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      The Neighborhood Food Environment and the Onset of Child-Hood Obesity: A Retrospective Time-Trend Study in a Mid-sized City in China

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          Abstract

          Nowadays, obesity and its associated chronic diseases have become a steadily growing public health problem, spreading from the older to younger age groups. Studies have contended that the built environment, particularly the food environment and walkability, may contribute to the prevalence of childhood obesity. In Asian countries which are characterized by rapid urbanization, high population density and oriental diets, little is known about how such urban built environment affects the onset of childhood obesity. This study juxtaposes the effect of food environment, walkability, and outdoor activity spaces at the neighborhood level upon childhood body weight in a mid-sized city in China. This observational study utilizes a retrospective time-trend study design to examine the associations between neighborhood built environment and children's body weight in Zhanjiang City, a mid-sized city in Guangdong Province, China. Robust multiple linear and logistic regression models were used to estimate associations between the built environments and child BMI and weight status (i.e., overweight/obesity and obesity only). This study finds that: (1) Western-style fast food and Chinese-style fast food have divergent impacts on childhood body weight. At neighborhood level, while increased exposure to Western-style fast food may increase child BMI and the risk of overweight and obesity, increased exposure to Chinese-style fast food, on the contrary, may reduce child BMI and the risk of overweight and obesity, indicating a positive health impact of Chinese-style fast food. (2) However, the positive health impacts brought about by Chinese-style fast food, walkable environments and accessible traditional fruit/vegetable markets have gradually disappeared in recent years. This study is among the first to simultaneously consider the divergent and changing impact of food environment upon childhood body weight in urban China. The findings provide important implications for healthy city design and the management of food retail industry in addressing the obesity epidemic in younger generations living in Asian cities. As prominent differences exist in food culture between Asian and Western cities, more attention should be paid to healthy food environment in future studies and related urban planning strategies formulation.

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          Most cited references42

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          Predicting adult obesity from childhood obesity: a systematic review and meta-analysis.

          A systematic review and meta-analysis was performed to investigate the ability of simple measures of childhood obesity such as body mass index (BMI) to predict future obesity in adolescence and adulthood. Large cohort studies, which measured obesity both in childhood and in later adolescence or adulthood, using any recognized measure of obesity were sought. Study quality was assessed. Studies were pooled using diagnostic meta-analysis methods. Fifteen prospective cohort studies were included in the meta-analysis. BMI was the only measure of obesity reported in any study, with 200,777 participants followed up. Obese children and adolescents were around five times more likely to be obese in adulthood than those who were not obese. Around 55% of obese children go on to be obese in adolescence, around 80% of obese adolescents will still be obese in adulthood and around 70% will be obese over age 30. Therefore, action to reduce and prevent obesity in these adolescents is needed. However, 70% of obese adults were not obese in childhood or adolescence, so targeting obesity reduction solely at obese or overweight children needs to be considered carefully as this may not substantially reduce the overall burden of adult obesity.
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            Multiple Inference and Gender Differences in the Effects of Early Intervention: A Reevaluation of the Abecedarian, Perry Preschool, and Early Training Projects

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                Author and article information

                Contributors
                Journal
                Front Public Health
                Front Public Health
                Front. Public Health
                Frontiers in Public Health
                Frontiers Media S.A.
                2296-2565
                26 July 2021
                2021
                : 9
                : 688767
                Affiliations
                [1] 1School of Architecture, Harbin Institute of Technology (Shenzhen) , Shenzhen, China
                [2] 2Shenzhen Key Laboratory of Urban Planning and Decision Making, Harbin Institute of Technology (Shenzhen) , Shenzhen, China
                Author notes

                Edited by: Elodie Faure, INSERM U1018 Centre de Recherche en Épidémiologie et Santé des Populations (CESP), France

                Reviewed by: Erica Ponzi, University of Oslo, Norway; Folarin Owagboriaye, Olabisi Onabanjo University, Nigeria; Inge Huybrechts, International Agency For Research On Cancer (IARC), France

                *Correspondence: Kun Liu liuk@ 123456hit.edu.cn

                This article was submitted to Environmental health and Exposome, a section of the journal Frontiers in Public Health

                Article
                10.3389/fpubh.2021.688767
                8350029
                34381750
                edfc1b97-5415-4fc6-8c71-87211a87540a
                Copyright © 2021 Zhou, Li and Liu.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                : 31 March 2021
                : 30 June 2021
                Page count
                Figures: 1, Tables: 4, Equations: 0, References: 49, Pages: 15, Words: 10186
                Categories
                Public Health
                Original Research

                childhood obesity,built environment,neighborhood,food environment,china

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