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      25-year trends in gender disparity for obesity and overweight by using WHO and IOTF definitions among Chinese school-aged children: a multiple cross-sectional study

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          Abstract

          Objectives

          We sought to explore 25-year trends of gender disparity in the prevalence of obesity and overweight both in urban and rural areas among Chinese children from 1985 to 2010.

          Methods

          Data included 1 280 239 children aged 7–18 years enrolled in the Chinese National Survey on Students's Constitution and Health (CNSSCH), which is the largest nationally representative sample of school-aged children in China. Obesity and overweight were defined according to both WHO and the International Obesity Task Force (IOTF) definitions. Logistic regression was used to estimate the prevalence OR (POR) of gender for obesity and overweight prevalence in different surveys.

          Results

          The prevalence of obesity increased (WHO definition: from 0.10% to 4.3%; IOTF definition: from 0.03% to 2.2%) over the past 25 years in urban and rural areas among Chinese children and it was much higher among boys than girls at each survey point (p<0.01). The increasing trend was significant in all age subgroups (p<0.01). Although the prevalence of obesity continuously increased in boys and girls, the changing pace was more rapid in boys than in girls. PORs of boys versus girls for obesity also increased over time, and the estimates of PORs were higher in urban areas than in rural areas at each survey point.

          Conclusions

          The gradually increasing gender disparity in urban and rural areas suggests that the prevalence of obesity and overweight in boys, and especially in urban boys, contributes to a large and growing proportion of obese and overweight children.

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          Most cited references21

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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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            Childhood obesity, prevalence and prevention

            Childhood obesity has reached epidemic levels in developed countries. Twenty five percent of children in the US are overweight and 11% are obese. Overweight and obesity in childhood are known to have significant impact on both physical and psychological health. The mechanism of obesity development is not fully understood and it is believed to be a disorder with multiple causes. Environmental factors, lifestyle preferences, and cultural environment play pivotal roles in the rising prevalence of obesity worldwide. In general, overweight and obesity are assumed to be the results of an increase in caloric and fat intake. On the other hand, there are supporting evidence that excessive sugar intake by soft drink, increased portion size, and steady decline in physical activity have been playing major roles in the rising rates of obesity all around the world. Consequently, both over-consumption of calories and reduced physical activity are involved in childhood obesity. Almost all researchers agree that prevention could be the key strategy for controlling the current epidemic of obesity. Prevention may include primary prevention of overweight or obesity, secondary prevention or prevention of weight regains following weight loss, and avoidance of more weight increase in obese persons unable to lose weight. Until now, most approaches have focused on changing the behaviour of individuals in diet and exercise. It seems, however, that these strategies have had little impact on the growing increase of the obesity epidemic. While about 50% of the adults are overweight and obese in many countries, it is difficult to reduce excessive weight once it becomes established. Children should therefore be considered the priority population for intervention strategies. Prevention may be achieved through a variety of interventions targeting built environment, physical activity, and diet. Some of these potential strategies for intervention in children can be implemented by targeting preschool institutions, schools or after-school care services as natural setting for influencing the diet and physical activity. All in all, there is an urgent need to initiate prevention and treatment of obesity in children.
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              Parental underestimates of child weight: a meta-analysis.

              Parental perceptions of their children's weight play an important role in obesity prevention and treatment. The objective of this study was to determine the proportion of parents worldwide who underestimate their children's weight and moderators of such misperceptions.
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                Author and article information

                Journal
                BMJ Open
                BMJ Open
                bmjopen
                bmjopen
                BMJ Open
                BMJ Publishing Group (BMA House, Tavistock Square, London, WC1H 9JR )
                2044-6055
                2016
                22 September 2016
                : 6
                : 9
                : e011904
                Affiliations
                [1 ]Institute of Child and Adolescent Health, School of Public Health, Peking University , Beijing, China
                [2 ]Division of Social Medicine and Global Health, Department of Clinical Sciences, Lund University , Malmö, Sweden
                [3 ]Centre for Chronic Disease, School of Medicine, University of Queensland , Royal Brisbane & Women's Hospital , Herston, Queensland, Australia
                Author notes
                [Correspondence to ] Professor Jun Ma; majunt@ 123456bjmu.edu.cn and Professor Hai-Jun Wang; whjun1@ 123456bjmu.edu.cn
                Article
                bmjopen-2016-011904
                10.1136/bmjopen-2016-011904
                5051387
                27660318
                6fd01db6-5a05-481d-bb05-6016e8fe9b40
                Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

                This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

                History
                : 14 March 2016
                : 29 August 2016
                : 31 August 2016
                Funding
                Funded by: National Natural Science Foundation of China, http://dx.doi.org/10.13039/501100001809;
                Award ID: 81302442
                Categories
                Public Health
                Research
                1506
                1724
                1692
                1699
                1719

                Medicine
                obesity,overweight,gender disparity,china,children
                Medicine
                obesity, overweight, gender disparity, china, children

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