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.     

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.     

The Mediating Effect of Body Dissatisfaction in Association between Obesity and Dietary Behavior Changes for Weight Loss in Chinese Children

Objective The aim of this study was to analyze the mediating effect of body dissatisfaction in correlation between obesity and dietary behavior changes for weight loss(DBCWL).Methods A total of 680 primary and middle school students were included in this study. Their body height, weight, and waistline were effectively measured, and they were also evaluated to assess their body dissatisfaction, perception of dietary behaviors, and DBCWL. The correlation among these factors was analyzed using mediating effect models.Results The prevalence of overweight/obesity and abdominal obesity was significantly higher in males than in females(P 0.05). Overweight/obesity, abdominal obesity, and body dissatisfaction significantly increased the risk for DBCWL(OR = 2.57, 2.77, and 1.95, respectively). Overweight/obesity and abdominal obesity significantly increased the risk for body dissatisfaction(OR = 6.00 and 4.70,respectively). Significant mediating effects of body dissatisfaction were observed in correlation between overweight/obesity and DBCWL and between abdominal obesity and DBCWL(OR = 2.20 and 1.92,respectively; P 0.05), and the proportions of mediating effects among the total effects were 48.89% and 46.60%, respectively.Conclusion Body dissatisfaction might play an important mediating effect in association between DBCWL and obesity, which indicates that guiding children to correctly recognize their body might be more conducive than promoting obese children toward weight loss through dietary behavior changes.     

The Rise and Fall of the Secular Trend in Body Height in Sardinia: An Age-Period-Cohort Analysis

Objective Over the last century, a progressive rise in stature, known as the ‘secular trend', was documented worldwide, and especially in Sardinia, it has reached a peak in Europe. However, this situation recently ceased in several populations. In this study, we tested the hypothesis that the stature secular trend has significantly leveled off in the Sardinian younger generations.Methods Height measurements were retrieved from a database of patients undergoing digestive endoscopy, spanning generations between 1920 and 1990. Sex-specific principal component regression models were fitted to decompose stature variation into the contribution of age, period, and birth cohort.Results A steady increase in stature was observed in generations born after 1920, with an upward surge in those born after 1950. However, a significant leveling off was observed among cohorts born after 1970 among both sexes, as mean heights stabilized at 171.1 cm with a standard error(SE) of 0.9 cm among men and a mean of 160.1 cm(SE = 0.9 cm) among women.Conclusion Our findings support a significant slowdown in the secular trend of stature among the latest Sardinian generations. Several factors, including the consumption of low-quality food, lack of physical activity, and late motherhood, among others, may explain the decline in the secular trend.     

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.     

1985年至2010年中国18个少数民族17岁学生身高趋势分析

目的：分析我国18个少数民族学生1985年至2010年成年身高生长长期变化的特点、规律和趋势。方法：利用1985、1995、2000、2005和2010年全国学生体质调查资料,对蒙古族、回族、维吾尔族、壮族、朝鲜族、藏族、苗族、布依族、侗族、白族、土家族、哈尼族、傣族、傈僳族、佤族、纳西族、土族和羌族18个少数民族17岁学生身高进行了分析。结果：我国大部分少数民族男生的成年身高有很大幅度提高,2010年18个少数民族17岁男生平均身高均超过162 cm,回族、蒙古族、朝鲜族17岁男生平均身高均超过170 cm;身高每10年增速超过2 cm的民族分别是回族（2.64 cm/10年）和侗族男生（2.05 cm/10年）,身高每10年增速超过1 cm的民族有朝鲜族（1.99 cm/10年）、藏族（1.90 cm/10年）、哈尼族（1.80 cm/10年）等12个少数民族。2010年,所调查的18个少数民族17岁女生平均身高均超过150 cm,有15个少数民族女生的成年身高出现不同程度的增长,身高每10年增速超过1 cm的民族分别是回族（1.56 cm/10年）和朝鲜族女生（1.29 cm/10年）,身高增长幅度具有显著性的民族有回族（3.89 cm）、朝鲜族（3.23 cm）、侗族（2.35 cm）等9个少数民族（P<0.05）。结论：我国大部分少数民族学生出现了较为明显的生长长期趋势,但各民族男、女生成年身高增长幅度存在明显不平衡,要给予生长长期趋势增长缓慢的少数民族更高的关注度。同时,对成年身高增长较为迅速的少数民族亦要注意其生长长期趋势所带来的负面效应。     

1995年九市城郊七岁以下儿童体格发育的调查

目的掌握中国儿童生长发育和营养状况的现状及变化趋势，并积累系统的历史性资料。方法采取随机整群抽样的方法。分城、郊、男、女２２个年龄组，共调查哈尔滨、北京、西安、南京、上海、武汉、广州、福州、昆明９个市０～７岁健康儿童１５７３６２名。结果９市儿童的体重、身高和坐高值与１９８５年比有明显的增长；头围、胸围的变化不大；体重、身高的城郊差别进一步缩小，地区差别也有逐渐缩小的趋势，但仍为北、中部地区大于南部地区。结论９市城郊０～７岁儿童的生长水平和营养状况较１０年前又有明显地提高，郊区儿童的１０年增长速度赶上和超过了城区儿童。     

Body Mass Index and Body Fat Percentage in Assessment of Obesity Prevalence in Saudi Adults

Objective To assess the obesity prevalence in Saudi adults according to the international standards of body mass index (BMI) and body fat percentage (BF%). Methods Five hundred and thirty healthy Saudi adults aged 18-72 years (mean 36.91±15.22 years) were enrolled in this study. Their body composition was assessed by bioelectrical impendence analysis with a commercially available body composition analyzer. Standard BMI and BF% values were used to define obesity. Results The prevalence of underweight, normal underweight, overweight and obesity in Saudi adults according to the BMI criteria (<18.5 kg/m 2 , 18.5-24.4 kg/m 2 , 25-29.9 kg/m 2 , 30 kg/m 2 and above, respectively) was 2.5%, 30.2%, 33.6%, and 33.8%, respectively, whereas the obesity prevalence was 60% (n=318) in Saudi adults according to the BF% criteria (25% for males and 30% for females), which was significantly higher than that according to BMI criteria. However, it was 50.6% (n=268) when the BMI cutoff point was 27.5 kg/m 2 , proposed by WHO for the Asian population. Kappa analysis showed that the obesity prevalence defined by BMI and BF% was higher in females than in males (k=0.530 vs k=0.418, P<0.0001). The sensitivity and specificity of BMI (30 kg/m 2 and 27.5 kg/m 2 ) were 54.1% and 96.7% and 76.4% and 88.2%, respectively, for obesity. A lower BMI cutoff point (26.60 kg/m 2 ) was proposed in this study, which gave the maximum sensitivity (84.3%) and specificity (85.4%), with a moderate kappa agreement (k=0.686). Moreover, the obesity prevalence at this cutoff point (56.4%) was significantly higher than that recommended by WHO. Conclusion The specificity of BMI for obesity is high and its sensitivity is low in both sexes. Its sensitivity can be increased by changing BMI cutoff to a lower value. The choice of BF% reference is of great influence for the assessment of obesity prevalence according to the BMI.     

An Objective Measure to Evaluate Actual Body Shape among Children and Adolescents in China

Objective The purpose of this study was to explore an objective measure to assess actual body shape of children and adolescents in China.Methods Based on the Chinese National Survey on Student’s Constitution and Health(CNSSCH)in2005,210 927 children and adolescents'(7-18 years)body height,body weight,chest circumference,sitting height,chest circumference-height ratio,chest circumference-sitting height ratio,chest circumference-low limb ratio,and sitting height-low limb ratio measurements were used to develop an objective measure by using transformation variables and explored factor analysis(EFA).Discrimination power of the objective measure was evaluated based on BMI reference and Receiver Operating Characteristic curves(ROC).Results The objective measure included four dimensions scores:transverse dimension(TD)indicating weight and chest circumference;length dimension(LD)indicating height and sitting height;transverse-length ratio dimension(TLD)indicating chest circumference-height ratio,chest circumference-sitting height and chest circumference-low limb ratio;proportion dimension(PD)indicating sitting height-low limb ratio.The whole dimension(WD)indicating the whole body shape was showed by the average of four dimensions scores.Four dimensions and WD scores were approximately80 in children and adolescents with normal weight,and higher than those of overweight,obesity,and underweight(all P-values0.001).Areas under ROC of overweight and obesity compared with normal weight ranged from 0.88 to 1.00 for scores of TD,TLD,and WD.Conclusion The objective measure which included four dimensions was explored,and TD,TLD,and WD had significant discrimination power.     

南宁市儿童睡眠呼吸障碍与超重和肥胖关系的调查

目的调查南宁市学龄前及学龄儿童睡眠打鼾和相关的超重和／或肥胖发生关系。方法采取随机整群分层抽样方法,应用由家长完成的问卷调查表,对12个幼儿园、8所小学和6所初级中学的6999名2—14岁儿童进行调查,确定夜间睡眠打鼾及相关症状的发生情况。实际发放调查问卷总数为9000份,应答8150份,回收率为90．6％。有效问卷6999份。结果本组儿童打鼾现患率32．7％,男性儿童打鼾发生率（44．22％）高于女性儿童（28．58％）,差异有统计学意义（P〈0．01）。儿童打鼾现患率以5岁以下儿童相对较高为35．86％。打鼾儿童有较高的体重超重现患率（13．61％）和肥胖现患率（8．68％）。超重和／或肥胖儿童打鼾发生率（13．61％）高于无超重和／或肥胖儿童（8．68％）（P〈0．05）。超重和／或肥胖儿童有打轩并呼吸暂停的发生率为3．04％,与无超重和／或肥胖儿童的有打鼾但不伴呼吸暂停的发生率1．13％相比较,差异有统计学意义（P〈0．01）。Logistic回归分析与睡眠打鼾儿童相关因素中扁桃体肥大、超重和／或肥胖及肥胖家族史为打鼾发生的危险因素。结论超重和／或肥胖儿童有较高的夜间睡眠打鼾报告率。适当控制体重对避免夜间睡眠打鼾或睡眠呼吸障碍的发生有意义。     

Prevalence of Overweight and Obesity among Students Aged 7-22 Years in Jiangsu Province,China

Objective To report the prevalence and trend of overweight and obesity among students aged 7-22 years in Jiangsu, 2010 to 2013. Methods This cross-sectional study was carried out as part of students physical fitness and health survey in Jiangsu province. A total of 255,581 subjects (50.03%males and 49.97%females) enrolled in 82 school and 10 universities in Jiangsu. Weights and heights were obtained for each subject and its body mass index (BMI) was calculated using the Chinese Working Group on Obesity in China (CWGO). Results Anthropometric measurement including bodyweight, height, BMI and bust were significantly different between males in urban compared to females living rural areas (P<0.001). The total prevalence of overweight and obesity was 12.4%and 5.7%. Males had a significantly higher rate than in female’s student. The prevalence of overweight and obesity by age groups was (14.5%, 10.3%) at age 7-11 years, (11.2%, 6.8%) at age 12-14 years, (11.7%, 3.1%) at age 15-17 years, and (11.4%, 2.3%) at age 18-22 years. By regions; the highest prevalence of overweight obesity reported in Taizhou (10%, 14.2%), Xuzhou (9.4%, 12.5%), and Nanjing (9.2%, 15.6%), respectively.     

Increases in Height among Chinese Children and Adolescents by Gender: An Age-Period-Cohort Analysis

Objective To examine increases in average height among Chinese children and adolescents. Methods The data were obtained from the China Health and Nutrition Survey conducted during the period 1989–2015. A stratified multistage cluster sampling method was utilized to select participants aged 2–22 years in each province. Linear regression was used to examine the effects of age, birth cohort, and survey period on height. Results A total of 15,227 males and 13,737 females were included in the final analysis. Age (A) showed a continuous effect on height. The average heights of the investigated groups increased continuously during the investigation period. By 2015, the average height of the overall group increased by 7.87 cm compared to the average height during the 1989 survey. Moreover, birth year (cohort, C) also had a stable effect on height. Using the height of individuals born in or before 1975 as a reference, the average height of each birth cohort increased in comparison to the previous birth cohort. Conclusions The height of Chinese children and adolescents was affected by age, period, and cohort effects, and this effect is governed by certain rules. The age-period-cohort model can be used to analyze the trends of children's and adolescent's heights. The findings provide a scientific basis for the formulation of children's and adolescents' growth and development policies in China.     

小儿减肥胶囊对单纯性肥胖症儿童脂类代谢的影响

35例单纯性肥胖症学龄儿童服用小儿减肥胶囊3个月后，通过测量皮下脂肪厚度(包括肱二、三头肌，肩胛下、腹侧壁)、腹围、上臂围、大、小腿围，证实体脂较治疗前明显减小，而患儿的血脂变化无显著性差异。     

中国儿童青少年生长长期趋势及其公共卫生意义

目的:分析中国大城市儿童青少年1979至2005年的生长长期趋势,为制定宏观干预策略措施提供科学依据.方法:来自16个省/直辖市7～18岁汉族中、小学生,分析其身高、体重、体重指数(BMI)增幅和不同阶段增速.结果:26年来男、女平均身高增幅为6.5和4.7 cm,体重增幅为8.9和5.2 kg.男、女增速均以1985至1995年期间最快,身高分别达每10年增加3.8和3.0 cm;体重分别达每10年增加4.7和3.1 kg;该长期趋势迄今仍保持强劲.青春期发育年龄持续提前,身高生长突增峰值(女12岁和男14岁分别达每10年3.3和2.4 cm)不断增长,对长期趋势贡献最大.男、女成年身高分别增长3.2和2.1 cm,增幅为每10年1.2和0.8 cm.近20年来BMI分布曲线加速右移,提示儿童肥胖流行增势迅猛.结论:我国正出现儿童期生长加速、青春期提前、成年身高增长和身体比例变化等迅猛的全方位生长长期趋势.不仅应看到该趋势对提高我国儿童少年体质健康水平的积极意义,还应高度关注该趋势在引发成年期慢性疾病(尤其如高血压、高血脂、2型糖尿病等代谢综合征疾病危险)等方面的消极影响.     

Empirical Changes in the Prevalence of Overweight and Obesity among Chinese Students from 1985 to 2010 and Corresponding Preventive Strategies

Objective To determine the extent of the obesity epidemic in school‐aged Chinese children in 2010 and track the increasing trend in different socioeconomic regions over the preceding 25 years. Strategies for preventing childhood obesity are suggested. Methods We used a dataset provided by the Chinese National Survey on Students’ Constitution and Health from 1985‐2010. Subjects were 7‐18‐year‐old students randomly selected from urban and rural areas in 30 provinces. Eight subgroups were created according to region and socioeconomic status. Results Increased rates of the epidemic (overweight and obesity combined) were greatest in large coastal cities‐32.6% and 19.1% among males and females, respectively. These rates has neared that of developed countries. Similar increases were found in all other regions, including the once poverty‐stricken rural west. The epidemic in most of the rural areas began after 2000, but has spread swiftly over the last decade. In 2010, it was estimated that 9.9% of Chinese school‐aged children and adolescents were overweight and that an additional 5.1% were obese, representing an estimated 30.43 million individuals. Conclusion The prognosis for China’s childhood‐obesity epidemic is dire. To prevent childhood obesity, we suggest several strategies, including reasonable dietary intake, increase physical activity, a change in sedentary lifestyles and corresponding behavioral modifications.     

血糖水平对缺氧缺血新生大鼠体重和脑重的影响观察

目的　观察不同血糖水平及缺氧缺血 (hypoxicischemia ,HI)前后血糖对缺氧缺血新生大鼠体重和脑重的影响。方法　通过制备缺氧缺血新生大鼠合并高低血糖模型 ,分别在脑HI后 2、2 4、48、72h和 7d共 5个时段 ,分别在断头前测体重和断头后取脑称脑重 ,并辅以免疫组化分析HI后 2 4h时段各组脑内葡萄糖转运蛋白 1(GLUT1)及葡萄糖转运蛋白 3 (GLUT3 )合成量的变化。结果　 2 4h时段HI组、HI前低血糖组、HI后低血糖组体重呈显著意义 ,低于正常组 ;2 4h时段缺氧缺血前后低血糖脑重均呈显著意义 ,低于其他各组 ,7d时段I前重高血糖组脑重高于HI组及HI前低血糖组。HI前重高血糖组HI后 2 4h在皮质部位GLUT1的合成量显著高于其他各组。HI前低血糖组HI后 2 4h在皮质部位GLUT3的合成量显著低于其他各组。结论　HI前低血糖对新生大鼠体重、脑重增长不利 ,HI前重高血糖有可能缓解HI引起的体重、脑重的减轻而显示一定的保护作用     

2077例布依族儿童健康素质调查

对２０７７例布依族儿童身高、体重进行了调查，以年龄别体重，年龄别身高和身高别体重为评价指标，以１９８５年９市城区正常儿童体格发育的测量值为对照人群值，比较结果显示：体重低下者占２７．６％，严重营养不良者占１．７％，发育迟缓者占３４．３％，消瘦者占２．０％，这些指标均高于国内其他城市水平。     

学龄期儿童超重和肥胖的危险因素分析

目的探讨学龄期儿童超重和肥胖的影响因素,为儿童超重和肥胖的防治提供基础资料。方法选取155名7~11岁儿童作为研究对象,其中肥胖104例、超重51例,160例7~11岁正常体重儿作为正常对照。通过问卷调查的方式研究儿童肥胖的影响因素,对相关因素采用多因素非条件Logistic回归分析。结果人工喂养、父亲超重或肥胖、母亲超重或肥胖、食欲好食量大、经常喝饮料或吃甜品、每天运动时间〈2 h是儿童肥胖的危险因素。结论儿童超重或肥胖的形成并非单一因素造成,与父母的肥胖程度和生活方式密切相关。     

1985～2005年中国7～18岁学生身高、体重变化趋势分析

目的：分析我国儿童、青少年20年间身高和体重的变化趋势及其特点。 方法：选择1985、1995和2005年的全国学生体质与健康调研数据,以身高和体重为指标,应用LMS方法绘制我国7～18岁学生身高、体重的第5、第50、第95百分位曲线,并进行比较。 结果：1985～1995年,7～18岁城市男生、乡村男生、城市女生、乡村女生第50百分位身高平均增幅分别为3.1、3.5、2.2和2.8 cm,体重平均增幅分别为3.2、1.9、2.0和1.3 kg;1995～2005年,7～18岁城市男生、乡村男生、城市女生、乡村女生第50百分位身高平均增幅分别为2.0、2.3、1.3和1.7 cm,体重平均增幅分别为3.1、1.9、1.7和1.2 kg。20年间, 7～18岁儿童、青少年生长增长的主要表现为：（1）各年龄组学生身高和体重都有明显增长;（2）身高和体重的第95百分位增长的幅度>第50百分位增长的幅度>第5百分位增长的幅度;（3）乡村学生身高和体重增长的平均幅度大于城市学生;（4）成年身高增长的幅度小于各年龄组身高增长的平均幅度;（5）1995～2005年身高增长的平均幅度明显小于1985～1995年,但1995～2005年成年身高增长的幅度大于1985～1995年。 结论：我国儿童、青少年的生长发育水平呈快速生长趋势,发育较好的儿童、青少年身高、体重增长的幅度更大。     

儿童哮喘严重度与体质指数的相关性研究

目的研究儿童哮喘严重度与体质指数的相关性。方法两组122例儿童,其中哮喘患儿62例,对照组60例,计算体质指数（BMI）值,BMI=体重（kg）／身高（m2）。BMI≥同年龄、同性别的95百分位数或BMI〉30者诊断为肥胖。结果25．8％哮喘组患儿肥胖,而对照组5％,两组比较,差别有显著性。哮喘严重度与体质指数相关性比较,轻度哮喘肥胖儿为25％,中度哮喘肥胖儿37．5％,重度哮喘肥胖儿50％,组间比较差别有显著性。结论儿童肥胖是哮喘发病的因素。哮喘的严重度与体质指数呈正相关性。