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    The anthropometric assessment of body composition and nutritional status in children aged 2-15 years: A cross-sectional study from three districts in Bangladesh. Kamruzzaman Md,Rahman Shah Arafat,Akter Sharmin,Shushmita Humaria,Ali Md Yunus,Billah Md Adnan,Kamal Md Sadat,Elahi M Toufiq,Paul Dipak Kumar PloS one BACKGROUND:Early life nutrition plays a critical role in the development of better health and nutrition in adulthood. However, assessing the nutritional status of Bangladeshi children and adolescents through measurement of body composition using skinfold thickness is barely studied. The current study aims to determine children's body composition and nutritional status, and contributing factors among children aged 2 to 15 years in the northern part of Bangladesh. METHODS:This is a descriptive cross-sectional study done in Bangladesh. Anthropometric methods, including multiple skinfold thickness and basic anthropometric and socio-demographic characteristics, were used. Body composition was calculated from multiple skinfold thicknesses using the standard regression equation. Nutritional status was measured using Z score according to WHO 2007 reference standard. A total of 330 children from Naogaon, Bogra and Kurigram districts in Bangladesh were examined from April 2019 to September 2019. RESULTS:The Nutritional status of 2-15 years old child is exceedingly poor in the northern part of Bangladesh. Fat mass and fat-free mass were higher among children from Kurigram district than from Bogra and Naogaon district. Body fat percentages and arm fat area were greater among female children than males. The overall prevalence of stunting, underweight and wasting was around 25%, 32% and 29%, respectively, and the rate was higher among girls and children aged 2-5 years. The average SD score for weight-for-age, height-for-age, and BMI-for-age was -1.295, -0.937 and -1.009. The median weight-for-age and height-for-age Z scores of boys and girls were below the WHO reference percentile rank. Girls were twice (OR:1.951, CI:1.150-3.331) as likely to suffer from being underweight than boys. Children who don't practice handwashing are three times (OR:3.531, CI:1.657-7.525) more likely to be underweight. Children become underweight and stunted when their family income is not sufficient to maintain their nutritional requirements. CONCLUSIONS:The children of the three northern districts had a poor nutritional status, and family income was the potential contributing factor. Therefore, interventions like the promotion of income-generating activities and integrated approaches to ensuring food diversification could be an option to address the nutritional problem of children of the three northern districts of Bangladesh. 10.1371/journal.pone.0257055
    Health policy and public health implications of obesity in China. Wang Youfa,Zhao Li,Gao Liwang,Pan An,Xue Hong The lancet. Diabetes & endocrinology China has experienced many drastic social and economic changes and shifts in people's lifestyles since the 1990s, in parallel with the fast rising prevalence of obesity. About half of adults and a fifth of children have overweight or obesity according to the Chinese criteria, making China the country with the highest number of people with overweight or obesity in the world. Assuming that observed time trends would continue in the future, we projected the prevalence of and the number of people affected by overweight and obesity by 2030, and the associated medical costs. The rising incidence of obesity and number of people affected, as well as the related health and economic consequences, place a huge burden on China's health-care system. China has made many efforts to tackle obesity, including the implementation of relevant national policies and programmes. However, these measures are inadequate for controlling the obesity epidemic. In the past decade, China has attached great importance to public health, and the Healthy China 2030 national strategy initiated in 2016 provides a historical opportunity to establish comprehensive national strategies for tackling obesity. China is well positioned to explore an effective model to overcome the obesity epidemic; however, strong commitment and leadership from central and local governments are needed, as well as active participation of all related society sectors and individual citizens. TRANSLATION: For the Chinese translation of the paper see Supplementary Materials section. 10.1016/S2213-8587(21)00118-2
    [Epidemiological characteristics of overweight and obesity in Chinese children and adolescents aged 6-17 years]. Fang H Y,Zhai Y,Zhao L Y,Yu D M,Zhang Q,Ju L H,Yu W T,Zhao W H Zhonghua liu xing bing xue za zhi = Zhonghua liuxingbingxue zazhi To analyze the prevalence rates of overweight and obesity in Chinese children and adolescents aged 6-17 years, and to provide scientific basis for the development of prevention strategies on obesity. Data was from children and adolescents aged 6-17 years in the China National Nutrition and Health Surveillance 2010-2012 program. In children aged 6 years, criteria of overweight and obesity were followed the WHO growth reference for school-aged children and adolescents. In children and adolescents aged 7-17 years, overweight and obesity were defined by sex and age specific BMI, recommended by Guidelines for prevention and control of overweight and obesity among school-age children and adolescents according to the Chinese guidelines. The overall rates on overweight and obesity were 9.6 and 6.4 among the Chinese children and adolescents aged 6-17 years, with 11.0 (12.8 for boys and 9.0 for girls) in urban and 7.7 (boys 9.7, girls 5.5) in rural areas. The rates of overweight and obesity among children and adolescents were 8.4 (boys 9.3, girls 7.4) and 5.2 (boys 6.2, girls 4.1) in the rural areas. According to the levels of household income, the overweight rates of children in high, middle and low incomes were 12.3, 10.7 and 8.2, with obesity as 8.6, 7.2 and 5.7 respectively. In 2012, the prevalence rates of overweight and obese were 9.6 and 6.4 among children and adolescents aged 6-17 years, respectively, higher in urban than in rural areas and higher boys than in girls. The prevalence rates of overweight and obesity seemed to be related to the levels of household income. 10.3760/cma.j.issn.0254-6450.2018.06.006
    [Multi-level mixed effect model study on the association between dietary environmental risk factors and obesity among Chinese children and adolescents]. Guo Chunlei,Wang Liusen,Wang Zhihong,Ouyang Yifei,Wang Huijun,Su Chang,Zhang Jiguo,Zhang Bing Wei sheng yan jiu = Journal of hygiene research OBJECTIVE:To analyze the influence of dietary environmental factors in 12 provinces of China on obesity among children and adolescents aged 7-17 in 2011. METHODS:Based on the dietary environmental and physical examination data of China Health and Nutrition Survey 2011(Multi-stage stratified cluster random sampling method, 3 day 24 hour retrospective method, individual-household-community questionnaire survey and physical examination method such as height and weight measurement were used), 1416 children and adolescents aged 7-17(male 50. 71%; the age group of 7-10 years old accounted for 43. 50%, that of 11-14 years old 37. 43%, and that of 15-17 years old 19. 07%) with complete data were selected as the research subjects, and combined with the dietary environmental data of the corresponding provinces from National Statistical Yearbook 2011, a three-level(province-community-individual) logistic mixed effect(random intercept) model was constructed to binary outcome variables of obesity or not, the effect of dietary environments on obesity in children and adolescents was analyzed, and the characteristics of risk factors were determined. RESULTS:Considering that the P values of the two-level empty model of "province-individual"and"community-individual" constructed separately were P<0. 005 and 0. 050<P<0. 100 respectively when the random effects of layering being tested, this study fitted the three-level(province-community-individual) logistic random intercept mixed effect model. The model analysis showed that after adjusting the impact of other indicators at various levels, the provincial GDP(OR=1. 00006, P=0. 001, 95% CI1. 00003-1. 00010) and the provincial per capita daily consumption of edible oil(OR=1. 18317, P<0. 001, 95% CI 1. 10054-1. 27200) were positively correlated with obesity aged 7-17. Taking the age group of 7-10 years old as the reference group, the two groups of 11-14 years old and 15-17 years old were negatively correlated with obesity, with parameter estimates of(OR=0. 59518, P=0. 049, 95% CI(0. 35465-0. 99885) and(OR=0. 13225, P<0. 001, 95% CI0. 04716-0. 37084) respectively. In addition, the estimated parameters of the logistic three-level random intercept prediction model for obesity in children and adolescents aged 7-17 years were obtained: intercept(-2. 23457, P<0. 001, 95% CI-2. 59581--1. 87334]); provincial GDP(0. 00003, P=0. 007, 95% CI 0. 00001-0. 00005); per capita edible oil intake in province(0. 10642, P<0. 001, 95% CI 0. 06365-0. 14919); taking age group 7-10 years old as a reference, the group of 11-14 years old(-0. 56777, P=0. 007, 95% CI-0. 97837--0. 15717), the group of 15-17 years old(-1. 36679, P<0. 001, 95% CI-2. 02890--0. 70469). CONCLUSION:This study suggests that in addition to individual factors, obesity of children and adolescents aged 7-17 years is also affected by the dietary environmental factors at provincial level, among which provincial GDP and per capita daily edible oil consumption have significant positive impacts. In terms of individuals, the age between 7 and 10 years before puberty is a highly risky period for childhood and adolescent obesity.
    Effect of Overweight and Obesity on High Blood Pressure in Chinese Children and Adolescents. Dong Yanhui,Jan Catherine,Zou Zhiyong,Dong Bin,Wang Zhenghe,Yang Zhaogeng,Li Yanhui,Wen Bo,Ma Yinghua,Song Yi,Ma Jun,Sawyer Susan M,Patton George C Obesity (Silver Spring, Md.) OBJECTIVE:This study aimed to compare the secular trends of high blood pressure (HBP) and the effects of overweight and obesity on HBP between Chinese ethnic minority and Han children and adolescents . METHODS:Data were collected from 224,151 Chinese ethnic minority and 664,094 Han children and adolescents aged 7 to 18 years during three successive, national cross-sectional surveys (2005, 2010, and 2014). Logistic regression and population-attributable risk analyses were used to evaluate the association between HBP and overweight and obesity. RESULTS:HBP prevalence in ethnic minorities increased from 4.8% in 2005 to 6.3% in 2014, which was significantly higher than the variable HBP trends (4.1% to 5.5%) in Han children and adolescents. Both ethnic minority and Han children and adolescents experienced a rapid increase in overweight and obesity, but the pace of growth for HBP, overweight, and obesity was faster in ethnic minorities than in their Han peers. Moreover, the effects of obesity on HBP in ethnic minorities showed a sustained increase over time but were stable for the Han. CONCLUSIONS:Higher HBP prevalence, faster obesity increases, and a stronger impact of obesity on HBP in children and adolescents of Chinese ethnic minorities predict their looming burden of HBP, which suggests that attention to the cardiovascular disease risks in children and adolescents from ethnic minorities is indicated to reduce their future adult risk. 10.1002/oby.22562
    Short duration of sleep and incidence of overweight or obesity in Chinese children and adolescents: A systematic review and meta-analysis of prospective studies. Guo Yuan,Miller Michelle A,Cappuccio Francesco P Nutrition, metabolism, and cardiovascular diseases : NMCD BACKGROUND AND AIMS:Overweight and obesity in children have become a global public health problem. Epidemiological studies suggest that sleep duration may contribute to the incidence of overweight and obesity in all stages of life. China has an increasing prevalence of overweight and obesity, and sleep deprivation is common among Chinese children. The aim of this study was to assess the prospective relationship between short sleep duration and overweight or obesity in Chinese children and to gain an estimate of the risk. METHODS AND RESULTS:A systematic search was performed on 28/04/2020 by using Medline, PubMed and Web of Science. The exposure was the duration of sleep, and the outcome measure the incidence of overweight or obesity. The odds ratios (OR) and hazard ratios (HR) and 95% confidence intervals (C.I.) were extracted to calculate the pooled relative risk (RR) by a random effect model. Heterogeneity and publication bias of the studies were checked by sensitivity analysis. Seven studies fulfilled the criteria for a systematic review, and 5 studies for a meta-analysis. The total of 33,206 participants included boys and girls, aged 6-17 years old. In Chinese children the pooled RR for short sleep duration and overweight or obesity combined was 1.47 (95% C.I. 1.26, 1.71, p < 0.00001, n = 32,607), and for obesity alone 1.40 (95% C.I. 1.01, 1.95, p = 0.04, n = 17,038). There was no significant heterogeneity or publication bias between studies. CONCLUSION:Short sleep duration is associated with the development of overweight and obesity in Chinese children. 10.1016/j.numecd.2020.11.001
    Trends in abdominal obesity among Chinese children and adolescents, 1993-2015. Ma Shujing,Hou Dongqing,Zhang Yanqing,Yang Liu,Sun Jiahong,Zhao Min,Magnussen Costan G,Xi Bo Journal of pediatric endocrinology & metabolism : JPEM OBJECTIVES:The prevalence of general overweight and obesity defined by body mass index criteria has greatly increased in Chinese children and adolescents in recent decades. However, few studies have considered the trend in abdominal obesity in Chinese children and adolescents. This study aimed to examine the secular trends in waist circumference (WC), waist-to-height ratio (WHtR) and the prevalence of abdominal obesity among Chinese children and adolescents aged 6-17 years from 1993 to 2015. METHODS:A total of 11,985 children and adolescents aged 6-17 years participated in the China Health and Nutrition Survey, a continuous cross-sectional survey, conducted from 1993 to 2015. Abdominal obesity was defined as WC≥age- and sex-specific 90th percentile based on the reference from Chinese children and adolescents or WHtR≥0.50. RESULTS:After adjustment for age, sex and region, mean WC increased from 60.27 cm in 1993 to 64.31 cm in 2015 (p for trend <0.001), and mean WHtR increased from 0.430 to 0.434 (p for trend <0.05). The prevalence of abdominal obesity defined by WC reference increased from 5.0% in 1993 to 19.3% in 2015 and defined by WHtR reference increased from 6.4% in 1993 to 14.5% in 2015 (p for trend <0.001). CONCLUSIONS:The prevalence of abdominal obesity among Chinese children and adolescents aged 6-17 years has increased between 1993 and 2015. 10.1515/jpem-2020-0461