Systems-oriented Global Childhood Obesity Intervention Program, Fisher Institute of Health and Well-being, College of Health, Ball State University, USA; Systems-oriented Global Childhood Obesity Intervention Program, Department of Epidemiology and Environmental Health, University at Buffalo, State University of New York, Buffalo, NY, USA.
Wagner School of Public Service, New York University, USA; Systems-oriented Global Childhood Obesity Intervention Program, Department of Epidemiology and Environmental Health, University at Buffalo, State University of New York, Buffalo, NY, USA.
Prev Med. 2017 Oct;103:8-13. doi: 10.1016/j.ypmed.2017.07.018. Epub 2017 Jul 21.
China's one-child policy (1979-2015) has affected Chinese parenting practices and children's health behaviors and also may have contributed to increased childhood obesity. However, very limited research has investigated the association between one-child policy and childhood obesity. We examined characteristics of single-child families and the influence of one-child policy (indicated by single-child status) on children's weight status and related health behaviors. Data from children aged 6-18years old in the 2011 (n=1580) and 2000 (n=2317) China Health and Nutrition Survey were cross-sectionally analyzed with multilevel models. From 2000 to 2011, the rates about doubled for being a single-child (30.1% to 57.0%) and being overweight or obese (OWB, 6.6% to 16.5%) along with urbanization (27.5% to 37.1%). Single-child families had higher levels of parental education, household income and urban residence than families with ≥ two children (p<0.05). Compared to the children with siblings, single children were more likely to be OWB; the association became stronger over time (OR=4.5 (1.7-12.4) in 2011 and 1.7 (1.0-2.8) in 2000). Also, single children had less recreational screen time, but similar physical activity levels; however single urban children were more likely to have excess total energy intake (OR=5.70 (1.58-20.60)) than those with siblings. Being single-child is about four times more likely to be overweight/obesity than those having siblings, and the association became stronger over time in China. China's one-child policy might have contributed to its rising childhood obesity rates. Obesity intervention programs may need to account for the influence of the one-child policy in China.
中国的独生子女政策（1979-2015 年）影响了中国父母的育儿方式和儿童的健康行为，也可能导致儿童肥胖率上升。然而，关于独生子女政策与儿童肥胖之间的关联，研究非常有限。本研究旨在探讨独生子女家庭的特征以及独生子女政策（以独生子女身份表示）对儿童体重状况和相关健康行为的影响。本研究使用多水平模型对 2011 年（n=1580）和 2000 年（n=2317）中国健康与营养调查中 6-18 岁儿童的数据进行了横断面分析。从 2000 年到 2011 年，独生子女（30.1%至 57.0%）和超重或肥胖（OWB，6.6%至 16.5%）以及城市化（27.5%至 37.1%）的比例几乎翻了一番。与有≥两个孩子的家庭相比，独生子女家庭的父母受教育程度、家庭收入和城镇居住水平更高（p<0.05）。与有兄弟姐妹的儿童相比，独生子女更有可能超重/肥胖；这种关联随着时间的推移而增强（2011 年的比值比[OR]为 4.5（1.7-12.4），2000 年的 OR 为 1.7（1.0-2.8））。此外，独生子女的娱乐屏幕时间较少，但体育活动水平相似；然而，与有兄弟姐妹的儿童相比，城市独生儿童摄入的总能量过多的可能性更大（OR=5.70（1.58-20.60））。与有兄弟姐妹的儿童相比，独生子女超重/肥胖的可能性高出约四倍，而且这种关联随着时间的推移在中国变得更强。中国的独生子女政策可能导致其儿童肥胖率上升。肥胖干预计划可能需要考虑中国独生子女政策的影响。
