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      Prevalence and Trends in Obesity among China’s Children and Adolescents, 1985–2010

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          Abstract

          Objectives

          We examined the prevalence of and trends in obesity among children and adolescents in China (1985–2010).

          Methods

          We used data from the 1985, 1991, 1995, 2000, 2005, and 2010 Chinese National Surveys on Students’ Constitution and Health (CNSSCH). The CNSSCH is a national survey of physical fitness and health status in Chinese students that uses multistage stratified sampling of 31 provinces and municipalities. A subject was considered obese or overweight if weight-for-height exceeded the 20% or 10% of standard weight-for-height. The standard weight-for-height was the 80th percentile for sex- and age-specific growth charts.

          Results

          The age-adjusted prevalence of obesity and of overweight and obesity combined was 8.1% (95% CI, 8.0–8.3%) and 19.2% (95% CI, 19.1–19.4%) among children and adolescents 7–18 years in age. Obesity was more likely to be present among children or adolescents who were male (RR, 1.93; 95% CI, 1.90–1.97), urban (RR, 1.99; 95% CI, 1.95–2.02), or 10–12 years (RR, 1.43; 95% CI, 1.40–1.46). Trend analyses of the 25-year period revealed a significant increasing trend in males (RR, 1.59; 95% CI, 1.58–1.60) and in females (RR, 1.49; 95% CI, 1.48–1.50). The rate of increase in obese or overweight prevalence was highest in boys from rural areas (9% annual increase).

          Conclusions

          During 1985–2010, there was a significant and continuous increase in the prevalence of obesity in children and adolescents. Obesity is epidemic in China, but may be reduced with evidence-based interventions (e.g., school intervention programs).

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          Most cited references25

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          The nutrition transition: worldwide obesity dynamics and their determinants.

          This paper explores the major changes in diet and physical activity patterns around the world and focuses on shifts in obesity. Review of results focusing on large-scale surveys and nationally representative studies of diet, activity, and obesity among adults and children. Youth and adults from a range of countries around the world. The International Obesity Task Force guidelines for defining overweight and obesity are used for youth and the body mass index > or =25 kg/m(2) and 30 cutoffs are used, respectively, for adults. The nutrition transition patterns are examined from the time period termed the receding famine pattern to one dominated by nutrition-related noncommunicable diseases (NR-NCDs). The speed of dietary and activity pattern shifts is great, particularly in the developing world, resulting in major shifts in obesity on a worldwide basis. Data limitations force us to examine data on obesity trends in adults to provide a broader sense of changes in obesity over time, and then to examine the relatively fewer studies on youth. Specifically, this work provides a sense of change both in the United States, Europe, and the lower- and middle-income countries of Asia, Africa, the Middle East, and Latin America. The paper shows that changes are occurring at great speed and at earlier stages of the economic and social development of each country. The burden of obesity is shifting towards the poor.
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            Worldwide trends in childhood overweight and obesity.

            Obesity has become a global epidemic but our understanding of the problem in children is limited due to lack of comparable representative data from different countries, and varying criteria for defining obesity. This paper summarises the available information on recent trends in child overweight and obesity prevalence. PubMed was searched for data relating to trends over time, in papers published between January 1980 and October 2005. Additional studies identified by citations in retrieved papers and by consultation with experts were included. Data for trends over time were found for school-age populations in 25 countries and for pre-school populations in 42 countries. Using these reports, and data collected for the World Health Organization's Burden of Disease Program, we estimated the global prevalence of overweight and obesity among school-age children for 2006 and likely prevalence levels for 2010. The prevalence of childhood overweight has increased in almost all countries for which data are available. Exceptions are found among school-age children in Russia and to some extent Poland during the 1990s. Exceptions are also found among infant and pre-school children in some lower-income countries. Obesity and overweight has increased more dramatically in economically developed countries and in urbanized populations. There is a growing global childhood obesity epidemic, with a large variation in secular trends across countries. Effective programs and policies are needed at global, regional and national levels to limit the problem among children.
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              Cultural expectations of thinness in women.

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                Author and article information

                Contributors
                Role: Editor
                Journal
                PLoS One
                PLoS ONE
                plos
                plosone
                PLoS ONE
                Public Library of Science (San Francisco, USA )
                1932-6203
                2014
                20 August 2014
                : 9
                : 8
                : e105469
                Affiliations
                [1]Department of Child Health, School of Public Health, Soochow University, Suzhou, China
                INIA, Spain
                Author notes

                Competing Interests: The authors have declared that no competing interests exist.

                Conceived and designed the experiments: HS YX. Analyzed the data: HS. Contributed reagents/materials/analysis tools: YM DH. Wrote the paper: CP HS YM. Revised the article: CP HS YX.

                Article
                PONE-D-13-53148
                10.1371/journal.pone.0105469
                4139359
                25140709
                37603205-57c1-43e9-99ac-c949197564d1
                Copyright @ 2014

                This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 23 December 2013
                : 24 July 2014
                Page count
                Pages: 8
                Funding
                This study was funded by General Financial Grant from the China Postdoctoral Science Foundation (Grant No. 2013M531405) and Priority Academic Program Development of Jiangsu Higher Education Institutions (PAPD). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
                Categories
                Research Article
                Biology and Life Sciences
                Nutrition
                Physiology
                Physiological Parameters
                Body Weight
                Obesity
                Medicine and Health Sciences
                Epidemiology
                Pediatric Epidemiology
                Pediatrics
                Child Health
                Public and Occupational Health
                Preventive Medicine
                Sports and Exercise Medicine
                People and Places
                Demography
                Research and Analysis Methods
                Research Design
                Survey Research
                Survey Methods
                Clinical Research Design

                Uncategorized
                Uncategorized

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