Systems-Oriented Global Childhood Obesity Intervention Program, Fisher Institute of Health and Well-Being, College of Health, Ball State University, Muncie, Indiana, USA.
Community and Behavioral Health Promotion, Joseph J. Zilber School of Public Health, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin, USA.
Obesity (Silver Spring). 2018 Nov;26(11):1777-1784. doi: 10.1002/oby.22310. Epub 2018 Oct 3.
This study examined secular trends in children's weight-status assessment, measured weight status, and ideal body image and their associations with subsequent changes in BMI, and it explored the differences between sociodemographic groups in China.
Longitudinal data from the China Health and Nutrition Survey of 4,605 children aged 6 to 17 collected between 2000 and 2011 were used and fitted to mixed models.
From 2000 to 2011, overweight/obesity prevalence increased from 6.5% to 16.8%, but the percentage of children with self-perceived weight status as "fat" remained around 2.0%; 49.0% of children underestimated their weight status at baseline. Self-perceived body image of most participants was tracked during follow-up. Children who perceived themselves as being fat at baseline had a higher BMI increase over time during follow-up than those with an average body image (β [SE] = 0.99 [0.14] kg/m per year, P < 0.001). Boys, young children, recent cohorts, and rural children had higher BMI increases than their counterparts. Over time, the thin-body silhouette became more desirable (8.4 percentage points higher, P < 0.001).
Chinese children experience a large incongruence between their weight-status assessment, ideal body image, and actual weight status. Health promotion programs should examine their role in assisting children in developing a healthy body image and gaining greater self-motivation toward promoting a healthy lifestyle.
本研究旨在考察儿童体重状况评估、体重状况测量和理想体型的长期变化趋势，及其与 BMI 变化的相关性，并探讨中国不同社会人口群体之间的差异。
本研究使用了 2000 年至 2011 年间中国健康与营养调查（CHNS）中 4605 名 6 至 17 岁儿童的纵向数据，并采用混合模型进行拟合。
从 2000 年到 2011 年，超重/肥胖的患病率从 6.5%上升到 16.8%，但自认为“胖”的儿童比例仍维持在 2.0%左右；49.0%的儿童在基线时低估了自己的体重状况。大多数参与者在随访期间跟踪了他们的自我体型感知。与体型正常的儿童相比，基线时自我感觉肥胖的儿童在随访期间 BMI 增长更高（β[SE] = 0.99 [0.14] kg/m 每 1 年，P < 0.001）。男孩、年幼儿童、近期队列和农村儿童的 BMI 增长高于同龄人。随着时间的推移，瘦体型的轮廓变得更受欢迎（高 8.4 个百分点，P < 0.001）。
中国儿童在体重状况评估、理想体型和实际体重状况之间存在较大的不一致性。健康促进项目应研究其在帮助儿童形成健康体型和增强促进健康生活方式的自我激励方面的作用。
