Report on Childhood Obesity in China (1) Body Mass Index Reference for Screening Overweight and Obesity in Chinese School-age Children

Purpose To establish and propose a national body mass index （BMI） reference for screening overweight and obesity in Chinese school-age children and adolescents. Methods 2000 CNSSCH （Chinese National Survey on Students Constitution and Health） data, including 216 620 primary and secondary school students aged 7 to 18 years old, were used as a reference population. Compared with those of the NCHS intematioanl reference, three temporary sets of cut-off BMI were proposed by testing different combinations of P85, P90, and P95. When physiological and biochemical measures between and among “obesity” “overweight”, and “normal weight” groups were taken into consideration, set Ⅱ was selected to be the most appropriate one. The sex-age-specific curves were then plotted and smoothed by using B-spline method. Results Based on the samples from costal developed metropolis, the BMI curves successfully overcame the shortcomings of lower and level-off tendency of the Chinese total population. Temporary set H, composed by cut-offs of P85 for overweight and P95 for obesity, was finally selected by its sensitivity and peculiarity. BMI 24 and 28 were used as cut-offs for overweight and obesity for both males and females aged 18 years old. These cut-offs, consistent with Chinese Adult＇s Reference, was proposed as the Body mass index reference for screening overweight and obesity in Chinese school-age children and adolescents. Conehlsion The new reference clearly showed its superiorty in both prospectivity and actuality. The proposed reference minimized the gaps of the BMI curve between Chinese adolescents and the international reference. Most importantly was that it was consistent with the Eastern Asia ethnic characteristics of body fatness growth. It was therefore proposed by the Working Group on Obesity in China （WGOC） to use it as an nationwide reference for screening overweight and obesity of school-age children and adolescents in China.

Energy Balance-related Behaviors Are Related to Cardiometabolic Parameters and Predict Adiposity in 8-14-year-old Overweight Chinese Children One Year Later

To identify target energy balance-related behaviors（ERBs）,baseline data from 141overweight or obese schoolchildren（aged 8-14years old）was used to predict adiposity[body mass index（BMI）and fat percentage]one year later.The ERBs included a modified Dietary Approach to Stop Hypertension diet score（DASH score）,leisure-time physical activity（PA,days/week）,and leisure screen time（minutes/day）.Several cardiometabolic variables were measured in the fasting state, including systolic blood pressure （SBP）, diastolic blood pressure （DBP）, blood glucose （GLU）, total cholesterol （TC）, triglycerides （TG）, low-density lipoprotein （LDL-C）, and high-density lipoprotein （HDL-C）.

Overweight and obesity among public and private primary school children in Nairobi, Kenya

Obesity is on the rise in developing countries, especially in urban areas. In this study, a cross-sectional study was conducted in two divisions in Nairobi province to determine the prevalence of and some risk factors associated with overweight and obesity among school children in Nairobi, Kenya. It involved 344 school children aged 9-14 years drawn from four randomly selected public and private primary schools. Weight and height were measured and body mass index was calculated. Nutrition status was determined using the World Health Organization age and gender specific BMI-for-age Z-scores (BAZ). The chi-square test was used to determine the relationship between overweight/obesity and selected socio-demographic characteristics. Complete anthropometric measurements were available for 321 children. Prevalence of combined overweight and obesity (BAZ > +1SD) was 19.0%, with prevalence being higher among girls (21.0%) than boys (16.9%) (p = 0.632). The prevalence among children in private schools was significantly higher (29.0%) than among those in public schools (11.5%) (p = 0.000). In addition, being a single child (p = 0.020), birth order (p = 0.017), mother’s occupation (p = 0.023) and type of residence (p = 0.028) were positively associated with overweight/obesity. The prevalence of overweight/obesity determined in this study is high and is a public health concern, with girls particularly at risk of becoming overweight.

Gender Differences in the Prevalence of Overweight and Obesity,Associated Behaviors,and Weight-related Perceptions in a National Survey of Primary School Children in China

Objective To in vestigate potential gender differences in the odds of overweight/obese, weight-related perceptions, and behaviors among Chinese school children. Methods Height, weight, and a survey of weight-related perceptions and behaviors were measured in a nationally representative survey of 12,811 children in primary schools in China. Logistic regression analyses were used to assess gender differences, adjusting for confounders. Results Boys had higher odds of being overweight/obese compared to girls within both urban [adjusted odds ratio （OR） 2.30, 95% CI 2.00 to 2.65] and rural areas （OR = 1.85, 95% CI 1.55 to 2.20）. Girls reported healthier diets （e.g., daily vegetables OR = 0.79, 95% CI 0.73 to 0.85） whereas boys consumed fried food （OR = 1.21, 95% CI 1.06 to 1.38） and sugar-sweetened drinks more often （OR = 1.49, 95% CI 1.34 to 1.65）. Gender differences included higher odds of boys perceiving themselves as overweight if they had more highly educated mothers （OR = 1.35, 95% CI 1.09 to 1.68）, less educated fathers （OR = 0.79, 95% CI 0.63 to 0.99）, and if they frequently consumed carbonated drinks （OR = 1.48, 95% CI 1.07 to 2.05）. Conclusion Childhood obesity prevention in China should be gender-focused, particularly for boys who reported an unhealthier diet but were less likely to see they were fat, even though more boys were overweight or obese than girls.

Report on Childhood Obesity in China (4) Prevalence and Trends of Overweight and Obesity in Chinese Urban School-age Children and Adolescents, 1985-2000

Objective To describe the nationwide prevalence of childhood overweight/obesity, and their group variations and trends over the past 20 years in the Chinese urban population. Methods Data sets of boys and girls at the age of 7-18 years collected from the series of Chinese national surveillance on students＇ constitution and health （CNSSCH） between 1985 and 2000 were divided into five socioeconomic and demographic groups, while BMI classification reference proposed by Working Group on Obesity in China （WGOC） was used as screening reference to calculate the prevalence and trends of overweight/obesity in these groups. Results In 2000, the prevalence of obesity and overweight in boys aged 7-18 years was 11.3% and 6.5% in Beijing, 13.2% and 4.9% in Shanghai, 9.9% and 4.5% in coastal big cities, and 5.8% and 2.0% in coastal medium/small-sized cities, respectively, while the prevalence of of obesity and overweight in girls of the same age group was 8.2% and 3.7% in Beijing, 7.3% and 2.6% in Shanghai, 5.9% and 2.8% in coastal big cities, and 4.8% and 1.7% in coastal medium/small-sized cities, respectively. The prevalence of obesity was low in most of the inland cities at an early stage of epidemic overweight. The epidemic manifested a gradient distribution in groups, which was closely related to status （SES） of the study population. However, a dramatic and steady increasing trend was witnessed among all sex-age subgroups in the five urban groups, and such a trend was stronger in boys than in girls, and much stronger in children than in adolescents. Conclusion Although China is at an early stage of epidemic obesity by and large, the prevalence of obesity in her urban population, particularly in coastal big cities has reached the average level of developed countries. The increasing trend has been rapid since early 1990s, and the increments in obesity and overweight are exceptionally high. The prospect of epidemic obesity in China is in no way optimistic. Therefore, preventive program should be focused on the improvement of the balance between caloric intake and energy expenditure, and interventions aimed at changing children＇s life styles.

Oral health status and performance of oral functions in children and adolescents in the treatment for overweight or obesity

The objective of this study was to evaluate the performance of oral functions and oral conditions in children and adolescents with overweight or obesity, investigating possible associations with treatment for weight reduction. Developing a cross-sectional research and quantitative approach with inductive and descriptive and critical analysis of data, such as from a range of 95%, the universe was represented by children and adolescents who were overweight or obese, in both sexes, treated at reference centers for the treatment of obesity by the National Health System, in Campina Grande, Paraíba, 2010-2012. As the control group considered subjects of the same age, in the process of screening for attention in the places listed, but without the condition of overweight or obese, the research was started after the approval by the Ethics Resarch Committee of the UEPB under the protocol number 0513.0.133.000-09. As instruments for data collection were used in the questionnaire and clinical examination, of the 70 surveyed, most were female, ranging in age from 3 to 17 years, overweight, without comorbidities and carriers of deleterious oral habits;especially the nail biting, significantly associated with female sex p < 0.05. Consistency was the preferred food paste and chewing quickly, unilaterally, without discomfort or gagging constant. There was a significant difference between the values of the DMFT index, the presence of visible biofilm and the frequency of halitosis, for groups with overweight or obesity, with association between time of treatment and medications.

Report on Childhood Obesity in China (5) Body Weight, Body Dissatisfaction, and Depression Symptoms of Chinese Children Aged 9-10 Years

Objective To investigate the relationship between body weight, body dissatisfaction and depression symptoms among Chinese children. Methods The fasting body weight and height of the third and fourth grade students （n=3886, aged 9 or 10 years） from 20 schools in Beijing, China, were measured, and the students were asked to choose the figures of body image and to complete the self-reported children＇s depression inventory （CDI） questionnaire. Results The CDI Cronbach＇s alpha was 0.81. The total CDI score was 9.60±7.50, 13.2% of children （boys 16.7% vs girls 9.5%） were at risk of developing depression symptoms. Overweight girls, but not boys, had significantly higher total CDI score than their normal weight counteparts. Both obese girls and boys showed a higher negative self-esteem score. More than one fifth underweight girls still wanted to be thinner while more than one third obese boys still wanted to be heavier. Children who wanted to be thinner showed slightly higher scores of ineffectiveness and negative self-esteem. After introducing the body dissatisfaction into the model, overweight was still associated with total CDI score among girls and obesity was still associated with negative self-esteem among both boys and girls. Conclusion Overweight girls show a significantly higher depression symptom score than their normal weight counterparts, which maybe partially explained by body dissatisfaction. Obese boys and girls are both more likely to suffer from low self-esteem, which is partially explained by body dissatisfaction.

Nutritional status of children with inflammatory boweldisease in Saudi Arabia

AIM: To assess the prevalence of nutritional disorders in children with inflammatory bowel disease(IBD) in Saudi Arabia.METHODS: The data from a national cohort of children newly diagnosed with IBD between 2003 and 2012 were analyzed. The diagnosis of IBD and the differentiation between Crohn's disease(CD) and ulcerative colitis(UC) were confirmed by gastroenterologists according to the standard criteria. The body mass index(BMI) of each child [weight(kg)/height^2(m)] was calculated at the time of diagnosis. The World Health Organization standards and references were used and the BMI for age > +1 and <-2 standard deviation score were used to define overweight and thinness, respectively. Age stratification analysis was performed to investigate any age-related variation in the prevalence of nutritional status between children < 10 years of age and older.RESULTS: There were 374 children from 0.33 to 17 years of age, including 119(32%) children with UC and 255(68%) with CD. All of the children were Saudi nationals, and 68(57%) of the UC and 150(59%) of the CD children were males. A positive history of anorexia at the time of diagnosis was found in 30(25%) patients with UC and 99(39%) patients with CD. The prevalence of thinness was 31%, 35% and 24% in children with IBD, CD and UC, respectively, with a significantly higher prevalence of thinness in children with CD than in children with UC(P = 0.037) only in the age group of 10-17 years(P = 0.030). The prevalence of overweight was 16 %, 15% and 20 % in the children with IBD, CD and UC, respectively, indicating a higher prevalence in UC that was statistically significant only in the age group of 10-17 years(P = 0.020). CONCLUSION: A high proportion of children with IBD presented with overweight instead of the classical underweight. Awareness of this finding is important for patient care.

Nutrition in Chinese-Korean Children and Adolescents

Objective To study the nutrition habits among Chinese-Korean children and adolescents in Yanbian Autonomous Prefecture, Jilin, China. Methods Data were obtained from the Chinese National Survey on Students＇ Constitution and Health in 1995, 2000, 2005, and 2010 for Chinese-Korean children and adolescents aged 7-18 years. The number of the subjects included was 4789, 4704, 5875, and 5315, respectively. Results The rate of the occurrence of stunting showed a declining trend from 1995 to 2010 （for boys： urban, 6.3%; rural, 12.7% in 1995 and 3.5% for both in 2010. For girls： urban, 7.8%; rural, 13.4% in 1995 and 4.2% and 5.5%, respectively, in 2010）. Although the ratio of wasting did not show significant differences between the urban and rural children and adolescents in 1995, 2000, 2005, and 2010 respectively, the ratio of occurrence of overweight or obesity increased （for boys： urban, 7.3% and 1.3% in 1995, 17.6% and 12.9% in 2010; rural, 7.0% and 1.3% in 1995, 14.6% and 12.8% in 2010, respectively. For girls： urban, 8.1% and 1.0% in 1995, 17.3% and 8.6% in 2010; rural 5.7% and 0.7% in 1995, 16.4% and 7.4% in 2010, respectively）. Conclusion The ratio of malnutrition in children and adolescents in Chinese-Korean areas declined from 1995 to 2010, and the distinction in malnutrition between the urban and rural areas was negligible in 2010. Further, the ratio of overweight and obesity increased over this period.

Is There a Correlation between Body Weight and Awareness of Healthy Life Style Components in Children?

Background: Incidence of obesity in children is increasing worldwide. Healthy eating and exercise are the major components of a healthy life style in the community. Objective: we aim to assess the knowledge of healthy eating and exercise in children?of varying weight?and to explore the correlation between knowledge and bodyweight. Method: School children are invited to fill in a 2 questions quiz about healthy life style.?BMI is calculated and children are classified into obese, overweight, normal and underweight. Answers are scored and results compared for different categories of the BMI. Results: 445 children participated. Age range (mean) was 7 - 13 (10) years. 67 were obese, 59 overweight, 237 normal weight and 34 were underweight. In the food question, 22%, 20%, 23% 15% of obese, overweight, underweight and normal weight children respectively gave wrong answers compared to 17.5%, 15% and 14.7%, 13.3% for the exercise question. Neither of the results was statistically significant. Boys are more knowledgeable about exercise than girls (P = 0.03). Conclusion: There is no difference in the level of knowledge about healthy eating and exercise among children with varying body weights. Tackling children behavior and attitude towards food and exercise is as important as improving their knowledge.

The potential of a year-round school calendar for maintaining children’s weight status and fitness:Preliminary outcomes from a natural experiment

Purpose: To evaluate the potential of a year-round school calendar (180-day school year distributed across 12 months) as an intervention comparedto a traditional school calendar (180-day school year distributed across 9 months) for mitigating children's weight gain and fitness loss viaa natural experiment.Methods. Height, weight, and cardiorespiratory fitness (CRF) (i.e., Fitnessgram Progressive Aerobic Cardiovascular Endurance Run) were measured inchildren (5—12 years old) in 3 schools (2 traditional, 1 year-round, n = 990 students, age = 8.6 土 2.4 years, 53.1% male, 68.9% African American) from1 school district. Structure (represented by the presence of a school day) was the independent variable. Changes in body mass index (BMI), age- andsex-specific BMI z-scores (zBMI), BMI percentile, percent of overweight or obese children, and CRF (Progressive Aerobic Cardiovascular EnduranceRun laps completed) were assessed for summer 2017 (May—August 2017), school year 2017/2018 (August 2017—May 2018), and summer 2018(May—August 2018). Primary analyses examined the overall change in weight and CRF from summer 2017 until summer 2018 via multilevel mixedeffects regression, with group (traditional vs. year-round calendar), time, and a group-by-time interaction as the independent variables. Secondaryregression analyses estimated differences in change within and between groups during each time period, separately.Results. Year-round students gained less BMI (difference in A = —0.44, 95% confidence interval (CI): —0.67 to —0.03) and less CRF (differencein △ = — 1.92, 95%CI: —3.56 to —0.28) than students attending a traditional school overall. Compared with traditional students, during both sum・mers, year-round students gained less BMI (summer 2017 difference in A = —0.15, 95%CI: —0.21 to —0.08;summer 2018 difference in△ = —0.16, 95%CI: —0.24 to —0.07) and zBMI (summer 2017 difference in A = —0.032, 95%CI: —0.050 to —0.010;summer 2018 difference in△ = —0.033, 95%CI: —0.056 to —0.009), and increased CRF (summer 2017 difference in A = 0.40, 95%CI: 0.02—0.85;summer 2018 differencein A = 0.23, 95%CI: —0.25 to 0.74). However, the opposite was observed for the school year, with traditional students gaining less BMI andzBMI and increasing CRF compared with year-round students (difference in BMI A = 0.05, 95%CI: 0.03—0.07;difference in zBMI A = 0.012,95%CI: 0.005—0.019;difference in Progressive Aerobic Cardiovascular Endurance Run laps A = —0.43, 95%CI: —0.58 to —0.28).Conclusion'. The year-round school calendar had a small beneficial impact on children's weight status but not CRF. It is unclear if this benefit tochildren's weight would be maintained because gains made in the summer were largely erased during the school year. Trajectories of weight andCRF gain/loss were consistent with the structured days hypothesis.

Waist Circumference Distribution of Chinese School-age Children and Adolescents

Background Waist circumference （WC）, a proxy measure of central body fat, is a better predictor than overall body fat for cardiovascular risk factors in both adults and children. WC cutoffs have been established in many countries, but the national WC reference has not been developed in China. Objective To study the distribution of WC in a representative group of Chinese children for establishing Chinese WC cutoff points. Methods Cross-sectional data obtained from 15 mainland provinces and Hong Kong were collected. There were 160 225 children and adolescents aged 7-18 years old in total. The subjects were divided into five regional groups namely costal city, other city, noah rural, south rural, and Hong Kong, for analyzing the distribution of WC. Results A large variation in WC distribution was found among the five groups for both sexes. Coastal city group had the highest P85 WC values consistently from the early school ages to 18-year-old compared with other groups. In contrast, south rural group had P85 values consistently lagged behind not only the city groups but also the north rural group. Hong Kong group had a high P85 WC at early ages, but because of the smaller increments of WC during adolescence, the P85 curve was gradually exceeded by the north rural groups. Catch-up trend was found in the two rural groups since the peak of puberty. These disparities were caused by not only socioeconomic and urban-rural factors but also north-south differences. Because of the regional variation of WC, a ＂gradient＂ prevalence of central obesity was prospected among these groups. Comparisons of WC distributions between the Chinese and the U.S.A or Netherlands demonstrated the necessary of setting up China＇s own WC cutoffs. Sex and age-specific percentiles were obtained and smoothed by using LMS method. Conclusion The data obtained from this study could be used to develop national WC cutoff points for Chinese children and adolescents.

超重和肥胖与哮喘患儿肺功能的相关性研究

目的 研究超重和肥胖与哮喘患儿肺功能的相关性。方法 选取2022年7月—2022年9月在呼吸科门诊就诊的368例哮喘患儿,根据体重指数(BMI)分为非超重肥胖组235例(63.8%)、超重组57例(15.5%)、肥胖组76例(20.7%),检测3组患儿肺功能的指标。包括用力肺活量(FVC)、第1秒用力呼气容积(FEV_(1))、1秒率(FEV_(1)/FVC),用力呼出25%肺活量时的瞬间流量(FEF_(25))、用力呼出50%肺活量时的瞬间流量(FEF_(50))、用力呼出75%肺活量时的瞬间流量(FEF_(75)),用力呼气中期流量(FEF_(25~75)),呼气峰值流量(PEF)。结果 在超重和肥胖患儿中,哮喘控制不良的比例更高,与非超重肥胖组比较,差异有统计学意义(P<0.05)。在368例哮喘患儿中,BMI数值和FEV_(1)/FVC呈负相关(r=-0.22,P<0.05),与FVC、FEV_(1)、FEF_(25)、FEF_(50)、FEF_(75)、FEF_(25~75)各指标呈正相关(P<0.05)。在急性发作期及缓解期患儿中,BMI数值和肺功能各指标的相关性表现结果同前。结论 超重和肥胖患儿中,哮喘控制不良的比例更高。随着BMI数值的升高,哮喘患儿的FEV_(1)/FVC呈下降趋势,超重和肥胖对哮喘患儿的负面影响主要表现在中央气道。

Childhood Obesity in Primary School Children of Middle and Upper-Middle Income Group in the Capital City of Bangladesh

Background: No published information is available on the status of childhood obesity in Bangladeshi primary school children of urban middle and upper-middle income group. The aim of the study was to explore the proportion of childhood obesity in the primary school children of middle and upper-middle income group in capital city and to gather information on their dietary pattern and physical activity. Methods: One hundred and fifty children (age 9 ± 1 years, height (ht) 118 ± 20 cm, weight (wt) 36 ± 8 kg, wt/ht% 126 ± 24, mean ± SD) were selected purposively from the primary schools of Dhaka city. On the basis of predefined scoring, subjects were classified as underweight, normal, overweight and obese if their weight-for-height values were 120% of median values for Bangladeshi children respectively. Dietary intake and energy expenditure of the study subjects were calculated by standard techniques. Results: The proportion of childhood overweight and obesity was 52% and 20%. The proportion of overweight and obesity was higher (78%) among girls compared to boys (54%). Similarly, height, weight and other anthropometrics indices were significantly (p < 0.05) higher in girls compared to boys. The daily intake of carbohydrate and protein was significantly (p < 0.05) higher among obese group. Total energy balance was significantly correlated with weight-for-height% (r = 0.541, p = 0.0001). Conclusions: A higher proportion of overweight and obesity had been found in girls’ children than their counter parts in this study. Positive energy balance with higher energy intake from carbohydrate and fast/processed food culture habit were found among primary school children of middle and upper-middle income group in the capital city of Bangladesh.

6~24岁超重/肥胖儿童青少年抑郁及焦虑症状检出率Meta分析

目的 评估6~24岁超重/肥胖儿童青少年抑郁及焦虑症状检出率。方法 系统检索中国知网、万方数据、重庆维普、中国生物医学文献数据库和PubMed,搜集有关超重/肥胖儿童青少年抑郁及焦虑症状检出率的文献,检索时限均由建库至2022年12月。由2位研究者独立筛选文献、提取数据并评价纳入研究的偏倚风险后,采用Stata 14.0软件进行Meta分析。结果 超重/肥胖儿童青少年中,抑郁及焦虑症状的总体检出率分别为21%(95%CI:17%~25%,I2=95.8%)和20%(95%CI:13%~27%,I2=96.7%);超重/肥胖儿童青少年比非超重/肥胖儿童青少年更有可能有抑郁症状(OR=1.62,95%CI:1.25~2.10,P<0.05)和焦虑症状(OR=2.13,95%CI:1.11~4.10,P<0.05)。结论 抑郁及焦虑症状在超重/肥胖儿童青少年中较常见,超重/肥胖儿童青少年有较高的抑郁及焦虑风险。为了减少抑郁及焦虑风险,应定期进行有效筛查和干预。

健康生活方式干预在超重与肥胖儿童中的应用效果

目的探讨健康生活方式干预在超重与肥胖儿童中的应用效果,并随访观察其效果的保持情况,旨在为儿童超重与肥胖的生活方式干预研究提供依据。方法于2020年7~8月招募216例9~16岁有减重意愿的超重与肥胖儿童作为研究对象,采用封闭式28 d的暑期夏令营方式对招募对象进行健康生活方式干预。比较健康生活方式干预前、后招募儿童的身体形态指标、代谢指标及男生和女生肥胖度构成情况;随访3年,观察干预效果维持情况。结果干预后,招募儿童的体重、体质量指数(BMI)均低于干预前(P<0.05)。干预后,招募儿童的甘油三酯、胆固醇、胰岛素水平均低于干预前(P<0.05);干预前、后,招募儿童的血糖水平无显著差异(P>0.05)。干预前、后,不同性别儿童肥胖度构成情况无显著差异(P>0.05)。3年随访期间,除了1例失访者,超重及肥胖儿童的BMI仍在持续改善,体重正常者体重虽有波动,但无1例反弹。结论健康生活方式干预可以有效减轻超重及肥胖儿童的体重,改善血液中甘油三脂和胆固醇水平,但对血糖改善作用不明显;随访期间通过有效的互动可以促进儿童保持健康的生活方式,使得减重效果得以保持。

福建省2012-2022年85159例5岁以下儿童营养状况分析

目的分析福建省2012—2022年5岁以下儿童营养情况和趋势,为制定适宜、有效的干预措施提供参考依据。方法根据《全国5岁以下儿童营养与健康监测方案》要求,在福建省抽取4个具有代表性的监测区,每个监测区随机抽取4个街道/乡镇,对2012年1月至2022年12月参与监测的85159例儿童营养指标进行分析,对5岁以下儿童的生长迟缓率、低体重率、消瘦率以及超重和肥胖率等指标分别进行单因素分析。结果2012年1月至2022年12月参与监测的儿童生长迟缓率2.04%,低体重率1.09%,消瘦率1.42%,超重和肥胖率5.13%。不同年份之间的低体重、消瘦的发生率不同,差异有统计学意义(P<0.05);不同年龄段儿童的低体重、生长迟缓的发生率不同,差异有统计学意义(P<0.05),其中以0~5月龄组的发生率最高,分别为1.35%、3.17%。不同年份之间和不同年龄段儿童之间的超重和肥胖率不同,差异有统计学意义(P<0.05);其中以0~5月龄组的发生率最高,为7.48%。结论福建省5岁以下儿童整体营养状况良好,低体重、生长迟缓、消瘦均处于低水平,但有回升趋势,需引起关注,加强营养与健康监测以及时发现问题并制定相应干预措施。超重及肥胖的控制不理想,应倡导科学喂养、合理膳食,培养健康饮食行为,促进体育锻炼。0~5月龄婴儿易患各类营养不良疾病,因此要重视该年龄段婴儿的营养。

理解不同体重儿童的身体活动:真实与自我知觉的动作能力匹配的影响

目的:探讨真实的动作能力(MC)与自我知觉的动作能力(PMC)匹配情况对不同体重儿童身体活动(PA)的影响。方法:使用加拿大灵敏与动作技能评价、Harter修订的儿童自我知觉量表中的运动分量表、Yamax EX510型计步器对济南市9~12岁342名(M年龄=10.73,SD=0.86)儿童的MC、PMC和PA进行测量,并运用多项式回归和响应面分析对数据进行分析。结果:1)在匹配情况下,相较于低MC-低PMC被试,具有高MC-高PMC特征的儿童的PA水平更高(正常体重,a_(1)=0.50,p<0.05且a_(2)=0.09,p>0.05;超重肥胖,a_(1)=0.59,p<0.05且a_(2)=0.01,p>0.05);2)在不匹配情况下:相较于低估MC的被试,高估MC的正常体重组儿童表现出更高的PA水平(a_(4)=0.07,p>0.05;a_(3)=-0.19,p<0.05),但这一差异在超重肥胖组儿童中并不显著(Z-Hat=0.19,p<0.05)。结论:在中国文化背景下,MC与PMC的协同提高对不同体重儿童的PA提高具有促进作用,但两者的不协调发展对不同体重儿童的PA的影响存在差异。建议采取针对性策略促进儿童MC与PMC的同步提高。

全血铜、锌、钙、镁、铁与超重肥胖儿童非酒精性脂肪肝病的关联

目的:非酒精性脂肪肝病(non-alcoholic fatty liver disease,NAFLD)是超重肥胖儿童中常见的一种代谢性疾病,其病因和发病机制尚未阐明,缺乏有效的预防和治疗手段。本研究旨在分析6~17岁超重肥胖儿童全血铜、锌、钙、镁、铁与NAFLD的关联,为超重肥胖儿童NAFLD的预防和早期干预提供依据。方法:采用横断面研究设计,通过问卷调查收集于2019年1月至2021年12月在湖南省儿童医院就诊的超重肥胖儿童的相关资料,采集受试者凌晨空腹血并检测血糖、血脂、微量元素等指标。将超重肥胖儿童分为单纯超重肥胖组(n=400)和NAFLD组(n=202);根据ALT水平,将NAFLD组划分为单纯性脂肪肝(non-alcoholic fatty liver,NAFL)组和非酒精性脂肪性肝炎(nonalcoholic steatohepatitis,NASH)组2个亚组。采用Logistic回归分析全血铜、锌、钙、镁、铁与NAFLD、NAFL和NASH之间的关联。结果:共纳入602名研究对象,其中73.6%为男性,年龄为10(9,11)岁,体重指数(body mass index,BMI)为24.9(22.7,27.4)kg/m~2。组间比较结果显示:NAFLD组的年龄、BMI、舒张压(diastolic blood pressure,DBP)、收缩压(systolic blood pressure,SBP)、甘油三酯(triglyceride,TG)、低密度脂蛋白(low density lipoprotein,LDL)、谷丙转氨酶(alanine transaminase,ALT)、谷草转氨酶(aspartate aminotransferase,AST)均高于单纯超重肥胖组,高密度脂蛋白(high density lipoprotein,HDL)低于单纯超重肥胖组;NAFL组的年龄、BMI、DBP、SBP、ALT、AST均高于单纯超重肥胖组,HDL低于单纯超重肥胖组;NASH组的年龄、BMI、DBP、SBP、TG、LDL、ALT、AST均高于单纯超重肥胖组,HDL低于单纯超重肥胖组(均P<0.017)。根据各微量元素水平划分为四分位组,在调整混杂因素年龄、性别、BMI、血压、TG、HDL、LDL后,与最低分位组相比,铁元素最高分位组NAFLD的OR值为1.79(95%CI 1.07~3.00),铜、锌、钙、镁元素与NAFLD均不存在关联。NAFLD亚组分析结果显示:在调整混杂因素后,铁元素最高分位组NAFL的OR值为2.21(95%CI 1.26~3.88),未发现铁与NASH以及铜、锌、钙、镁与NAFL或NASH之间的关联。结论:铁水平过高增加超重肥胖儿童NAFLD(更有可能是NAFL)的患病风险,而铜、锌、钙、镁等与超重肥胖儿童NAFLD的患病风险无关。

我国6~12岁儿童超重/肥胖流行状况及影响因素分析

目的:了解6~12岁儿童超重/肥胖的流行现状,探讨该时期儿童发生超重/肥胖的相关经济指标影响因素,为研究儿童肥胖预防措施提供参考依据。方法:选取2020年中国家庭追踪调查中的3 685名6~12岁儿童为研究对象,利用身高、体重和BMI数据,并结合家庭问卷、经济问卷中相关经济指标,采用logistic回归分析探讨6~12岁儿童发生超重/肥胖的影响因素。结果:3 685名6~12岁儿童超重/肥胖率为32.4%,其中男生为37.4%,女生为26.6%。不同性别、父亲教育程度、母亲教育程度、伙食费、家庭食品支出、儿童教育支出儿童,超重/肥胖率比较,差异均有统计学意义(χ^(2)值分别为48.531、11.193、32.659、9.050、9.016、15.293,P<0.05)。logistic回归分析结果显示,性别、母亲受教育程度、伙食费和儿童教育支出是儿童发生超重/肥胖的影响因素。结论:我国6~12岁儿童超重/肥胖率为32.4%,男生高于女生,性别、母亲受教育程度、伙食费和儿童教育支出是儿童发生超重/肥胖的影响因素。