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      Obesity and activity patterns before and during COVID‐19 lockdown among youths in China


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          This study aim to assess changes in obesity and activity patterns among youths in China during the COVID‐19 lockdown. We used the COVID‐19 Impact on lifestyle change survey (COINLICS), a national retrospective survey distributed via social media platforms in early May 2020 where more than 10 000 youth participants in China have voluntarily reported their basic sociodemographic information, weight status, and routine lifestyles in the months before and during COVID‐19 lockdown. The extended IOTF and WHO standards were used to define overweight and obesity of the participants. We used paired t‐tests or χ 2 tests and non‐parametric methods to evaluate the significance of differences in weight‐related outcomes and lifestyles across education levels, between sexes, and before and during COVID‐19 lockdown. The mean body mass index of all participating youths has significantly increased (21.8‐22.6) and in all education subgroups during COVID‐19 lockdown. Increases also occurred in the prevalence of overweight/obesity (21.3%‐25.1%, P < .001) and obesity (10.5% to 12.9%, P < .001) in overall youths, especially in high school and undergraduate students. Their activity patterns had also significantly changed, including the decreased frequency of engaging in active transport, moderate−/vigorous‐intensity housework, leisure‐time moderate−/vigorous‐intensity physical activity, and leisure‐time walking, and the increased sedentary, sleeping, and screen time. Our findings would inform policy‐makers and clinical practitioners of these changes in time, for better policy making and clinical practice. School administrators should also be informed of these changes, so in‐class and/or extracurricular physical activity programs could be designed to counteract them.

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          Most cited references11

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          International physical activity questionnaire: 12-country reliability and validity.

          Physical inactivity is a global concern, but diverse physical activity measures in use prevent international comparisons. The International Physical Activity Questionnaire (IPAQ) was developed as an instrument for cross-national monitoring of physical activity and inactivity. Between 1997 and 1998, an International Consensus Group developed four long and four short forms of the IPAQ instruments (administered by telephone interview or self-administration, with two alternate reference periods, either the "last 7 d" or a "usual week" of recalled physical activity). During 2000, 14 centers from 12 countries collected reliability and/or validity data on at least two of the eight IPAQ instruments. Test-retest repeatability was assessed within the same week. Concurrent (inter-method) validity was assessed at the same administration, and criterion IPAQ validity was assessed against the CSA (now MTI) accelerometer. Spearman's correlation coefficients are reported, based on the total reported physical activity. Overall, the IPAQ questionnaires produced repeatable data (Spearman's rho clustered around 0.8), with comparable data from short and long forms. Criterion validity had a median rho of about 0.30, which was comparable to most other self-report validation studies. The "usual week" and "last 7 d" reference periods performed similarly, and the reliability of telephone administration was similar to the self-administered mode. The IPAQ instruments have acceptable measurement properties, at least as good as other established self-reports. Considering the diverse samples in this study, IPAQ has reasonable measurement properties for monitoring population levels of physical activity among 18- to 65-yr-old adults in diverse settings. The short IPAQ form "last 7 d recall" is recommended for national monitoring and the long form for research requiring more detailed assessment.
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            Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies.

            A WHO expert consultation addressed the debate about interpretation of recommended body-mass index (BMI) cut-off points for determining overweight and obesity in Asian populations, and considered whether population-specific cut-off points for BMI are necessary. They reviewed scientific evidence that suggests that Asian populations have different associations between BMI, percentage of body fat, and health risks than do European populations. The consultation concluded that the proportion of Asian people with a high risk of type 2 diabetes and cardiovascular disease is substantial at BMIs lower than the existing WHO cut-off point for overweight (> or =25 kg/m2). However, available data do not necessarily indicate a clear BMI cut-off point for all Asians for overweight or obesity. The cut-off point for observed risk varies from 22 kg/m2 to 25 kg/m2 in different Asian populations; for high risk it varies from 26 kg/m2 to 31 kg/m2. No attempt was made, therefore, to redefine cut-off points for each population separately. The consultation also agreed that the WHO BMI cut-off points should be retained as international classifications. The consultation identified further potential public health action points (23.0, 27.5, 32.5, and 37.5 kg/m2) along the continuum of BMI, and proposed methods by which countries could make decisions about the definitions of increased risk for their population.
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              Extended international (IOTF) body mass index cut-offs for thinness, overweight and obesity : Extended international BMI cut-offs

              The international (International Obesity Task Force; IOTF) body mass index (BMI) cut-offs are widely used to assess the prevalence of child overweight, obesity and thinness. Based on data from six countries fitted by the LMS method, they link BMI values at 18 years (16, 17, 18.5, 25 and 30 kg m(-2)) to child centiles, which are averaged across the countries. Unlike other BMI references, e.g. the World Health Organization (WHO) standard, these cut-offs cannot be expressed as centiles (e.g. 85th). To address this, we averaged the previously unpublished L, M and S curves for the six countries, and used them to derive new cut-offs defined in terms of the centiles at 18 years corresponding to each BMI value. These new cut-offs were compared with the originals, and with the WHO standard and reference, by measuring their prevalence rates based on US and Chinese data. The new cut-offs were virtually identical to the originals, giving prevalence rates differing by < 0.2% on average. The discrepancies were smaller for overweight and obesity than for thinness. The international and WHO prevalences were systematically different before/after age 5. Defining the international cut-offs in terms of the underlying LMS curves has several benefits. New cut-offs are easy to derive (e.g. BMI 35 for morbid obesity), and they can be expressed as BMI centiles (e.g. boys obesity = 98.9th centile), allowing them to be compared with other BMI references. For WHO, median BMI is relatively low in early life and high at older ages, probably due to its method of construction. © 2012 The Authors. Pediatric Obesity © 2012 International Association for the Study of Obesity.

                Author and article information

                Clin Obes
                Clin Obes
                Clinical Obesity
                Blackwell Publishing Ltd (Chichester, UK )
                02 October 2020
                : e12416
                [ 1 ] West China School of Public Health and West China Fourth Hospital Sichuan University Chengdu China
                [ 2 ] International Institute of Spatial Lifecourse Epidemiology (ISLE) Hong Kong China
                [ 3 ] Department of Epidemiology and Health Statistics, School of Public Health Southwest Medical University Luzhou China
                [ 4 ] College of Cybersecurity Sichuan University Chengdu China
                [ 5 ] Department of Land Surveying and Geo‐Informatics The Hong Kong Polytechnic University Hong Kong China
                Author notes
                [*] [* ] Correspondence

                Peng Jia, PhD, Department of Land Surveying and Geo‐Informatics, The Hong Kong Polytechnic University, Hong Kong, China

                Email: jiapengff@ 123456hotmail.com

                Author information
                © 2020 World Obesity Federation

                This article is being made freely available through PubMed Central as part of the COVID-19 public health emergency response. It can be used for unrestricted research re-use and analysis in any form or by any means with acknowledgement of the original source, for the duration of the public health emergency.

                : 14 August 2020
                : 20 August 2020
                : 22 August 2020
                Page count
                Figures: 0, Tables: 3, Pages: 7, Words: 4654
                Original Research Article
                Original Research Articles
                Custom metadata
                Converter:WILEY_ML3GV2_TO_JATSPMC version:5.9.3 mode:remove_FC converted:06.11.2020

                covid‐19,lockdown,overweight,physical activity,youth
                covid‐19, lockdown, overweight, physical activity, youth


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