Li M, Xue H, Wang W, Wen M, Wang Y
Systems-oriented Global Childhood Obesity Intervention Program, Department of Epidemiology and Environmental Health, University at Buffalo, State University of New York, Buffalo, NY, USA; Department of Sociology, University of Notre Dame, Notre Dame, IN, USA.
Department of Health Behavior and Policy, School of Medicine, Virginia Commonwealth University, USA.
Public Health. 2017 Dec;153:44-51. doi: 10.1016/j.puhe.2017.07.002. Epub 2017 Aug 24.
Given the rapid demographic transition and obesity growth in China, it is important to study how the large only-child population (≈100 million) might contribute to the obesity epidemic. This study evaluated associations of only-child status with weight and energy expenditure-related behaviors in China and examined how the associations may vary by sex and urbanicity.
Secondary analyses of nationally representative cross-sectional data from China Education Panel Survey: Junior Cohorts 2013-14, which included 19,487 students from 112 middle schools in 28 regions across China.
We used propensity-score-weighted multilevel models to test associations between only-child status and weight outcomes.
Compared with sibling-sons, only-sons had higher body mass index (BMI) (Beta = 0.32, P < 0.05) and higher risks of overweight (OR = 1.24, 95% CI = [1.07-1.45]) and obesity (OR = 1.29, 95% CI = [1.02-1.64]); and spent less time on TV watching (Incidence rate ratio (IRR) = 0.89, 95% CI = [0.81-0.98]), internet use (IRR = 0.87, 95% CI = [0.79-0.96]), after-school sports (IRR = 0.91, 95% CI = [0.83-0.99]), and household chores (IRR = 0.85, 95% CI = [0.80-0.92]). Overweight/obesity risks for only-sons were particularly pronounced in urban China, where only-sons were 36% more likely to be overweight and 43% more likely to be obese than sibling-sons. Only-daughters had a higher risk of obesity (OR = 1.43, 95% CI = [1.01-2.04]) than sibling-daughters. However, the association was not significant for either urban girls or rural girls examined separately. Only-daughters in rural areas spent less time helping with household chores (IRR = 0.88, 95% CI = [0.80-0.97]) than sibling-daughters.
Future childhood obesity interventions should pay special attention targeting the large young only-child population in China.
鉴于中国人口结构的快速转变和肥胖率的上升，研究庞大的独生子女群体（约1亿）对肥胖流行的影响具有重要意义。本研究评估了独生子女身份与中国儿童体重及能量消耗相关行为之间的关联，并探讨了这些关联在性别和城市化程度上的差异。
对中国教育追踪调查2013 - 2014初中阶段全国代表性横断面数据进行二次分析，该数据涵盖了中国28个地区112所中学的19487名学生。
我们使用倾向得分加权多级模型来检验独生子女身份与体重结果之间的关联。
与有兄弟姐妹的儿子相比，独生子女的体重指数（BMI）更高（β = 0.32，P < 0.05），超重（OR = 1.24，95%置信区间 = [1.07 - 1.45]）和肥胖风险（OR = 1.29，95%置信区间 = [1.02 - 1.64]）更高；花在看电视（发病率比（IRR） = 0.89，95%置信区间 = [0.81 - 0.98]）、上网（IRR = 0.87，95%置信区间 = [0.79 - 0.96]）、课后运动（IRR = 0.91，95%置信区间 = [0.83 - 0.99]）和家务劳动（IRR = 0.85，95%置信区间 = [0.80 - 0.92]）上的时间更少。独生子女的超重/肥胖风险在中国城市地区尤为明显，城市独生子女超重的可能性比有兄弟姐妹的儿子高36%，肥胖的可能性高43%。独生子女女儿比有兄弟姐妹的女儿肥胖风险更高（OR = 1.43，
