Abstract
OBJECTIVE: To examine predictors and time trends of obesity in pre-school children in China.
DESIGN: This study was based on data from China Health and Nutrition Survey, a longitudinal survey from 1989 to 1997.
SUBJECTS: For cross-sectional analysis, we included 944, 1058, 903 and 483 children aged 2–6 y in 1989, 1991, 1993 and 1997, respectively. For longitudinal analysis, we included 944 children and 3146 measurements during four time periods.
MEASURES: Overweight and obesity according to age- and sex-specific BMI cut-off points proposed by International Obesity Task Force.
RESULTS: The overall prevalence of obesity increased from 4.2% in 1989 to 6.4% in 1997 among children aged 2–6 y. The increase largely occurred in urban areas, where the prevalence of obesity increased from 1.5% in 1989 to 12.6% in 1997 and prevalence of overweight increased from 14.6 to 28.9% at the same period. Longitudinal analysis shows BMI increased by 0.2 kg/m2 per year in urban areas and 0.1 kg/m2 per year in rural areas. In multivariate analysis, overweight in early childhood (2–6 y), parental overweight, high income and urban areas independently predicted overweight at age 10–14 y.
CONCLUSION: A substantial increase in overweight and obesity among children aged 2–6 y was observed in urban areas in China from 1989 to 1997. Overweight in early childhood significantly predicted overweight during adolescence. Urgent public health strategies are needed to prevent childhood obesity in China.
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References
Galuska DA, Serdula M, Pamuk E, Siegel PZ, Byers T . Trends in overweight among US adults from 1987 to 1993: a multistate telephone survey Am J Public Health 1996 86: 1729–1735.
Popkin BM, Doak CM . The obesity epidemic is a worldwide phenomenon Nutr Rev 1998 56: 106–114.
Mokdad AH et al. The spread of the obesity epidemic in the United States, 1991–1998 JAMA 1999 282: 1519–1522.
Loughlin JO, Paradis G, Meshefedjan G, Gray-Donald K . A five-year trend of increasing obesity among elementary schoolchildren in multiethnic, low-income, inner-city neighborhoods in Montreal, Canada Int J Obes Relat Metab Disord 2000 24: 1176–1182.
Troiano RP, Flegal KM, Kuczmarski RJ, Campbell SM, Johnson CL . Overweight prevalence and trends for children and adolescents: The National Health and Nutrition Examination Surveys, 1963 to 1991 Arch Pediatr Adolesc Med 1995 149: 1085–1091.
Bundred P, Kitchiner D, Buchan I . Prevalence of overweight and obese children between 1989 and 1998: population based series of cross sectional studies Br Med J 2001 322: 1–4.
Lewis CE, Smith DE, Wallace DD, Williams OD, Bild DE, Jacobs DR . Seven-year trends in body weight and associations with lifestyle and behavioral characteristics in black and white young adults: the CARDIA Study Am J Publ Health 1997 87: 635–642.
Chinn S, Hughes JM, Rona RJ . Trends in growth and obesity in ethnic groups in Britain Arch Dis Child 1998 78: 513–517.
Pi-Sunyer FX . Health implications of obesity Am J Clin Nutr 1991 53: 1595s–1603s.
Must A, Spadano J, Coakley EH, Field AE, Colditz G, Dietz WH . The disease burden associated with overweight and obesity JAMA 1999 282: 1523–1529.
Lee ZS, Critchley JA, Chan JC, Anderson PJ, Thomas GN, Ko GT, Young RP, Chna TY, Cockram CS, Tomlinson B . Obesity is the key determinant of cardiovascular risk factors in the Hong Kong Chinese population: cross-sectional clinic-based study Hong Kong Med J 2000 6: 13–23.
Hu FB, Wang BY, Chen CZ, Jin YT, Yang JH, Stampfer MJ, Xu XP . Body mass index and cardiovascular risk factors in a rural Chinese population Am J Epidemiol 2000 151: 88–97.
Stoll BA . Adiposity as a risk determinant for postmenopausal breast cancer. [Review.] Int J Obes Relat Metab Disord 2000 24: 527–533.
He Q, Ding ZY, Fong DY, Karlberg J . Blood pressure is associated with body mass index in both normal and obese children Hypertension 2000 36: 165–170.
Figuermo-Colon R, Franklin FA, Lee JY, Aldridge B, Alexander L . Prevalence of obesity with increased blood pressure in elementary school-aged children South Med J 1997 90: 806–813.
Young TK, Dean HJ, Flett B, Wood-Steiman P . Childhood obesity in a population at high risk for type 2 diabetes J Pediatr 2000 136: 365–369.
Erickson, SJ . Are overweight children unhappy? Body mass index, depressive symptoms, and overweight concerns in elementary school children. Arch Pediatr Adolesc Med 2000 154: 931–935.
Braet C, Mervielde I, Vandereycken W . Psychological aspects of childhood obesity: a controlled study in a clinical and nonclinical sample J Pediatr Psychol 1997 22: 59–71.
Kotani K et al. Two decades of annual medical examinations in Japanese obese children: do obese children grow into obese adults? Int J Obes Relat Metab Disord 1997 21: 912–921.
Popkin BM, Paeratakul S, Zhai F, Ge K . Body weight patterns among the Chinese: results from 1989 and 1991 China Health and Nutrition Surveys Am J Publ Health 1995 85: 690–694.
Popkin BM, Paeratakul S, Zhai F, Ge K . Dietary and environmental correlates of obesity in a population study in China Obes Res 1995 3(Suppl): 135s–143s.
Zhai F, Guo X, Popkin BM, Ma L, Wang Q, Yu W, Jin S, Ge K . The evaluation of the 24-hours individual recall method in China Food Nutr Bull 1996 17: 154–161.
Wang Y, Popkin BM, Zhai F . The nutritional status and dietary pattern of Chinese adolescents, 1991 and 1993 Eur J Clin Nutr 1998 52: 908–916.
Cole TJ, Bellizzi MC, Flegal KM, Dietz WH . Establishing a standard definition for child overweight and obesity worldwide: international survey Br Med J 2000 320: 1240.
Wang Y, Ge K, Popkin BM . Tracking of body mass index from childhood to adolescence: a 6-y follow-up in China Am J Clin Nutr 2000 72: 1018–1024.
SAS/STAT User's Guide, Version 6, 4th edn Vols 1 and 2: Cary, NC: SAS Institute Inc
Freedman DS, Srinivasan SR, Valdez RA, Williamson DF, Berenson GS . Secular increases in relative weight and adiposity among children over two decades; the Bogalusa Heart Study Pediatrics 1997 99: 420–426.
De Onis M, Blossner M . Prevalence and trends of overweight among preschool children in developing countries Am J Clin Nutr 2000 72: 1032–1039.
Sakamoto N, Wansorn S, Tontisirin K, Marui E . A social epidemiologic study of obesity among preschool children in Thailand Int J Obes Relat Metab Disord 2001 25: 389–394.
Mo-suwan L, Junjana C, Puetpaiboon A . Increasing obesity in school children in a transitional society and the effect of the weight control program Southeast Asian J Trop Med Publ Health 1993 24: 590–594.
Boldori L, Marelli A . Monitoring the trend of overweight children in Cremona Minerva Pediatr 2000 52: 21–27.
Ding ZY, He Q, Fan ZH et al. National epidemiological study on obesity of children aged 0–7 y in China 1996 Natl Med J China 1998 78: 121–123.
Martorell R, Khan K, Hughes ML, Grummer-Strawn LM . Overweight and obesity in preschool children from development countries Int J Obes Relat Metab Disord 2000 24: 959–967.
Flegal KM, Ogden CL, Wei R, Kuczmarski RL, Johnson CL . Prevalence of overweight in US children: comparison of US growth charts from the Centers for Disease Control and Prevention with other reference values for body mass index Am J Clin Nutr 2001 73: 1086–1093.
WHO Expert Committee . Physical status, the use and interpretation of anthropometry. World Health Organization Technical Report Series no. 854 1995.
Barlow SE, Dietz WH . Obesity evaluation and treatment: expert committee recommendations Pediatrics 1998 102: 626.
Himes JH, Dietz WH . Guidelines for overweight in adolescent preventive services: recommendations from an expert committee. The Expert Committee on Clinical Guidelines for overweight in Adolescent Preventive Services Am J Clin Nutr 1994 59: 307–316.
Poskitt EM . Defining children obesity: the relative body mass index (BMI). European Childhood Obesity group Acta Paediatr 1995 84: 961–963.
Wang et al . Standard definition of child overweight and obesity worldwide. (Letters.) Br Med J 2000 321: 1158.
Obesity: preventing and managing the global epidemic Report of a WHO Consultation on Obesity, Geneva 3–5 June 1997.
Gortmaker SL et al. Television viewing as a cause of increasing obesity among children in the United States, 1986–1990 Arch Pediatr Adolesc Med 1996 150: 356–362.
Yang NH, Zhou YZH, Mao LM . Survey on prevalence and affecting factors of obesity of schoolchildren in Wuhan Proceedings of Danone Institute China 3rd Annually Symposium, Beijing 2000 62–65.
Popkin BM, Ge K, Zhai F, Guo X, Ma H, Zohoori N . The Nutrition transition in China: a cross-sectional analysis Eur J Clin Nutr 1993 47: 333–346.
Acknowledgements
This study was supported by Takemi Program at Harvard School of Public Health and the Chinese Academy of Preventive Medicine. We thank Drs Walter C Willett, Barry M Popkin, Shuigao Jin and Youfa Wang for their helpful comments. The China Health and Nutrition Survey data were collected through P01HD2807601 from National Institutes of Health. The survey is a collaborative project between researchers from the Chinese Academy of Preventive Medicine, directed by Dr Keyou Ge and Dr Fengying Zhai; and a research group from University of North Carolina at Chapel Hill and the Carolina population center, directed by Barry M Popkin. The analyses were partly supported by a pilot grant from Boston Obesity Nutrition Research Center.
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Luo, J., Hu, F. Time trends of obesity in pre-school children in China from 1989 to 1997. Int J Obes 26, 553–558 (2002). https://doi.org/10.1038/sj.ijo.0801944
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DOI: https://doi.org/10.1038/sj.ijo.0801944
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