Overweight In Chinese Children Research Articles

Regional Disparities in Prevalences and Risk Factors of Obesity and Overweight in Chinese Children and Adolescents

Background: Geographical profiles of overweight and obesity in China are limited. We aimed to compare region-specific prevalences of overweight and obesity for Chinese children with a full range of ages and to describe the distribution of potential risk factors.Methods: We analyzed data from Prevalence and Risk factors for Obesity and Diabetes in Youth (PRODY) study, which was a cross-sectional survey of children aged 3-18 years from 11 provinces, autonomous regions, and municipalities that are geographically representative of western, southern, eastern, northern and central China. All participants underwent physical examinations, and their parents or caregivers completed online, self-administered questionnaires. We used multilevel logistic regression models to estimate prevalences of overweight and obesity and to assess related risk factors across sexes, age groups and regions. Findings: Between January 2017 and December 2019, 200,937 children in the PRODY study were included in our analysis. We found that children aged 8-13 years in northern China and children aged 3-5 years in western China were heavily burdened with overweight and obesity. In northern China the obesity prevalences peaked at 31·0% for boys and at 18·8% for girls, while in western China the prevalences of overweight and obesity peaked at 39·0% and 26·0%, respectively. Boys were vulnerable to overweight and obesity throughout all ages and regions (except western China). In addition, risk factors for overweight and obesity varied across ages, sexes and regions. Early-life factors (breast-feeding duration) and lifestyle factors (daily screen time, sleep time and exercise frequency) were the most important, modifiable factors for obesity control. Parental factors (parent’s overweight, socioeconomic characteristics and education status) had noteworthy impacts on their offspring’s overweight and obesity. Interpretation: The age- and sex-specific prevalences of overweight and obesity in Chinese children vary geographically; therefore, modifications of the major risk factors for the prevention and treatment of overweight and obesity should take age, sex and regional characteristics into consideration. Special attention should be paid to the most vulnerable children, and targeted interventions are urgently needed to mitigate the obesity burden in such a vast country. Funding: National Key RD National Natural Science Foundation of China; Zhejiang Provincial Key Science and Technology Project; Key Disciplines of Medicine; Fundamental Research Funds for the Central Universities. Declaration of Interest: We declare no competing interests. Ethical Approval: The study protocol was approved by the ethics review committee of The Children’s Hospital of the Zhejiang University (Approval Number:2016-JRB-018) and the cooperating institutions.

Complementary Feeding and Childhood Adiposity in Preschool-Aged Children in a Large Chinese Cohort

To examine the association between the timing and type of complementary feeding and childhood adiposity in Mainland China. During 1999-2009, 97 424 singletons were enrolled in the Jiaxing Birth Cohort, a population-based prospective cohort study in Southeast China. Of these children, 43 848 children provided complementary diet information and other anthropometric measurements at 1, 3, and 6 months of age and were followed up until 4-5 years of age. Obesity and overweight were identified as body mass index (BMI)-for-age z-score (SD) ≥2 and between 1 and 2, respectively. Among 40 510 children in the statistical analysis, 3.18% were overweight and 64.8% were fed complementary food before 3 months of age. Early introduction of complementary foods was associated with greater BMI z-score (P-trend < .001) and higher risk of overweight (P-trend = .033). Compared with introduction of complementary foods between 4-6 months of age, before 3 months of age of introduction was associated with 11% greater risk of overweight (OR 1.11, 95% CI 1.03-1.19). No significant association between timing of complementary feeding and obesity was observed. Fish liver oil was the major type of complementary food associated with adiposity. Early introduction of fish liver oil was associated with greater BMI z-score (P < .001) and greater risk of overweight (P-trend = .004). Early introduction of fish liver oil is associated with greater childhood BMI and risk of overweight in Chinese children at 4-5 years of age.

Exclusive Breastfeeding Is Inversely Associated with Risk of Childhood Overweight in a Large Chinese Cohort

The association between breastfeeding status and childhood overweight is inconclusive. The aim of the present study was to investigate the relation between exclusive breastfeeding and childhood overweight risk in children 4–5 y of age in Southeast China. Among 97,424 children enrolled between 1999 and 2009 in the Jiaxing Birth Cohort, 42,550 of them were included in the final analysis with complete records on breastfeeding status and anthropometric measurements at 4–5 y of age (48–60 mo). Overweight and being at risk of overweight were identified as a body mass index (BMI)-for-age Z-score ≥ 2 and between 1 and 2, respectively. After 4–5 y of follow-up, 4845 (11.4%) children were identified as being at risk of overweight, and 1343 (3.16%) children were overweight. Adjusting for important child and maternal characteristics, longer duration of breastfeeding was associated with lower risk of childhood overweight (P-trend = 0.009) and being at risk of overweight (P-trend < 0.001). Children exclusively breastfed for 3–5 mo and ≥6 mo had 13% (RR = 0.87; 95% CI: 0.77, 0.99) and 27% (RR = 0.73; 95% CI: 0.56, 0.95) lower risk of becoming overweight compared with children exclusively breastfed for <1 mo, respectively. In boys, there were inverse associations of 3–5 mo (RR = 0.83; 95% CI: 0.71, 0.98) or ≥6 mo (RR = 0.65; 95% CI: 0.47, 0.91) of exclusive breastfeeding against becoming overweight, but there were no significant associations in girls (3–5 mo: RR = 0.96, 95% CI: 0.76, 1.22; ≥6 mo: RR = 0.92, 95% CI: 0.60, 1.41). In conclusion, the present findings suggest that longer duration of exclusive breastfeeding is associated with lower risk of becoming overweight in Chinese children.