Institute of Child and Adolescent Health, Peking University, Beijing, China.
Stanford Prevention Research Center, Department of Medicine, Stanford University, Stanford, CA, USA.
Int J Obes (Lond). 2019 Feb;43(2):402-411. doi: 10.1038/s41366-018-0129-7. Epub 2018 Jun 18.
We sought to examine changes in regional and sex disparities in stunting, thinness, and overweight among Chinese school-aged children from 1985 to 2014.
We analyzed data on 1,489,953 children aged 7-18 years in the Chinese National Survey on Students' Constitution and Health. Stunting, thinness, and overweight were defined according to WHO anthropomorphic definitions. After adjustment for age, socioeconomic status, and school, logistic regression was used to estimate the prevalence of stunting, thinness, and overweight by region and sex over 30 years' time.
From 1985 to 2014, the prevalence of stunting progressively decreased from 16.4% in 1985 to 2.3% in 2014, thinness prevalence also declined overtime, from 8.4 to 4.0% and overweight prevalence continually increased from 1.1% in 1985 to 20.4% in 2014 in Chinese school-aged children. Stunting and thinness were more common in rural areas, although urban/rural differences declined over time. Overweight was a greater problem in urban than rural areas, and this difference increased over time. Some provinces showed high levels of stunting, thinness, and overweight. The stunting prevalence of boys was higher than girls from 1985 and 1995, but lower than girls for the past 15 years. Thinness was consistently more common in boys than girls across regions and time. Overweight continuously increased for boys and girls; however, the increase was more rapid in boys.
Over the past 30 years, Chinese children have shifted in anthropomorphic measures indicating a shift from problems of under-nutrition to measures consistent with over-nutrition, particularly in urban areas and among boys. Some regions are burdened by problems of both under- and over-nutrition. Regional and sex-specific guidelines and public health policies for childhood nutrition are needed in China.
本研究旨在探讨 1985 年至 2014 年期间中国学龄儿童生长迟缓、消瘦和超重的区域性和性别差异变化。
我们分析了中国学生体质与健康调研中的 1489953 名 7-18 岁儿童的数据。生长迟缓、消瘦和超重的定义按照世卫组织人体测量定义。在调整年龄、社会经济地位和学校因素后，采用 logistic 回归估计 30 年来不同地区和性别的生长迟缓、消瘦和超重的流行率。
1985 年至 2014 年，生长迟缓的患病率逐渐从 1985 年的 16.4%下降到 2014 年的 2.3%，消瘦的患病率也随时间逐渐下降，从 1985 年的 8.4%下降到 2014 年的 4.0%，超重的患病率则持续上升，从 1985 年的 1.1%上升到 2014 年的 20.4%。农村地区的生长迟缓、消瘦更为常见，但城乡差异随时间逐渐缩小。超重在城市地区更为严重，且这种差异随时间逐渐增加。一些省份存在较高的生长迟缓、消瘦和超重水平。1985 年和 1995 年，男孩的生长迟缓患病率高于女孩，但过去 15 年，女孩的患病率则高于男孩。消瘦在各地区和各时间段均更为常见于男孩。超重在男孩和女孩中均持续增加，但男孩的增加速度更快。
在过去的 30 年中，中国儿童的人体测量指标发生了变化，表明营养不足的问题已从农村地区转移到城市地区，从女孩转移到男孩，营养过剩的问题越来越严重。一些地区同时面临营养不足和营养过剩的问题。中国需要制定针对儿童营养的区域性和性别特异性指南和公共卫生政策。
