Ji Cheng-ye, Sun Jun-ling, Chen Tian-jiao
Institute of Child and Adolescent Health, Peking University Health Science Center, Beijing 100083, China.
Zhonghua Liu Xing Bing Xue Za Zhi. 2004 Feb;25(2):103-8.
In order to develop strategies on prevention and cure for obesity, a study regarding dynamic analyses on the prevalence of obesity and overweight of Chinese children and adolescents was carried out.
Data of more than 980 thousands students of Han nationality, aged 7 through 18 years old were collected from National Surveys on Chinese Students' Constitution and Health which were carried out in 1985, 1991, 1995 and 2000. Samples were divided into four groups as "metropolis", "medium and small sized cities", "prosperous village" and "below-averaged village". Study targets were screened using the new criterion-the "Reference Norm for Screening Overweight and Obesity in Chinese Children and Adolescents" which was set up by the Working Group on Obesity in China. The prevalence of overweight and obesity in various groups in different years were compared and analyzed.
The prevalence rates of obesity in 1985 including from the metropolis area, were only 0.2% and 0.1% for boys and girls, and the prevalence of overweight was between 1% and 2% indicating that was no trend of obesity epidemic then. However, a rapid increase of overweight prevalence has been noticed since the early 1990s, and the increments were more seen in the urban than in the rural areas and more in boys than in girls. In the most developed cities including Beijing, the prevalence rates of obesity appeared to be 4.7%, 3.8% and 3.2%, among three groups with higher risk: the 7 - 9, 10 - 12 year-old boys and 7 - 9 year-old girls, respectively. Both high prevalence rates of malnutrition and overweight were also found in that period. Around 1995, a large scale of increments of overweight were found both in the urban and rural groups. In the most developed metropolis, the prevalence of overweight was two to three folds more than that of 10 years ago. The prevalence of obesity were 6% - 8% for boys and 4% - 6% for girls, respectively. Since 2000, most of the Chinese metropolis have started the so called 'overall increment period' of obesity. The prevalence rates of obesity plus overweight had reached 25.4%, 25.5%, 17.0% and 14.3% for boys aged 7 - 9 years and 10 - 12 years, and girls aged 7 - 9 years and 10 - 12 years, respectively. Among them, the prevalence rates of obesity were 12.9% and 9.1% for boys aged 7 - 9 and 10 - 12 years, which had already reached the average level seen in the medium-developed countries in the world. Although the increments of overweight were high, the prevalence of obesity was still low in most of the other groups: 4.8% for boys and 2.6% for girls in the "medium sized" group, 1.5% for boys and 1.7% for girls in the "prosperous village" group, and 0.9% for boys and 1.2% for girls in the "below-averaged village" group, respectively.
The prevalence of obesity in Chinese children and adolescents was considered to be still relatively low. However, the rapid increasing of both obesity and overweight, in both urban and rural areas would arouse special attention. Comprehensive strategies of intervention should include periodical monitoring, education on pattern of nutrition, oxygen-consuming physical exercises and healthy dietary behavior. Two areas on obesity prevention to protect the child from becoming overweight in early ages, and to control the tendency of obesity from overweight, should be emphasized in order to improve the health status and life quality of the Chinese children and adolescents.
为制定肥胖防治策略,开展了一项关于中国儿童青少年肥胖及超重患病率动态分析的研究。
收集了1985年、1991年、1995年和2000年全国学生体质与健康调研中98万余名7至18岁汉族学生的数据。样本分为“大城市”“中小城市”“富裕农村”和“贫困农村”四组。研究对象采用中国肥胖问题工作组制定的新的“中国儿童青少年超重、肥胖筛查体重指数值标准”进行筛查。对不同年份各群体超重和肥胖的患病率进行比较分析。
1985年,包括大城市地区在内,男孩和女孩的肥胖患病率仅分别为0.2%和0.1%,超重患病率在1%至2%之间,表明当时不存在肥胖流行趋势。然而,自20世纪90年代初以来,超重患病率迅速上升,城市地区的增幅高于农村地区,男孩高于女孩。在包括北京在内的最发达城市,肥胖患病率在三个高危群体中分别为:7至9岁男孩4.7%、10至12岁男孩3.8%、7至9岁女孩3.2%。在同一时期,还发现营养不良和超重的患病率都很高。1995年左右,城乡群体的超重患病率都出现了大幅上升。在最发达的大城市,超重患病率比10年前增加了两到三倍。男孩肥胖患病率分别为6%至8%,女孩为4%至6%。自2000年以来,中国大多数大城市开始进入肥胖的“全面上升期”。7至9岁男孩、10至12岁男孩、7至9岁女孩和10至12岁女孩的肥胖加超重患病率分别达到25.4%、25.5%、17.0%和14.3%。其中,7至9岁男孩和10至12岁男孩的肥胖患病率分别为12.9%和9.1%,已达到世界中等发达国家的平均水平。尽管超重增幅较大,但其他大多数群体的肥胖患病率仍然较低:“中等城市”组男孩为4.8%,女孩为2.6%;“富裕农村”组男孩为1.5%,女孩为1.7%;“贫困农村”组男孩为0.9%,女孩为1.2%。
中国儿童青少年肥胖患病率仍相对较低。然而,城乡肥胖和超重患病率的快速上升应引起特别关注。综合干预策略应包括定期监测、营养模式教育、有氧运动和健康饮食行为。应强调两个预防肥胖领域:一是防止儿童早期超重,二是控制超重导致的肥胖倾向,以提高中国儿童青少年的健康状况和生活质量。