Incidence of childhood overweight and obesity and its association with weight-related attitudes and behaviors in China: a national longitudinal study

Abstract

BackgroundChildhood obesity is a major public health challenge. We aimed to investigate the incidence of overweight/obesity among Chinese children; and prospectively examine the associations of weight-change intention with risk of overweight/obesity and behavioral changes in initially normal-weight children.MethodsA national sample of 21,796 children aged 6–17 years were investigated in September 2013 and followed up nine months later, of which 19,887 (91%) were normal weight and 1909 (9%) were underweight at baseline. Weight and height were objectively measured. Weight perception, weight-change intention, weight control practices, weight-related behaviors, and demographic information were obtained by questionnaires.ResultsAmong children with underweight or normal-weight, the cumulative incidence of overweight/obesity was 2.77% (95% CI 2.55–2.99). Among normal-weight children, those who overestimated their weight had higher baseline BMI z-scores and an increased relative risk (RR) of overweight/obesity (RR 1.51, 95% CI 1.15–1.99). Children who misperceived themselves as underweight or overweight had stronger weight-change intention than their counterparts. However, children with weight-change intention did not develop greater changes in dietary intakes, physical activities, or sedentary behaviors than those without intention. There was no significant association between weight-change intention and incidence after adjusting for BMI z-scores at baseline. Self-reported improving diet, increasing physical activity, and dieting were associated with certain actual behavioral improvements and smaller increase in BMI z-score, but not associated with decreased risk of overweight/obesity.ConclusionThe 9-months cumulative incidence of overweight/obesity was 2.77% among Chinese children. Weight-change intention was not associated with incidence of overweight/obesity in normal-weight children, regardless of their weight perception. More importantly, children’s weight-change intention was insufficient in achieving desirable behavioral changes. Future overweight and obesity prevention programs should directly target on promoting children’s actual behavioral changes.Electronic supplementary materialThe online version of this article (10.1186/s12966-018-0737-6) contains supplementary material, which is available to authorized users.

The Prevalence of Depression and Anxiety Symptoms among Overweight/Obese and Non-Overweight/Non-Obese Children/Adolescents in China: A Systematic Review and Meta-Analysis

“…In China’s education system, it relies almost entirely on test scores to evaluates progress, which lead to more reading, examinations, or/and homework for Chinese children and less time for physical activities [8]. In 2013, approximately 23.0% and 14.0% of Chinese boys and girls aged 2–19 years were overweight or obese [9]. Overweightness and obesity in children and adolescents can lead to developmental problems, such as poor cognitive function and altered timing of puberty [8].…”

Caregivers’ feeding behaviour, children's eating behaviour and weight status among children of preschool age in China

“…A systematic analysis reported that the rates of overweight/obesity in developing and developed countries were 13% and 24%, respectively, in 2013 4 . The Nutrition and Chronic Diseases of Chinese Residents Report in 2015 showed that the prevalence of overweight and obesity in children < 6 years of age was 8.4% and 3.1%, respectively, and these rates are increasing 2,6 . Childhood overweight and obesity are closely related to the occurrence of chronic diseases such as hypertension, diabetes and coronary heart disease 3,5 and also have a negative association with mental health, intellectual and learning abilities, personality development and psychosocial well‐being 1…”

“…4 The Nutrition and Chronic Diseases of Chinese Residents Report in 2015 showed that the prevalence of overweight and obesity in children < 6 years of age was 8.4% and 3.1%, respectively, and these rates are increasing. 2,6 Childhood overweight and obesity are closely related to the occurrence of chronic diseases such as hypertension, diabetes and coronary heart disease 3,5 and also have a negative association with mental health, intellectual and learning abilities, personality development and psychosocial well-being. 1 Recent increases in the rates of childhood obesity and associated health risks have drawn the attention of scientists.…”

Caregivers’ Feeding Behavior, Children's Eating Behavior, and Weight Status among Children of Preschool Age in China

“…A systematic analysis reported that the rates of overweight/obesity in developing and developed countries were 13% and 24%, respectively, in 2013 [4]. The Nutrition and Chronic Diseases of Chinese Residents Report (2015) showed that the prevalence of overweight and obesity in children < 6 years of age was 8.4% and 3.1%, respectively, and these rates are increasing [2,6]. Childhood overweight and obesity are closely related to the occurrence of chronic diseases such as hypertension, diabetes, and coronary heart disease [3,5] and also have a negative association with mental health, intellectual and learning abilities, personality development, and psychosocial well-being [1].…”