Wu Wei-Jia, Chen Ping-Hao, Huang Zhen-Ning, Lei Xue-Lu, Wang Chen, Zhang Chun-Hui, Wang Ping, Huang Chui-Can, Luo Qing, Fan Li-Chun
Hainan Women and Children's Medical Center, Hainan Medical University, Hainan Academy of Medical Sciences, Haikou, China.
School of Pediatrics, Hainan Medical University, Haikou, China.
Front Pediatr. 2025 Jan 7;12:1476231. doi: 10.3389/fped.2024.1476231. eCollection 2024.
Childhood obesity leads to significant health risks, emphasizing the critical need for effective preventive measures during the preschool years. However, there is a lack of comprehensive studies on overweight and obesity among preschool children in Hainan Island, China's largest free-trade zone. Our study assessed the prevalence of overweight and obesity among preschool children across Hainan Island using Chinese, World Health Organization (WHO), and International Obesity Task Force (IOTF) criteria. Additionally, the potential factors influencing overweight and obesity among preschool children in Hainan Island were further explored.
We conducted a cross-sectional survey of children aged 3-6 years covering 18 cities and counties in China's largest free trade zone. The survey primarily involved anthropometric data collection and questionnaires on children's information and the sociodemographic characteristics of their parents or guardians. We recorded the height and weight of each child and calculated their body mass index (BMI). The z-score for BMI-for-age was calculated using the WHO-recommended Anthro and AnthroPlus software, and diagnoses of overweight and obesity were determined separately according to the Chinese, WHO, and IOTF criteria. The chi-squared test, -test, or rank-sum test was applied to describe and statistically analyze the baseline characteristics of the participating children. Additionally, potential factors affecting overweight and obesity were analyzed using a multifactor binary logistic regression model.
The prevalence of overweight and obesity among preschool children in Hainan Island was 11.30% based on the Chinese criteria, significantly higher than the rates of 5.80% and 5.40% observed according to the WHO and IOTF criteria, respectively ( = 12,870.368, 0.001). After multifactorial adjusted analyses, we found that according to the three growth criteria, having overweight fathers or mothers, family incomes of more than 100,000 Yuan, fully active eating, and higher birth weights increased the risk of overweight and obesity among preschool children in Hainan Island.
The prevalence of overweight and obesity among preschool children in Hainan Island was lower compared to rates reported in other regions. Considering that the growth and development indicators for children under 7 years old in Hainan Island are generally lower than international standards, the use of Chinese standards may be more suitable for detecting overweight and obesity among preschool children in this area. Based on the risk factors identified in this study, preventive measures can be targeted in the future to reduce the risk of overweight and obesity in preschool children in Hainan Island.
儿童肥胖会带来重大健康风险，这凸显了在学龄前采取有效预防措施的迫切需求。然而，在中国最大的自由贸易区海南岛，针对学龄前儿童超重和肥胖的综合研究较为缺乏。我们的研究采用中国、世界卫生组织（WHO）和国际肥胖特别工作组（IOTF）的标准，评估了海南岛学龄前儿童超重和肥胖的患病率。此外，还进一步探讨了影响海南岛学龄前儿童超重和肥胖的潜在因素。
我们对中国最大自由贸易区内18个市县的3至6岁儿童进行了横断面调查。该调查主要包括人体测量数据收集以及关于儿童信息及其父母或监护人社会人口学特征的问卷调查。我们记录了每个孩子的身高和体重，并计算其体重指数（BMI）。使用WHO推荐的Anthro和AnthroPlus软件计算年龄别BMI的z评分，并分别根据中国、WHO和IOTF的标准确定超重和肥胖的诊断。应用卡方检验、t检验或秩和检验来描述和统计分析参与儿童的基线特征。此外，使用多因素二元逻辑回归模型分析影响超重和肥胖的潜在因素。
根据中国标准，海南岛学龄前儿童超重和肥胖的患病率为11.30%，显著高于分别按照WHO和IOTF标准观察到的5.80%和5.40%的患病率（χ² = 12870.368，P < 0.001）。经过多因素调整分析，我们发现，根据这三种生长标准，父亲或母亲超重、家庭收入超过10万元、饮食完全规律以及出生体重较高会增加海南岛学龄前儿童超重和肥胖的风险。
与其他地区报告的患病率相比，海南岛学龄前儿童超重和肥胖的患病率较低。鉴于海南岛7岁以下儿童的生长发育指标普遍低于国际标准，使用中国标准可能更适合检测该地区学龄前儿童的超重和肥胖情况。基于本研究确定的风险因素，未来可以针对性地采取预防措施，以降低海南岛学龄前儿童超重和肥胖的风险。
