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Street ME, Casadei F, Di Bari ER, Ferraboschi F, Montani AG, Mele MC, Shulhai AM, Esposito S. The Role of Nutraceuticals and Probiotics in Addition to Lifestyle Intervention in the Management of Childhood Obesity-Part 2: Comorbidities. Nutrients 2025; 17:1487. [PMID: 40362796 PMCID: PMC12073779 DOI: 10.3390/nu17091487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2025] [Revised: 04/19/2025] [Accepted: 04/21/2025] [Indexed: 05/15/2025] Open
Abstract
Pediatric obesity is associated with a wide range of comorbidities beyond metabolic changes, affecting cardiovascular, endocrine, reproductive, musculoskeletal systems, and also mental health. Hypertension, commonly observed in children with obesity, increases the risk of long-term cardiovascular disease. Polycystic ovary syndrome (PCOS) presents another significant endo-reproductive challenge that often develops during adolescence in females, leading to further comorbidities in adulthood. Additionally, excess adiposity can negatively impact bone health by modifying bone metabolism and increasing fracture risk. Obesity is also strongly linked to mental health disorders, including depression, anxiety, and low self-esteem, which can further exacerbate unhealthy lifestyle behaviors and disorders. Given the limitations and poor adherence of traditional treatment strategies, nutraceuticals have emerged as potential complementary therapies due to their bioactive properties. Various compounds have demonstrated antihypertensive, insulin-sensitizing, and anti-inflammatory effects, while others support bone metabolism and promote mental well-being. Herewith, we discuss the role of nutraceuticals in managing hypertension, PCOS, bone health, and mental health issues in individuals with obesity, evaluating their mechanisms of action and clinical relevance. Integrating nutraceutical compounds with dietary and lifestyle interventions may improve treatment outcomes and prevent obesity-related comorbidities. Further, we emphasize the need for further large-scale clinical studies, especially in pediatric patients.
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Affiliation(s)
- Maria Elisabeth Street
- Department of Medicine and Surgery, University of Parma, 43121 Parma, Italy; (F.C.); (E.R.D.B.); (F.F.); (A.G.M.); (A.-M.S.); (S.E.)
- Unit of Paediatrics, P. Barilla Children’s Hospital, University Hospital of Parma, 43121 Parma, Italy;
| | - Federica Casadei
- Department of Medicine and Surgery, University of Parma, 43121 Parma, Italy; (F.C.); (E.R.D.B.); (F.F.); (A.G.M.); (A.-M.S.); (S.E.)
| | - Erika Rita Di Bari
- Department of Medicine and Surgery, University of Parma, 43121 Parma, Italy; (F.C.); (E.R.D.B.); (F.F.); (A.G.M.); (A.-M.S.); (S.E.)
| | - Francesca Ferraboschi
- Department of Medicine and Surgery, University of Parma, 43121 Parma, Italy; (F.C.); (E.R.D.B.); (F.F.); (A.G.M.); (A.-M.S.); (S.E.)
| | - Anna Giuseppina Montani
- Department of Medicine and Surgery, University of Parma, 43121 Parma, Italy; (F.C.); (E.R.D.B.); (F.F.); (A.G.M.); (A.-M.S.); (S.E.)
| | - Maria Concetta Mele
- Unit of Paediatrics, P. Barilla Children’s Hospital, University Hospital of Parma, 43121 Parma, Italy;
| | - Anna-Mariia Shulhai
- Department of Medicine and Surgery, University of Parma, 43121 Parma, Italy; (F.C.); (E.R.D.B.); (F.F.); (A.G.M.); (A.-M.S.); (S.E.)
| | - Susanna Esposito
- Department of Medicine and Surgery, University of Parma, 43121 Parma, Italy; (F.C.); (E.R.D.B.); (F.F.); (A.G.M.); (A.-M.S.); (S.E.)
- Unit of Paediatrics, P. Barilla Children’s Hospital, University Hospital of Parma, 43121 Parma, Italy;
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Huang F, Lin Z, Lu Y, Zhou Y, Zhu L, Wang X, Zhu Y. The Prevalence and Associated Factors of Impaired Fasting Glucose among Children and Adolescents in Urban China: A Large-Scale Cross-Sectional Study. Pediatr Diabetes 2024; 2024:6701192. [PMID: 40302960 PMCID: PMC12017157 DOI: 10.1155/2024/6701192] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 03/05/2024] [Accepted: 03/06/2024] [Indexed: 05/02/2025] Open
Abstract
This study aimed to investigate the level of fasting plasma glucose (FPG), the prevalence of impaired fasting glucose (IFG), and the associated factors among children and adolescents in urban China. Based on a cross-sectional study conducted in three Chinese metropolises during 2013-2014, this analysis included 7,143 participants aged 7-18 years. Information on demographics, family environment, diet, and physical activity was collected by questionnaires. Anthropometric parameters and blood biochemical indicators were measured. Logistic regression models were applied to assess risk factors of glucose level. Results revealed that the average FPG level was 4.81 ± 0.53 mmol/L, and the prevalence of IFG was 3.3%. Trends of these two variables varied significantly with age increasing (all p < 0.001), reaching double peaks at 10-12 and 15-17 years. IFG was positively associated with the male sex, age increasing, obesity, higher triglyceride (TG) levels, and living in northern China. When stratified by sex, family history of diabetes, elevated total cholesterol levels, and higher intake of sugar-sweetened beverages were positively associated with IFG only in females, suggesting these parameters were female-specific risk factors of IFG. We concluded that the prevalence of IFG among children and adolescents aged 7-18 years in urban China was higher than that reported in previous regional studies and was associated with obesity and higher levels of TG. Therefore, sex-specific lifestyle interventions should be provided to promote healthy weight and lipids and stem the upward trend of IFG.
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Affiliation(s)
- Fenglian Huang
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, (No.74 Zhongshan Road II), Guangzhou City, China
| | - Zongyu Lin
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, (No.74 Zhongshan Road II), Guangzhou City, China
| | - Yeling Lu
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, (No.74 Zhongshan Road II), Guangzhou City, China
| | - Yueqin Zhou
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, (No.74 Zhongshan Road II), Guangzhou City, China
| | - Lewei Zhu
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, (No.74 Zhongshan Road II), Guangzhou City, China
| | - Xiaotong Wang
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, (No.74 Zhongshan Road II), Guangzhou City, China
| | - Yanna Zhu
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, (No.74 Zhongshan Road II), Guangzhou City, China
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Öz B, Kıvrak AC. Evaluation of depression, anxiety symptoms, emotion regulation difficulties, and self-esteem in children and adolescents with obesity. Arch Pediatr 2023; 30:226-231. [PMID: 37062655 DOI: 10.1016/j.arcped.2023.02.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 12/02/2022] [Accepted: 02/12/2023] [Indexed: 04/18/2023]
Abstract
OBJECTIVE Pediatric obesity negatively affects many areas of mental health, especially anxiety and depression. This study aimed to investigate the effects of obesity on anxiety, depression, self-esteem, and emotion regulation in children and adolescents. METHODS Our study included 50 children and adolescents aged 11-17 years with a diagnosis of obesity and 48 control participants. The Revised Child Anxiety and Depression Scale (RCADS), Rosenberg Self-Esteem Scale (RSE), Difficulties in Emotion Regulation Scale (DERS), and Piers-Harris Children's Self-Concept Scale 1 (PHCSCS) were administered to all participants. RESULTS A significant difference was found between the groups (p < 0.05) in the analysis of the PHCSCS and RCADS total score; the GAD, PD, SOC, and MDD subscale scores; the DERS total score; the Clarity, Impulse, Strategies, Goals subscale scores; and the RSE Self-Esteem subscale. A significant correlation was found between the PHCSCS, RCADS, DERS, and RSE total scores and some subscale scores (p < 0.05). CONCLUSION On the basis of the results, it was determined that children and adolescents with obesity had high levels of anxiety and depression symptoms, they had lower self-esteem, and had more difficulties in emotion regulation. Furthermore, those with anxiety and depression symptoms had lower self-esteem, and the children who had problems in emotion regulation also had lower self-esteem. Anxiety, depression, low self-esteem, and difficulties in emotion regulation can negatively affect obesity treatment. Therefore, screening and treatment of these conditions are of great importance.
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Affiliation(s)
- Büşra Öz
- Department of Child and Adolescent Psychiatry, Düzce University Faculty of Medicine, Düzce, Turkey.
| | - Asil Can Kıvrak
- Department of Child and Adolescent Psychiatry, Düzce University Faculty of Medicine, Düzce, Turkey
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The Associations of Birthweight for Gestational Age Status with Its Differential 0-2 Year Growth Trajectory and Blood Pressure at Two Years of Age in Chinese Boys and Girls. Nutrients 2023; 15:nu15040979. [PMID: 36839337 PMCID: PMC9959466 DOI: 10.3390/nu15040979] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 02/12/2023] [Accepted: 02/13/2023] [Indexed: 02/18/2023] Open
Abstract
The first 1000 days of life represents a critical period for lifelong metabolic health. This study prospectively examined the contrasts between the growth trajectories of large, small, and appropriate sizes for gestational age (LGA, SGA, and AGA) term-born infants in their first two years, and their blood pressure at two years. In 2012-2013, 806 Chinese mother-newborn dyads were enrolled in the Shanghai Obesity and Allergy Birth Cohort Study. Repeated anthropometric measures were obtained at age 42 days, and at 3, 6, 9, 12, 18 and 24 months. Systolic and diastolic blood pressure (SBP, DBP) were measured at two years of age. Linear random effect models were employed to evaluate growth trajectory differences between LGA, SGA, and AGA infants. Of the study infants, 12.4% were LGA and 4.0% SGA. Length, weight, and weight-for-length z-score (ZWFL) were all consistently higher in LGA infants and lower in SGA infants than AGA infants. SGA infants had a higher ZWFL (0.11 unit/month; 95% CI: 0.04, 0.19) and a higher BMI (0.19; 95% CI: 0.09, 0.28 kg/m2 per month) growth velocity at age 0-6 months, relative to AGA infants. SGA was associated with 6.4 (0.4-12.4) mmHg higher SBP, and LGA was associated with 2.9 (95% CI -5.2, -0.5) mmHg lower DBP at two years of age in boys, however, not in girls. In conclusion, in this prospective birth cohort with repeated anthropometric measures and BP at two years of age, LGA, SGA, and AGA term-born infants manifested differential patterns of weight growth trajectory and BP, providing new insight into developmental origins of cardiometabolic health.
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Schade R, Song L, Cordner ZA, Ding H, Peterson DA, Moran TH, Tamashiro KL, Serre CBDL. Rat offspring's microbiota composition is predominantly shaped by the postnatal maternal diet rather than prenatal diet. Physiol Behav 2023; 258:113987. [PMID: 36198343 PMCID: PMC10088501 DOI: 10.1016/j.physbeh.2022.113987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 09/28/2022] [Accepted: 09/30/2022] [Indexed: 01/26/2023]
Abstract
This study assessed the impact of maternal diet during pregnancy versus lactation on offspring gut microbiota. Sprague-Dawley dams were fed high fat (HF) or Chow diets during pregnancy, and their male offspring were raised by a different dam consuming the same or opposite diet (Chow-Chow, Chow-HF, HF-Chow, and HF-HF). Microbiota analysis showed that maternal lactation diet, rather than pregnancy diet, determined offspring microbiota profiles at weaning. Increased abundances of Turicibacter, Staphylococcus , and Ruminococcus were characteristic of chow lactation groups. Lactococcus , Streptococcus , and Parabacteroides were characteristic of HF lactation groups and positively correlated with offspring body weight.
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Affiliation(s)
- Ruth Schade
- Department of Nutritional Sciences, University of Georgia, Athens, GA, U.S.A; Current address: Department of Microbiology and Immunology, Stanford University, Palo Alto, CA, U.S.A
| | - Lin Song
- Departments of Psychiatry & Behavioral Science, Johns Hopkins University School of Medicine, Baltimore, MD, U.S.A; Department of Physiology and Pathophysiology, School of Basic Medical Sciences, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China; Key Laboratory of Environment and Genes Related to Diseases, Ministry of Education of China, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Zachary A Cordner
- Departments of Psychiatry & Behavioral Science, Johns Hopkins University School of Medicine, Baltimore, MD, U.S.A
| | - Hua Ding
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, U.S.A
| | - Daniel A Peterson
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, U.S.A
| | - Timothy H Moran
- Departments of Psychiatry & Behavioral Science, Johns Hopkins University School of Medicine, Baltimore, MD, U.S.A
| | - Kellie L Tamashiro
- Departments of Psychiatry & Behavioral Science, Johns Hopkins University School of Medicine, Baltimore, MD, U.S.A.
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Zhang BG, Qian XF. Weight self-stigma and engagement among obese students in a physical education class. Front Psychol 2022; 13:1035827. [PMID: 36425828 PMCID: PMC9679520 DOI: 10.3389/fpsyg.2022.1035827] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Accepted: 10/03/2022] [Indexed: 09/20/2023] Open
Abstract
BACKGROUND This is a cross-sectional in design. It involves the mediating effects of basic psychological need satisfaction in relation to the moderating effects of teacher autonomy support regarding weight self-stigma's effect on engagement among obese students in physical education classes. METHODS This study includes 165 Chinese high school obese students [mean age, 16.84 (±0.147) years], comprising 93 males (56.63%) and 72 females (43.63%), with a mean body mass index (BMI) of 30.453 (SD = 2.426). Participants completed the weight self-stigma questionnaire, basic psychological need satisfaction questionnaire, teacher autonomy support questionnaire, and student engagement questionnaire. RESULTS Weight self-stigma and engagement among obese students were mediated by basic psychological need satisfaction. Moreover, the mediated effect of basic psychological need satisfaction was moderated by teacher autonomy support. CONCLUSION Weight self-stigma and basic psychological need satisfaction are the antecedents influencing the engagement of obese students. Notably, weight self-stigma not only directly blocks the engagement of obese students but also their engagement by hindering the acquisition of basic psychological need satisfaction. Teacher autonomy support can significantly reduce the negative impact of weight self-stigma on basic psychological need satisfaction and significantly promote engagement. Therefore, by promoting their physical education engagement, physical education teachers should strengthen the application of their supportive autonomous teaching strategies to help obese students meet their basic psychological needs.
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Affiliation(s)
- Bao Gen Zhang
- School of Physical Education and Health, Zhao Qing University, Zhao Qing, China
| | - Xiao Fang Qian
- Department of Physical Education, School of Humanities, Zhao Qing Medical College, Zhao Qing, China
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Han SH, Yee JY, Pyo JS. Impact of Short Sleep Duration on the Incidence of Obesity and Overweight among Children and Adolescents. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:medicina58081037. [PMID: 36013503 PMCID: PMC9415582 DOI: 10.3390/medicina58081037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 07/22/2022] [Accepted: 07/26/2022] [Indexed: 11/16/2022]
Abstract
Background and Objectives: The prevalence of obesity among children is increasing and is highlighting many problems. Lack of sleep is common among children and adolescents. Although several studies have investigated sleep duration and overweight and obesity from a sex perspective, data regarding age and sex effects remain limited and inconclusive. This study aimed to evaluate the risk(s) for overweight or obesity according to sleep duration among children and adolescents; to evaluate the effect of short sleep duration on the incidence of overweight/obesity among children and adolescents; and to evaluate sex differences in the risk of overweight or obesity with shorter sleep durations. Materials and Methods: The PubMed database was searched for relevant studies published up to June 30, 2021. Odds ratios for obesity/overweight were estimated for short compared with long sleep duration. Subgroup analysis based on sleep duration, sex, and study location was also performed. Results: The estimated odds ratio for combined obesity and overweight was 1.171 (95% confidence interval (CI) 1.092−1.256) according to short sleep duration. Obesity/overweight with short sleep duration was significantly prevalent in the <6 and 6−10 years’ subgroups (odds ratio 1.226 (95% CI 1.083−1.387) and 1.341 (95% CI 1.175−1.530), respectively). Among boys, short sleep duration was significantly correlated with a high occurrence of obesity/overweight (odds ratio 1.294 (95% CI 1.153−1.452)); no such correlation was found among girls. Conclusions: Short sleep duration may increase risk of obesity among children and adolescents, especially those <6 and 6−10 years of age. In the subgroup analysis, the incidence of obesity/overweight for short sleep time revealed significant results among Asians and boys.
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Affiliation(s)
- Seung-Ho Han
- Department of Physiology and Biophysics, Eulji University School of Medicine, Daejeon 34824, Korea; (S.-H.H.); (J.-Y.Y.)
| | - Jae-Yong Yee
- Department of Physiology and Biophysics, Eulji University School of Medicine, Daejeon 34824, Korea; (S.-H.H.); (J.-Y.Y.)
| | - Jung-Soo Pyo
- Department of Pathology, Uijeongbu Eulji Medical Center, Eulji University School of Medicine, Uijeongbu 11759, Korea
- Correspondence: ; Tel.: +82-31-951-2493
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Guo H, Phung D, Chu C. Sociodemographic, lifestyle, behavioral, and parental factors associated with sugar-sweetened beverage consumption in children in China. PLoS One 2021; 16:e0261199. [PMID: 34890424 PMCID: PMC8664181 DOI: 10.1371/journal.pone.0261199] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Accepted: 11/25/2021] [Indexed: 11/18/2022] Open
Abstract
Objective Evidence shows sugar-sweetened beverage (SSB) consumption is a risk factor for obesity and non-communicable diseases (NCDs) in children. Investigating the influential profiles, which have been examined insufficiently, will help to inform the reduction of SSB consumption. The present research examines the current trend in SSB consumption and associated factors among children in China, in order to inform policy development. Methods Secondary data was extracted from China’s Health and Nutrition Survey (CHNS; 2004, 2006, 2009, and 2011), a repeated cross-sectional research, and a Chi-squared test was applied to compare SSB consumption in the last year, queried by social demographical, `environmental, behavioral, and parental factors. Multilevel mixed-effects logistic regression was employed to examine the trend and effects of the multiple factors. Results A total of 6015 Chinese children aged 6–17 years were investigated. From 2004 to 2011, the percentage of SSB consumption in children increased from 72.6% to 90.3%. The prevalence in urban areas was higher than the prevalence in rural areas, higher in high schools than primary and middle schools, higher in east coast affluent provinces than other provinces, and higher in high-income households than low-income households. Other associated factors include children’s fast food and salty snacks preference, level of physical activity, sedentariness, and parental education. The strongest association with SSB consumption in children was the mother’s SSB consumption (adjusted odds ratio: 5.54, 95% CI: 3.17–9.67). Conclusion Children’s SSB consumption has increased significantly in China, and is associated with socio-economic, demographic, level of physical activity, food preference, and parental factors. Future strategies aimed at reducing SSB consumption among children need to consider these factors.
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Affiliation(s)
- Haijun Guo
- Centre for Environment and Population Health, Griffith University, Nathan, Australia
- * E-mail:
| | - Dung Phung
- Centre for Environment and Population Health, Griffith University, Nathan, Australia
| | - Cordia Chu
- Centre for Environment and Population Health, Griffith University, Nathan, Australia
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Sbaraini M, Cureau FV, Ritter JDA, Schuh DS, Madalosso MM, Zanin G, Goulart MR, Pellanda LC, Schaan BD. Prevalence of overweight and obesity among Brazilian adolescents over time: a systematic review and meta-analysis. Public Health Nutr 2021; 24:6415-6426. [PMID: 33821783 PMCID: PMC11148597 DOI: 10.1017/s1368980021001464] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
OBJECTIVE To estimate the burden of excess weight in Brazilian adolescents. DESIGN Systematic review with meta-analysis. SETTING We searched the literature in four databases (MEDLINE/PubMed, EMBASE, SciELO and LILACS). Studies were included if they had cross-sectional or cohort design and enrolled Brazilian adolescents. Studies based on self-reported measures were excluded. Random effect models were used to calculate prevalence estimates and their 95 % CI. PARTICIPANTS Brazilian adolescents (10 to 19 years old). RESULTS One hundred and fifty-one studies were included. Trend analyses showed a significant increase in the prevalence of excess weight in the last decades: 8·2 % (95 % CI 7·7, 8·7) until year 2000, 18·9 (95 % CI 14·7, 23·2) from 2000 to 2009, and 25·1 % (95 % CI 23·4, 26·8) in 2010 and after. A similar temporal pattern was observed in the prevalence of overweight and obesity separately. In sensitivity analyses, lower prevalence of excess weight was found in older adolescents and those defined using International Obesity Task Force cut-off points. The Southeast and South regions had the highest prevalence of excess weight, overweight and obesity. No significant difference in prevalence by sex was found, except for studies before the year 2000. CONCLUSIONS The prevalence of overweight and obesity in Brazilian adolescents is high and continues to rise. Public policies on an individual level and targeting modifications in the obesogenic environment are necessary.
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Affiliation(s)
- Mariana Sbaraini
- Universidade Federal do Rio Grande do Sul (UFRGS), Programa de Pós-Graduação em Ciências da Saúde: Cardiologia e Ciências Cardiovasculares, Porto Alegre, RS, Brazil
| | - Felipe Vogt Cureau
- Universidade Federal do Rio Grande do Sul (UFRGS), Programa de Pós-Graduação em Ciências Médicas: Endocrinologia, Porto Alegre, RS, Brazil
| | - Julianna do Amaral Ritter
- Universidade Federal do Rio Grande do Sul (UFRGS), Programa de Pós-Graduação em Ciências Médicas: Endocrinologia, Porto Alegre, RS, Brazil
| | - Daniela Schneid Schuh
- Instituto de Cardiologia/Fundação Universitária de Cardiologia do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Mariana Migliavacca Madalosso
- Universidade Federal do Rio Grande do Sul (UFRGS), Programa de Pós-Graduação em Ciências Médicas: Endocrinologia, Porto Alegre, RS, Brazil
| | - Gabriella Zanin
- Universidade Luterana do Brasil (ULBRA), Porto Alegre, RS, Brazil
| | - Maíra Ribas Goulart
- Instituto de Cardiologia/Fundação Universitária de Cardiologia do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Lucia Campos Pellanda
- Instituto de Cardiologia/Fundação Universitária de Cardiologia do Rio Grande do Sul, Porto Alegre, RS, Brazil
- Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, RS, Brazil
| | - Beatriz D Schaan
- Universidade Federal do Rio Grande do Sul (UFRGS), Programa de Pós-Graduação em Ciências da Saúde: Cardiologia e Ciências Cardiovasculares, Porto Alegre, RS, Brazil
- Universidade Federal do Rio Grande do Sul (UFRGS), Programa de Pós-Graduação em Ciências Médicas: Endocrinologia, Porto Alegre, RS, Brazil
- Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
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Zhou Y, Yu P, Zhang Y, Wang T, Wang A. Distinct Patterns of Urban-Rural and Sex Disparities in Children's BMI Trajectories From 2013 to 2018. Front Public Health 2021; 9:689021. [PMID: 34368059 PMCID: PMC8339214 DOI: 10.3389/fpubh.2021.689021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Accepted: 05/24/2021] [Indexed: 11/13/2022] Open
Abstract
Background: To identify distinct trajectories of body mass index (BMI) in a large sample of Chinese children by urban-rural and sex disparities. Methods: Data for this study were obtained from the National Surveys on Chinese Students' Constitution and Health among 16,060 children aged 6-11 years. Weight and height data were used to calculate BMI. Group-based trajectory modeling (GBTM) was used to identify distinct BMI trajectories. Results: Seven distinct trajectories were identified, "sustained healthy weight" (46.01%), "sustained obesity" (17.26%), "sustained underweight" (4.50%), "obesity to overweight" (6.45%), "obesity to healthy weight" (11.75%), "healthy weight to overweight" (8.67%), and "healthy weight to obesity" (5.36%). The proportions of "sustained obesity," "healthy weight to obesity," and "healthy weight to overweight" trajectories were much higher among boys compared with girls (P < 0.001). Meanwhile, children living in rural areas were more represented in the "healthy weight to obesity" trajectory (P < 0.001). Conclusion: In this study, the proportions of BMI development trajectories among 6-11-year-old children varied by sex and urban-rural areas, which may require tailored interventions specifically toward these at-risk trajectories.
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Affiliation(s)
- Yunping Zhou
- School of Nursing, Qingdao University, Qingdao, China
| | - Pengli Yu
- School of Nursing, Qingdao University, Qingdao, China
| | - Yanqing Zhang
- Zibo Center for Disease Control and Prevention, Zibo, China
| | - Tao Wang
- School of Public Health, Qingdao University, Qingdao, China
| | - Aimin Wang
- School of Nursing, Qingdao University, Qingdao, China
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11
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Zhu XW, Liu KQ, Wang PY, Liu JQ, Chen JY, Xu XJ, Xu JJ, Qiu MC, Sun Y, Liu C, Bai WY, Zhao PP, Xia J, Gai SR, Guan PL, Qian Y, Cong PK, Xie SY, Zheng HF. Cohort profile: the Westlake BioBank for Chinese (WBBC) pilot project. BMJ Open 2021; 11:e045564. [PMID: 34183340 PMCID: PMC8240579 DOI: 10.1136/bmjopen-2020-045564] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
PURPOSE The Westlake BioBank for Chinese (WBBC) pilot cohort is a population-based prospective study with its major purpose to better understand the effect of genetic and environmental factors on growth and development from adolescents to adults. PARTICIPANTS A total of 14 726 participants (4751 males and 9975 females) aged 14-25 years were recruited and the baseline survey was carried out from 2017 to 2019. The pilot cohort contains rich range of information regarding of demographics and anthropometric measurements, lifestyle and sleep patterns, clinical and health outcomes. Visit the WBBC website for more information (https://wbbc.westlake.edu.cn/index.html). FINDINGS TO DATE The mean age of the study samples were 18.6 years for males and 18.5 years for females, respectively. The mean height and weight were 172.9 cm and 65.81 kg for males, and 160.1 cm and 52.85 kg for females. Results indicated that the prevalence of underweight in female was much higher than male, but the prevalence of overweight and obesity in female was lower than male. The mean serum 25(OH)D level in the 14 726 young participants was 22.4±5.3 ng/mL, and male had a higher level of serum 25(OH)D than female, overall, 33.5% of the participants had vitamin D deficiency and even more participants suffered from vitamin D insufficiency (58.2%). The proportion of deficiency in females was much higher than that in males (41.8 vs 16.4%). The issue of underweight and vitamin D deficiency in young people should be paid attention, especially in females. These results reflected the fact that thinness and paler skin are preferred in modern aesthetics of Chinese culture. FUTURE PLANS WBBC pilot is designed as a prospective cohort study and provides a unique and rich data set analysing health trajectories from adolescents to young adults. WBBC will continue to collect samples with old age.
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Affiliation(s)
- Xiao-Wei Zhu
- Diseases & Population (DaP) Geninfo Lab, School of Lifesciences, Westlake University, Hangzhou, Zhejiang, China
- Westlake Laboratory of Life Sciences and Biomedicine, Hangzhou, Zhejiang, China
- Institute of Basic Medical Sciences, Westlake Institute for Advanced Study, Westlake University, Hangzhou, Zhejiang, China
| | - Ke-Qi Liu
- WBBC Jiangxi Center, Jiangxi Medical College, Shangrao, Jiangxi, China
| | - Ping-Yu Wang
- WBBC Shandong Center, Binzhou Medical University, Yantai, Shandong, China
| | - Jun-Quan Liu
- Hangzhou Kingmed Diagnostics Co., Ltd, Hangzhou, Zhejiang, China
| | - Jin-Yang Chen
- Zhejiang Healthfuture Institute for Cell-Based Applied Technology, Hangzhou, Zhejiang, China
| | - Xue-Jin Xu
- Jiading District Center for Disease Control and Prevention, Shanghai, China
| | - Jin-Jian Xu
- WBBC Jiangxi Center, Jiangxi Medical College, Shangrao, Jiangxi, China
| | - Mo-Chang Qiu
- WBBC Jiangxi Center, Jiangxi Medical College, Shangrao, Jiangxi, China
| | - Yi Sun
- Hangzhou Kingmed Diagnostics Co., Ltd, Hangzhou, Zhejiang, China
| | - Chun Liu
- Department of Health Management, Hangzhou Normal University, Hangzhou, Zhejiang, China
| | - Wei-Yang Bai
- Diseases & Population (DaP) Geninfo Lab, School of Lifesciences, Westlake University, Hangzhou, Zhejiang, China
- Westlake Laboratory of Life Sciences and Biomedicine, Hangzhou, Zhejiang, China
- Institute of Basic Medical Sciences, Westlake Institute for Advanced Study, Westlake University, Hangzhou, Zhejiang, China
| | - Pian-Pian Zhao
- Diseases & Population (DaP) Geninfo Lab, School of Lifesciences, Westlake University, Hangzhou, Zhejiang, China
- Westlake Laboratory of Life Sciences and Biomedicine, Hangzhou, Zhejiang, China
| | - Jiangwei Xia
- Diseases & Population (DaP) Geninfo Lab, School of Lifesciences, Westlake University, Hangzhou, Zhejiang, China
- Westlake Laboratory of Life Sciences and Biomedicine, Hangzhou, Zhejiang, China
| | - Si-Rui Gai
- Diseases & Population (DaP) Geninfo Lab, School of Lifesciences, Westlake University, Hangzhou, Zhejiang, China
- Westlake Laboratory of Life Sciences and Biomedicine, Hangzhou, Zhejiang, China
| | - Peng-Lin Guan
- Diseases & Population (DaP) Geninfo Lab, School of Lifesciences, Westlake University, Hangzhou, Zhejiang, China
- Westlake Laboratory of Life Sciences and Biomedicine, Hangzhou, Zhejiang, China
| | - Yu Qian
- Diseases & Population (DaP) Geninfo Lab, School of Lifesciences, Westlake University, Hangzhou, Zhejiang, China
- Westlake Laboratory of Life Sciences and Biomedicine, Hangzhou, Zhejiang, China
| | - Pei-Kuan Cong
- Diseases & Population (DaP) Geninfo Lab, School of Lifesciences, Westlake University, Hangzhou, Zhejiang, China
- Westlake Laboratory of Life Sciences and Biomedicine, Hangzhou, Zhejiang, China
- Institute of Basic Medical Sciences, Westlake Institute for Advanced Study, Westlake University, Hangzhou, Zhejiang, China
| | - Shu-Yang Xie
- WBBC Shandong Center, Binzhou Medical University, Yantai, Shandong, China
| | - Hou-Feng Zheng
- Diseases & Population (DaP) Geninfo Lab, School of Lifesciences, Westlake University, Hangzhou, Zhejiang, China
- Westlake Laboratory of Life Sciences and Biomedicine, Hangzhou, Zhejiang, China
- Institute of Basic Medical Sciences, Westlake Institute for Advanced Study, Westlake University, Hangzhou, Zhejiang, China
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12
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Taghizadeh S, Khodayari-Zarnaq R, Farhangi MA. Childhood obesity prevention policies in Iran: a policy analysis of agenda-setting using Kingdon's multiple streams. BMC Pediatr 2021; 21:250. [PMID: 34044800 PMCID: PMC8155654 DOI: 10.1186/s12887-021-02731-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Accepted: 05/24/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Pediatric obesity is one of the most important health challenges of the twenty-first century. Primary prevention of childhood obesity, can lessen its consequences. This study aims to assess childhood obesity prevention policies in Iran through a policy analysis of agenda-setting using Kingdon's multiple streams. METHODS A qualitative study was conducted using in-depth interviews with 39 key informants and document review from different stages of the policymaking process of childhood and adolescent obesity prevention programs in Iran. The analysis of documents and interviews were guided based on Kingdon's multiple streams (problem, policy and political streams). RESULTS The important factors of the problem stream were the high prevalence of childhood and adolescent obesity and its risk factors in Iran. In the policy stream, a focus on preventing non-communicable diseases in the health system, increasing the workforce in health centers, promoting health school programs, and creating healthy eating buffets in schools was identified. Under the political stream, the impact of the WHO ECHO program in 2015 and the implementation of the health system transformation plan in Iran in the new government took place after 2013, caused the Iran ECHO program entered the agenda and implemented from 2016. CONCLUSIONS Now that a window of opportunity for childhood and adolescent obesity prevention policymaking has been created, the problems such as the therapeutic approach in the health system, the existence of sanctions against Iran and outbreak of coronavirus disease-19 (COVID-19), have hindered the successful implementation of this policy and the opportunity window has not been well used. However, actors need political support from the high levels of government to keep this policy on the agenda.
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Affiliation(s)
- Shahnaz Taghizadeh
- Department of Community Nutrition, Faculty of Nutrition, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Rahim Khodayari-Zarnaq
- Department of Health Policy and Management, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mahdieh Abbasalizad Farhangi
- Department of Community Nutrition, Tabriz University of Medical Sciences, 5166614711, Attar Nishabouri St, PO BOX: 14711, Tabriz, I. R Iran
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13
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Wu Y, Marc I, Bouchard L, Ouyang F, Luo ZC, Fan J, Dubois L, Mâsse B, Zhang J, Leung PCK, Liao XP, Herba CM, Booij L, Shen J, Lewin A, Jiang H, Wang L, Xu J, Wu W, Sun W, Wu J, Li H, Lei C, Kozyrskyj A, Semenic S, Chaillet N, Fortier I, Masse L, Zhan J, Allard C, Knoppers B, Zawati M, Baillargeon JP, Velez MP, Zhang H, Yu Y, Yu W, Ding Y, Vaillancourt C, Liu H, Tetu A, Fang W, Zhang R, Zhao X, Jin Y, Liu XM, Zhang H, Chen Z, Yang X, Hao YH, Abdelouahab N, Fraser W, Huang HF. Study protocol for the Sino-Canadian Healthy Life Trajectories Initiative (SCHeLTI): a multicentre, cluster-randomised, parallel-group, superiority trial of a multifaceted community-family-mother-child intervention to prevent childhood overweight and obesity. BMJ Open 2021; 11:e045192. [PMID: 33795307 PMCID: PMC8021741 DOI: 10.1136/bmjopen-2020-045192] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION Childhood overweight and obesity (OWO) is a primary global health challenge. Childhood OWO prevention is now a public health priority in China. The Sino-Canadian Healthy Life Trajectories Initiative (SCHeLTI), one of four trials being undertaken by the international HeLTI consortium, aims to evaluate the effectiveness of a multifaceted, community-family-mother-child intervention on childhood OWO and non-communicable diseases risk. METHODS AND ANALYSIS This is a multicentre, cluster-randomised, controlled trial conducted in Shanghai, China. The unit of randomisation is the service area of Maternal Child Health Units (N=36). We will recruit 4500 women/partners/families in maternity and district level hospitals. Participants in the intervention group will receive a multifaceted, integrated package of health promotion interventions beginning in preconception or in the first trimester of pregnancy, continuing into infancy and early childhood. The intervention, which is centred on a modified motivational interviewing approach, will target early-life maternal and child risk factors for adiposity. Through the development of a biological specimen bank, we will study potential mechanisms underlying the effects of the intervention. The primary outcome for the trial is childhood OWO (body mass index for age ≥85th percentile) at 5 years of age, based on WHO sex-specific standards. The study has a power of 0.8 (α=0.05) to detect a 30% risk reduction in the proportion of children with OWO at 5 years of age, from 24.4% in the control group to 17% in the intervention group. Recruitment was launched on 30 August 2018 for the pilot study and 10 January 2019 for the formal study. ETHICS AND DISSEMINATION The study has been approved by the Medical Research Ethics Committee of the International Peace Maternity and Child Health Hospital in Shanghai, China, and the Research Ethics Board of the Centre Intégré Universitaire de Santé et Services Sociaux de l'Estrie-CHUS in Sherbrooke, Canada. Data sharing policies are consistent with the governance policy of the HeLTI consortium and government legislation. TRIAL REGISTRATION NUMBER ChiCTR1800017773. PROTOCOL VERSION November 11, 2020 (Version #5).
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Affiliation(s)
- Yanting Wu
- International Peace Maternity and Child Health Hospital, Shanghai, China
- Key Laboratory of Embryo Molecular Biology, Ministry of Health, Shanghai, China
| | - Isabelle Marc
- Department of Pediatrics, Université Laval, Quebec City, Quebec, Canada
- Centre de recherche du CHUQ, Quebec City, Quebec, Canada
| | - Luigi Bouchard
- Centre de recherche du Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Quebec, Canada
- Department of Biochemistry, Université de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Fengxiu Ouyang
- Shanghai Jiaotong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Children’s Environmental Health, Xinhua Hospital, Shanghai, China
| | - Zhong-Cheng Luo
- Mount Sinai Hospital, Lunenfeld-Tanenbaum Research Institute, Toronto, Ontario, Canada
- Department of Obstetrics and Gynecology, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Jianxia Fan
- International Peace Maternity and Child Health Hospital, Shanghai, China
| | - Lise Dubois
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
| | - Benoît Mâsse
- School of Public Health, Université de Montréal, Montreal, Québec, Canada
- Unité de Recherche Clinique Appliquée, CHU Sainte-Justine, Montreal, Québec, Canada
| | - Jun Zhang
- Shanghai Jiaotong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Children’s Environmental Health, Xinhua Hospital, Shanghai, China
| | - Peter C K Leung
- The University of British Columbia, Vancouver, British Columbia, Canada
- Department of Obstetrics and Gynecology, BC Children’s Hospital Research Institute, Vancouver, British Columbia, Canada
| | - Xiang Peng Liao
- Centre de recherche du Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Quebec, Canada
| | - C M Herba
- Department of Psychology, Université du Québec à Montréal, Montreal, Québec, Canada
- CHU Sainte-Justine Centre de Recherche, Montreal, Québec, Canada
| | - Linda Booij
- CHU Sainte-Justine Centre de Recherche, Montreal, Québec, Canada
- Department of Psychology, Concordia University, Montreal, Québec, Canada
| | - Jian Shen
- Key Laboratory of Systems Biomedicine (Ministry of Education), Shanghai Center for Systems Biomedicine, Shanghai Jiao Tong University, Shanghai, China
| | - Antoine Lewin
- Centre de recherche du Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Quebec, Canada
- Department of Obstetrics and Gynecology, Université de Sherbrooke, Sherbrooke, Québec, Canada
| | - Hong Jiang
- Department of Maternal and Child Care, School of Public Health, Fudan University, Shanghai, China
| | - Liping Wang
- International Peace Maternity and Child Health Hospital, Shanghai, China
| | - Jian Xu
- International Peace Maternity and Child Health Hospital, Shanghai, China
| | - Weibin Wu
- International Peace Maternity and Child Health Hospital, Shanghai, China
| | - Wenguang Sun
- International Peace Maternity and Child Health Hospital, Shanghai, China
| | - Jiahao Wu
- International Peace Maternity and Child Health Hospital, Shanghai, China
| | - Hong Li
- International Peace Maternity and Child Health Hospital, Shanghai, China
| | - Chen Lei
- International Peace Maternity and Child Health Hospital, Shanghai, China
| | - Anita Kozyrskyj
- Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada
| | - Sonia Semenic
- Ingram School of Nursing, McGill University, Montreal, Québec, Canada
| | - N Chaillet
- Department of Pediatrics, Université Laval, Quebec City, Quebec, Canada
- Centre de recherche du CHUQ, Quebec City, Quebec, Canada
| | - Isabel Fortier
- Research Institute of the McGill University Health Centre, Montreal, Québec, Canada
| | - Louise Masse
- School of Population and Public Health, The University of British Columbia, Vancouver, British Columbia, Canada
- BC Children’s Hospital Research Institute, Vancouver, British Columbia, Canada
| | - Janelle Zhan
- Unité de Recherche Clinique Appliquée, CHU Sainte-Justine Centre de Recherche, Montreal, Québec, Canada
| | - Catherine Allard
- Centre de recherche du Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Bartha Knoppers
- Centre of Genomics and Policy, McGill University, Montreal, Québec, Canada
| | - Ma'n Zawati
- Centre of Genomics and Policy, McGill University, Montreal, Québec, Canada
| | - Jean-Patrice Baillargeon
- Centre de recherche du Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Quebec, Canada
- Department of Medicine, Division of Endocrinology, Université de Sherbrooke, Sherbrooke, Québec, Canada
| | - Maria P Velez
- Department of Obstetrics and Gynecology, Queen’s University, Kingston, Ontario, Canada
| | - Hanqiu Zhang
- International Peace Maternity and Child Health Hospital, Shanghai, China
| | - Yamei Yu
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Wen Yu
- International Peace Maternity and Child Health Hospital, Shanghai, China
| | - Yan Ding
- International Peace Maternity and Child Health Hospital, Shanghai, China
| | - Caroline Vaillancourt
- Department of Pediatrics, Université Laval, Quebec City, Quebec, Canada
- Centre de recherche du CHUQ, Quebec City, Quebec, Canada
| | - Han Liu
- International Peace Maternity and Child Health Hospital, Shanghai, China
| | - Amelie Tetu
- Centre de recherche du Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Wenli Fang
- Changing Maternity and Infant Health Hospital, East China Normal University, Shanghai, China
| | - Rong Zhang
- Department of Obstetrics and Gynecology, Shanghai Fengxian Central Hospital, Shanghai, China
| | - Xinzhi Zhao
- International Peace Maternity and Child Health Hospital, Shanghai, China
| | - Yan Jin
- International Peace Maternity and Child Health Hospital, Shanghai, China
| | - Xin-Mei Liu
- International Peace Maternity and Child Health Hospital, Shanghai, China
| | - Huijuan Zhang
- International Peace Maternity and Child Health Hospital, Shanghai, China
| | - Zhirou Chen
- International Peace Maternity and Child Health Hospital, Shanghai, China
| | - Xi Yang
- International Peace Maternity and Child Health Hospital, Shanghai, China
| | - Yan-Hui Hao
- International Peace Maternity and Child Health Hospital, Shanghai, China
| | - Nadia Abdelouahab
- Centre de recherche du Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Quebec, Canada
- Department of Obstetrics and Gynecology, Université de Sherbrooke, Sherbrooke, Québec, Canada
| | - William Fraser
- Centre de recherche du Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Quebec, Canada
- Department of Obstetrics and Gynecology, Université de Sherbrooke, Sherbrooke, Québec, Canada
| | - He-Feng Huang
- International Peace Maternity and Child Health Hospital, Shanghai, China
- Key Laboratory of Embryo Molecular Biology, Ministry of Health, Shanghai, China
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Yin X, Yang X, Zhang T, Yuan Z, Chen H, Jin L, Chen X, Lu M, Ye W. Changes of Body Mass Index and Body Shape in relation to risk of Gastric Cancer: A population-based case-control study. J Cancer 2021; 12:3089-3097. [PMID: 33854608 PMCID: PMC8040898 DOI: 10.7150/jca.56149] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Accepted: 03/04/2021] [Indexed: 12/24/2022] Open
Abstract
Background: The results of previous studies are heterogeneous about the effect of body fatness on risk of gastric cancer (GC). Herein we investigated the effect of changes of BMI and body shape on risk of GC. Methods: A population-based case-control study enrolled 1989 controls and 937 GC cases. Logistic regression models were used to calculate odd ratios (ORs) and 95% confidence intervals (CIs) for BMI and body shape in association with GC risk, according to anatomical subsite, Laurén's classification, sex and Helicobacter pylori (Hp) infection. Results: Subjects with higher BMI or body shape 10 years before interview had a lower risk of GC regardless of anatomical subsite, Laurén's classification, and sex (all P for trend <0.05). But the relative risk patterns were different by Hp status. When checking the effect of changes of body fatness, in Hp+ stratum, the ORs (95% CI) were 0.40 (0.17-0.93) for subjects who were underweight at age 20 but had increased BMI afterwards, and 0.48 (0.32-0.73) for those of body shape 1/2 at age 20 but increased body shape subsequently, compared to subjects with stable BMI or body shape. When subjects had a normal BMI or 3/4 body shape at age 20, weight loss nearly doubled the risk of GC, and weight gain would decrease the risk. Conclusion: The association between body fatness and GC risk might differ by time point of measurement and Hp-infection status. Further, the influence of changes of body fatness might be different by baseline body fatness and Hp-infection status.
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Affiliation(s)
- Xiaolin Yin
- Department of Epidemiology and Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Xiaorong Yang
- Clinical Epidemiology Unit, Qilu Hospital of Shandong University, Jinan, China.,Clinical Research Center of Shandong University, Jinan, China
| | - Tongchao Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Ziyu Yuan
- State Key Laboratory of Genetic Engineering, Collaborative Innovation Center for Genetics and Development, School of Life Sciences, Fudan University, Shanghai, China.,Fudan University Taizhou Institute of Health Sciences, Taizhou, China
| | - Hui Chen
- Clinical Epidemiology Unit, Qilu Hospital of Shandong University, Jinan, China.,Clinical Research Center of Shandong University, Jinan, China
| | - Li Jin
- State Key Laboratory of Genetic Engineering, Collaborative Innovation Center for Genetics and Development, School of Life Sciences, Fudan University, Shanghai, China.,Fudan University Taizhou Institute of Health Sciences, Taizhou, China.,Human Phenome Institute, Fudan University, Shanghai, China
| | - Xingdong Chen
- State Key Laboratory of Genetic Engineering, Collaborative Innovation Center for Genetics and Development, School of Life Sciences, Fudan University, Shanghai, China.,Fudan University Taizhou Institute of Health Sciences, Taizhou, China.,Human Phenome Institute, Fudan University, Shanghai, China
| | - Ming Lu
- Department of Epidemiology and Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China.,Clinical Epidemiology Unit, Qilu Hospital of Shandong University, Jinan, China.,Clinical Research Center of Shandong University, Jinan, China.,State Key Laboratory of Genetic Engineering, Collaborative Innovation Center for Genetics and Development, School of Life Sciences, Fudan University, Shanghai, China
| | - Weimin Ye
- Fudan University Taizhou Institute of Health Sciences, Taizhou, China.,Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.,Department of Epidemiology and Health Statistics & Key Laboratory of Ministry of Education for Gastrointestinal Cancer, Fujian Medical University, Fuzhou, China
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15
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Guo Y, Miller MA, Cappuccio FP. Short duration of sleep and incidence of overweight or obesity in Chinese children and adolescents: A systematic review and meta-analysis of prospective studies. Nutr Metab Cardiovasc Dis 2021; 31:363-371. [PMID: 33487495 DOI: 10.1016/j.numecd.2020.11.001] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Revised: 10/29/2020] [Accepted: 11/03/2020] [Indexed: 12/16/2022]
Abstract
BACKGROUND AND AIMS Overweight and obesity in children have become a global public health problem. Epidemiological studies suggest that sleep duration may contribute to the incidence of overweight and obesity in all stages of life. China has an increasing prevalence of overweight and obesity, and sleep deprivation is common among Chinese children. The aim of this study was to assess the prospective relationship between short sleep duration and overweight or obesity in Chinese children and to gain an estimate of the risk. METHODS AND RESULTS A systematic search was performed on 28/04/2020 by using Medline, PubMed and Web of Science. The exposure was the duration of sleep, and the outcome measure the incidence of overweight or obesity. The odds ratios (OR) and hazard ratios (HR) and 95% confidence intervals (C.I.) were extracted to calculate the pooled relative risk (RR) by a random effect model. Heterogeneity and publication bias of the studies were checked by sensitivity analysis. Seven studies fulfilled the criteria for a systematic review, and 5 studies for a meta-analysis. The total of 33,206 participants included boys and girls, aged 6-17 years old. In Chinese children the pooled RR for short sleep duration and overweight or obesity combined was 1.47 (95% C.I. 1.26, 1.71, p < 0.00001, n = 32,607), and for obesity alone 1.40 (95% C.I. 1.01, 1.95, p = 0.04, n = 17,038). There was no significant heterogeneity or publication bias between studies. CONCLUSION Short sleep duration is associated with the development of overweight and obesity in Chinese children.
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Affiliation(s)
- Yuan Guo
- University of Warwick, Warwick Medical School, Division of Health Sciences (Mental Health & Wellbeing), Gibbet Hill Road, Coventry, CV4 7AL, UK
| | - Michelle A Miller
- University of Warwick, Warwick Medical School, Division of Health Sciences (Mental Health & Wellbeing), Gibbet Hill Road, Coventry, CV4 7AL, UK
| | - Francesco P Cappuccio
- University of Warwick, Warwick Medical School, Division of Health Sciences (Mental Health & Wellbeing), Gibbet Hill Road, Coventry, CV4 7AL, UK; University Hospital Coventry & Warwickshire NHS Trust, Clifford Bridge Road, Coventry, CV2 2DX, UK.
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16
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Zhang Y, Wang R, Liu B, Sun L. Weight in the mind: Weight perception and depressive symptoms in Chinese adolescents. J Affect Disord 2021; 278:506-514. [PMID: 33017678 DOI: 10.1016/j.jad.2020.09.112] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 08/25/2020] [Accepted: 09/26/2020] [Indexed: 01/27/2023]
Abstract
BACKGROUND Increasing evidence demonstrates the significant role of weight perception in shaping the mental health of adolescents. This study sought to extend previous literature by examining the associations of weight perception categories with depressive symptoms for both boys and girls in China, and further explored whether the associations varied between urban and rural areas. METHODS Data were from a large-scale, national survey of Chinese middle school students. The analytical sample had 8568 respondents with a mean age of 13.9 years (SD=0.7). Bivariate and multiple regression analyses were adopted to examine the links between weight perception and depressive symptoms. RESULTS Overweight perceptions were more prevalent in girls than in boys (47.0% vs. 29.3%), whereas underweight perceptions were less common in girls than in boys (15.7% vs. 29.3%). After adjusting for sociodemographic characteristics and health conditions, self-perceiving as "slightly overweight" and "very overweight" were significantly related to more depressive symptoms for both boys (p<0.05) and girls (p<0.05). A "very underweight" perception, however, was found to be only linked to greater depressive symptoms in boys (p<0.05). Notably, these patterns showed no significant rural-urban difference, as evidenced by the lack of significant interactive effects of all weight perceptions categories and region (urban/rural) on depressive symptoms. LIMITATIONS This study was based on a cross-sectional design, which essentially precludes the possibility to determine the causality of the observed associations. CONCLUSION Findings in this study indicated that the impacts of subjective physical attractiveness have been gendered and regionally pervasive in affecting emotional well-being of Chinese adolescents.
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Affiliation(s)
- Yueyun Zhang
- School of Philosophy and Social Development, Shandong University, China
| | - Ruochen Wang
- School of Sociology and Population Studies, Renmin University of China, China
| | - Baozhong Liu
- Institute of Sociology, Chinese Academy of Social Sciences, China
| | - Long Sun
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, China; NHC Key Lab of Health Economics and Policy Research (Shandong University), China.
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Sarokhani D, Sarokhani M, Hasanpour Dehkordi A, Ghanei Gheshlagh R, Fakhri M. Prevalence of obesity and overweight in Iranian students: a systematic review and meta-analysis. J Pediatr Endocrinol Metab 2020; 33:453-468. [PMID: 32126015 DOI: 10.1515/jpem-2019-0474] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Accepted: 01/22/2020] [Indexed: 12/21/2022]
Abstract
Background Obesity and overweight are among the most common and serious health issues in many countries, leading to numerous medical consequences such as heart disease, hypertension, fatty liver etc. This review article addressed the prevalence of obesity and overweight in Iranian students by using meta-analysis. Methods A number of domestic and international databases were searched, including IranMedex, Magiran, SID, Scopus, PubMed, IranDoc, Web of Science and Google Scholar. Eligible publications were 160 articles that addressed the prevalence of obesity or overweight. Data were combined using random effects model. Heterogeneity of the studies was examined by Q statistics and the I2 index. Data were analyzed using STATA version 11.1. Results In the 160 reviewed studies, a total of 481,070 individuals (6-20 years) were included. The prevalence of obesity among Iranian students based on body mass index (BMI) was 11% (95% confidence interval [CI]: 10%-12%) (in girls 8% [95% CI: 7%-10%] and in boys 11% [95% CI: 10%-13%]). The prevalence of overweight in students based on BMI was 12% (95% CI: 12%-13%) (in girls 13% [95% CI: 11%-14%] and in boys 11% [95% CI: 18%-30%]). The rate of obesity was 13% (95% CI: 11%-16%) in elementary school students, 10% (95% CI: 7%-14%) in secondary school students and 7% (95% CI: 6%-9%) in high school students. Conclusions The prevalence rate of overweight was more than that of obesity with a 1% difference. The prevalence of obesity was higher in boys, while the prevalence of overweight was higher in girls. The prevalence of obesity was higher in primary school students than in secondary school students. This prevalence was higher in secondary school students than in high school students.
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Affiliation(s)
- Diana Sarokhani
- Psychosocial Injuries Research Center, Ilam University of Medical Sciences, Ilam, Iran
| | - Mandana Sarokhani
- Psychosocial Injuries Research Center, Ilam University of Medical Sciences, Ilam, Iran
| | - Ali Hasanpour Dehkordi
- Social Determinants of Health Research Center, School of allied medical sciences, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Reza Ghanei Gheshlagh
- Department of Nursing, Faculty of Nursing and Midwifery, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Moloud Fakhri
- Traditional and Complementary Medicine Research Center, Addiction Institute, Mazandaran University of Medical Sciences, Sari, Iran.,World Federation of Acupuncture-Moxibustion Societies (WFAS), Beijing, China
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Keung V, Lo K, Cheung C, Tam W, Lee A. Changes in dietary habits and prevalence of cardiovascular risk factors among school students in Macao, China. Obes Res Clin Pract 2019; 13:541-547. [PMID: 31780298 DOI: 10.1016/j.orcp.2019.10.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 10/20/2019] [Accepted: 10/29/2019] [Indexed: 01/14/2023]
Abstract
OBJECTIVE Given the increasing burden of childhood obesity, it is important to examine the changes in dietary habits and prevalence of cardiovascular risk factors among Macao students. METHODS A cross-sectional study was conducted among primary and secondary school students in Macao, China in 2014-2015 with addition to data collected from 2008 to 2009 for comparison. The dietary behaviours, prevalence of obesity and dyslipidaemia were compared by study period. SUBJECTS In 2014-2015, dietary assessment was conducted among 3635 students, physical assessment was conducted among 1427 school students. In 2008-2009, dietary assessment was conducted among 4271 students, physical assessment was conducted among 1700 school students. RESULTS When compared with students in 2008, higher percentage of students from present study period consumed dairy products, crispy food and chocolate, while fewer students had fruits, vegetables and fried food at least once every day. Despite lower prevalence of elevated total cholesterol and low-density-lipoprotein cholesterol, the rate of general obesity, low high-density-lipoprotein cholesterol and hyperglycaemia has increased significantly in 2014-2015. Students aged 12-14 consumed less fruits and vegetables and suffered from higher rate of general and abdominal obesity, as well as low high-density-lipoprotein cholesterol and elevated serum triglycerides in 2014-15. CONCLUSIONS The students' diet had both favourable and unfavourable changes. The rate of obesity and dyslipidaemia rises, while the situation for students aged 12-14 is more concerning.
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Affiliation(s)
- Vera Keung
- JC School of Public Health and Primary Care, Faculty of Medicine, Shatin, The Chinese University of Hong Kong, Hong Kong; Center for Health Education and Health Promotion, Shatin, The Chinese University of Hong Kong, Hong Kong
| | - Kenneth Lo
- JC School of Public Health and Primary Care, Faculty of Medicine, Shatin, The Chinese University of Hong Kong, Hong Kong; Department of Cardiology, Guangdong Cardiovascular Institute, Hypertension Research Laboratory, Guangdong Provincial People's Hospital, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Academy of Medical Sciences, South China University of Technology School of Medicine, Guangzhou, China; Centre for Global Cardiometabolic Health, Department of Epidemiology, Brown University, USA
| | - Calvin Cheung
- JC School of Public Health and Primary Care, Faculty of Medicine, Shatin, The Chinese University of Hong Kong, Hong Kong; Center for Health Education and Health Promotion, Shatin, The Chinese University of Hong Kong, Hong Kong
| | - Wilson Tam
- Department of Cardiology, Guangdong Cardiovascular Institute, Hypertension Research Laboratory, Guangdong Provincial People's Hospital, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Academy of Medical Sciences, South China University of Technology School of Medicine, Guangzhou, China; Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
| | - Albert Lee
- JC School of Public Health and Primary Care, Faculty of Medicine, Shatin, The Chinese University of Hong Kong, Hong Kong; Center for Health Education and Health Promotion, Shatin, The Chinese University of Hong Kong, Hong Kong
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Guo Y, Yin X, Wu H, Chai X, Yang X. Trends in Overweight and Obesity Among Children and Adolescents in China from 1991 to 2015: A Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E4656. [PMID: 31766709 PMCID: PMC6926698 DOI: 10.3390/ijerph16234656] [Citation(s) in RCA: 64] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Revised: 11/19/2019] [Accepted: 11/20/2019] [Indexed: 01/06/2023]
Abstract
This meta-analysis of overweight and obesity (ow/ob) among children and adolescents in China from 1991 to 2015 provides a reference for promoting the healthy development of children and adolescents. The studies were retrieved from the China National Knowledge Infrastructure, Wanfang, and PubMed databases for the period from January 1991 to January 2018. The data were combined and analyzed, and the combined effect magnitude odds ratio and the 95% confidence interval were calculated. Publication bias was determined using Stata/SE12.0. We found that (1) the prevalence of ow/ob increased from 5.0% and 1.7% in 1991-1995 to 11.7% and 6.8% in 2011-2015, respectively, and the overweight rate was the greatest in 2006-2010; (2) from 1991 to 2015, the prevalence of ow/ob was greater in urban areas than in rural areas; (3) compared with girls, boys were more likely to be ow/ob; and (4) the prevalence rates of ow and ob were greater in infancy than in other growth stages, with values of 11.7% and 7.0%, respectively. The prevalence of ow/ob among Chinese children and adolescents showed significant differences based on region, sex, and age. An overall upward trend was observed that decreased slightly from 2011 to 2015.
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Affiliation(s)
- Yaru Guo
- Key Laboratory of Adolescent Health Assessment and Exercise Intervention, Ministry of Education, College of Physical Education & Health, East China Normal University, Shanghai 200241, China; (Y.G.); (X.C.)
| | - Xiaojian Yin
- Key Laboratory of Adolescent Health Assessment and Exercise Intervention, Ministry of Education, College of Physical Education & Health, East China Normal University, Shanghai 200241, China; (Y.G.); (X.C.)
- College of Economics and Management, Shanghai Institute of Technology, Shanghai 201418, China
| | - Huipan Wu
- Leisure Sports Department of Taiyuan Institute of Technology, Taiyuan 030008, China;
| | - Xiaojiang Chai
- Key Laboratory of Adolescent Health Assessment and Exercise Intervention, Ministry of Education, College of Physical Education & Health, East China Normal University, Shanghai 200241, China; (Y.G.); (X.C.)
| | - Xiaofang Yang
- Key Laboratory of Adolescent Health Assessment and Exercise Intervention, Ministry of Education, College of Physical Education & Health, East China Normal University, Shanghai 200241, China; (Y.G.); (X.C.)
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Qureshi R, Jadotte Y, Zha P, Porter SA, Holly C, Salmond S, Watkins EA. The association between prenatal exposure to environmental tobacco smoke and childhood obesity: a systematic review. ACTA ACUST UNITED AC 2019; 16:1643-1662. [PMID: 30113549 DOI: 10.11124/jbisrir-2017-003558] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECTIVE The objective of the review was to determine if prenatal exposure to environmental tobacco smoke (ETS) increases the risk of obesity and overweight in children. INTRODUCTION Childhood obesity has reached epidemic proportions in many developed countries. This is of great concern as childhood obesity is associated with early onset of chronic diseases such as coronary artery disease, type II diabetes and hypertension in adulthood. Extensive research suggests a multifactorial etiology. These factors include genetic markers, individual lifestyle, social and environmental factors, particularly the interaction between these factors. Among environmental factors, prenatal exposure to ETS has been linked to increased rates of obesity and overweight in childhood. INCLUSION CRITERIA This review considered studies on children of women who were non-smokers and who reported exposure to ETS during pregnancy. The exposure of interest was exposure to ETS or second hand smoke during pregnancy, determined by either: i) self-reported maternal exposure; and/or ii) serum cotinine levels. Observational studies such as cohort studies, case control studies, retrospective studies and analytical cross-sectional studies were included. Outcomes of interest were weight, height and body mass index of children from birth up to 18 years. METHODS A three-step search strategy was used to search for published and unpublished studies in the English language. No search range (years) was set. Two reviewers assessed the studies for inclusion and methodological quality using the Joanna Briggs Institute System for the Unified Management, Assessment and Review of Information (JBI SUMARI) standardized appraisal instruments. Data was extracted by two people independently and entered into the JBI extraction tool. Extracted data was pooled in a statistical meta-analysis based on a random effects model. RESULTS Nineteen studies were included in the review. Eight of the studies were included in the final meta-analysis. Findings suggest that there was an association between prenatal exposure to ETS and childhood obesity (odds ratio [OR]: 1.905, CI: 1.23-2.94), and no association between ETS exposure and overweight (OR: 1.51, CI: 0.49-4.59). The high rates of heterogeneity between studies in both of the meta-analyses determined by the I statistic (97% and 99%, respectively) sanction caution in the interpretation and use of these findings. CONCLUSIONS Based on the evidence, childhood obesity is associated with exposure to prenatal ETS, however overweight does not appear to be associated with this type of exposure.
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Affiliation(s)
- Rubab Qureshi
- School of Nursing, Rutgers University, Newark, USA.,The Northeast Institute for Evidence Synthesis and Translation (NEST): A Joanna Briggs Institute Centre of Excellence
| | - Yuri Jadotte
- School of Nursing, Rutgers University, Newark, USA.,The Northeast Institute for Evidence Synthesis and Translation (NEST): A Joanna Briggs Institute Centre of Excellence
| | - Peijia Zha
- School of Nursing, Rutgers University, Newark, USA
| | - Sallie Ann Porter
- School of Nursing, Rutgers University, Newark, USA.,The Northeast Institute for Evidence Synthesis and Translation (NEST): A Joanna Briggs Institute Centre of Excellence
| | - Cheryl Holly
- School of Nursing, Rutgers University, Newark, USA.,The Northeast Institute for Evidence Synthesis and Translation (NEST): A Joanna Briggs Institute Centre of Excellence
| | - Susan Salmond
- School of Nursing, Rutgers University, Newark, USA.,The Northeast Institute for Evidence Synthesis and Translation (NEST): A Joanna Briggs Institute Centre of Excellence
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Weldearegay HG, Gebrehiwot TG, Abrha MW, Mulugeta A. Overweight and obesity among children under five in Ethiopia: further analysis of 2016 national demographic health survey: a case control study. BMC Res Notes 2019; 12:716. [PMID: 31672167 PMCID: PMC6822342 DOI: 10.1186/s13104-019-4752-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Accepted: 10/18/2019] [Indexed: 01/19/2023] Open
Abstract
OBJECTIVE The objective of this study was to assess the determinants of overweight and obesity among children under 5 years in Ethiopia. RESULTS Data from a total of 672 (224 cases and 448 controls) under 5 years of age children were included in the study. Urban residence (AOR = 2.63, 95% CI 1.29, 5.34), boys (AOR = 1.56, 95% CI 1.10, 2.22) and age of the child less than 6 months (AOR = 3.40, 95% CI 2.05, 5.64) were the determinants for being childhood overweight and obesity.
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Affiliation(s)
| | | | | | - Afework Mulugeta
- College of Health Sciences, Mekelle University, Mekelle, Ethiopia
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22
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Adom T, Kengne AP, De Villiers A, Puoane T. Prevalence of overweight and obesity among African primary school learners: a systematic review and meta-analysis. Obes Sci Pract 2019; 5:487-502. [PMID: 31687173 PMCID: PMC6819980 DOI: 10.1002/osp4.355] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Revised: 06/05/2019] [Accepted: 06/11/2019] [Indexed: 12/19/2022] Open
Abstract
INTRODUCTION The increasing trend in the global prevalence of childhood overweight and obesity presents a major public health challenge. This study reports the results of a systematic review and meta-analysis to estimate the prevalence of overweight and obesity among primary school learners residing in Africa according to the different body mass index criteria and population level characteristics. METHODS A search of multiple databases was conducted to identify relevant research articles published between January 1980 and February 2017. Random effects models were used to pool prevalence data within and across population level characteristics after variance stabilization through arcsine transformation (PROSPERO registration number CRD42016035248). RESULTS Data from 45 studies across 15 African countries, and comprising 92,379 and 89,468 participants for overweight and obesity estimates were included. Estimated overweight and obesity prevalence differed significantly across criteria: 10.5% [95% confidence interval, CI: 7.1-14.3] and 6.1% [3.4-9.7] by World Health Organization; 9.5% [6.5-13.0] and 4.0% [2.5-5.9] by International Obesity Task Force; and 11.5% [9.6-13.4] and 6.9% [5.0-9.0] by Centre for Diseases Control, respectively (p = 0.0027 for overweight; p < 0.0001 for obesity). Estimates were mostly higher in urban, and private schools, but generally similar by gender, major geographic regions, publication year and sample size. Substantial heterogeneity in the estimates across and within criteria were not always explained by major study characteristics. CONCLUSION Overweight and obesity are prevalent among African primary school learners, particularly those attending urban, and private schools. The results from this meta-analysis could be helpful in making informed decisions on childhood obesity prevention efforts in African countries.
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Affiliation(s)
- T. Adom
- School of Public Health, Faculty of Community and Health SciencesUniversity of Western CapeCape TownSouth Africa
- Nutrition Research CentreRadiological and Medical Sciences Research Institute, Ghana Atomic Energy CommissionAccraGhana
| | - A. P. Kengne
- Non‐communicable Disease Research UnitSouth African Medical Research CouncilCape TownSouth Africa
| | - A. De Villiers
- Division of Research Capacity DevelopmentSouth African Medical Research CouncilCape TownSouth Africa
| | - T. Puoane
- School of Public Health, Faculty of Community and Health SciencesUniversity of Western CapeCape TownSouth Africa
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Qian Y, Liu W, Wang W, Fan C. Obesity may be a risk factor for recurrent heterotopic ossification in post-traumatic stiff elbow among children and teenagers. Orthop Traumatol Surg Res 2019; 105:1193-1198. [PMID: 31088773 DOI: 10.1016/j.otsr.2019.03.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2018] [Revised: 02/14/2019] [Accepted: 03/05/2019] [Indexed: 02/02/2023]
Abstract
BACKGROUND Post-traumatic elbow stiffness and heterotopic ossification (HO) affects long-term life quality, as commonly in children and teenagers as in grownups. Childhood obesity considerably influences public health because it causes stroke, hypertension and diabetes mellitus. Previous research discussed its clinical complications in orthopedic diseases. However, no clinical research reveals the interaction between childhood obesity and HO after elbow injuries. HYPOTHESIS Obesity might be a risk factor of recurrent HO after elbow arthrolysis in children and teenagers, correlated with the severity of postoperative HO. METHODS Fifty seven post-traumatic children and teenagers undergoing elbow arthrolysis were retrospectively reviewed and divided into underweight/normal-weight group (n=28) and overweight/obese group (n=29) according to the gender-specific body mass index (BMI)-for-age growth chart. The Hastings and Graham classification was used to evaluate HO recurrence. We also assessed Mayo elbow performance scores and range of motion. RESULTS The mean age, gender, pathogenesis, side of injury, time of injury, follow-up duration were analyzed. Overweight/obese children and teenagers were more likely to develop recurrent HO (p=0.005) than underweight/normal-weight children and teenagers. A significant difference in the severity of recurrent HO between two groups was confirmed (p=0.028). The range of motion was improved greatly in underweight/normal-weight group compared with that in overweight/obese group (p=0.001). CONCLUSIONS The HO recurrence difference between two groups confirmed the hypothesis. Although underlying mechanisms are unclear, weight control might promote postoperative and long-term rehabilitation of the elbow joint for children and teenagers. LEVEL OF EVIDENCE III, retrospective cohort study, treatment study.
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Affiliation(s)
- Yun Qian
- Department of Orthopedics, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China
| | - Wenjun Liu
- Shanghai Sixth People's Hospital East Affiliated to Shanghai University of Medicine & Health Sciences, Shanghai 201306, China; Taishan Medical University, Taian, 271016, China
| | - Wei Wang
- Shanghai Sixth People's Hospital East Affiliated to Shanghai University of Medicine & Health Sciences, Shanghai 201306, China.
| | - Cunyi Fan
- Department of Orthopedics, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China; Shanghai Sixth People's Hospital East Affiliated to Shanghai University of Medicine & Health Sciences, Shanghai 201306, China.
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Lo K, Keung V, Cheung C, Tam W, Lee A. Associations between Sleep Pattern and Quality and Cardiovascular Risk Factors among Macao School Students. Child Obes 2019; 15:387-396. [PMID: 31140858 DOI: 10.1089/chi.2018.0319] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Background: Despite accumulating evidence showing that sleep duration and cardiometabolic health are correlated, the association of sleep regularity and quality with cardiovascular risk factors in children and adolescents remains inconclusive. Therefore, we examined the relationship between sleep regularity/quality and cardiovascular risk factors in children and adolescents in Macao, China. Methods: We conducted a cross-sectional study among primary and secondary school students (age range: 9-18 years) in Macao, China. Body weight, height, waist circumference (WC), and serum lipid levels were measured. Sleep regularity and sleep quality were assessed by using the Pittsburgh Sleep Quality Index. Multivariable logistic regression was conducted to examine the relationship of sleep variables with the increased likelihood of body mass index (BMI)-classified overweight/obesity, WC-classified obesity, and dyslipidemia. Results: A total of 1078 school students were included in the analysis. Differences of >2 hours between weekday and weekend bedtimes were associated with the increased risk of BMI-classified overweight/obesity (odds ratio = 2.58, 95% confidence interval = 1.55-4.31, p < 0.01) after being adjusted for sleep variables and lifestyle factors. No statistically significant association was found between poor sleep quality and any other outcome. Conclusions: Irregular bedtime was associated with elevated body weight regardless of sleep amount and quality. Thus, regular bedtimes are recommended as a simple but practical strategy for preventing obesity.
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Affiliation(s)
- Kenneth Lo
- 1Department of Cardiology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guang Zhou, China.,2Department of Epidemiology, Center for Global Cardiometabolic Health, Brown University, Providence, RI.,3JC School of Public Health and Primary Care, Faculty of Medicine, Shatin, the Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Vera Keung
- 3JC School of Public Health and Primary Care, Faculty of Medicine, Shatin, the Chinese University of Hong Kong, Hong Kong, Hong Kong.,4Center for Health Education and Health Promotion, Shatin, the Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Calvin Cheung
- 3JC School of Public Health and Primary Care, Faculty of Medicine, Shatin, the Chinese University of Hong Kong, Hong Kong, Hong Kong.,4Center for Health Education and Health Promotion, Shatin, the Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Wilson Tam
- 5Alice Lee Center for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Albert Lee
- 3JC School of Public Health and Primary Care, Faculty of Medicine, Shatin, the Chinese University of Hong Kong, Hong Kong, Hong Kong.,4Center for Health Education and Health Promotion, Shatin, the Chinese University of Hong Kong, Hong Kong, Hong Kong
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25
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Alfadda AA, Masood A. Now trending in Riyadh: Increased urbanization equals to more obesity in children and adolescents. Saudi J Gastroenterol 2019; 25:207-209. [PMID: 31424001 PMCID: PMC6714473 DOI: 10.4103/sjg.sjg_347_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Assim A. Alfadda
- Obesity Research Center, College of Medicine, King Saud University, Riyadh, Saudi Arabia
- Department of Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Afshan Masood
- Obesity Research Center, College of Medicine, King Saud University, Riyadh, Saudi Arabia
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Jiang H, Li M, Wen LM, Baur L, He G, Ma X, Qian X. A Community-Based Short Message Service Intervention to Improve Mothers' Feeding Practices for Obesity Prevention: Quasi-Experimental Study. JMIR Mhealth Uhealth 2019; 7:e13828. [PMID: 31162133 PMCID: PMC6638993 DOI: 10.2196/13828] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Revised: 04/19/2019] [Accepted: 04/20/2019] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND The prevalence of childhood obesity is increasing in China, and the effect of mobile phone short message service (SMS) interventions to prevent early childhood obesity needs to be evaluated. OBJECTIVE The objective of this study was to assess the effect of an SMS intervention on the prevention of obesity in young children. METHODS A quasi-experimental design SMS intervention was carried out in 4 community health centers (CHCs) in Shanghai, China. A total of 2 CHCs were assigned to the intervention group, and 2 CHCs were assigned to the control group. Mothers in the intervention group received weekly SMS messages on breastfeeding and infant feeding from the third trimester to 12 months postpartum. The primary outcomes were children's body mass index (BMI), BMI z-score, and weight-for-length z-score at 12 and 24 months. Factors associated with higher BMI and weight-for-length z-score at 24 months were also assessed. RESULTS A total of 582 expectant mothers were recruited at the beginning of the third gestational trimester. 477 (82.0%) and 467 (80.2%) mothers and their children were followed up to 12 and 24 months postpartum, respectively. There were no significant differences in children's BMI, BMI z-score, and weight-for-length z-score at 12 and 24 months between the 2 groups. Factors associated with higher BMI, BMI z-score, and weight-for-length z-score at 24 months included higher birth weight, introduction of solid foods before 4 months, and taking a bottle to bed at 12 months. CONCLUSIONS The SMS intervention did not show a significant effect on children's BMI, BMI z-score, or weight-for-length z-score at 12 and 24 months. Introduction of solid foods before 4 months and taking a bottle to bed at 12 months were significantly and positively correlated with a higher BMI, BMI z-score, and weight-for-length z-score at 24 months. Further studies with more rigorous design are needed to evaluate the effect of SMS interventions on preventing early childhood obesity.
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Affiliation(s)
- Hong Jiang
- School of Public Health, Global Health Institute, Fudan University, Shanghai, China.,Key Lab of Health Technology Assessment, National Health Commission of the People's Republic of China, Fudan University, Shanghai, China
| | - Mu Li
- School of Public Health, University of Sydney, Sydney, Australia.,China Studies Centre, University of Sydney, Sydney, Australia
| | - Li Ming Wen
- School of Public Health, University of Sydney, Sydney, Australia.,Health Promotion Unit, Sydney Local Health District, Sydney, Australia
| | - Louise Baur
- School of Public Health, University of Sydney, Sydney, Australia.,Discipline of Child & Adolescent Health, University of Sydney, Sydney, Australia
| | - Gengsheng He
- School of Public Health, Global Health Institute, Fudan University, Shanghai, China.,Key Lab of Health Technology Assessment, National Health Commission of the People's Republic of China, Fudan University, Shanghai, China
| | - Xiaoying Ma
- School of Public Health, Global Health Institute, Fudan University, Shanghai, China.,Key Lab of Health Technology Assessment, National Health Commission of the People's Republic of China, Fudan University, Shanghai, China
| | - Xu Qian
- School of Public Health, Global Health Institute, Fudan University, Shanghai, China.,Key Lab of Health Technology Assessment, National Health Commission of the People's Republic of China, Fudan University, Shanghai, China
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Wang S, Sun Q, Zhai L, Bai Y, Wei W, Jia L. 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. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16030340. [PMID: 30691096 PMCID: PMC6388174 DOI: 10.3390/ijerph16030340] [Citation(s) in RCA: 89] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/02/2018] [Revised: 01/14/2019] [Accepted: 01/22/2019] [Indexed: 12/11/2022]
Abstract
With the dramatic growth of the Chinese economy, the number of children/adolescents with being overweight/having obesity is increasing, which has a certain impact on their psychology, such as depression and anxiety symptoms. Our purpose was to conduct a meta-analysis to assess the prevalence and odds ratios of depression and anxiety symptoms among overweight/obese children/adolescents and non-overweight/obese children/adolescents in China. As of July 2018, the three most comprehensive computerized academic databases in China have been systematically screened, namely China national knowledge infrastructure (CNKI) databases, Wanfang databases and Vip databases. The same operations are performed in PubMed and Web of Science (SCIE) databases without language restrictions. Case-control studies on prevalence of depression and anxiety symptoms in overweight/obese children/adolescents in China were analyzed. Study selection and evaluation were performed independently by three authors. Unweighted prevalence, pooled random-effects estimates of odds ratio (OR), and 95% confidence intervals (CI) were all calculated. A total of 11 eligible studies involving 17,894 subjects were included. The prevalence of depression and anxiety symptoms in overweight/obese children/adolescents was significantly higher than that in non-overweight/non-obese children/adolescents (depression: 21.73% vs. 17.96%, OR = 1.46, 95% CI: 1.14, 1.87, p = 0.003; anxiety: 39.80% vs. 13.99%, OR = 1.47, 95% CI: 1.21, 1.79, p < 0.001). Subgroup analyses conducted according to scale types showed that scale types have certain significance to evaluate the relationship between depression symptoms and overweight/obesity. The OR of depression symptoms between overweight/obese children/adolescents and non-overweight/non-obese children/adolescents was greatest on the Middle School Student Mental Health Scale (MSSMHS) was 2.06 (95% CI: 1.41, 3.02, I2 = 0.00%), Center for Epidemiologic Studies Depression Scale (CES-D) was 1.03 (95% CI: 0.84, 1.25, I2 = 0.00%), and Children’s Depression Inventory (CDI) was 1.21 (95% CI: 1.02, 1.42, I2 = 0.00%). We concluded that the prevalence of depression and anxiety symptoms in overweight/obese children/adolescents in China is higher than that in the non-overweight/obese children/adolescents. The results of the study indicate that the prevalence of depression and anxiety symptoms among overweight/obese children/adolescents in Chinese medical institutions should receive more attention. Physical exercise and psychological interventions should be strengthened to prevent psychological problems. However, because of some clear limitations (no clinical interview and few studies), these results should be interpreted with caution.
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Affiliation(s)
- Simeng Wang
- Department of Child and Adolescent Health, School of Public Health, China Medical University, Shenyang 110122, China.
| | - Qi Sun
- Department of Child and Adolescent Health, School of Public Health, China Medical University, Shenyang 110122, China.
| | - Lingling Zhai
- Department of Child and Adolescent Health, School of Public Health, China Medical University, Shenyang 110122, China.
| | - Yinglong Bai
- Department of Child and Adolescent Health, School of Public Health, China Medical University, Shenyang 110122, China.
| | - Wei Wei
- Department of Child and Adolescent Health, School of Public Health, China Medical University, Shenyang 110122, China.
| | - Lihong Jia
- Department of Child and Adolescent Health, School of Public Health, China Medical University, Shenyang 110122, China.
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Stenvinkel P. Obesity in Kidney Disease. ENDOCRINE DISORDERS IN KIDNEY DISEASE 2019:265-275. [DOI: 10.1007/978-3-319-97765-2_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2025]
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Xia B, Zhu Q, Zhao Y, Ge W, Zhao Y, Song Q, Zhou Y, Shi H, Zhang Y. Phthalate exposure and childhood overweight and obesity: Urinary metabolomic evidence. ENVIRONMENT INTERNATIONAL 2018; 121:159-168. [PMID: 30208345 DOI: 10.1016/j.envint.2018.09.001] [Citation(s) in RCA: 75] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Revised: 08/07/2018] [Accepted: 09/01/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVE Metabolomics may unravel global metabolic changes in response to environmental exposures and identify important biological pathways involved in the pathophysiology of childhood obesity. Phthalate has been considered an obesogen and contributing to overweight and obesity in children. The purpose of this study is to evaluate changes in urine metabolites in response to the environmental phthalate exposure among overweight or obese children, and to investigate the metabolic mechanisms involved in the obesogenic effect of phthalate on children at puberty. METHODS Within the national Puberty Timing and Health Effects in Chinese Children (PTHEC) study, 69 overweight/obese children and 80 normal weight children were selected into the current study according to their puberty timing and WGOC (The Working Group for obesity in China) references. Urinary concentrations of six phthalate monoesters (MMP, MEP, MnBP, MEHP, MEOHP and MEHHP) were measured using API 2000 electrospray triple quadrupole mass spectrometer (ESIMS/MS). Metabolomic profiling of spot urine was performed using gas chromatography-mass spectrometry. Differentially expressed urinary metabolites associated with phthalate monoesters exposure were examined using orthogonal partial least square-discriminant analysis and multiple linear regression models. In addition, the candidate metabolites were regressed to obesity indices with multiple linear regression models and logistic regression models in all subjects. RESULTS Compared with normal weight children, higher levels of MnBP were detected in urinary samples of children with overweight and obesity. After adjusting for confounders including chronological age, gender, puberty onset, daily energy intake and physical activity and socio-economic level, positive association remained between urinary MnBP concentration and childhood overweight/obesity [OR = 1.586, 95% CI:1.043,2.412]. We observed elevated MnBP concentration was significantly correlated with increased levels of monostearin, 1-monopalmitin, stearic acid, itaconic acid, glycerol 3-phosphate, 5-methoxytryptamine, kyotorphin, 1-methylhydantoin, d-alanyl-d-alanine, pyrrole-2-carboxylic acid, 3,4-Dihydroxyphenylglycol, and butyraldehyde. Meanwhile, increased MnBP concentration was also significantly correlated with decreased levels of lactate, glucose 6-phosphate, d-fructose 6-phosphate, palmitic acid, 4-acetamidobutyric acid, l-glutamic acid, n-acetyl-l-phenylalanine, iminodiacetic acid, hydroxyproline, pipecolinic acid, l-ornithine, n-acetyl-l-glutamic acid, guanosine, cytosin, and (s)-mandelic acid in the normal weight subjects. The observations indicated that MnBP exposure was related to global urine metabolic abnormalities characterized by disrupting arginine and proline metabolism and increasing oxidative stress and fatty acid reesterification. Among the metabolic markers related to MnBP exposure, 1-methylhydantoin, pyrrole-2-carboxylic acid and monostearin were found to be positively correlated with obesity indices, while hydroxyproline, l-ornithine, and lactate were negatively associated with overweight/obesity in children. CONCLUSIONS Our results suggested that the disrupted arginine and proline metabolism associated with phthalate exposure might contribute to the development of overweight and obesity in school-age children, providing insights into the pathophysiological changes and molecular mechanisms involved in childhood obesity.
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Affiliation(s)
- Bin Xia
- Key Lab of Health Technology Assessment, National Health Commission of the People's Republic of China (Fudan University), China; Key Laboratory of Public Health Safety, Ministry of Education, School of Public Health, Fudan University, Shanghai 200032, China
| | - Qingyang Zhu
- Key Lab of Health Technology Assessment, National Health Commission of the People's Republic of China (Fudan University), China; Key Laboratory of Public Health Safety, Ministry of Education, School of Public Health, Fudan University, Shanghai 200032, China
| | - Yingya Zhao
- Key Lab of Health Technology Assessment, National Health Commission of the People's Republic of China (Fudan University), China; Key Laboratory of Public Health Safety, Ministry of Education, School of Public Health, Fudan University, Shanghai 200032, China
| | - Wenzhen Ge
- Regeneron Pharmaceuticals Inc., New York, NY, USA
| | - Yan Zhao
- Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, China
| | - Qi Song
- Key Lab of Health Technology Assessment, National Health Commission of the People's Republic of China (Fudan University), China; Key Laboratory of Public Health Safety, Ministry of Education, School of Public Health, Fudan University, Shanghai 200032, China
| | - Yuhan Zhou
- Key Lab of Health Technology Assessment, National Health Commission of the People's Republic of China (Fudan University), China; Key Laboratory of Public Health Safety, Ministry of Education, School of Public Health, Fudan University, Shanghai 200032, China
| | - Huijing Shi
- Key Laboratory of Public Health Safety, Ministry of Education, School of Public Health, Fudan University, Shanghai 200032, China.
| | - Yunhui Zhang
- Key Lab of Health Technology Assessment, National Health Commission of the People's Republic of China (Fudan University), China; Key Laboratory of Public Health Safety, Ministry of Education, School of Public Health, Fudan University, Shanghai 200032, China.
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Chitosan Oligosaccharides Improve Glucolipid Metabolism Disorder in Liver by Suppression of Obesity-Related Inflammation and Restoration of Peroxisome Proliferator-Activated Receptor Gamma (PPARγ). Mar Drugs 2018; 16:md16110455. [PMID: 30463189 PMCID: PMC6265870 DOI: 10.3390/md16110455] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Revised: 11/01/2018] [Accepted: 11/16/2018] [Indexed: 12/30/2022] Open
Abstract
Chitosan oligosaccharides (COS) display various biological activities. In this study, we aimed to explore the preventive effects of COS on glucolipid metabolism disorder using palmitic acid (PA)-induced HepG2 cells and high-fat diet (HFD)-fed C57BL/6J mice as experimental models in vitro and in vivo, respectively. The results showed that COS pretreatment for 12 h significantly ameliorated lipid accumulation in HepG2 cells exposed to PA for 24 h, accompanied by a reversing of the upregulated mRNA expression of proinflammatory cytokines (IL-6, MCP-1, TNF-α) and glucolipid metabolism-related regulators (SCD-1, ACC1, PCK1-α). In addition, COS treatment alleviated glucolipid metabolism disorder in mice fed with HFD for five months, including reduction in body weight and fasting glucose, restoration of intraperitoneal glucose tolerance, and suppression of overexpression of proinflammatory cytokines and glucolipid metabolism-related regulators. Furthermore, our study found that COS pretreatment significantly reversed the downregulation of PPARγ at transcriptional and translational levels in both PA-induced HepG2 cells and liver tissues of HFD-fed mice. In summary, the study suggests that COS can improve glucolipid metabolism disorder by suppressing inflammation and upregulating PPARγ expression. This indicates a novel application of COS in preventing and treating glucolipid metabolism-related diseases.
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Martinson ML, Chang YL, Han WJ, Wen J. Child Overweight and Obesity in Shanghai, China: Contextualizing Chinese Socioeconomic and Gender Differences. Int J Behav Med 2018; 25:141-149. [PMID: 29030808 DOI: 10.1007/s12529-017-9688-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
PURPOSE Childhood overweight and obesity is on the rise in China and in Chinese cities in particular. The aim of this study is to explore the extent of income differences in childhood overweight in Shanghai, China, and examine demographic, social, and behavioral explanations for these differences. METHODS Using the 2014 Child Well-Being Study of Shanghai, China-a survey that included extensive contextual information on children and their families in China's most populous city, prevalence rates and adjusted odds ratios of child overweight and obesity at age 7 were calculated by income tercile controlling for a wide variety of sociodemographic variables. RESULTS District aggregate income increases the odds of child overweight/obesity, but only for boys. In contrast, rural hukou status was associated with lower odds of overweight/obesity for girls. CONCLUSIONS Boys at age 7 are more likely to be overweight and obese than girls. District income further increases this likelihood for boys, while rural hukou status decreases this likelihood for girls, suggesting that preferences for boys and thinness ideals for girls may play a role in the income patterning of childhood overweight and obesity.
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Affiliation(s)
| | | | - Wen-Jui Han
- New York University Silver School of Social Work, New York, NY, USA
| | - Jun Wen
- NYU-ECNU Institute for Social Development at NYU Shanghai, East China Normal University, Shanghai, China
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Ortega-García JA, Kloosterman N, Alvarez L, Tobarra-Sánchez E, Cárceles-Álvarez A, Pastor-Valero R, López-Hernández FA, Sánchez-Solis M, Claudio L. Full Breastfeeding and Obesity in Children: A Prospective Study from Birth to 6 Years. Child Obes 2018; 14:327-337. [PMID: 29912590 PMCID: PMC6066191 DOI: 10.1089/chi.2017.0335] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
BACKGROUND Obesity is a major public health crisis among both children and adults and contributes to significant physical, psychological, and economic burden. We aim to investigate the effect of duration of breastfeeding on excessive weight and obesity at 6 years of age. SUBJECTS/METHODS Data on breastfeeding and child anthropometric measurements were collected in a birth-cohort study in Murcia, Spain (n = 350). Breastfeeding status and body mass index (BMI) were established according to WHO definitions. Other factors potentially related to children's weight were considered. Multiple log-linear and ordinal regressions were used to analyze the effects of breastfeeding on overweight and obesity when considering potential confounders. RESULTS 33% and 17.3% of children in the study were of excess weight and obesity, respectively. Univariate predictors of BMI in children aged 6 were as follows: pregestational maternal BMI (kg/m2) (R2 = 0.127, p < 0.01); full breastfeeding (weeks) R2 = -0.035, p < 0.01); infant weight gain (kg) (R2 = 0.348, p < 0.01); and maternal alcohol consumption during pregnancy (g/day) (R2 = 0.266, p < 0.01) at age 6. In the ordinal logistic regression, full breastfeeding was associated with a significant decrease in obesity -0.052 (95% CI, -0.10 to -0.003). CONCLUSIONS The delay of bottle feeding introduction may have a protective effect against obesity at 6 years of age. Our findings reinforce the need for greater support of breastfeeding and to promote a healthy environment and antipoverty interventions during pregnancy and infancy, alongside other strategies for obesity prevention.
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Affiliation(s)
- Juan Antonio Ortega-García
- Pediatric Environmental Health Speciality Unit, Laboratory of Environmental and Human Health (A5), Department of Paediatrics, Institute of Biomedical Research, IMIB-Arrixaca, Virgen de la Arrixaca University Hospital, University of Murcia, Murcia, Spain
| | - Nicole Kloosterman
- Pediatric Environmental Health Speciality Unit, Laboratory of Environmental and Human Health (A5), Department of Paediatrics, Institute of Biomedical Research, IMIB-Arrixaca, Virgen de la Arrixaca University Hospital, University of Murcia, Murcia, Spain
| | - Lizbeth Alvarez
- Pediatric Environmental Health Speciality Unit, Laboratory of Environmental and Human Health (A5), Department of Paediatrics, Institute of Biomedical Research, IMIB-Arrixaca, Virgen de la Arrixaca University Hospital, University of Murcia, Murcia, Spain
| | - Esther Tobarra-Sánchez
- Pediatric Environmental Health Speciality Unit, Laboratory of Environmental and Human Health (A5), Department of Paediatrics, Institute of Biomedical Research, IMIB-Arrixaca, Virgen de la Arrixaca University Hospital, University of Murcia, Murcia, Spain
| | - Alberto Cárceles-Álvarez
- Pediatric Environmental Health Speciality Unit, Laboratory of Environmental and Human Health (A5), Department of Paediatrics, Institute of Biomedical Research, IMIB-Arrixaca, Virgen de la Arrixaca University Hospital, University of Murcia, Murcia, Spain
| | - Rebeca Pastor-Valero
- Pediatric Environmental Health Speciality Unit, Laboratory of Environmental and Human Health (A5), Department of Paediatrics, Institute of Biomedical Research, IMIB-Arrixaca, Virgen de la Arrixaca University Hospital, University of Murcia, Murcia, Spain
| | | | - Manuel Sánchez-Solis
- Pediatric Environmental Health Speciality Unit, Laboratory of Environmental and Human Health (A5), Department of Paediatrics, Institute of Biomedical Research, IMIB-Arrixaca, Virgen de la Arrixaca University Hospital, University of Murcia, Murcia, Spain
| | - Luz Claudio
- Division of International Health, Mount Sinai School of Medicine, New York, NY
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Zhang J, Wang H, Wang Z, Du W, Su C, Zhang J, Jiang H, Jia X, Huang F, Ouyang Y, Wang Y, Zhang B. Prevalence and stabilizing trends in overweight and obesity among children and adolescents in China, 2011-2015. BMC Public Health 2018; 18:571. [PMID: 29716560 PMCID: PMC5930802 DOI: 10.1186/s12889-018-5483-9] [Citation(s) in RCA: 81] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Accepted: 04/19/2018] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND The prevalence of childhood overweight and obesity in developed countries appears to be plateauing. The purpose of this study was to provide the most recent data on the prevalence and trends in overweight and obesity among Chinese children and adolescents from 2011 to 2015. METHODS We used data collected in the China Health and Nutrition Survey (CHNS) and China Nutritional Transition Cohort Study (CNTCS). We used two waves of the survey in 12 provinces conducted in 2011 (aged 7-18 years; n = 1458) and 2015 (aged 7-18 years; n = 1084) to perform a trend analysis. We used data collected in 15 provinces (aged 7-18 years; n = 1617) to estimate the prevalence of overweight and obesity among Chinese children and adolescents in 2015. RESULTS In 2015, based on the Working Group for Obesity in China (WGOC) criteria, the prevalence of overweight and obesity were 14.0% (95% CI, 11.6-16.3) and 10.5% (95% CI, 8.4-12.6) in boys, and 9.7% (95% CI, 7.7-11.8) and 7.1% (95% CI, 5.2-8.9) in girls, respectively. The increase in BMI z-scores from 2011 to 2015 was statistically significant among adolescents (p = 0.0083), but not among children. No significant changes were observed in prevalence of overweight and obesity between 2011 and 2015, excepting adolescents aged 12-18 years (p = 0.0086). CONCLUSIONS Since 2011, overweight has remained stable, and obesity has stabilized in children, though not in adolescents. Although levels of childhood overweight and obesity in China are not high compared to other developed countries, they remain concerning enough that effective policies and interventions need to be sustained and intensified for lowering rates of childhood overweight and obesity.
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Affiliation(s)
- Jiguo Zhang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, No.29 Nanwei Road, Beijing, 100050, China
| | - Huijun Wang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, No.29 Nanwei Road, Beijing, 100050, China
| | - Zhihong Wang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, No.29 Nanwei Road, Beijing, 100050, China
| | - Wenwen Du
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, No.29 Nanwei Road, Beijing, 100050, China
| | - Chang Su
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, No.29 Nanwei Road, Beijing, 100050, China
| | - Ji Zhang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, No.29 Nanwei Road, Beijing, 100050, China
| | - Hongru Jiang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, No.29 Nanwei Road, Beijing, 100050, China
| | - Xiaofang Jia
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, No.29 Nanwei Road, Beijing, 100050, China
| | - Feifei Huang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, No.29 Nanwei Road, Beijing, 100050, China
| | - Yifei Ouyang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, No.29 Nanwei Road, Beijing, 100050, China
| | - Yun Wang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, No.29 Nanwei Road, Beijing, 100050, China
| | - Bing Zhang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, No.29 Nanwei Road, Beijing, 100050, China.
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Zhang J, Li X, Hawley N, Zheng Z, Zou Z, Tan L, Chen Q, Shi H, Zhao H, Zhang Z. Trends in the Prevalence of Overweight and Obesity among Chinese School-Age Children and Adolescents from 2010 to 2015. Child Obes 2018; 14:182-188. [PMID: 29620919 DOI: 10.1089/chi.2017.0309] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
BACKGROUND In China, recent rapid economic growth has been associated with increasing prevalence of childhood obesity. This study aimed to provide the most updated prevalence and trends in overweight and obesity among school-age children and adolescents in Shanghai, China, in 2010-2015. METHODS Annual physical examination data were collected from 66,410, 43,812, 104,887, 113,667, 119,401, and 109,068 school children and adolescents aged 6-17 in Minhang District, Shanghai, in 2010-2015. The outcome of interest was the prevalence of overweight and obesity based on the body mass index (BMI) criteria from the International Obesity Task Force. RESULTS In 2010-2015, the age-adjusted prevalence of overweight and obesity among boys increased from 21.2% to 31.7% and from 10.6% to 16.9% among girls. In 2015, the prevalence of obesity among boys was 9.3% higher than among girls (3.5%). The prevalence for boys was consistently higher than that for girls at each age and across years. The prevalence of overweight and obesity was highest at 11 years: 37.3% for boys and 19.8% for girls. CONCLUSIONS The prevalence of overweight and obesity among Chinese urban children and adolescents is comparable to that in developed countries and was still increasing in 2010-2015. The prevalence among boys was alarmingly high. The findings highlight the need to develop public intervention strategies targeting urban children to stop the increasing trend in childhood obesity in China.
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Affiliation(s)
- Jing Zhang
- 1 School of Public Health, Shanghai Jiao Tong University , School of Medicine, Shanghai, China
| | - Xinyue Li
- 2 Department of Biostatistics, Yale School of Public Health , New Haven, Connecticut
| | - Nicola Hawley
- 3 Department of Chronic Disease Epidemiology, Yale School of Public Health , New Haven, CT
| | - Zhijie Zheng
- 1 School of Public Health, Shanghai Jiao Tong University , School of Medicine, Shanghai, China
| | - Zhen Zou
- 4 Shanghai Municipal Center for Disease Control and Prevention, Institute of Non-Communicable Disease and Injury , Shanghai, China
| | - Linglin Tan
- 5 Longbai Community Health Service Center of Minhang District , Shanghai, China
| | - Qian Chen
- 5 Longbai Community Health Service Center of Minhang District , Shanghai, China
| | - Hong Shi
- 5 Longbai Community Health Service Center of Minhang District , Shanghai, China
| | - Hongyu Zhao
- 2 Department of Biostatistics, Yale School of Public Health , New Haven, Connecticut.,6 Yale Joint Center for Biostatistics, Shanghai Jiao Tong University , Shanghai, China
| | - Zhiruo Zhang
- 1 School of Public Health, Shanghai Jiao Tong University , School of Medicine, Shanghai, China
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Park J, Ishikawa-Takata K, Lee S, Kim E, Lim K, Kim H, Lee IS, Tanaka S. Comparison of daily physical activity parameters using objective methods between overweight and normal-weight children. JOURNAL OF SPORT AND HEALTH SCIENCE 2018; 7:210-217. [PMID: 30356488 PMCID: PMC6180554 DOI: 10.1016/j.jshs.2017.01.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/22/2016] [Revised: 07/19/2016] [Accepted: 11/28/2016] [Indexed: 06/08/2023]
Abstract
PURPOSE The purpose of the present study was to determine if there were any differences in various aspects of physical activity such as energy expenditure, intensity, and type of activity between normal-weight and overweight boys. METHODS Children aged 9-12 years were recruited from 2 elementary schools located in different urban districts in Republic of Korea. The present study included 45 Korean boys, of which 19 were normal-weight and 26 were overweight. Daily physical activity was estimated over the same 1-week study period under free-living conditions using the doubly labeled water (DLW) method and a tri-axial accelerometer. Resting metabolic rate (RMR) was measured using the Douglas bag method and open-circuit indirect calorimetry. We calculated the physical activity level (PAL) as the total energy expenditure (TEE)/RMR. RESULTS PAL was not significantly different between the groups. In the accelerometer data, time spent in locomotive moderate-to-vigorous physical activity (MVPA) was significantly lower in overweight boys than in normal-weight subjects, whereas other variables including non-locomotive activity did not differ between groups. In addition, among all participants, time spent in total locomotive activity was significantly associated with PAL. Time spent in locomotive MVPA was significantly associated with PAL. CONCLUSION Overweight boys may be less physically active based on locomotive MVPA, which was positively related with PAL. Our findings suggest that the contribution of locomotive MVPA to the increase in PAL was relatively significant.
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Affiliation(s)
- Jonghoon Park
- Department of Physical Education, Korea University, Seoul 02841, Republic of Korea
| | - Kazuko Ishikawa-Takata
- Department of Nutritional Education, National Institute of Health and Nutrition, Tokyo 162-8636, Japan
| | - Sangjik Lee
- Division of Physical Education, Uiduk University, Gyeongju 38004, Republic of Korea
| | - Eunkyung Kim
- Department of Food and Nutrition, Gangneung-Wonju National University, Gangneung 25457, Republic of Korea
| | - Kiwon Lim
- Department of Physical Education, Konkuk University, Seoul 05029, Republic of Korea
| | - Hyungryul Kim
- Division of Physical Education, Uiduk University, Gyeongju 38004, Republic of Korea
| | - In-Sook Lee
- Division of Food Service Industry, Uiduk University, Gyeongju 38004, Republic of Korea
| | - Shigeho Tanaka
- Department of Nutritional Science, National Institute of Health and Nutrition, Tokyo 162-8636, Japan
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Zhu X, Haegele JA, Tang Y, Wu X. Prevalence and Demographic Correlates of Overweight, Physical Activity, and Screen Time Among School-Aged Children in Urban China: The Shanghai Study. Asia Pac J Public Health 2018; 30:118-127. [PMID: 29457497 DOI: 10.1177/1010539518754538] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This study reports the prevalence and demographic correlates of overweight, as well as meeting physical activity and screen time guidelines, in Chinese children. A representative sample of school-aged children ( n = 49 549) in Shanghai were participants. Children's anthropometrics were objectively measured; their physical activity and screen time, and demographic variables including age, sex, skill proficiency, sport affiliation, and transportation mode were self-reported. Multivariate logistic regression analyses were conducted. The prevalence of overweight was 24.9%, meeting physical activity guidelines was 20.5%, and meeting screen time guidelines was 73.5%. Boys (odds ratio [OR] = 1.60, 95% confidence interval [CI] = 1.50-1.71) had higher overweight prevalence than girls. Girls (OR = 0.91, 95% CI = 0.85-0.97) and those without sport affiliation (OR = 0.48, 95% CI = 0.42-0.54) were less likely to meet physical activity recommendations than their counterparts. Girls were more likely than boys to meet screen time recommendations (OR = 1.29, 95% CI = 1.22-1.37). Children's sex, sport affiliation, and skill proficiency are factors that policymakers can use to improve body weight status, physical activity participation, and screen time.
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Affiliation(s)
- Xihe Zhu
- 1 Old Dominion University, Norfolk, VA, USA.,2 Shanghai University of Sport, Shanghai, People's Republic of China
| | | | - Yan Tang
- 2 Shanghai University of Sport, Shanghai, People's Republic of China
| | - Xueping Wu
- 2 Shanghai University of Sport, Shanghai, People's Republic of China
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Body Mass Index (BMI) assessment among Macau students: age group differences and weight management strategies. ANTHROPOLOGICAL REVIEW 2017. [DOI: 10.1515/anre-2017-0025] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
There is evidence that rapid weight gain during the first year of life is associated with being overweight later in life. Therefore, overweight tendencies need to be detected at an appropriate age, and suitable strategies need to be implemented for weight management to achieve optimal long-term health. The objective of this study was to investigate comparisons in BMI status and associated categories in male and female students over ten years in two phases, including 2008-2013 and 2009-2014. Weight and height data were collected to obtain BMI (Body Mass Index) over ten years in two phases. The first phase occurred from 2008 to 2013, and the second phase occurred from 2009 to 2014 in a population of 10846 school children (Males: 6970, 64.3%, and females: 3875, 35.7%) in Macau. Their ages ranged from 6 years old in 2008 to 11 years old in 2013. The same age range was observed in the second phase, i.e., 2009-2014. Statistical analyses included descriptive statistics, such as the mean, standard deviation, t-tests to determine gender differences (year-wise) and a Chi square test for independence to determine the relationship between BMI (Underweight, Standard, Overweight and Obese) and age groups. In the first phase (2008-2013), the findings indicated a higher BMI level among the male students than the female students across all age groups (2008 t = 5.24, 2009 t = 88.25, 2010 t = 11.32, 2011 t = 17.45, 2012 t = 19.70 and 2013 t = 19.92). In the second phase (2009-2014), a higher BMI level was found among the male students than the female students across all age groups (2009 t = 2.68, 2010 t = 2.886, 2011 t = 3.076, 2013 t = 4.228, and 2014 t = 2.405). The results of the two phases combined (2008 to 2014 and 2009 to 2014) revealed that male students in 2008 had a higher BMI level than their counterparts in 2009 in the two age categories (8 years t = 3.025 and 11 years t = 3.377). Female students in the second phase (2009-2014) showed a higher BMI level than their male counterparts (9 years, t = 3.151). The results indicate the need to have focused strategies and structured interventions for male students at the critical age range of 8 to 9 years old. The results of this study also imply the need for the delivery of suitable school intervention activities at the appropriate time. Specifically, the prevention of weight gain should start early in life to encourage the development of healthier behaviours and habits throughout childhood and later ages.
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Cai Y, Zhu X, Wu X. Overweight, obesity, and screen-time viewing among Chinese school-aged children: National prevalence estimates from the 2016 Physical Activity and Fitness in China-The Youth Study. JOURNAL OF SPORT AND HEALTH SCIENCE 2017; 6:404-409. [PMID: 30356639 PMCID: PMC6189269 DOI: 10.1016/j.jshs.2017.09.002] [Citation(s) in RCA: 82] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/22/2017] [Revised: 06/18/2017] [Accepted: 08/04/2017] [Indexed: 05/03/2023]
Abstract
PURPOSE This study presents the most recent estimates of prevalence of overweight, obesity, and screen-time viewing among Chinese school-aged children. Demographic differences in these estimates between sexes and resident locales were also examined. METHODS Cross-sectional analyses of 116,615 Chinese school children 9 to 17 years of age who participated in the 2016 Physical Activity and Fitness in China-The Youth Study project. Outcomes were the prevalence of children's overweight (85th ≤ body mass index (BMI) < 95th percentile) and obesity (BMI ≥95th percentile) (defined by the Working Group on Obesity in China) and not meeting screen-time viewing recommendations ("not meeting" was defined as more than 2 h per day of viewing activities after school). Analyses were conducted on the whole sample and by school grade cohorts (primary, junior middle, and junior high schools), sex, and residence locales (urban, rural). RESULTS Overall, 14.4% (95% confidence interval (CI): 13.8%-15.0%) of children and adolescents were overweight, 11.9% (95%CI: 11.0%-13.0%) were obese, and 36.8% (95%CI: 34.7%-38.9%) did not meet screen-time viewing recommendations. Across the 3-grade cohorts, boys were more likely to be obese than girls, and primary and junior middle school children living in urban areas were more likely to be obese than those living in rural areas. Primary and junior middle school boys were less likely to meet screen-time recommendations than girls, and junior high school children living in urban areas were less likely to meet screen-time recommendations than school children of the same grades living in rural areas. CONCLUSION In 2016, the prevalence of obesity among Chinese school children was about 12%, and about 37% of them did not meet screen-time viewing recommendations. The prevalence of obesity and sedentary behavior was generally higher among boys than among girls, and it was higher for children living in urban areas than for those living in rural areas.
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Affiliation(s)
- Yujun Cai
- School of Physical Education and Sport Training, Shanghai University of Sport, Shanghai 200438, China
| | - Xihe Zhu
- Department of Human Movement Sciences, Old Dominion University, Norfolk, VA 23529, USA
| | - Xueping Wu
- School of Physical Education and Sport Training, Shanghai University of Sport, Shanghai 200438, China
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The association between ambient fine particulate air pollution and physical activity: a cohort study of university students living in Beijing. Int J Behav Nutr Phys Act 2017; 14:136. [PMID: 28982357 PMCID: PMC5629773 DOI: 10.1186/s12966-017-0592-x] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2017] [Accepted: 09/27/2017] [Indexed: 12/20/2022] Open
Abstract
Background Air pollution has become a substantial environmental issue affecting human health and health-related behavior in China. Physical activity is widely accepted as a method to promote health and well-being and is potentially influenced by air pollution. Previous population-based studies have focused on the impact of air pollution on physical activity in the U.S. using a cross-sectional survey method; however, few have examined the impact on middle income countries such as China using follow-up data. The purpose of this study is to examine the impact of ambient fine particulate matter (PM2.5) air pollution on physical activity among freshmen students living in Beijing by use of follow-up data. Methods We conducted 4 follow-up health surveys on 3445 freshmen students from Tsinghua University from 2012 to 2013 and 2480 freshmen completed all 4 surveys. Linear individual fixed-effect regressions were performed based on repeated-measure physical activity-related health behaviors and ambient PM2.5 concentrations among the follow-up participants. Results An increase in ambient PM2.5 concentration by one standard deviation (44.72 μg/m3) was associated with a reduction in 22.32 weekly minutes of vigorous physical activity (95% confidence interval [CI] = 24.88–19.77), a reduction in 10.63 weekly minutes of moderate physical activity (95% CI = 14.61–6.64), a reduction in 32.45 weekly minutes of moderate to vigorous physical activity (MVPA) (95% CI = 37.63–27.28), and a reduction in 226.14 weekly physical activity MET-minute scores (95% CI = 256.06–196.21). The impact of ambient PM2.5 concentration on weekly total minutes of moderate physical activity tended to be greater among males than among females. Conclusions Ambient PM2.5 air pollution significantly discouraged physical activity among Chinese freshmen students living in Beijing. Future studies are warranted to replicate study findings in other Chinese cities and universities, and policy interventions are urgently needed to reduce air pollution levels in China.
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Increased obesity risks for being an only child in China: findings from a nationally representative study of 19,487 children. Public Health 2017; 153:44-51. [PMID: 28843799 DOI: 10.1016/j.puhe.2017.07.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2017] [Revised: 05/18/2017] [Accepted: 07/06/2017] [Indexed: 11/22/2022]
Abstract
OBJECTIVES Given the rapid demographic transition and obesity growth in China, it is important to study how the large only-child population (≈100 million) might contribute to the obesity epidemic. This study evaluated associations of only-child status with weight and energy expenditure-related behaviors in China and examined how the associations may vary by sex and urbanicity. STUDY DESIGN Secondary analyses of nationally representative cross-sectional data from China Education Panel Survey: Junior Cohorts 2013-14, which included 19,487 students from 112 middle schools in 28 regions across China. METHODS We used propensity-score-weighted multilevel models to test associations between only-child status and weight outcomes. RESULTS Compared with sibling-sons, only-sons had higher body mass index (BMI) (Beta = 0.32, P < 0.05) and higher risks of overweight (OR = 1.24, 95% CI = [1.07-1.45]) and obesity (OR = 1.29, 95% CI = [1.02-1.64]); and spent less time on TV watching (Incidence rate ratio (IRR) = 0.89, 95% CI = [0.81-0.98]), internet use (IRR = 0.87, 95% CI = [0.79-0.96]), after-school sports (IRR = 0.91, 95% CI = [0.83-0.99]), and household chores (IRR = 0.85, 95% CI = [0.80-0.92]). Overweight/obesity risks for only-sons were particularly pronounced in urban China, where only-sons were 36% more likely to be overweight and 43% more likely to be obese than sibling-sons. Only-daughters had a higher risk of obesity (OR = 1.43, 95% CI = [1.01-2.04]) than sibling-daughters. However, the association was not significant for either urban girls or rural girls examined separately. Only-daughters in rural areas spent less time helping with household chores (IRR = 0.88, 95% CI = [0.80-0.97]) than sibling-daughters. CONCLUSIONS Future childhood obesity interventions should pay special attention targeting the large young only-child population in China.
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Li M, Xue H, Jia P, Zhao Y, Wang Z, Xu F, Wang Y. Pocket money, eating behaviors, and weight status among Chinese children: The Childhood Obesity Study in China mega-cities. Prev Med 2017; 100:208-215. [PMID: 28465131 DOI: 10.1016/j.ypmed.2017.04.031] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2016] [Revised: 03/16/2017] [Accepted: 04/23/2017] [Indexed: 10/19/2022]
Abstract
Both the obesity rate and pocket money are rising among children in China. This study examined family correlates of children's pocket money, associations of pocket money with eating behaviors and weight status, and how the associations may be modified by schools' unhealthy food restrictions in urban China. Data were collected in 2015 from 1648 students in 16 primary and middle schools in four mega-cities in China (4 schools/city): Beijing, Shanghai, Nanjing, and Xi'an. Cluster robust negative binomial regression models were fit to assess family correlates of pocket money, associations of pocket money with child eating behaviors and weight outcomes, and possible modifying effects of schools' unhealthy food restrictions. Sixty-nine percent of students received pocket money weekly. Students received more pocket money if mothers frequently ate out of home (IRR=2.28 [1.76, 2.94]) and/or family rarely had dinner together (IRR=1.42, 95%=[1.01, 1.99]). Students got less pocket money if parents were concerned about child's future health due to unhealthy eating (IRR=0.56 [0.32,0.98]). Students with more pocket money more frequently consumed (by 25-89%) sugary beverages, snacks, fast food, or at street food stalls, and were 45-90% more likely to be overweight/obese. Associations of pocket money with unhealthy eating and overweight/obesity were weaker in schools with unhealthy food restrictions. Pocket money is a risk factor for unhealthy eating and obesity in urban China. School policies may buffer pocket money's negative influence on students' eating and weight status.
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Affiliation(s)
- Miao Li
- Systems-Oriented Global Childhood Obesity Intervention Program, Department of Epidemiology and Environmental Health, University at Buffalo, State University of New York, Buffalo, NY 14215, USA; Department of Sociology, University of Notre Dame, Notre Dame, IN 46556, USA
| | - Hong Xue
- Fisher Institute of Health and Well-being, College of Health, Ball State University, Muncie, IN 47306, USA
| | - Peng Jia
- Systems-Oriented Global Childhood Obesity Intervention Program, Department of Epidemiology and Environmental Health, University at Buffalo, State University of New York, Buffalo, NY 14215, USA; Department of Earth Observation Science, Faculty of Geo-Information Science and Earth Observation, University of Twente - ITC, Enschede 7500, The Netherlands
| | - Yaling Zhao
- School of Public Health, Xi'an Jiaotong University Health Science Center, No. 76 West Yanta Road, Xi'an, Shaanxi 710061, PR China
| | - Zhiyong Wang
- Department of Non-Communicable Disease Prevention, Nanjing Municipal Center for Disease Control & Prevention, Nanjing 210003, PR China
| | - Fei Xu
- Department of Non-Communicable Disease Prevention, Nanjing Municipal Center for Disease Control & Prevention, Nanjing 210003, PR China
| | - Youfa Wang
- Fisher Institute of Health and Well-being, College of Health, Ball State University, Muncie, IN 47306, USA.
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Developmental origins of type 2 diabetes: a perspective from China. Eur J Clin Nutr 2017; 71:870-880. [PMID: 28378847 DOI: 10.1038/ejcn.2017.48] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2017] [Accepted: 03/04/2017] [Indexed: 12/20/2022]
Abstract
There has been a marked increase in the prevalence of diabetes in Asia, including China, over the last few decades. While the increased prevalence of diabetes has often been attributed to the nutritional transition associated with recent economic development, emerging data suggest that early-life exposures also play a major role in shaping developmental trajectories, and contributes to alter an individual's susceptibility to diabetes and other non-communicable diseases (NCDs). Early-life exposures such as in utero exposure to undernutrition has been consistently linked with later risk of diabetes and obesity. Furthermore, in utero exposure to maternal hyperglycemia, maternal obesity and excess gestational weight gain are all linked with increased childhood obesity and later risk of diabetes. Emerging data have also highlighted the potential link between early-feeding practices, the role of one-carbon metabolism in metabolic programming and endocrine disrupting chemicals (EDCs) with later risk of diabetes. These different developmental exposures may all be highly relevant to the current epidemic of diabetes in China. For example, the prevalence of gestational diabetes has increased markedly over the last two decades, and may contribute to the diabetes epidemic by driving macrosomia, childhood obesity and later risk of diabetes. In order to address the current burden of diabetes, a lifecourse perspective, incorporating multisectoral efforts from public health policy down to the individuals, will be needed. Several major initiatives have been launched in China as part of its national plans for NCD prevention and treatment, and the experience from these efforts would be invaluable.
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Jia P, Xue H, Zhang J, Wang Y. Time Trend and Demographic and Geographic Disparities in Childhood Obesity Prevalence in China-Evidence from Twenty Years of Longitudinal Data. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:E369. [PMID: 28362361 PMCID: PMC5409570 DOI: 10.3390/ijerph14040369] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/11/2017] [Revised: 03/16/2017] [Accepted: 03/28/2017] [Indexed: 11/16/2022]
Abstract
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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Affiliation(s)
- Peng Jia
- Department of Earth Observation Science, Faculty of Geo-Information Science and Earth Observation (ITC), University of Twente, Enschede 7500, The Netherlands.
| | - Hong Xue
- Fisher Institute of Health and Well-Being, Systems-Oriented Global Childhood Obesity Intervention Program, College of Health, Ball State University, Muncie, IN 47306, USA.
| | - Ji Zhang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100000, China.
| | - Youfa Wang
- Fisher Institute of Health and Well-Being, Systems-Oriented Global Childhood Obesity Intervention Program, College of Health, Ball State University, Muncie, IN 47306, USA.
- Department of Nutrition and Health Sciences, College of Health, Ball State University, Muncie, IN 47306, USA.
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Zhai L, Dong Y, Bai Y, Wei W, Jia L. Trends in obesity, overweight, and malnutrition among children and adolescents in Shenyang, China in 2010 and 2014: a multiple cross-sectional study. BMC Public Health 2017; 17:151. [PMID: 28148243 PMCID: PMC5288974 DOI: 10.1186/s12889-017-4072-7] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2016] [Accepted: 01/25/2017] [Indexed: 11/18/2022] Open
Abstract
Background The prevalence, characteristics, and trends in obesity, overweight, and malnutrition among children and adolescents in 2010 and 2014 in Shenyang, China was described. Methods This was a multiple cross-sectional study using data from the 2010 and 2014 National Survey on Students’ Constitution and Health. A total of 31,031 children and adolescents were included in this survey. Differences in the percentages of obesity, overweight, and malnutrition by age, gender, and living region in 2010 and 2014 were compared using the χ2 test. Stepwise logistic regression was performed to select potential covariates for the dependent variable (overweight, obesity, or malnutrition). Results The prevalence of obesity and overweight in 2010 was 8.99% and 13.72%, respectively, and 12.64% and 14.06% in 2014, respectively. The prevalence of malnutrition was 10.68% and 10.69% in 2010, and 2014, respectively. In 2010 and 2014, boys and girls 7–11 years of age had higher rates of obesity than other age groups (P < 0.01). The prevalence of obesity and overweight was significantly higher in the urban residents compared to the rural residents, and was also significantly higher in boys than girls (P < 0.01); however, the prevalence of malnutrition was significantly lower in boys than girls (P < 0.01). Compared to 2010, the prevalence of obesity in 2014 increased significantly in boys and girls, and urban and rural residents (P < 0.05), but the prevalence of malnutrition did not change. The prevalence of obesity, overweight, and malnutrition was associated with gender, age, and living region by univariate logistic regressions. Conclusion The prevalence of obesity and overweight has continuously risen since 2010, and there is a low-age trend of obesity and overweight among children and adolescents in Shenyang, China. The increasing rate of obesity and overweight was faster in rural than urban areas. Malnutrition did not significantly decrease during the 4-year period from 2010–2014.
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Affiliation(s)
- Lingling Zhai
- Department of Maternal and Child Health, School of Public Health, China Medical University, No. 77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning Province, 110122, People's Republic of China
| | - Youdan Dong
- Department of Rheumatology, Shengjing Hospital of China Medical University, Shenyang Liaoning Province, People's Republic of China
| | - Yinglong Bai
- Department of Maternal and Child Health, School of Public Health, China Medical University, No. 77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning Province, 110122, People's Republic of China
| | - Wei Wei
- Department of Maternal and Child Health, School of Public Health, China Medical University, No. 77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning Province, 110122, People's Republic of China
| | - Lihong Jia
- Department of Maternal and Child Health, School of Public Health, China Medical University, No. 77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning Province, 110122, People's Republic of China.
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Zhang J, Huang Y, Shao H, Bi Q, Chen J, Ye Z. Grape seed procyanidin B2 inhibits adipogenesis of 3T3-L1 cells by targeting peroxisome proliferator-activated receptor γ with miR-483-5p involved mechanism. Biomed Pharmacother 2017; 86:292-296. [DOI: 10.1016/j.biopha.2016.12.019] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2016] [Revised: 12/03/2016] [Accepted: 12/04/2016] [Indexed: 12/20/2022] Open
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Ju R, Zheng S, Luo H, Wang C, Duan L, Sheng Y, Zhao C, Xu W, Huang K. Purple Sweet Potato Attenuate Weight Gain in High Fat Diet Induced Obese Mice. J Food Sci 2017; 82:787-793. [PMID: 28135399 DOI: 10.1111/1750-3841.13617] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2016] [Revised: 12/09/2016] [Accepted: 12/13/2016] [Indexed: 11/26/2022]
Abstract
Purple sweet potato (PSP) is widely grown in Asia and considered as a healthy vegetable. The objective of the current study was to determine the anti-obesity effect of the PSP on high fat diet induced obese C57BL/6J mice. The mice were administrated with high fat diet supplemented with the sweet potato (SP) or PSP at the concentration of 15% and 30% for 12 wk, respectively. The results showed that the supplementation of SP or PSP at 30% significantly ameliorated high fat diet induced obesity and its associated risk factors, including reduction of body weight and fat accumulation, improvement of lipid profile and modulation of energy expenditure. Moreover, PSP also posed beneficial effect on the liver and kidney functions. These results indicate that PSP and SP have anti-obesity effect and are effective to reduce the metabolic risk.
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Affiliation(s)
| | | | - Hongxia Luo
- Dept. of Food and Bioengineering, Beijing Vocational College of Agriculture, 102442, Beijing, China
| | - Changgang Wang
- Dept. of Food and Bioengineering, Beijing Vocational College of Agriculture, 102442, Beijing, China
| | - Lili Duan
- Dept. of Food and Bioengineering, Beijing Vocational College of Agriculture, 102442, Beijing, China
| | - Yao Sheng
- Beijing Advanced Innovation Center for Food Nutrition and Human Health, College of Food Science and Nutritional Engineering, China Agricultural Univ., 100083, Beijing, China
| | - Changhui Zhao
- Dept. of Food Quality and Safety, College of Food Science and Engineering, Jilin Univ., 130062, Jilin Province, China
| | - Wentao Xu
- Beijing Advanced Innovation Center for Food Nutrition and Human Health, College of Food Science and Nutritional Engineering, China Agricultural Univ., 100083, Beijing, China
| | - Kunlun Huang
- Beijing Advanced Innovation Center for Food Nutrition and Human Health, College of Food Science and Nutritional Engineering, China Agricultural Univ., 100083, Beijing, China
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Wu Y, Qi D. Regional Disparities in China in the Prevalence of Children Who Are Obese or Overweight. SOCIAL WORK IN PUBLIC HEALTH 2017; 32:1-10. [PMID: 27559769 DOI: 10.1080/19371918.2016.1160350] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
China has experienced rapid socioeconomic transitions during the last three decades, which may result in a rising prevalence of overweight and obese children in China. This article aims to fill in the existing knowledge gap by an analysis of the China Health and Nutrition Survey data to study the national prevalence of children who are overweight and obese as well as how the regional disparities and age differences in prevalence have changed between 1989 and 2009.
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Affiliation(s)
- Yichao Wu
- a School of Economics and Management, Southeast University , Nanjing , China
| | - Di Qi
- b Department of Sociology, Hohai University , Nanjing , China
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Si Q, Cardinal BJ. The Health Impact of Air Pollution and Outdoor Physical Activity on Children and Adolescents in Mainland China. J Pediatr 2017; 180:251-255. [PMID: 28029345 DOI: 10.1016/j.jpeds.2016.10.016] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2016] [Revised: 08/12/2016] [Accepted: 10/05/2016] [Indexed: 10/20/2022]
Affiliation(s)
- Qi Si
- Department of Sport and Exercise Science, Zhejiang University, Hangzhou, Zhejiang, China.
| | - Bradley J Cardinal
- School of Biological and Population Health Sciences, Oregon State University, Corvallis, OR
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Ren H, Zhou Z, Liu WK, Wang X, Yin Z. Excessive homework, inadequate sleep, physical inactivity and screen viewing time are major contributors to high paediatric obesity. Acta Paediatr 2017; 106:120-127. [PMID: 27759894 PMCID: PMC6680318 DOI: 10.1111/apa.13640] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2016] [Revised: 08/31/2016] [Accepted: 10/17/2016] [Indexed: 11/29/2022]
Abstract
Aim This study examined the relationships between energy balance‐related behaviours (EBRBs) outside school hours and obesity in Chinese primary school students. We also explored the influence of gender on those relationships. Methods The study sample was a cross‐sectional cohort of 5032 Chinese children who were enrolled in grades 1–6 in primary schools in five Chinese cities and whose mean ages ranged from seven years and three months to 11.9 years. The children's parents completed a survey on their child's height, weight and EBRBs outside school hours. Results The response rate was 97%, and the reported rates of overweight and obesity were 13.6% and 13.8%, respectively. The obesity rates were higher in boys and lower grade children. Most EBRBs varied between boys and girls and with increased grade levels. The amount of time spent on academic‐related activities, screen viewing, outdoor activities and sleep was mostly associated with obesity on weekdays and varied by gender. Conclusion Rate of obesity was alarmingly high in the primary school Chinese children in this cohort, especially in younger children. Excessive time spent on academic‐related activities outside school hours, inadequate sleep, physical inactivity and higher levels of screen viewing were major contributors to obesity in these Chinese children.
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Affiliation(s)
- Hong Ren
- School of Sport Sciences; Beijing Sport University; Beijing China
| | - Zhixiong Zhou
- School of Physical Education and Coaching Science; Capital University of Physical Education and Sports; Beijing China
| | - Wenxi Kevin Liu
- Department of Kinesiology, Health, and Nutrition; University of Texas at San Antonio; San Antonio TX USA
| | | | - Zenong Yin
- Department of Kinesiology, Health, and Nutrition; University of Texas at San Antonio; San Antonio TX USA
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Kim S, So WY. Secular trends in weight status and weight-related behaviors in Korean adolescents from 2006 to 2013. Technol Health Care 2016; 24:933-941. [PMID: 27589507 DOI: 10.3233/thc-161252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The purpose of this study was to examine the secular trends in weight status and weight-related behaviors in adolescents in Korea from 2006 to 2013. Using a repeated cross-sectional design, we analyzed raw data from the 2006 and 2013 Korea Youth Risk Behavior Web-based Survey, which included 69,500 adolescents in 2006 and 70,354 adolescents in 2013. Subjects were 12- to 18-year-old boys and girls from the first grade of middle school through the third grade of high school. The data was collected by using an anonymous self-administered online survey. From 2006 to 2013, the prevalence of obesity increased by 0.7 (percent point; %p) (p < 0.001) in boys and 1.0%p (p < 0.001) in girls. At the same time, the prevalence of obesity increased by 1.0%p (p < 0.001) in middle-school students and decreased by 0.7%p (p < 0.001) in high-school students. Healthy, unhealthy, and extreme weight-control behaviors decreased in all adolescents (all p < 0.001). Obesity and unhealthy weight control behaviors in Korean adolescents remain major public concerns, and programs to encourage healthy weight control behaviors are required.
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Affiliation(s)
- Seonho Kim
- Department of Nursing, Chungbuk National University, Cheongju, Korea
| | - Wi-Young So
- Sports and Health Care Major, College of Humanities and Arts, Korea National University of Transportation, Chungju-si, Korea
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