The Association of Overweight and Obesity with Blood Pressure among Chinese Children and Adolescents

ObjectiveTo examine the association between obesity and high blood pressure (BP) in Chinese children and adolescents.MethodsBody mass index (BMI) and blood pressure measurements of 197 191 children aged 7–17 years were obtained from a Chinese national survey in 2010. Obesity and high BP were defined according to the reference values for Chinese children. Adjusted odds ratios (ORs) and 95% confidence intervals (CIs) of different BMI categories for high BP, as well as the population attributable risk percent (PAR%), were also calculated.ResultsThe prevalence of high BP was 16.1% for boys and 12.9% for girls in 2010. Overweight and obese children had a significantly higher prevalence of high BP than non-overweight children in both boys and girls in each age group. ORs (95% CI) for high BP were 4.1 (3.9, 4.4) in obese boys and 4.0 (3.7, 4.3) in obese girls. The overall PAR% for high BP due to overweight and obesity was 14.4%.ConclusionOverweight and obese children have a significantly higher risk of high BP than non-overweight children. Eliminating overweight and obesity could reduce 14.4% of high BP cases.     

重庆地区儿童肥胖症患病率及其与血压的关系

目的：了解重庆地区城市和农村儿童肥胖的发病情况及其与血压的关系。方法：对重庆地区37785名7-17岁儿童进行流行病学调查。测量指标包括：身高、体重、血压。结果：（1）城市儿童中,超重13．16％,肥胖3．73％,农村儿童中,超重5．26％,肥胖0．90％。（2）男性儿童的超重肥胖患病率13．16％,女性8．39％。（3）超重肥胖组的收缩压及舒张压高于P90和P95者明显高于正常体重组。结论：重庆地区城市儿童超重肥胖患病率高于农村儿童,男性儿童超重及肥胖患病率高于女性,超重肥胖组儿童的血压升高者明显多于正常体重组,对超重肥胖儿童应加强行为干预。     

合肥市城区学龄前儿童超重和肥胖的流行病学调查及影响因素分析

目的 了解合肥市学龄前儿童超重和肥胖的发生现状并探讨其影响因素。方法 依据地理分布、办学性质、经济情况,采用分层抽样的方法抽取合肥市11所托幼机构的儿童共2 768名,通过安徽医科大学公共卫生学院自编的《学龄前儿童健康发育调查》问卷,调查学龄前儿童超重和肥胖的发生率;采用单因素分析儿童超重和肥胖的可能影响因素,通过logistic回归分析引起儿童超重和肥胖的风险因素。结果 在2 755份有效问卷中,儿童超重发生率为9.22%,肥胖为4.94%,超重和肥胖发生率为14.20%;logistic回归分析显示,男童、剖宫产、父母体型偏胖和饮食口味偏油腻、偏荤菜是儿童超重和肥胖的危险因素,家庭经济状况较差、饮食行为中有时或需要喂养、不能愉快进餐、一般挑食、吃饭速度较慢是儿童超重和肥胖的保护因素。结论 合肥市学龄前儿童超重、肥胖发生率较高,男童、剖宫产、父母体型偏胖及部分不良的饮食行为是引起儿童超重和肥胖的原因。     

Nutrition in Chinese-Korean Children and Adolescents

ObjectiveTo study the nutrition habits among Chinese-Korean children and adolescents in Yanbian Autonomous Prefecture, Jilin, China. MethodsData were obtained from the Chinese National Survey on Students’ Constitution and Health in 1995, 2000, 2005, and 2010 for Chinese-Korean children and adolescents aged 7-18 years.The number of the subjects included was 4789, 4704, 5875, and 5315, respectively. ResultsThe rate of the occurrence of stunting showed a declining trend from 1995 to 2010 (for boys:urban, 6.3%; rural, 12.7% in 1995 and 3.5% for both in 2010. For girls: urban, 7.8%; rural, 13.4% in 1995 and 4.2% and 5.5%, respectively, in 2010). Although the ratio of wasting did not show significant differences between the urban and rural children and adolescents in 1995, 2000, 2005, and 2010 respectively, the ratio of occurrence of overweight or obesity increased (for boys: urban, 7.3% and 1.3%in 1995, 17.6% and 12.9% in 2010; rural, 7.0% and 1.3% in 1995, 14.6% and 12.8% in 2010, respectively. For girls: urban, 8.1% and 1.0% in 1995, 17.3% and 8.6% in 2010; rural 5.7% and 0.7% in 1995, 16.4%and 7.4% in 2010, respectively). ConclusionThe ratio of malnutrition in children and adolescents in Chinese-Korean areas declined from 1995 to 2010, and the distinction in malnutrition between the urban and rural areas was negligible in 2010. Further, the ratio of overweight and obesity increased over this period.     

承德地区学龄期儿童肥胖现状和影响因素研究

目的 探索承德市6～17岁儿童肥胖的发生情况及相关影响因素.方法 采用随机抽样的方法抽取本市城区和农村10所中小学,对入选的16 811例儿童进行体格检查.计算超体质量、肥胖率及不同年龄、性别、地区儿童超体质量、肥胖率.通过问卷调查初步筛选儿童肥胖的危险因素,将可能的危险因素进行Logistic回归,进一步分析儿童肥胖的危险因素.结果 抽取的16 811例儿童中,超体质量率为13.09％,肥胖率为12.1％.其中男孩的超体质量、肥胖率高于女孩;城市、农村儿童超体质量、肥胖率相比差异无统计学意义(P＞0.05);青春期超体质量、肥胖发生率高于青春前期;经多因素Logistic回归分析结果显示,肥胖与父母超体质量、喜喝含糖饮料、上网看电视时间长可能是儿童肥胖的危险因素.结论 该市6～17岁儿童超重、肥胖率较高.合理饮食、正确生活方式、增加运动可以部分减少肥胖的发生率.     

Report on Childhood Obesity in China （4） Prevalence and Trends of Overweight and Obesity in Chinese Urban School-age Children and Adolescents, 1985-2000

Objective To describe the nationwide prevalence of childhood overweight/obesity, and their group variations and trends over the past 20 years in the Chinese urban population. Methods Data sets of boys and girls at the age of 7-18 years collected from the series of Chinese national surveillance on students' constitution and health (CNSSCH) between 1985 and 2000 were divided into five socioeconomic and demographic groups, while BMI classification reference proposed by Working Group on Obesity in China (WGOC) was used as screening reference to calculate the prevalence and trends of overweight/obesity in these groups. Results In 2000, the prevalence of obesity and overweight in boys aged 7-18 years was 11.3% and 6.5% in Beijing, 13.2% and 4.9% in Shanghai, 9.9% and 4.5% in coastal big cities, and 5.8% and 2.0% in coastal medium/small-sized cities, respectively, while the prevalence of of obesity and overweight in girls of the same age group was 8.2% and 3.7% in Beijing, 7.3% and 2.6% in Shanghai, 5.9% and 2.8% in coastal big cities, and 4.8% and 1.7% in coastal medium/small-sized cities, respectively. The prevalence of obesity was low in most of the inland cities at an early stage of epidemic overweight. The epidemic manifested a gradient distribution in groups, which was closely related to socioeconomic status (SES) of the study population. However, a dramatic and steady increasing trend was witnessed among all sex-age subgroups in the five urban groups, and such a trend was stronger in boys than in girls, and much stronger in children than in adolescents. Conclusion Although China is at an early stage of epidemic obesity by and large, the prevalence of obesity in her urban population, particularly in coastal big cities has reached the average level of developed countries. The increasing trend has been rapid since early 1990s, and the increments in obesity and overweight are exceptionally high. The prospect of epidemic obesity in China is in no way optimistic. Therefore, preventive program should be focused on the improvement of the balance between caloric intake and energy expenditure, and interventions aimed at changing children's life styles.     

上海地区高出生体质量与儿童肥胖关系的横断面研究

目的 探讨高出生体质量与儿童肥胖之间的关系,为预防和减少儿童肥胖的发生提供科学依据。方法 采用多阶段分层整群随机抽样调查方法,选取70 284名3~12岁上海儿童作为研究对象,通过问卷调查收集所有研究对象年龄、性别、体质量、身高、新生儿时期数据（包括出生孕周、出生体质量和喂养方式）等信息,分析高出生体质量与儿童肥胖之间的关系。结果 男孩高出生体质量组和正常出生体质量组超重、肥胖及重度肥胖构成比差异均有统计学意义（P均<0.05）,女孩高出生体质量组和正常出生体质量组超重、肥胖及重度肥胖构成比差异有统计学意义（P均<0.05）。经多变量logistic回归模型调整年龄及性别因素后,高出生体质量是引起儿童超重（OR=1.41,95%CI 1.33~1.51,P<0.05）、肥胖（OR=1.45,95%CI 1.31~1.62,P<0.05）、重度肥胖（OR=1.51,95%CI 1.35~1.68,P<0.05）的独立危险因素;调整年龄、性别及新生儿特征因素（包括孕周、喂养模式）后,高出生体质量是引起儿童超重（OR=1.40,95%CI 1.31~1.50,P<0.05）、肥胖（OR=1.44,95%CI 1.28~1.61,P<0.05）、重度肥胖（OR=1.42,95%CI 1.25~1.60,P<0.05）的独立危险因素。结论 高出生体质量是儿童超重、肥胖和重度肥胖的重要危险因素。     

Prevalence of overweight/obesity in Chinese children

BACKGROUND: The purpose of this paper was to report the prevalence of overweight/obesity by area, age, and gender in the year 2000 and to explore at what age adiposity rebound as measured by BMI occurs for Chinese children. METHODS: A cross-sectional study was carried out among 262,738 children aged 3.5-6.4 years in 26 counties/cities in China. Weight and height were measured from March 2000 through July 2000 by local trained health workers. International age- and gender-specific BMI cut-off points were used to obtain comparable prevalence rates of overweight/obesity. Multiple logistic regression was used to estimate odds ratios (OR) of being overweight/obesity for different comparisons. RESULTS: There were 19,390 overweight (16,738) or obese (2,652) children, resulting in an overall prevalence rate of 7.4% (95% CI: 7.3-7.5%). Girls were more likely to be overweight or obese than boys (OR = 1.14, 95% CI: 1.11-1.17). Compared with children living in the southern urban area, multivariate ORs for those living in northern rural and southern rural areas were 2.58 and 1.15, respectively. Compared with children aged 6.0-6.4 years old, multivariate ORs for children aged 3.5, 4.0, 4.5, 5.0 and 5.5 years were 1.96, 1.88, 1.56, 1.53, and 1.11, respectively (p<0.001). CONCLUSIONS: Childhood overweight/obesity in Chinese children in 2000 is similar to the conditions of Great Britain or the U.S. in the 1980s or earlier. Age at adiposity rebound as measured by BMI for Chinese children is >6.5 years old.     

山东省3县农村地区儿童超重肥胖的影响因素分析

目的了解山东省3县农村地区儿童超重和肥胖现况及其影响因素。方法于2009年9月至2010年1月随机选取山东省3县17个行政村的7～12岁儿童进行横断面研究;采用χ2检验和非条件Logistic回归模型对儿童超重肥胖的影响因素进行单因素和多因素分析。结果 7～12岁儿童超重和肥胖率分别为11.41%和5.86%,男童和女童之间超重率和肥胖率差异均无统计学意义(P<0.05)。儿童每天看电视时间(OR=3.062,95%CI:1.708～4.932)、每天睡眠时间(OR=2.693,95%CI:1.136～5.641)、油炸食品的食用频率(OR=2.024,95%CI:1.041～3.570)、膨化食品的食用频率(OR=2.304,95%CI:1.208～5.416)是儿童超重肥胖的主要影响因素,儿童出生体质量(OR=1.615,95%CI:1.013～2.742)以及父亲或母亲是否肥胖(OR=1.846,95%CI:1.109～3.520)也与农村儿童超重肥胖相关联。结论山东省3县农村地区儿童超重肥胖的比例相对较高,控制农村儿童超重肥胖应重点关注儿童日常生活和饮食习惯。     

Childhood BMI and Adult Obesity in a Chinese Sample:A 13-Year Follow-up Study

Objective Obesity is recognized as a significant risk factor for diabetes and hypertension. The present study aimed to examine the associations between adults' obesity risk and childhood and parental obesity. Methods A total of 204 children aged 6-17 years were recruited in 2002 with an average follow-up period of 13.2 years. Height and body weight were measured by trained staffs. Overweight and obesity were defined based on the Chinese standard for children and adults. T-test, analysis of variance, and Chi-square analysis were used for single factor analysis. Multiple linear and logistic regression analyses were used to perform multifactor analysis. Results The percentage of non-obese children who grew up to be non-obese adults was 62.6%, and that of obese children who grew up to be obese adults was 80.0%. There was a significant association between childhood body mass index(BMI) and adulthood BMI with a β regression coefficient of 3.76 [95% confidence interval(CI): 1.36-6.16], and between childhood obesity and adulthood obesity with an odds ratio of 5.76(95% CI: 1.37-24.34). There was no statistical difference between parental obesity at baseline and children's adulthood obesity, after adjustment of confounders. Male participants and those aged 10.0-13.0 years had a higher risk of adulthood obesity with odds ratios of 2.50(95% CI: 1.12-5.26) and 3.62(95% CI: 1.17-11.24), respectively. Conclusion Childhood obesity is an important predictor of adulthood obesity.     

Epidemics of overweight and obesity among growing childhood in China between 1997 and 2009: Impact of Family Income,Dietary Intake,and Physical Activity Dynamics

Background:Obesity has become a major health problem among children and adolescents worldwide.This study aimed to examine the trends of overweight and obesity among childhood in China and assess their ...     

山东沿海成人超重和肥胖的流行病学特征分析

目的    了解山东沿海地区2004年超重和肥胖的流行特征,确定超重和肥胖的高危人群和地区。方法    采用随机、分层、整群抽样的方法调查烟台、威海、日照、东营、青岛沿海5城市的常住成年居民,通过面对面询问调查获取居民的一般情况,体检获取身高、体质量、腰围数据,分析超重和肥胖的发生率及其影响因素。结果    共调查≥18岁成年人4752人,体质量指数（BMI）均值为（24.12±3.57）kg/m2,男性［（24.22±3.43）kg/m2］与女性［（24.07±3.69）kg/m2］、城市［（24.22±3.56）kg/m2］与农村［（24.06±3.57）kg/m2］之间差异无统计学意义(P>0.05);腰围均值为（84.09±11.01）cm,男性［（86.69±10.36）cm］大于女性［(81.70±11.06）cm］,差异有统计学意义(P<0.01),城乡之间差异无统计学意义(P>0.05);超重、肥胖、腹型肥胖的标化发生率分别为32.2%、13.3%、54.9%;超重发生率男性高于女性（35.6% vs 30.8%,P<0.01）,城市高于农村（35.8% vs 32.4%,P<0.01）;肥胖和腹型肥胖发生率在性别和城乡之间差异无统计学意义(P>0.05);超重和肥胖的影响因素为性别、城乡、年龄、吸烟、饮酒、劳动强度、体育锻炼;年龄、饮酒、劳动强度、体育锻炼是腹型肥胖的影响因素。结论    2004年山东沿海地区有一半的成年人处于超重和肥胖状态,早期干预势在必行。     

Childhood obesity: epidemiology, comorbid conditions, psychological ramifications, and clinical recommendations

The prevalence of childhood obesity in the United States has increased dramatically in recent years, doubling in the last 20 years, and is expected to result in a major public health crisis. This epidemic has left no race, socioeconomic status, or age unaffected. Children in Oklahoma are no exception; according to the Centers for Disease Control and Prevention, Morbidity and Mortality Weekly Report, 25% of Oklahoma's adolescents are at risk for overweight or are overweight. In order to address this problem, efforts are underway nationally to institute preventive measures for childhood obesity and its comorbid conditions.     

加味二陈汤联合耳穴疗法治疗60例儿童单纯性肥胖病临床疗效观察

[目的]探究加味二陈汤联合耳穴疗法治疗儿童单纯性肥胖病（含超重儿）脾虚痰阻证的临床疗效。[方法]将60例符合儿童单纯性肥胖病（含超重儿）脾虚痰阻证诊断标准的门诊患儿随机分为治疗组和对照组,各30例。对照组为健康干预组,包括健康宣教、饮食控制、鼓励体育锻炼等。治疗组在健康干预的基础上合用加味二陈汤联合耳穴疗法。疗程为3个月,治疗结束时评估肥胖程度、体重指数（BMI）、中医症状积分等情况。[结果]两组方法治疗儿童单纯性肥胖病（含超重儿）均有效,且治疗组疗效优于对照组,患儿善食、肢体困重和便秘症状较对照组也有所改善。[结论]加味二陈汤联合耳穴疗法与健康干预合用治疗儿童单纯性肥胖病（含超重儿）脾虚痰阻证的疗效优于单纯运用健康干预法。     

重庆市城区3～18岁儿童青少年肥胖症及相关疾病的流行病学调查

目的为掌握重庆市儿童青少年超重肥胖的发病情况,并对心血管疾病相关的高危指标进行观察。方法对重庆市城区23293名3~18岁儿童青少年进行了流行病学调查。测量指标包括身高、体重、腰围、臀围、血压。结果(1)总体检出超重12.44%,肥胖为3.72%,其中男孩分别为14.38%、4.99%,女孩为10.37%、2.35%。(2)肥胖组及超重组男女儿童的收缩压及舒张压高于90百分位及95百分位者均多于正常体重组,χ2值分别为404.535、618.486,115.912、131.641,P值均<0.005。(3)腰-臀围比值肥胖男孩中有10.89%腰-臀围比值>1.0,肥胖女孩中有75.00%腰-臀围比值>0.85。结论重庆市城区儿童青少年超重检出率为12.44%,肥胖检出率为3.72%。肥胖儿童中的血压升高者明显的多于同年龄同性别正常体重儿童。女孩中心性肥胖高于男孩。     

Obesity in Indian children: time trends and relationship with hypertension

BACKGROUND: Limited data are available from India regarding the distribution and profile of childhood obesity and hypertension. We examined the time trends in childhood obesity in a representative sample of schoolchildren from Ernakulam District, Kerala and determined the relationship of obesity with blood pressure. METHODS: We used a stratified random cluster sampling method to select the children. Anthropometric data were collected from 24 842 students, 5-16 years of age, during 2003-04. Blood pressure and anthropometric data were collected from 20 263 students during 2005-06. Overweight and obesity were defined by body mass index for gender and age. Gender, age and height were considered for determining hypertension. RESULTS: The proportion of overweight children increased from 4.94% of the total students in 2003 to 6.57% in 2005 (OR: 1.36; 95% CI: 1.25-1.47; p < 0.0001). The increase was significant in both boys and girls. The proportion of overweight children was significantly higher in urban regions and in private schools, and the rising trend was limited to private schools. Systolic or diastolic incident hypertension was found in 17.34% of overweight children versus 10.1% of the remaining students (OR: 1.87; 95% CI: 1.60-2.17; p < 0.0001). CONCLUSION: Childhood obesity showed an increasing trend in a short period of 2 years. Hypertension was common in overweight children. The results suggest the need for greater public awareness and prevention programmes on childhood obesity and hypertension.     

Secular Changes on the Distribution of Body Mass Index among Chinese Children and Adolescents, 1985-2010

ObjectiveTo analyze the change in Body Mass Index (BMI) distribution among Chinese children and adolescents for the development of more effective intervention for childhood obesity.MethodsData on the national students' constitution and health survey between 1985 and 2010 was used for this study. Subjects were students aged 7-18 randomly selected from 30 provinces in China. BMI for-age curves were developed by LMS method, and the trend of BMI distribution was determined by comparing the upper BMI percentiles and analyzing the skew shift of distribution between 1985 and 2010.ResultsAn overall positive swift trend of BMI between 1985 and 2010 was observed among the Chinese school-age children and adolescents. The average median of the BMI increased from 16.8 and 17.0 kg/m² to 18.2 and 17.9 kg/m² in 25 years, with increments 0.56 and 0.36 kg/m² per decade for males and females, respectively. The more obvious increments were found at the high BMI. The total increments of BMI in this period were 4.03 and 2.20 kg/m² at the 85th, 6.14 and 3.57 kg/m² at the 95th, and 6.99 and 4.27 kg/m² at the 97th percentiles, for males and females, respectively.ConclusionObvious increments were observed at high BMI of the Chinese children and adolescents. More effective interventions should be taken for control and prevention of obesity and its health consequence for these subgroups. It is necessary to establish a risk-complex system consisting of the identification of BMI scope, the screen of the disease risk factors and the assessment of excessive adiposity.     

Secular Change in Stature of Urban Chinese Children and Adolescents, 1985-2010

Objective Research evidence shows a secular trend in Chinese physical growth in recent years.The aim of this study was to analyze and assess changes in stature of children and adolescents during the 25 years from 1985‐2010,using national data.Methods Data came from successive cycles of the Chinese National Survey on Students’ Constitution and Health(CNSSCH).Subjects were 7‐ to 18‐year‐old children and adolescents.Results An overall positive secular trend occurred in urban China during 1985‐2010.The overall average rates of increment were 2.4 and 1.7 cm/decade for boys and girls,respectively.Total increases in adult stature for boys and girls were 2.6 and 1.7 cm,yielding rates of 1.0 and 0.7 cm/decade,respectively.Cities with different socioeconomic levels had different characteristic trends.Mean stature increases in big cities were larger than those in moderate and small cities,and boys and girls in moderate and small cities showed greater potential for growth in stature.Conclusion An overall positive secular growth trend was associated with socioeconomic progress and differed with area socioeconomic levels.School policies and strategies should be developed based on increased stature,and should continue narrowing the inequity between different socioeconomic populations.     

广西6～13岁儿童超重肥胖影响因素分析

目的了解广西6~13岁儿童超重肥胖流行现状及影响因素,为进一步研究超重肥胖的发病机制及有效防治措施提供科学依据。方法按照分层整群随机的方法,于2010年抽取广西6 370名6~13岁儿童,进行身高、体重测量及问卷调查,以《中国学龄儿童少年超重和肥胖预防与控制指南》(试用)为判断标准,对检出的超重肥胖儿童进行影响因素分析。结果 6370名儿童超重肥胖率为9.9%,其中男童超重肥胖率为12.2%、女童7.5%;城市儿童超重肥胖率14.6%、农村儿童4.8%。单因素分析显示,性别、城乡、父母亲文化程度、出生体重、饮食开支、偏食、吃饭速度、户外活动时间、睡眠时间与儿童超重肥胖有统计学关联(P0.05);多因素非条件Logistic回归分析显示,性别、城乡、吃油炸食品、喝碳酸饮料、偏食是儿童超重肥胖的危险因素;父母亲文化程度、睡眠时间是儿童超重肥胖的保护因素。结论广西6~13岁儿童超重肥胖率低于全国水平,生活环境、饮食行为及运动是儿童超重肥胖的主要影响因素,健康教育、饮食调整及运动锻炼是减少儿童超重肥胖的重要措施。     

Malnutrition in Relation with Dietary,Geographical, and Socioeconomic Factors among Older Chinese

Objective Nutrition is closely related to the health of the elderly population. This study aimed to provide a comprehensive picture of the nutrition status of elderly Chinese and its related dietary, geographical, and socioeconomic factors. Methods A total of 13,987 ≥ 60-year-old persons from the 2010–2013 Chinese National Nutrition and Health Survey were included to evaluate various aspects of malnutrition, including underweight, overweight or obesity, and micronutrient inadequacy. Results Overall, the prevalence of obesity, overweight, and underweight was 12.4％, 34.8％, and 5.7％, respectively, with disparities both geographically and socioeconomically. The prevalence of underweight was higher among the older old (≥ 75 years), rural residents and those with low income, with low education status, and residing in undeveloped West areas. More than 75％ of the elderly do not meet the Dietary Reference Intakes for vitamins A, B1, B2, and E, folate, calcium, selenium, potassium, biotin, and choline, with the prevalence of inadequate intake increasing with age for most nutrients. At the population level, the mean intakes of numerous food groups did not meet the recommendations by the Chinese Dietary Guideline. Conclusions Obesity epidemic, inadequacy of micronutrient intake, and high prevalence of underweight and anemia in susceptible older people are the major nutrition challenges for the rapidly aging population in China.