School environment and policies, child eating behavior and overweight/obesity in urban China: the childhood obesity study in China megacities

Jia, Peng; Li, M; Xue, Hong; Lü, Li; Xu, Fei; Wang, Y

doi:10.1038/ijo.2017.2

Cited by 53 publications

(59 citation statements)

References 30 publications

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“…The ow/ob prevalence in boys was higher and increased faster than in girls, especially in the urban settings. Boys in China have been described as being particularly vulnerable to obesity because of genetic, behavioral, and socio-cultural reasons [10,20]. However, the gender ratios in general and in the urban setting found in our study were on average lower than ratios found by previous studies [8,10].…”

Section: Discussioncontrasting

confidence: 89%

Time Trend and Demographic and Geographic Disparities in Childhood Obesity Prevalence in China—Evidence from Twenty Years of Longitudinal Data

Jia

Xue

Zhang

2017

IJERPH

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Childhood overweight and obesity (ow/ob) has become a serious threat to many countries, including China. However, limited evidence was obtained from longitudinal data in China. This study examined the secular trends and geographic variation in the prevalence of ow/ob and obesity only, and age, gender, and urban-rural disparities among school-aged children across China. Data from children aged 6–17 surveyed in China Health and Nutrition Survey (CHNS) from 1991 (n = 2712) to 2011 (n = 1054) were used. Overweight and obesity were defined based on the International Obesity Task Force (IOTF) recommended Asian age-sex-specific BMI cut-off-points. We found that: (1) childhood ow/ob and obesity prevalence increased from 11.7% to 25.2% and from 2.8% to 10.1% during 1991–2011, respectively; (2) children aged 6–12 experienced a 1.3 and 1.6 times increase in ow/ob and obesity prevalence than children aged 13–17, respectively; (3) the urban-rural gap in ow/ob prevalence widened; (4) ow/ob prevalence in boys was higher and increased faster than in girls, especially in an urban setting; and (5) geographic variation was observed with faster increases in more economically developed east, central and northeast regions than in the less developed west. The findings added more nuances to the picture of temporal changes in ow/ob prevalence among Chinese children.

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Section: Discussioncontrasting

confidence: 89%

Time Trend and Demographic and Geographic Disparities in Childhood Obesity Prevalence in China—Evidence from Twenty Years of Longitudinal Data

Jia

Xue

Zhang

2017

IJERPH

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“…The school built environment was reported to be closely related to PA, but its associations with ov/ob were inconsistent [47][48][49]. Rashad and colleagues identi ed a signi cant and negative association between access to the sports eld at school and BMI [50], while another study reported that BMI was not associated with PA equipment, or vise versa [51,52].…”

Section: Discussionmentioning

confidence: 99%

A 3-year Longitudinal Study of the Effects of Physical Activity and Sedentary Behaviors on Childhood Obesity in China: The Childhood Obesity Study in China Mega-Cities

Sun

Zhao

Liu

et al. 2020

Preprint

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Objectives: Examine school children’s physical activity (PA) and sedentary behaviors (SB) during 2015-2017 and study their effects on children’s weight status and their relevant gender differences in China. Methods: This open cohort study included students from 5 major cities (Beijing, Shanghai, Xi’an, Nanjing, and Chengdu) across China. Data were collected from students in 2015, 2016, and 2017 (n = 5,535) and from their parents and school personnel. Children’s weight, height, and waist circumference were measured. SB and PA factors were evaluated using questionnaires. Mixed effects models examined the relationship between weight status and PA/SB-associated factors using this longitudinal data. Results: These children had high rates of obesity (12.4%, 95% CI 11.6%-13.3%) and central obesity (28.1%, 95% CI 26.9%-29.3%) during 2015-2017. Boys were more likely to be obese (16.5% vs. 8.4%) and central obese (36.3% vs. 19.8%) and spent more time in screen viewing than girls (hours/week ± SD: 2015, 1.8 ± 2.5 vs. 1.5 ± 2.0; 2016, 2.0 ± 2.4 vs. 1.8 ± 2.5; 2017, 1.7 ± 2.3vs. 1.4 ± 2.1 hours/week). Those who walked ＜ 5 minutes on their average daily walk to school were more likely to be obese (OR: 1.96, 95% CI 1.03-3.73) than those who spent ≥ 15 minutes on walking to school. When stratified by gender, this higher risk was only observed in girls (OR: 3.01, 95% CI 1.09-8.35). Children who spent more time in screen viewing were more likely to be obese (OR: 1.13, 95% CI 1.06-1.21) and have central obesity (OR: 1.05, 95% CI 1.02-1.09). The association for obesity was consistent in boys and girls (boys, OR: 1.15, 95% CI 1.05-1.25; girls, OR: 1.12, 95% CI 1.00-1.24). Conclusions: More screen time and less active time were risk factors for developing obesity in urban Chinese children. The associations varied by gender.

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“…Furthermore, food offerings in the same type of food outlets may greatly vary by region, except for the case of national chain stores. More work is needed in the future to untangle these complexities, eg, the inclusion of household surveys and individual purchasing and consumption data …”

Section: Discussionmentioning

confidence: 99%

Improvement in food environments may help prevent childhood obesity: Evidence from a 9‐year cohort study

et al. 2019

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Summary Background Effects of food environments (FEs) on childhood obesity are mixed. Objectives To examine the association of residential FEs with childhood obesity and variation of the association across gender and urbanicity. Methods We used the US Early Childhood Longitudinal Study—Kindergarten Cohort data, with 9440 kindergarteners followed up from 1998 to 2007. The Dun and Bradstreet commercial datasets in 1998 and 2007 were used to construct 12 FE measures of children, ie, changes in the food outlet mix and density of supermarkets, convenience stores, full‐service restaurants, fast‐food restaurants, retail bakery, dairy‐product stores, health/dietetic food stores, confectionery stores, fruit/vegetable markets, meat/fish markets, and beverage stores. Two‐level mixed‐effect and cluster robust logistic regression models were fitted to examine associations. Results Decreased exposures to full‐service restaurants, retail bakeries, fruit/vegetable markets, and beverage stores were generally obesogenic, while decreased exposure to dairy‐product stores was generally obesoprotective; the magnitude and statistical significance of these associations varied by gender and urbanicity of residence. Higher obesity risk was associated with increased exposure to full‐service restaurants among girls, and with decreased exposures to fruit/vegetable markets in urban children, to beverage stores in suburban children, and to health/dietetic food stores in rural children. Mixed findings existed between genders on the associations of fruit/vegetable markets with child weight status. Conclusion In the United States, exposure to different FEs seemed to lead to different childhood obesity risks during 1998 to 2007; the association varied across gender and urbanicity. This study has important implications for future urban design and community‐based interventions in fighting the obesity epidemic.

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School environment and policies, child eating behavior and overweight/obesity in urban China: the childhood obesity study in China megacities

Abstract: SEP are heterogeneous in the four Chinese megacities, high-income areas. They affect child unhealthy eating and overweight/obesity, and are critical for fighting childhood obesity in China.

Cited by 53 publications

References 30 publications

Time Trend and Demographic and Geographic Disparities in Childhood Obesity Prevalence in China—Evidence from Twenty Years of Longitudinal Data

Time Trend and Demographic and Geographic Disparities in Childhood Obesity Prevalence in China—Evidence from Twenty Years of Longitudinal Data

A 3-year Longitudinal Study of the Effects of Physical Activity and Sedentary Behaviors on Childhood Obesity in China: The Childhood Obesity Study in China Mega-Cities

Improvement in food environments may help prevent childhood obesity: Evidence from a 9‐year cohort study

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