Children and adolescents with high BMI and high WC might have an increased risk of elevated BP. Our results suggest that the additional measurement of WC is better than BMI alone to help identify high BP risks.

The average value of BMI has increased over time; overweight and obesity among children and adolescents have become a serious public health problem. Comprehensive evidence-based strategies of intervention should be introduced, including periodic monitoring.

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The prevalence of overweight and obesity among children and adolescents in Shangdong rural areas increased rapidly between 1985 and 2014. Rural areas should not be neglected in obesity intervention, policy-makers and experts should pay more attention to the new tendency.

The change trend of urban-rural disparity should be concerned in the future; policies and interventions focused on childhood overweight and obesity should pay attention to rural areas.

The prevalence of childhood thinness is still wide in Shandong Province, and public health and nutritional strategies must give attention to the intervention for thinness, including periodic monitoring, education on pattern of nutrition and healthy dietary behavior.

There have been obvious regional variations in development and the prevalence of obesity in children and adolescents in Shandong, China, These variations in development and prevalence of obesity in children and adolescents among different SES districts being related to the local SES, process of urbanization, living environments, nutritional status, dietary pattern, physical activity and public health.

No abstract