Secular trends in childhood obesity and associated risk factors in China from 1982 to 2006
This chapter reviews the secular trends in childhood obesity and associated risk factors from three nationwide surveys across China conducted between 1982 and 2006. The Chinese National Surveys on Students' Constitution and Health (CNSSCH) have been conducted every five years since 1985. To date, it is the largest nutrition and health survey of a nationally representative sample of school-age children and adolescents in China. All the subjects were primary or high school students aged 7–18 years randomly selected from each of the mainland provinces, excluding Tibet. The China National Nutrition (and Health) Surveys (CNNHS) are nationally representative cross-sectional surveys conducted in 1982, 1992, and 2002; and include dietary intake data in 1982, 1992, and 2002 and physical activity information in 2002. The survey is a longitudinal study conducted in eight provinces in 1991, 1993, and 1997; and nine provinces in 2000, 2004, and 2006. The average interval between surveys was three years. For CNSSCH, the 2000 weight for height screening criteria in Chinese children and adolescents was used to define childhood overweight and obesity. For the same age-, sex-, and height- group, a child with body weight equal to or more than 110% of the reference body weight was categorized as overweight, and a child with body weight equal to or more than 120% of the reference body weight was categorized as obesity. The age- and sex-specific BMI cut-offs recommended by the International Obesity Task Force (IOTF) were used in CNNHS and CHNS. The prevalence of childhood overweight and obesity in China has increased dramatically over last three decades, especially in boys in urban areas. Parallel with the increasing prevalence of childhood obesity has been a decline in the intake of dietary energy and vegetables, and an increase in the intake of dietary fat and animal foods among Chinese children. In 2002, the proportion of children who reported regular exercise was very low while the level of reported sedentary activity was high.
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