Status In Chinese Children Research Articles

Meeting 24-Hour Movement and Dietary Guidelines: Prevalence, Correlates and Association with Weight Status among Children and Adolescents: A National Cross-Sectional Study in China.

China is confronted with a “double burden” of underweight and overweight/obesity in children and adolescents. This study aimed to investigate the prevalence and correlates of meeting 24 h movement and dietary guidelines among Chinese children and adolescents. Further, the study aimed to examine the association of meeting 24 h movement and dietary guidelines with weight status in Chinese children and adolescents. A total of 34,887 Chinese children and adolescents were involved. Only 2.1% of participants met the 24 h movement guidelines. Compared to those who met all three 24 h movement guidelines, those who only met the sleep duration guideline was significantly associated with a higher risk of underweight (p < 0.05), and those who only met the moderate-to-vigorous physical activity, or screen time guidelines were significantly associated with a higher risk of overweight/obesity (p < 0.05). Compared with those meeting the dietary guidelines, those who did not meet the soft drink intake guideline had a significantly lower risk of underweight (p < 0.05), those who did not meet the fruit intake guideline had a significantly lower risk of overweight/obesity (p < 0.05), and those who did not meet the milk intake guideline showed a significantly higher risk of overweight/obesity (p < 0.001). These findings indicate a significant association between meeting the 24 h movement and dietary guidelines and weight status among Chinese children and adolescents.

Associations between sleep duration, sleep quality, and weight status in Chinese children and adolescents

Background and objectiveThe high prevalence of obesity is a serious problem, and sleep is considered to be a factor for obesity. This study aimed to examine the relationship between sleep duration, sleep quality, and weight status among children and adolescents in China and to explore whether the relationship between sleep duration and weight status is independent of sleep quality. Sex and age differences were also explored.MethodsA cross-sectional research was conducted among 2019 children and adolescents (1029 boys and 990 girls) aged 8–16 years in Shanghai. An open-question was used to obtain data on sleep duration, which was categorized into the following four groups based on the age-specific National Sleep Foundation Sleep Duration Recommendations: 1) very short, 2) short, 3) recommended, and 4) long. The Pittsburgh Sleep Quality Index was used to assess sleep quality. Weight and height were measured for all participants. The variable weight status was estimated with the Chinese children and adolescent age- and sex-specific body mass index (BMI) and was categorized into overweight/obesity and normal weight.ResultsShort sleep duration (7–8 and 6–7 h for 6–13 and 14–16 years old, respectively) significantly increased odds of overweight/obesity (OR = 1.32, 95% CI: 1.06–1.64) compared with that of the recommended sleep duration (9–11 and 8–10 h for 6–13 and 14–16 years old, respectively). The relationship between the two variables existed independent of sleep quality. No significant relationship was found between sleep quality and overweight/obesity of children and adolescents. Sleep quality (OR = 1.07, 95% CI: 1.01–1.14) and short sleep duration (OR = 1.51, 95% CI: 1.06–2.13) increased the risk for overweight/obesity among girls, whereas no significant relationships between sleep duration, sleep quality, and overweight/obesity were found among boys. Short sleep duration increased the risk of overweight/obesity in children aged 8–13 years (OR = 1.34, 95% CI: 1.05–1.71), independent of sleep quality, but no significant relationships between these two variables existed for adolescents aged 14–16 years.ConclusionsOverall, short sleep duration increased the risks of overweight/obesity in children and adolescents in China, independent of sleep quality. This relationship is significant for girls and children aged 8–13 years instead of boys and adolescents aged 14–16 years. Interventions to extend the sleep duration of children and adolescents, especially girls and children aged 8–13 years in China, are necessary to improve their weight status.

Central body fat deposits are associated with poor vitamin D status in Chinese children and adolescents

ObjectivesTo examine the association between regional fat deposits and vitamin D levels in Chinese children. Whether regional fat distribution contributes to vitamin D deficiency remains uncertain. MethodsA population-based, nationwide and multicenter cross-sectional study involving 6,589 pediatric participants (49.9% boys) ages 6 to 18 y. The regional fat mass index (FMI) variables were calculated as regional fat mass (kg) divided by the square of height (m2), and plasma 25-hydroxyvitamin D (25[OH]D) levels were measured. ResultsAmong boys, after adjustment for multiple variables (including opposite regional fat), higher values for trunk FMI and android FMI were associated with a greater likelihood of vitamin D inadequacy (odds ratios [ORs], 2.14 and 1.87, respectively), whereas the extremity FMI and gynoid FMI were associated with protection from vitamin D inadequacy (ORs, 0.63 and 0.71, respectively). Consistently, increased central fat distribution (e.g., trunk or android to total fat ratio) and decreased peripheral fat distribution (e.g., extremity or gynoid to total fat ratio) were associated with greater odds of vitamin D inadequacy. Among girls, the associations of regional fat with vitamin D were weaker than those in boys, and most analyses did not reach statistical significance. ConclusionsRegional fat deposits were associated with vitamin D status in Chinese school-aged children and more pronounced among boys.

Status of Cardiovascular Health in Chinese Children and Adolescents

The American Heart Association defined "ideal cardiovascular health (CVH)" in pediatric populations to promote primordial prevention in cardiovascular diseases. Little is known about CVH and associated sociodemographic factors among Chinese children and adolescents. This study aimed to evaluate CVH and the associations with sociodemographic characteristics in Chinese children and adolescents. This cross-sectional study analyzed baseline data of 15,583 participants aged 7 to 17 years from a Chinese national intervention program against obesity (2013-2014). CVH status was estimated according to 4 health behaviors (nonsmoking, body mass index, physical activity, and diet) and 3 health factors (total cholesterol, blood pressure, and fasting plasma glucose), using revised American Heart Association criteria. Multinomial logistic regression was used to assess the association between sociodemographic characteristics and the number of ideal CVH metrics. The prevalence of ideal CVH status was 1.7% (males: 1.9%; females: 1.6%) in the study population. The prevalence of ideal CVH behaviors and ideal health factors was 3.1% (males 3.3%; females: 3.0%) and 53.6% (males: 52.4%; females: 54.9%), respectively. Ideal fasting plasma glucose was the most prevalent component (males: 94.4%; females: 97.4%), whereas ideal physical activity (males: 34.6%; females: 23.9%) and diet (males: 28.3%; females: 30.1%) were the least prevalent. Female sex, younger age, undeveloped economy, residence in the southern region, and no family history of cardiovascular diseases were associated with more ideal CVH metrics. Ideal CVH status in Chinese children and adolescents is alarmingly rare. Physical activity and diet arekeytopromotion of CVH. Effective interventions are needed to promote CVH and reduce health disparities in early life.

Growth and Weight Status in Chinese Children and Their Association with Family Environments.

The growth status and weight status of Chinese children have experienced remarkable changes in the past decades. Using China Health and Nutrition Survey (CHNS) data, this paper examines the secular trends and disparity of the growth status and weight status in Chinese children and further investigates the impact of various family environments on children’s growth from 1991 to 2011. We found an increasing trend in standardized growth indicators (height, weight, and BMI), overweight, and obesity from 1991 to 2011. We also observed an increasing disparity in overweight and obesity over time. Family environments had a significant impact on children’s growth status and weight status. In particular, children that live in families with a small size, higher family income, better sanitary conditions, and with well-educated parents or overweight parents tended to be taller and heavier and have a higher BMI, lower risk of being underweight, and higher risk of exhibiting overweight and obesity. Further decomposition analysis showed that more than 70% of the disparity in standardized height, weight, and overweight and around 50% of the disparity in standardized BMI, underweight, and obesity could be attributed to heterogeneity in family environments. Moreover, the disparity associated with family environments tended to increase over time.

Status of Cardiovascular Health in Chinese Children and Adolescents: A Cross-Sectional Study in China

Background: This study aimed to evaluate cardiovascular health (CVH) status and the associations with sociodemographic characteristics among Chinese children and adolescents. Methods: This cross-sectional study analyzed baseline data of 15583 participants aged 7-17y from a Chinese national intervention program against obesity (2013-2014). CVH status was estimated by four health behaviors (non-smoking, body mass index, physical activity, diet) and three health factors (total cholesterol, blood pressure, and fasting plasma glucose (FPG)), using revised American Heart Association criteria. Multinomial logistic regression was used to assess the association between sociodemographic characteristics and CVH. Findings: The prevalence of ideal CVH status was 1.7% (boys 1.9%, girls 1.6%) in the study population. The prevalence of ideal CVH behaviors and ideal health factors were 3.1% (boys 3.3%, girls 3.0%) and 53.6% (boys 52.4%, girls 54.9%). Ideal FPG was the most prevalent component (boys 94.4%, girls 97.4%), whereas ideal physical activity (boys 34.6%, girls 23.9%) and diet (boys, 28.3%; girls, 30.1%) were the least prevalent. Girls, younger age, undeveloped economy, southern region, no family history were associated with more ideal CVH metrics. Interpretation: Ideal CVH status in Chinese children and adolescents is alarmingly rare. Physical activity and diet are key to CVH promotion. Effective interventions are needed to improve health disparities in terms of socio-demographic characteristics. Funding Information: This project has been funded by the Special Research Grant for Non-profit Public Service of the Ministry of Health of China (No.201202010), the Guangdong Provincial Natural Science Foundation (No.2017A030313844 and No.2021A1515010439), and the Research fund for medical science. Declaration of Interests: No conflicts of interest exist. Ethics Approval Statement: The Ethical Committee of Peking University approved the study’s protocol. All students and parents participated in this study with written informed consent voluntarily.

Vitamin A status and recurrent respiratory infection among Chinese children: A nationally representative survey.

Vitamin A is involved in immune function, vision, reproduction, and cell differentiation and is essential for child growth. Vitamin A deficiency (VAD) contributes significantly to mortality and morbidity in developing countries. This study assessed the current vitamin A status in Chinese children. A cross-sectional survey was conducted in 26 provinces in China between 2015 and 2018, and 277,064 children aged 0-14 years were enrolled. Data on sociodemographic factors and dietary supplements were obtained through interviews with their parents. Serum vitamin A concentrations were measured using HPLC. To reduce the sampling error, a weighted distribution was produced to estimate the distribution of serum vitamin A concentration in Chinese children. A new method was used calculate the CI. The results revealed that 10.4% (23.9 million) (95% CI: 10.1%-10.8%) of Chinese children aged 0-14 years were at risk of suffering from subclinical VAD (SVAD) (<0.2 mg/L). Sick children, especially those with recurrent respiratory infections (21.3%, 95% CI: 20.5%-22.2%), were vulnerable to SVAD. A high prevalence of SVAD was observed in western and northeastern areas in China. Serum vitamin A concentrations in ethnic minority groups were significantly lower than those in Han Chinese children (p<0.01). VAD is still a moderate public health problem in Chinese children, especially in those with respiratory symptoms. Regular consumption of vitamin A-rich foods should be promoted through nutrition education for parents.

Iron Status in Relation to Low-Level Lead Exposure in a Large Population of Children Aged 0-5Years.

There are limited data regarding low lead exposure and iron status in Chinese children. This study aimed to examine the association between low-level lead exposure and iron status in a large population of children aged 0-5years. We reviewed the records of children aged 0-5years who had blood lead, iron, ferritin, and hemoglobin measurements during 2014-2017 at the Guangdong Women and Children Hospital. We identified 17,486 children with a blood lead level < 100μg/L. Multiple linear and logistic regression analyses were performed to estimate the associations between blood lead levels and blood iron, serum ferritin, and hemoglobin. The mean concentrations of blood lead, iron, ferritin, and hemoglobin were 31.50μg/L, 7.50mmol/L, 46.98ng/mL, and 120.41g/L, respectively. Adjusting for age and sex, blood lead was negatively correlated with iron (r = - 0.073, p < 0.05), ferritin (r = - 0.043, p < 0.05), and hemoglobin (r = - 0.047, p < 0.05). Compared with the 1st quintile of lead exposure, the 5th quintile of lead exposure was associated with a 0.146mmol/L decrease in blood iron, a 4.678ng/mL decrease in serum ferritin, and a 1.245g/L decrease in hemoglobin. Adjusted odds ratios (95% confidence interval) for the 5th quintile of blood lead were 1.39 (1.25-1.55) for iron deficiency and 1.45 (1.26-1.67) for anemia, relative to the 1st quintile. Our study findings confirmed the previously established association of blood lead levels with decreasing iron status and extended previous findings to even low-level lead exposure in Chinese children.

Association between Physician-Diagnosed Asthma and Weight Status among Chinese Children: The Roles of Lifestyle Factors.

Childhood asthma and obesity have posed a parallel epidemic over the past few decades. However, whether asthma diagnosis is associated with obesity, and what the roles of lifestyle factors play in this relationship, remained unclarified. This study aimed to investigate the association between asthma and weight status in Chinese children and explore the potential mediating and/or modifying roles of lifestyle factors in the association. In this cross-sectional study, 16,837 children aged 6–12 years were recruited from Guangzhou, China. Participants’ information on physician-diagnosed asthma was collected from parents, and data on physical activity, screen time, and sleeping were reported in a validated questionnaire. Height and weight were objectively measured, and weight status was classified by body mass index (BMI). Multiple logistic regression analysis and mediation analysis were used. Results showed that asthmatic children were at significantly higher risk of obesity (odds ratio (OR) 1.51, 95% confidence interval (CI) 1.03, 2.21) compared with non-asthmatic children. More importantly, this increased risk was even greater in children with moderate-to-vigorous physical activity <60 min/d and children with screen time >2 h/d (both Pinteraction < 0.05). Also, a positive relationship of asthma with overweight was found in children with screen time >2 h/d (OR 3.92, 95% CI 1.56, 9.88), while a negative association was observed between asthma and underweight in children aged 9–12 years (OR 0.23, 95% CI 0.06, 0.92). Mediation analysis indicated that these associations were not mediated by physical activity, screen time, or sleeping. The findings suggested that physician-diagnosed asthma was associated with higher risks of overweight and obesity, and these risks might be exacerbated by insufficient physical activity and prolonged screen time.

Universal and Specific Predictors of Chinese Children With Dyslexia - Exploring the Cognitive Deficits and Subtypes.

While previous studies have shown that the impact of phonological awareness (PA) and rapid automatized naming (RAN) on dyslexia depends on orthographic complexity in alphabetic languages, it remains unclear whether this relationship generalizes to the more complex orthography of Chinese. We investigated the predictive power of PA, RAN, and morphological awareness (MA) in dyslexia diagnosis status in a sample of 241 typically developing and 223 dyslexic Chinese-speaking children. Compared with the control group, children with dyslexia performed notably worse on character reading and all three cognitive measures. A logistic regression analysis showed that PA and RAN were both significant predictors, while MA also played a relatively important role for predicting dyslexia status in Chinese children. In the next step, we used multigroup analyses to test if these three cognitive predictors were of the same importance in predicting reading variance in different reading proficiency groups. And the results showed that the regression coefficient of MP is stronger for the control group than the dyslexia group, while the regression coefficient of PD tends to be stronger for the dyslexic group. Further cluster analysis identified four subtypes of dyslexia in this sample: a global deficit group, a phonological deficit group, a RAN deficit group, and a mild morphological deficit group. Our findings are largely consistent with previous studies of predictors of dyslexia, while uniquely demonstrating the differences in predictive power of these three cognitive variables on reading, as well as the unique contribution of MA in Chinese reading.

Metabolic Syndrome and Related Factors in Chinese Children and Adolescents: Analysis from a Chinese National Study.

Aims: Metabolic syndrome (MetS) has become a worldwide epidemic; however, few studies have described its status in Chinese children. This study aimed to estimate MetS status and its associations with geography, economic development, birth weight, and parental education of Chinese children and adolescents.Methods: Data were derived from 15,045 participants aged 7–18 years across seven Chinese provinces. Physical measurement and blood tests were conducted to assess the five classical MetS components described by the International Diabetes Federation, including abdominal obesity (the essential component), high blood pressure, low high-density cholesterol (HDL-C), high triglyceride, and elevated fasting glucose (FG). Logistic regression was adopted to explore possible associations between MetS and other factors.Results: Overall, MetS prevalence was 2.3%, higher in males (2.8% vs. 1.7% in females), northern regions (3.1%), more developed regions (2.9%), and older participants (aged 16–18 years) (P < 0.05 for all). Among the five MetS components, abdominal obesity and low HDL-C level were most prevalent (21.8% and 14.4%), and 35.9% of the participants had at least one component. In logistic regression, MetS itself did not correlate with birth weight or parental education. High birth weight was positively correlated with abdominal obesity (odds ratio, 1.48) butnegatively associated with elevated FG (odds ratio, 0.49).Concusions: MetS itself was not common in Chinese children and adolescents, whereas its certain components were far more prevalent. Children from North China, more-developed areas, and at an older age were more likely to develop MetS. Strategies designed to prevent pediatric MetS in China should focus on prevalent components as well as its geographic and economic development predilections.

Secular Trends of Ascariasis Infestation and Nutritional Status in Chinese Children From 2000 to 2014: Evidence From 4 Successive National Surveys.

BackgroundThis study aimed to assess secular trends and epidemiological status of ascariasis infestations and to explore its effects on the nutritional transition among Chinese children from 2000 to 2014.MethodsData were collected from 69 435 Chinese children aged 7-year-olds and 9-year-olds in 4 successive cross-sectional surveys of Chinese National Survey on Students’ Constitution and Health. Ascariasis infestation was defined by using the Kato-Katz method. Nutritional status was classified into stunting, thinness, overweight, and obesity by WHO definition.ResultsFrom 2000 to 2014, the ascariasis infestation rates decreased from 9.1% to 1.7%, the stunting and thinness prevalence decreased from 4.3% and 13.8% to 0.7% and 7.1%, while the overweight and obesity prevalence increased from 3.6% and 2.1% to 9.8% and 9.1%, respectively. Compared to children in the ascariasis noninfestation group, those infected with ascariasis had a worse nutritional status. Yet, the disparity in nutritional status between 2 groups disappeared over time. Provinces with a higher gross domestic product per capita simultaneously had lower ascariasis infestation rates, lower stunting and thinness prevalence, and higher overweight and obesity prevalence.ConclusionsThe retardation effects caused by ascariasis infestation on nutritional status in Chinese children seemed to be offset by the rapid economic development and nutritional transition over time; nevertheless, multiple prevention and control measures are still needed and should be continuously strengthened.

Kids Nutrition and Health Study in China.

The Kids Nutrition and Health Study (KNHS) in China is part of a global research project focusing on the assessment of children's dietary intakes and eating behaviors. By analyzing data from the 2011 China Health and Nutrition Survey (CHNS), we found that most Chinese children did not consume enough nutrients, such as fiber, calcium, and vitamin D, whereas the intakes of saturated fat and sodium were excessive in 57 and 85% of children, respectively. Children from urban areas and from higher-income households were more likely to have higher micronutrient intakes and consume more animal source foods, especially dairy products, than those from rural areas and from lower-income households. The prevalence of overweight and obesity in children was higher in urban areas and higher-income families than in rural settings and those from lower-income households. We also reported that almost all children had 3 main meals (breakfast, lunch, and dinner), and 71% of them consumed snacks that contributed 10% of daily energy. Results suggested that a comprehensive approach that includes nutrition education, nutrition intervention programs targeting vulnerable populations, and promotion of physical activity is needed to improve the nutrition and health status in Chinese children.

Acyl-carnitine, C5DC, and C26 as potential biomarkers for diagnosis of autism spectrum disorder in children

Autism spectrum disorder (ASD) is a group of neurodevelopmental disorders that shown a close association with impaired lipid metabolism. The acyl-carnitine spectrum status in Chinese children with ASD has not been reported. In this study, we assessed the levels of blood acyl-carnitines in Chinese children with ASD and examined the relation between acyl-carnitine profiles and the intelligence levels. Blood levels of acyl-carnitines were determined by tandem mass spectrometry in 60 children with ASD and 30 typically developing children. Chinese Wechsler Young Children Scale of Intelligence (C-WYCSI) was used in ASD group. Blood levels of free carnitine, glutaricyl carnitine, octyl carnitine, twenty four carbonyl carnitine and carnosyl carnitine in the ASD group were significantly lower than those in the control group. Glutaryl carnitine and carnosyl carnitine might be potential biomarkers for diagnosis of ASD. The changes in the acyl-carnitine spectrum indicate potential mitochondrial dysfunction and abnormal fatty acid metabolism in preschool ASD children.

Association between Cesarean Section and Weight Status in Chinese Children and Adolescents: A National Survey.

Previous research on the association between cesarean section (CS) and childhood obesity has yielded inconsistent findings. This study assessed the secular trend of CS and explored the relationship between CS and the risks of overweight and obesity in Chinese children and adolescents. Data came from a national multicenter school-based study conducted in seven provinces of China in 2013. Covariate data including weight, height and delivery mode were extracted. Poisson regression was applied to determine the risk ratios (RRs) and 95% confidence intervals (CIs) for the risks of overweight and obesity associated with the delivery mode. A total of 18,780 (41.2%) subjects were born by CS between 1997 and 2006. The rate of CS increased from 27.2% in 1997 to 54.1% in 2006. After adjusting for major confounders, the RRs (95% CI) of overweight and obesity among subjects born by CS were 1.21 (1.15 to 1.27) and 1.51 (1.42 to 1.61), respectively. Similar results were observed in different subgroups stratified by sex, age, and region. In summary, the CS rate increased sharply in China between 1997 and 2006. CS was associated with increased risks of overweight and obesity in offspring after accounting for major confounding factors.

Serum 25-hydroxyvitamin D status in chinese children with vitiligo: a case-control study.

Vitamin D can play a vital role in autoimmune diseases. Epidemiologic evidence demonstrates vitamin D deficiency excited in adult patients with vitiligo. To investigate 25-hydroxyvitamin D (25(OH)D) levels in children with vitiligo and explore possible relevant factors. A total of 114 patients and 100 controls were included in our case-control study. We analyzed the required data collected by the questionnaire and examination to reveal the correlation with 25(OH)D levels. The mean serum 25(OH)D levels in patients and controls were 43.62 ± 19.23 and 67.87 ± 19.45 nmol/L, respectively. The rate of deficient in patients and controls are 14.9% and 2%, respectively. There was significant difference between the 2 groups. Significant differences also existed on different ages comparing serum vitamin D levels of patients with controls ( P < .001). Age was an independent factor affecting 25(OH)D level ( P = .032). Two (1.8%) and 4 (3.5%) of children with vitiligo have comorbid autoimmune diseases and family history, respectively. There was no correlation between sex, duration of disease, type of vitiligo, skin lesion location, stage, family history, and comorbid autoimmune diseases with 25(OH)D levels. Serum vitamin D level was associated with onset vitiligo children. More sunshine and vitamin D fortified foods are necessary among children with age. The rates of children vitiligo with family history has decreased in China.

Vitamin D Nutritional Status and its Related Factors for Chinese Children and Adolescents in 2010-2012.

Vitamin D plays a critical role in calcium and phosphate metabolism and helps maintain skeletal integrity in childhood, yet vitamin D status in Chinese children and adolescents is not well documented. The aim of this study was to assess the vitamin D status and analyze the risk factors for vitamin D deficiency in Chinese children and adolescents aged 6–17 years. Serum 25 hydroxyvitamin D (25(OH)D) was measured with a radioimmunoassay kit in 15,000 children and adolescent participants in the Chinese national nutrition and health survey (CNNHS) 2010–2012. Age, gender, region type, ethnicity, outdoor time, and vitamin D supplementation were recorded in unified design questionnaires. The season was recorded by the date of blood taken; location was divided into north and south by China’s Qinling Mountains and Huaihe River; and ambient ultraviolet B (UVB) radiation level was classified according to the corresponding dose of each participant living area from National Aeronautics and Space Administration data. 14,473 participants from the cross-sectional study of CNNHS 2010–2012 were included in this study. The median serum 25(OH)D concentration was 48.2 (35.4–63.4) nmol/L, and the concentration for males was 50.0 (36.5–65.7) nmol/L, which was statistically higher than that of females (46.7 (34.4–60.9) nmol/L) (P < 0.001). The general prevalence of vitamin D deficiency was 53.2%; 50.0% for males and 56.5% for females at the cut-off 50 nmol/L. According to the results of the log-binomial regression analysis, vitamin D deficiency in Chinese children and adolescents was specifically related to female gender (P < 0.0001), to ages 12–14 years (P < 0.0001) and 15–17 years (P < 0.0001), living in large cities (P < 0.0001) or ordinary rural areas (P < 0.0001), low ambient UVB levels (P < 0.0001) and medium ambient UVB levels (P < 0.0001), spring (P < 0.0001), autumn (P < 0.0001) and winter seasons (P < 0.0001). The data showed that vitamin D deficiency was very common among children and adolescents aged 6–17 years in China. Effective sun exposure should be encouraged in both genders aged 6–17 years, dietary vitamin D and vitamin D supplements are also recommended, especially in the seasons of spring and winter.

Understanding the Relations between Physical Activity and Obesity among Chinese Children and Adolescents

PURPOSE: The purpose of this study was to examine the relations between self-reported physical activity and obesity among children and adolescents in China. METHODS: The participants are 18424 students (51.9% boys, 49.1% girls) aged 8-18 years old in grades 3 to 12 from six provinces in China. They were divided into three groups by age: 8-12, 13-15, and 16-18. Physical activity level (PAL) was measured by Physical Activity Questionnaire for Children and Adolescents in Chinese (PAQ; Chen, 2008; Li, 2015; Jing, 2016). The summary scores of the PAQ were classified into three PAL categories “low (PAQ≤2), medium (2<PAQ≤3), and high (PAQ >3)”. In addition, physical fitness including high and weight were measured according to national standards of physical fitness during physical education classes. Weight status was classified into four categories “malnutrition, normal, overweight and obese” using BMI cut-points. Descriptive analysis, independent t-tests, ANOVA and Chi-square were used in the study. RESULTS: The distribution of PAL decreased for girls with age and the PAL of boys was significantly higher than girls in all three groups (t=9.12, t=18.91, t=16.72, p < 0.01). The percentage of PAL of girls in the low category dramatically increased from 15 years (47%) to 18 years (66%). Significant differences in PAL were found across obesity classifications (for 8-12, fboys=12.39, fgirls=6.86; for 13-15, fboys=11.88; for 16-18, fboys=7.66, fgirls=6.69, p < 0.001) except girls aged 13-15 years (f=1.42, p>0.05). Furthermore, the distribution of PAL in obesity classifications presents like a “U” that shows values of PAL were higher in the classifications of malnutrition and obesity than values in normal and overweight. Obesity status was significantly related to PAL (for 8-12, χ2boys= 34.86, χ2girls= 28.07; for 13-15, χ2boys= 27.80; for 16-18, χ2boys= 21.56, χ2girls=29.04, p < 0.01), but not girls aged 13-15 (χ2 = 5.81, p > 0.05). CONCLUSIONS: PAL was significantly related to weight status in Chinese children and adolescents. Boys demonstrated higher levels of PA across all age groups. Girls demonstrated a 19% decrease in PAL across 15 to 18 years of age.

LBPS 01-06 GENETIC AND ENVIRONMENTAL FACTORS OF METABOLICALLY HEALTHY OBESITY IN CHINESE CHILDREN

Objective: The metabolically healthy obesity (MHO), a sub-phenotype of obesity with a favorable metabolic profile, has been the focus of recent research interest. But the potential role of genetic predisposition or lifestyle factors in the MHO phenotype is yet to be clarified. We aimed to investigate the impact factors of MHO status in Chinese children. Design and Method: 1790 overweight and obese children aged 6–18 years old were included in this study. Participants were classified as MHO or metabolically unhealthy obesity (MUO) based on insulin resistance (IR) or cardio-metabolic risk (CR) factors (blood pressure, lipids and glucose). 28 genetic variants previously reported from GWAS on obesity, hypertension and dyslipidemia were genotyped. The environmental factors of lifestyle, socio-economic status and birth weight were assessed by questionnaire. Overweight and obesity were defined using the sex- and age-specific BMI cut-offs recommended by the International Obesity Task Force. Age, sex, tanner stage and residence were adjusted for covariates. Results: The prevalence of MHO-IR and MHO-CR were 60.7% and 30.7%, respectively. Proportion of severe obesity and central obesity and levels of BMI and WC were lower in MHO children compared with MUO children regardless of definitions. In addition to BMI and WC, the frequency of meat and fruit consumption, GNPDA2- rs10938397 and KCTD15-rs29941 were independent predictors of MHO-IR, whereas the frequency of meat consumption, FTO -rs9939609, and CYP17A1- rs11191548 were independent predictors of MHO-CR. Conclusions: At least one-third of Chinese obese children can be classified as MHO. Both genetic predisposition and environment factors contribute to the prediction of MHO status.

Risks of undernutrition and malnutrition in hospitalized pediatric patients with spinal cord injury.

Prospective study. To describe the nutritional risk/status of Chinese children with spinal cord injury (SCI) at admission and determine the relationship between nutritional risk/status and demography/SCI characteristics. China Rehabilitation Research Center, Beijing, China. Baseline clinical data, appetite level, anthropometric measurements and Screening Tool for the Assessment of Malnutrition in Pediatrics (STAMP) scores were obtained for pediatric SCI patients. The relationships among the demographic/SCI characteristics and STAMP score and z-scores of weight-for-age (WAZ), height-for-age (HAZ) and body mass index-for-age (BAZ) were assessed. The risk of undernutrition was compared with actual nutritional status. Forty-five children including 12 boys and 33 girls were included. The risks of undernutrition using the STAMP tool and malnutrition were 51.1% and 55.6%, respectively. Children with different demographic characteristics had similar nutritional status and risk of malnutrition. The risk of undernutrition was associated with nutritional status, including WAZ (P<0.001), HAZ (P=0.001), BAZ (P<0.001) and appetite level (P<0.001). Compared with nutritional status, STAMP had a sensitivity of 100%, a specificity of 73.3% and an overall agreement of 82.2%. As the duration of SCI increased, the risks of overweight and stunting increased. Nutritional screening in all pediatric SCI patients should be performed periodically. The decreasing trends in nutritional status and appetite level after SCI require special attention. The STAMP may be an alternative method for assessing nutritional status in Chinese children with SCI.