In China, a full fat soy powder mixed with multiple micronutrient powders (Ying Yang Bao (YYB)) was developed, and the efficacy of YYB was shown in controlling anaemia and improving child growth and development. However, prior to 2008, there was no sustainable way to provide YYB to vulnerable populations, except through free distribution by the government. This study was to test the concept of public-private partnership (PPP) to deliver YYB and to evaluate the effectiveness of marketing YYB through PPP. Programme activities included development of a complementary food supplement (CFS) national standard, product concept test, product development and marketing, behavior change communication, monitoring and evaluation. Baseline and end-line surveys were used to evaluate product awareness, purchasing and the impacts of the project on anaemia and feeding practices. A Chinese CFS standard was approved. Caregivers and their 6-to-24-month-old children participated in the baseline (n = 226) and the end-line survey (n = 221). A concept test at the baseline survey showed that 78% of caregivers were willing to buy YYB at 0.1 USD. After developing the product and implementing the intervention for 8 months, 59.6% of surveyed caregivers purchased YYB.While not significant, the prevalence of anaemia was marginally lower at the end line (28.8%) than at the baseline (36.2%). For those purchasing YYB, the risk of anaemia was significantly reduced by 87% of odds (P < 0.009). The end-line survey found that feeding practices had improved significantly following the intervention. An enabling policy and regulatory environment in which CFSs are defined and parameters for appropriate marketing are identified as a prerequisite for marketing YYB or other nutritious CFS. Public and private advocacy and marketing could successfully increase awareness of YYB and access and use through market channels. The YYB project may be effective for reducing anaemia and improving feeding practices.

No abstract

The present study aimed to estimate the differences in rates of prehypertension and hypertension in children and adolescents among three regions with different socioeconomic status in China, and explore the corresponding risk factors associated with prehypertension and hypertension to guide the prevention. Blood pressure measurements of 13 762 children and adolescents aged 6–17 years were obtained from a prospective national survey (the China Health and Nutrition Survey, 1991–2011). Prehypertension and hypertension were defined by age and gender, according to China’s standard criteria. Chi-square tests were used to compare the differences in the prevalence of prehypertension and hypertension among three regions. Trend chi-square tests were used to detect the trends in rates of prehypertension and hypertension over survey years. Logistic regression models were used to detect the potential risk factors of prehypertension and hypertension in children and adolescents. During the survey years, the overall prevalence of prehypertension and hypertension were 6.0% and 10.6%. The corresponding rates in the western region were lowest, but increased rapidly over the two decades (84.0% and 122.6% increases respectively, P<0.001). The overall hypertension rate remained high in the eastern region, despite the slower increase (24.2% increase). In the central region, although the prehypertension rate remained stable, the rate of hypertension had a 94.8% increase these years (P<0.0001). According to the results of logistic regression, age, body mass index (BMI) and waist/height ratio (WHtR) were associated with prehypertension and hypertension. Children and adolescents in the eastern region had the highest level of prehypertension and hypertension, while the rapid increase of blood pressure in the western and central regions were also supposed to concern. Improvement of the healthy lifestyle is urgent for prehypertension and hypertension prevention in children and adolescents.

The IMCI strategy has been shown to contribute to the improvement of the health system, promoting the efficient management of medical care at township and village level, as well as improving the relationship between doctors and patients.

The results of this study demonstrated a substantial decline in BLLs from 2004 to 2010 among Chinese children 0-6 years living in cities. However, these levels were higher than levels in countries, such as the USA, Canada, Japan and Sweden. These data demonstrate that Chinese children's lead exposure remains a public health problem that requires additional effort and resources.

The adverse effects of lead on human especially childhood have been well established. Largely due to the phase out of lead in gasoline, blood lead levels (BLLs) had declined substantially all over the world including China. In 2004, 2007, 2010, and 2013, we conducted a continuous project including 47,346 children aged 0-6 years old from 11 cities all over China to show how the decline happened and to explore what to do next to improve the BLLs of children of China. Our data shown the BLLs of Chinese children decreased from 46.38, 43.58, 38.95 to 37.17 μg/L, but the decline was not enough. These decline was mainly because of the number decrease of children with high BLLs. Integrated strategy should be used to promote the BLLs of Chinese children, like striving to improve the environment, setting new cutoff for high BLLs, and establishing routine blood lead screening.

Breast milk is a potential source of infant and young children lead exposure, but national-level data on breast milk lead (BML) is unknown in China. To fill up this gap, we conducted a review by analyzing the articles enrolled through searching Wanfang MedOnline, CNKI, SinoMed, Pubmed, and Embase databases and relevant articles from 2000 through 2017. After screening and assessing process, 17 articles were included. The average concentrations of BML in these studies varied with regions (1.54-171.84 μg/L), and the BML level was dropping down in general. In conclusion, breast milk should still be encouraged to infant and young children in normal areas of China, and stopping breastfeeding should be considered prudently. Education for health workers and families on BML should be strengthened, and more surveys on BML should be conducted.

No abstract