Fu Qiang, George Linda K
Department of Sociology, The University of British Columbia, Vancouver, BC, Canada.
Department of Sociology, Duke University, Durham, NC, USA.
Asian Popul Stud. 2015;11(2):134-148. doi: 10.1080/17441730.2015.1038873. Epub 2015 May 29.
Using a longitudinal dataset from the China Health and Nutrition Survey (CHNS), growth curve models were employed to examine age trajectories of BMI for 1,694 subjects who were aged 2-11 in 1993 and followed in four waves (1997, 2000, 2004 and 2006). Based on age- and sex-specific BMI cut-points recommended for international use, the prevalence rates of overweight and underweight in the transition from childhood to adulthood (age 6-18) were also predicted. Sex, family income, rural-urban residency and geographical location were found to be significantly associated with the onsets, slopes, and acceleration of age trajectories in BMI, overweight, and underweight (P<0.01). Children who had lower prevalence of underweight in the transition from childhood to adulthood exhibited higher prevalence of overweight than their counterparts did. Moreover, the age interval during which children were more vulnerable to an increase in underweight was different from that for overweight. There were substantial regional disparities in the age trajectories of childhood overweight and underweight. Whereas the analyses suggest that the dual burden of nutritional problems (the coexistence of overweight and underweight) in China is more like two sides of a coin than two separate health issues, the critical age period for intervening in childhood overweight is different from that of childhood underweight. Geographical indicators of childhood obesity in China deserve further attention.
利用中国健康与营养调查（CHNS）的纵向数据集，采用生长曲线模型研究了1993年年龄在2至11岁且随访了四个阶段（1997年、2000年、2004年和2006年）的1694名受试者的体重指数（BMI）随年龄的变化轨迹。基于国际推荐的按年龄和性别划分的BMI切点，还预测了从儿童期到成年期（6至18岁）超重和体重不足的患病率。研究发现，性别、家庭收入、城乡居住情况和地理位置与BMI、超重和体重不足的年龄变化轨迹的起始点、斜率和加速度显著相关（P<0.01）。在从儿童期到成年期体重不足患病率较低的儿童，其超重患病率高于同龄人。此外，儿童体重不足增加更易发生的年龄区间与超重的不同。儿童超重和体重不足的年龄变化轨迹存在显著的地区差异。尽管分析表明，中国营养问题的双重负担（超重和体重不足并存）更像是一枚硬币的两面，而非两个独立的健康问题，但干预儿童超重的关键年龄期与儿童体重不足的不同。中国儿童肥胖的地理指标值得进一步关注。
