Overweight, obesity, and screen-time viewing among Chinese school-aged children: National prevalence estimates from the 2016 Physical Activity and Fitness in China-The Youth Study

Yujun Cai, Xihe Zhu, Xueping Wu, Yujun Cai, Xihe Zhu, Xueping Wu

Abstract

Purpose: This study presents the most recent estimates of prevalence of overweight, obesity, and screen-time viewing among Chinese school-aged children. Demographic differences in these estimates between sexes and resident locales were also examined.

Methods: Cross-sectional analyses of 116,615 Chinese school children 9 to 17 years of age who participated in the 2016 Physical Activity and Fitness in China-The Youth Study project. Outcomes were the prevalence of children's overweight (85th ≤ body mass index (BMI) < 95th percentile) and obesity (BMI ≥95th percentile) (defined by the Working Group on Obesity in China) and not meeting screen-time viewing recommendations ("not meeting" was defined as more than 2 h per day of viewing activities after school). Analyses were conducted on the whole sample and by school grade cohorts (primary, junior middle, and junior high schools), sex, and residence locales (urban, rural).

Results: Overall, 14.4% (95% confidence interval (CI): 13.8%-15.0%) of children and adolescents were overweight, 11.9% (95%CI: 11.0%-13.0%) were obese, and 36.8% (95%CI: 34.7%-38.9%) did not meet screen-time viewing recommendations. Across the 3-grade cohorts, boys were more likely to be obese than girls, and primary and junior middle school children living in urban areas were more likely to be obese than those living in rural areas. Primary and junior middle school boys were less likely to meet screen-time recommendations than girls, and junior high school children living in urban areas were less likely to meet screen-time recommendations than school children of the same grades living in rural areas.

Conclusion: In 2016, the prevalence of obesity among Chinese school children was about 12%, and about 37% of them did not meet screen-time viewing recommendations. The prevalence of obesity and sedentary behavior was generally higher among boys than among girls, and it was higher for children living in urban areas than for those living in rural areas.

Keywords: Physical inactivity; Sedentary behavior; Unhealthy lifestyle; Weight status.

References

    1. Hills A.P., Andersen L.B., Byren N.M. Physical activity and obesity in children. Br J Sports Med. 2011;45:866–870.
    1. Karnik S., Kanekar A. Childhood obesity: a global public health crisis. Int J Prev Med. 2012;3:1–7.
    1. U.S. Centers for Disease Control and Prevention Childhood obesity facts. 2017. Available at: accessed 21.07.2017.
    1. Duan J., Hu H., Wang G., Arao T. Study on current levels of physical activity and sedentary behavior among middle school students in Beijing, China. PLoS One. 2015;10:1371–1383.
    1. Cui Z., Hardy L.L., Dibbley M.J., Bauman A. Temporal trends and recent correlates in sedentary behaviors in Chinese children. Int J Behav Nutr Phys Act. 2011;8:93.
    1. Sun H., Ma Y., Han D., Pan C.W., Xu Y. Prevalence and trends in obesity among China's children and adolescents, 1985–2010. PLoS One. 2014;9 e105469.
    1. Zhai L., Dong Y., Bai Y., Wei W., Jia L. Trends in obesity, overweight, and malnutrition among children and adolescents in Shenyang, China in 2010 and 2014: a multiple cross-sectional study. BMC Public Health. 2017;17:151.
    1. Wang Y., Monterio C., Popkin B.M. Trends of obesity and underweight in older children and adolescents in the United States, Brazil, China, and Russia. Am J Clin Nutr. 2002;75:971–977.
    1. Zong X.N., Li H. Physical growth of children and adolescents in China over the past 35 years. Bull World Health Organ. 2014;92:555–564.
    1. Yu Z., Han S., Chu J., Xu Z., Zhu C., Guo X. Trends in overweight and obesity among children and adolescents in China from 1981 to 2010: a meta-analysis. PLoS One. 2012;7 e51949.
    1. Gordon-Larsen P., Wang H., Popkin B.M. Overweight dynamics in Chinese children and adults. Obes Res. 2014;1:37–48.
    1. Hardy L.L., Dobbins T.A., Denney-Wilson E.A., Okely A.D., Booth M.L. Sedentariness, small-screen recreation, and fitness in youth. Am J Prev Med. 2009;36:120–125.
    1. Hardy L.L., Denney-Wilson E., Thrift A.P., Okely A.D., Baur L.A. Screen time and metabolic risk factors among adolescents. Arch Pediatr Adolesc Med. 2010;164:643–649.
    1. Nelson M.C., Neumark-Stzainer D., Hannan P.J., Sirard J.R., Story M. Longitudinal and secular trends in physical activity and sedentary behavior during adolescence. Pediatrics. 2006;118:e1627–34.
    1. Sabo R.T., Lu Z., Daniels S., Sun S.S. Serial childhood BMI and associations with adult hypertension and obesity: the Fels Longitudinal Study. Obesity (Silver Spring) 2012;20:1741–1743.
    1. Central Committee of the Communist Party of China, State Council of China Healthy China 2030 Blueprint Guide. 2016. Available at: accessed 03.08.2017.
    1. Fan X., Cao Z.B. Physical activity among Chinese school-aged children: national prevalence estimates from the 2016 Physical Activity and Fitness in China—The Youth Study. J Sport Health Sci. 2017;6:388–394.
    1. Ji C. BMI screening standards of overweight and obesity in Chinese students. Chin J School Health. 2004;25:125–128. in Chinese.
    1. Liu Y., Tang Y., Cao Z.B., Chen P.J., Zhang J.L., Zhu Z. Results from Shanghai's (China) 2016 Report Card on Physical Activity for Children and Youth. J Phys Act Health. 2016;13(Suppl. 2):S124–8.
    1. Tremblay M.S., Leblanc A.G., Janssen I., Kho M.E., Hicks A., Murumets K. Canadian sedentary behavior guidelines for children and youth. Appl Physiol Nutr Metab. 2011;36:59–64.
    1. Song Y., Wang H.J., Ma J., Wang Z. Secular trends of obesity prevalence in urban Chinese children from 1985 to 2010: Gender disparity. PLoS One. 2013;8 e53069.
    1. Ogden C.L., Carroll M.D., Kit B.K., Flegal K.M. Prevalence of obesity and trends in body mass index among US children and adolescents, 1999–2010. JAMA. 2012;307:483–490.
    1. Ogden C.L., Connor G.S., Vivera Dommarco J., Carroll M.D., Shields M., Flegal K.M. The epidemiology of childhood obesity in Canada, Mexico and the United States. In: Moreno L., Pigeot I., Ahrens W., editors. Epidemiology of obesity in children and adolescents—prevalence and etiology. Springer; New York, NY: 2010.
    1. Jiang X.X., Hardy L.L., Ding D., Baur L.A., Shi H.J. Recreational screen-time among Chinese adolescents: a cross-sectional study. J Epidemiol. 2014;24:397–403.
    1. Fakhouri T.H., Hughes J.P., Brody D.J., Kit B.K., Ogden C.L. Physical activity and screen-time viewing among elementary school-aged children in the United States from 2009 to 2010. JAMA Pediatr. 2013;167:223–229.
    1. Pate R.R., Mitchell J.A., Byun W., Dowda M. Sedentary behavior in youth. Br J Sports Med. 2011;45:906–913.
    1. Xiao Y., Qiao Y., Pan L., Liu J., Zhang T., Li N. Trends in the prevalence of overweight and obesity among Chinese preschool children from 2006 to 2014. PLoS One. 2015;10 e0134466.
    1. Tian Y., Jiang C., Wang M., Cai R., Zhang Y., He Z. BMI, leisure-time physical activity, and physical fitness in adults in China: results from a series of national surveys 2000–14. Lancet Diabetes Endocrinol. 2016;6:487–497.
    1. Kuczmarski R.J., Ogden C.L., Guo S.S., Grummer-Strawn L.M., Flegal K.M., Mei Z. 2000 CDC Growth Charts for the United States: methods and development. Vital Health Stat. 2002;11:1–190.
    1. World Health Organization Growth reference data for 5–19 years. 2006. Available at: accessed 23.07.2017.
    1. WHO Multicentre Growth Reference Study Group . World Health Organization; Geneva: 2006. WHO child growth standards: length/height-for-age, weight-for-age, weight-for-length, weight-for-height and body mass index-for-age: methods and development.

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