Predictors of overweight or obesity in school age children in Shanghai,China (1024.4)

Abstract

Background. Childhood obesity is increasing dramatically in China, with causes presumed to be complex and as yet poorly understood. Identifying modifiable behavior risk factors can inform important insights into obesity intervention in school‐age children in China.Methods. We assessed the trend of overweight and obesity in school‐age children in Shanghai from 2009 to 2012, and examined the contribution of diet and physical activity to the risk of overweight/obesity. Eight hundred and seventeen subjects from seven elementary schools in the Zhabei District of Shanghai, China were selected using stratified cluster sampling. Weight and height were measured by trained community health workers. A self‐administered lifestyle survey assessing diet and physical activity was completed by subjects’ caregivers. Overweight was defined as BMI z‐score >1 and 蠄2, and obesity was defined as BMI z‐score >2, according to the WHO definitions.Results. Six hundred and eight‐six (84.0%) subjects had complete information on weight, height and lifestyle measures for all years 2009‐2012. The prevalence of overweight/obesity increased from 33.5% in 2009 to 41.7% in 2012 (an absolute 24.5% increase over the four‐year study period). Low vegetable consumption (grams/day per Kg of weight) (β =0.06, 95%CI: 0.03‐0.09), low fruit consumption (times/week per Kg of weight) (β =1.99,95%CI: 1.15‐2.83) and high screen time (hours/day) (β =0.22, 95%CI: 0.04‐0.41) were significantly associated with a high BMI z‐score at the final follow‐up, after adjusting for sex, age, parents’ education level.Conclusions. Obesity is a significant public health problem in school age children in Shanghai, China. Increasing vegetables and fruits intake and reducing sedentary behavior may represent promising targets for intervention in this population group.