What factors may contribute to sex differences in childhood obesity prevalence in China?

Abstract

Objective Previous studies in China showed large sex differences in childhood overweight and obesity (ow/ob) rates. However, limited research has examined the cause of these sex differences. This study aimed to examine individual and parental/familial factors associated with sex differences in childhood ow/ob rates in China. Design Variables associated with child weight status, beliefs and behaviors, and obesity-related parenting practices were selected to examine their sex differences and association with a sex difference in child ow/ob outcomes using logistic regression analysis. Setting Cross-sectional data analysis using the 2011 China Health and Nutrition Survey. Subjects Children aged 6–17 years (n=1,544) and their parents. Results Overall child ow/ob prevalence was 16.8%. Adolescent boys (AB; 12–17 years) were about twice as likely to be ow/ob as adolescent girls (AG; 15.5 vs. 8.4%, p<0.05). AB more likely had energy intake exceeding recommendations, self-perceived underweight, underestimated their body weight, and were satisfied with their physical activity level than AG. AG more likely practiced weight loss management through diet and self-perceived overweight than AB. Mothers more likely identified AG’s weight accurately but underestimated AB’s weight. Stronger associations with risk of childhood ow/ob were found in boys than girls in dieting to lose weight (OR= 6.7 in boys vs. 2.6 in girls) and combined maternal and child perception of the child’s overweight (OR= 35.4 in boys vs. 14.2 in girls). Conclusions Large sex differences in childhood obesity may be related to the sex disparities in weight-related beliefs and behaviors among children and their parents in China.

Double Burden of Malnutrition: Examining the Growth Profile and Coexistence of Undernutrition, Overweight, and Obesity among School-Aged Children and Adolescents in Urban and Rural Counties in Henan Province, China

“…stunting. e findings are consistent with the literature as studies suggest overweight or obesity is more prevalent in urban than in rural areas [32][33][34][35], trends uncommon across the globe, and unique to the country of China. Surprisingly, subjects in a small-medium city had the highest rate of underweight and second-highest rate of overweight or obesity.…”

“…Our findings also suggest that boys were more likely than girls to be overweight or obese [33-35, 41, 42]. A good understanding of the factors, such as weight management behaviors, weight perceptions, body image, and food parenting behaviors, that contribute to the sex differences in overweight or obesity will shed light to guide intervention efforts [42,43]. Investments in the early years of childhood can be effective in reducing gender inequality in nutritional health in China.…”

Mismatch in Children’s Weight Assessment, Ideal Body Image, and Rapidly Increased Obesity Prevalence in China: A 10‐Year, Nationwide, Longitudinal Study

“…In one study, mothers and children had 77.1% agreement in their perception of the child’s weight status, and about 10% of children and their mothers underestimated the weight status of the child . In particular, several studies have found that Chinese boys are more likely to underestimate their weight status than girls . Girls are more likely to be sensitive to their body size and have greater discrepancies between current weight and desired weight than boys in general .…”

Genetic risk score predicts risk for overweight and obesity in Finnish preadolescents

“…Differences in the prevalence of excess weight appear after childhood, suggesting that growth pattern and hormonal changes play a role, which is also supported by the fact that similar or even higher prevalence is reported in girls at younger age groups . Sex differences may also be related to life‐style factors and beliefs in children and their parents . Previously, we have shown that unhealthy eating habit was more common in boys than in girls, while typically boys are more physically active at this age providing no simple explanation for the phenomenon.…”

“…41 Sex differences may also be F I G U R E 2 Effect size comparison of the Fin-HIT suggestive SNPs for BMIz in adult population and in young children related to life-style factors and beliefs in children and their parents. 42 Previously, we have shown that unhealthy eating habit was more common in boys than in girls, 28 while typically boys are more physically active at this age 43,44 providing no simple explanation for the phenomenon.…”