 1994-2013 in catchment area hospitals. Next steps and strategies for overcoming limitations are described.
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Affiliation(s)
- Martha S Linet
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA
| | - Linhong Wang
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Ning Wang
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Robert J Berry
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Ann Chao
- Center for Global Health, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Ling Hao
- CDC Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Zhu Li
- Independent Consultant, Beijing, China
| | - Liwen Fang
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Peng Yin
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Nancy Potischman
- Office of Dietary Supplements, National Institutes of Health, Bethesda, Maryland, USA
| | - Xin Sun
- National Institute of Occupational Health and Poison Control, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Fanweng Meng
- Department of Surgery, Laoting County Maternal and Child Health Hospital, Laoting, China
| | - Ruilan Yang
- Taicang County Maternal and Child Hospital, Taicang, China
| | - Shu Cong
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Jing Fan
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Cari M Kitahara
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA
| | - Xiaofeng Liang
- Chinese Center for Disease Control and Prevention, Beijing, China
| | - Fang Liu
- Center of Pediatric Blood Diseases, Tianjin Hematology Institute and Hospital, Tianjin, China
| | - Xiaojun Lu
- Department of Surgery, Taicang First People's Hospital, Taicang, China
| | - Fan Lv
- Department of Pediatric Oncology, Shanghai Xinhua Hospital, Shanghai, China
| | | | - Joshua Sampson
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA
| | - Yongmin Tang
- Department of Hematology, Zhejiang University School of Medicine Children's Hospital, Hangzhou, China
| | - Weiqing Wan
- Department of Neurosurgery, Tiantan Hospital, Beijing, China
| | - Baohua Wang
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Hongsheng Wang
- Department of Hematology/Oncology, Fudan University Children's Hospital, Shanghai, China
| | - Leping Zhang
- Department of Pediatric Hematology/Oncology, Peking University Renmin Hospital, Beijing, China
| | - Yu Wang
- Chinese Center for Disease Control and Prevention, Beijing, China
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16
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Zhang J, Feng X, Zhai Y, Li W, Lv YB, Astell-Burt T, Shi X. Clustering of unhealthy lifestyle behaviours and associations with perceived and actual weight status among primary school children in China: A nationally representative cross-sectional study. Prev Med 2018; 112:6-14. [PMID: 29596917 DOI: 10.1016/j.ypmed.2018.03.017] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Revised: 03/14/2018] [Accepted: 03/25/2018] [Indexed: 11/16/2022]
Abstract
Few studies have focused on clustering of unhealthy lifestyle behaviours among primary school children and potential associations with perceived and actual weight status. An index was constructed from adding up 13 unhealthy behaviours measured by survey responses. Multilevel linear regressions were used to analyse associations between child personal characteristics, perceived and actual weight status with the unhealthy lifestyle index among 11,157 children in primary schools across China. Parental and area factors were also taken into account, including education, weight status, physical activity, urban/rural and area socioeconomic circumstances. The unhealthy lifestyle index normally distributed, with 84.5% of children reporting between 2 and 6 unhealthy behaviours. Boys reported more unhealthy behaviours compared with girls (coefficient 0.32, 95%CI 0.26 to 0.37) and children in urban areas had fewer unhealthy behaviours than their rural counterparts (-0.29, 95%CI -0.56 to -0.03). An interaction revealed stronger 'protective' effects of living in cities for girls than boys, which were not explained by differences in child overweight/obesity. More unhealthy behaviours were characteristic of children in more affluent areas, and of those born to mothers and/or fathers with lower educational attainment. Children who perceived themselves as overweight or underweight both scored higher on the unhealthy lifestyle index. Unhealthy behaviours that could increase the risk of childhood obesity are common among Chinese primary school children, particularly among boys in cities, those in more affluent areas and with parents with lower education. There was no effect of actual weight status on number of unhealthy behaviours. Perceived, but not actual weight status, was also a significant correlate of unhealthy behaviours. Clustering of unhealthy lifestyle behaviours that could increase the risk of childhood obesity are common among Chinese primary school children, particularly among boys in cities, those in more affluent areas and with parents with lower education. Perceived, but not actual weight status, was also a significant correlate of unhealthy lifestyle. This has important implications for public health because understanding clustering of unhealthy lifestyle behaviours can be used to assist in the development of targeted obesity prevention initiatives.
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Affiliation(s)
- Juan Zhang
- School of Public Health, Peking Union Medical College, & Chinese Academy of Medical Sciences, Beijing 100730, China
| | - Xiaoqi Feng
- Population Wellbeing and Environment Research Lab (PowerLab), School of Health and Society, Faculty of Social Sciences, University of Wollongong, Wollongong, New South Wales, Australia; Early Start Research, Faculty of Social Sciences, University of Wollongong, Wollongong, New South Wales 2522, Australia; Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, New South Wales, Australia; Menzies Centre for Health Policy, School of Public Health, University of Sydney, Sydney, New South Wales, Australia
| | - Yi Zhai
- Division of Non-Communicable Disease Control and Community Health, Chinese Center for Disease Control and Prevention, 102206 Beijing, China
| | - Weirong Li
- Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
| | - Yue-Bin Lv
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, 100021, China
| | - Thomas Astell-Burt
- Population Wellbeing and Environment Research Lab (PowerLab), School of Health and Society, Faculty of Social Sciences, University of Wollongong, Wollongong, New South Wales, Australia; Early Start Research, Faculty of Social Sciences, University of Wollongong, Wollongong, New South Wales 2522, Australia; Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, New South Wales, Australia; Menzies Centre for Health Policy, School of Public Health, University of Sydney, Sydney, New South Wales, Australia
| | - Xiaoming Shi
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, 100021, China.
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17
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Zhang J, Wang H, Wang Z, Du W, Su C, Zhang J, Jiang H, Jia X, Huang F, Ouyang Y, Wang Y, Zhang B. Prevalence and stabilizing trends in overweight and obesity among children and adolescents in China, 2011-2015. BMC Public Health 2018; 18:571. [PMID: 29716560 PMCID: PMC5930802 DOI: 10.1186/s12889-018-5483-9] [Citation(s) in RCA: 78] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Accepted: 04/19/2018] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND The prevalence of childhood overweight and obesity in developed countries appears to be plateauing. The purpose of this study was to provide the most recent data on the prevalence and trends in overweight and obesity among Chinese children and adolescents from 2011 to 2015. METHODS We used data collected in the China Health and Nutrition Survey (CHNS) and China Nutritional Transition Cohort Study (CNTCS). We used two waves of the survey in 12 provinces conducted in 2011 (aged 7-18 years; n = 1458) and 2015 (aged 7-18 years; n = 1084) to perform a trend analysis. We used data collected in 15 provinces (aged 7-18 years; n = 1617) to estimate the prevalence of overweight and obesity among Chinese children and adolescents in 2015. RESULTS In 2015, based on the Working Group for Obesity in China (WGOC) criteria, the prevalence of overweight and obesity were 14.0% (95% CI, 11.6-16.3) and 10.5% (95% CI, 8.4-12.6) in boys, and 9.7% (95% CI, 7.7-11.8) and 7.1% (95% CI, 5.2-8.9) in girls, respectively. The increase in BMI z-scores from 2011 to 2015 was statistically significant among adolescents (p = 0.0083), but not among children. No significant changes were observed in prevalence of overweight and obesity between 2011 and 2015, excepting adolescents aged 12-18 years (p = 0.0086). CONCLUSIONS Since 2011, overweight has remained stable, and obesity has stabilized in children, though not in adolescents. Although levels of childhood overweight and obesity in China are not high compared to other developed countries, they remain concerning enough that effective policies and interventions need to be sustained and intensified for lowering rates of childhood overweight and obesity.
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Affiliation(s)
- Jiguo Zhang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, No.29 Nanwei Road, Beijing, 100050, China
| | - Huijun Wang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, No.29 Nanwei Road, Beijing, 100050, China
| | - Zhihong Wang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, No.29 Nanwei Road, Beijing, 100050, China
| | - Wenwen Du
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, No.29 Nanwei Road, Beijing, 100050, China
| | - Chang Su
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, No.29 Nanwei Road, Beijing, 100050, China
| | - Ji Zhang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, No.29 Nanwei Road, Beijing, 100050, China
| | - Hongru Jiang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, No.29 Nanwei Road, Beijing, 100050, China
| | - Xiaofang Jia
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, No.29 Nanwei Road, Beijing, 100050, China
| | - Feifei Huang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, No.29 Nanwei Road, Beijing, 100050, China
| | - Yifei Ouyang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, No.29 Nanwei Road, Beijing, 100050, China
| | - Yun Wang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, No.29 Nanwei Road, Beijing, 100050, China
| | - Bing Zhang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, No.29 Nanwei Road, Beijing, 100050, China.
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18
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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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Physical fitness and anthropometric characteristics among adolescents living in urban or rural areas of Kosovo. BMC Public Health 2017; 17:711. [PMID: 28915864 PMCID: PMC5602925 DOI: 10.1186/s12889-017-4727-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Accepted: 09/08/2017] [Indexed: 12/26/2022] Open
Abstract
Background High physical fitness levels in childhood and adolescence are associated with positive health-related outcomes later in life. Albeit many researchers investigated rural-urban differences in physical fitness, the outcomes of these studies are inconsistent and data on Kosovo are widely missing. Thus, this study aims to examine anthropometric and physical fitness parameters in 14 to 15 year old Kosovan adolescents living in rural and urban areas. Methods Two schools from Pristina (mostly urban population) and two schools in the surrounding villages of the district of Deçan (mostly rural population) were selected. Anthropometric and physical fitness parameters were determined from a total of 354 adolescents (216 urban: 14.5 ± 0.4 years, 138 rural: age 14.5 ± 0.4 years) who volunteered to participate in this cross-sectional study performed in 2013/14. Results The prevalence of overweight and obesity was 18.9% in girls and 28.2% in males and excess body fat was detected in 18.2% of the girls and 15.9% of the boys with no differences between rural and urban adolescents. Rural adolescents performed slightly better in relative handgrip strength (+4.7%, p = 0.032) and running speed (10 m: +2.2%, p = 0.012; 20 m: +1.9%, p = 0.035), but no other differences were detected in standing long jump, counter movement jump, cardiorespiratory fitness and sit and reach test. A multinomial logistic regression analysis revealed that being a female was associated with a lower relative risk for overweight (RR = 0.11, 95% CI: 0.03–0.34, p < 0.001) and high body fat content (RR = 0.20, 95% CI: 0.05–0.56, p < 0.001). In addition, higher handgrip strength, longer sprinting time and lower aerobic fitness were associated with a higher relative risk for overweight and excess body fat. In contrast, lower handgrip strength increased the risk for experiencing thinness (RR = 0.92, 95% CI: 0.89–0.96, p < 0.001). Conclusions It could be shown that there is a high prevalence of overweight and obesity, especially in 14 to 15 year old boys in Kosovo which does not differ between rural and urban areas. Worse physical performance is associated with a higher risk for overweight and obesity highlighting the importance for interventions in this area and for starting longitudinal observations of a secular trend. Electronic supplementary material The online version of this article (10.1186/s12889-017-4727-4) contains supplementary material, which is available to authorized users.
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Bloomfield GS, Leung Yinko SSL. A Series of Unhealthy Developments: The Multiple Facets of Cardiovascular Risk Factors in China. J Am Coll Cardiol 2016; 68:834-5. [PMID: 27539175 DOI: 10.1016/j.jacc.2016.06.012] [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: 05/31/2016] [Accepted: 06/06/2016] [Indexed: 11/30/2022]
Affiliation(s)
- Gerald S Bloomfield
- Duke Global Health Institute, Duke Clinical Research Institute and Department of Medicine, Duke University, Durham, North Carolina.
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