中国学龄儿童青少年1985～2000年超重、肥胖流行趋势动态分析

目的 分析中国不同群体儿童青少年1985～2000年期间超重、肥胖流行动态。方法 资料来自1985、1991、1995和2000年全国学生体质健康调查,7～18岁汉族儿童青少年共计98万余人,分大城市、中小城市、富裕乡村、中下水平乡村4个群体,统一使用中国肥胖工作组(WGOC)新制定的中国学龄儿童青少年超重、肥胖体重指数筛查分类标准,筛查超重、肥胖,分析不同群体在不同年代的检出率。结果 1985年,中国即使大城市男女儿童青少年肥胖检出率也仅为0．2％和0．1％,超重率1％～2％,无实质性肥胖流行。90年代开始超重率大幅上升,增幅城市高于乡村,男生高于女生。北京等发达大城市男性7～9岁、10～12岁和女性7～9岁年龄组肥胖率分别为4．7％、3．8％和3．2％,肥胖高发人群初步形成。学生人群中营养不良和超重增加趋势并存,两极分化明显。1995年前后,城乡均出现超重检出率大幅增长．发达大城市男女超重率分别比10年前增长3倍和2倍;肥胖检出率男性6％～8％,女性4％～6％。2000年前后,大城市进入肥胖全面增长期,北京等发达大城市男性7～9岁、10～12岁和女性7～9岁、10～12岁年龄组超重 肥胖检出率分别达到254％、25．5％和17．0％、14．3％,男性小学生肥胖率分别为12．9％和9．1％,接近中等发达国家水平。其他群体超重率都增长迅猛,但肥胖率还较低,中小城市为4．8％(男)和2．6％(女),富裕乡村为1．2％(男)和0．9％(女),经济中下水平乡村为0．9％(男)和1．2％(女)。结论 中国儿童青少年总体上处于肥胖流行早期,但增势迅猛。提出加强监测、营养教育、科学膳食、有氧锻炼、培养健康饮食行为等肥胖综合防治策略,并针对大城市、中小城市和乡村人群不同特点分别提出有针对性的措施,以达到早期预防超重发生、控制超重向肥胖发展的目标。

Dynamic analysis on the prevalence of obesity and overweight school--age children and adolescents in recent 15 years in China

OBJECTIVE: In order to develop strategies on prevention and cure for obesity, a study regarding dynamic analyses on the prevalence of obesity and overweight of Chinese children and adolescents was carried out. METHODS: Data of more than 980 thousands students of Han nationality, aged 7 through 18 years old were collected from National Surveys on Chinese Students' Constitution and Health which were carried out in 1985, 1991, 1995 and 2000. Samples were divided into four groups as "metropolis", "medium and small sized cities", "prosperous village" and "below-averaged village". Study targets were screened using the new criterion-the "Reference Norm for Screening Overweight and Obesity in Chinese Children and Adolescents" which was set up by the Working Group on Obesity in China. The prevalence of overweight and obesity in various groups in different years were compared and analyzed. RESULTS: The prevalence rates of obesity in 1985 including from the metropolis area, were only 0.2% and 0.1% for boys and girls, and the prevalence of overweight was between 1% and 2% indicating that was no trend of obesity epidemic then. However, a rapid increase of overweight prevalence has been noticed since the early 1990s, and the increments were more seen in the urban than in the rural areas and more in boys than in girls. In the most developed cities including Beijing, the prevalence rates of obesity appeared to be 4.7%, 3.8% and 3.2%, among three groups with higher risk: the 7 - 9, 10 - 12 year-old boys and 7 - 9 year-old girls, respectively. Both high prevalence rates of malnutrition and overweight were also found in that period. Around 1995, a large scale of increments of overweight were found both in the urban and rural groups. In the most developed metropolis, the prevalence of overweight was two to three folds more than that of 10 years ago. The prevalence of obesity were 6% - 8% for boys and 4% - 6% for girls, respectively. Since 2000, most of the Chinese metropolis have started the so called 'overall increment period' of obesity. The prevalence rates of obesity plus overweight had reached 25.4%, 25.5%, 17.0% and 14.3% for boys aged 7 - 9 years and 10 - 12 years, and girls aged 7 - 9 years and 10 - 12 years, respectively. Among them, the prevalence rates of obesity were 12.9% and 9.1% for boys aged 7 - 9 and 10 - 12 years, which had already reached the average level seen in the medium-developed countries in the world. Although the increments of overweight were high, the prevalence of obesity was still low in most of the other groups: 4.8% for boys and 2.6% for girls in the "medium sized" group, 1.5% for boys and 1.7% for girls in the "prosperous village" group, and 0.9% for boys and 1.2% for girls in the "below-averaged village" group, respectively. CONCLUSIONS: The prevalence of obesity in Chinese children and adolescents was considered to be still relatively low. However, the rapid increasing of both obesity and overweight, in both urban and rural areas would arouse special attention. Comprehensive strategies of intervention should include periodical monitoring, education on pattern of nutrition, oxygen-consuming physical exercises and healthy dietary behavior. Two areas on obesity prevention to protect the child from becoming overweight in early ages, and to control the tendency of obesity from overweight, should be emphasized in order to improve the health status and life quality of the Chinese children and adolescents.