Li Hongai, Xiang Wei, Yi Yajun, Huang Xiaoyan, Luo Hailing, Cai Yuhua, Liu Li, Li Haidan, Huang Yan, Luo Qing, Fan Lichun, Lin Qiuyu
Department of Pediatrics, Hainan Women and Children's Medical Center (Children's Hospital Affiliated to Hainan Medical University), Haikou, 570206, People's Republic of China.
National Health Commission (NHC) Key Laboratory of Control of Tropical Diseases, Hainan Medical University, Haikou, 571199, People's Republic of China.
Diabetes Metab Syndr Obes. 2025 May 29;18:1809-1822. doi: 10.2147/DMSO.S493135. eCollection 2025.
To evaluate the epidemiological landscape and identify the risk factors associated with overweight and obesity in early childhood in China.
We collected measurements of weight and height and calculated the body mass index (BMI) for preschool children. The overweight and obesity status of children aged 2 to 6 years was examined using the 2005 China BMI growth chart. WHO weight-for-length (WFL) charts were used to identify those at risk for early childhood overweight. Data on potential risk factors for childhood overweight/obesity were obtained through questionnaires. Multiple logistic regression analyses were conducted to determine the association between risk factors and overweight/obesity.
Among the 13,896 participants, 7.5% of infants and toddlers were overweight, 18.4% of preschoolers were overweight, and 10.3% of preschoolers were obese. The prevalence of obesity among preschool boys (12.6%) was significantly greater than that among preschool girls (7.7%, p<0.001). Our analysis identified nine risk factors significantly associated with an increased risk of early childhood overweight or obesity. These include guardian status, paternal height, frequency of weekly candy consumption, maternal weight, leg circumference, waist circumference, age at the onset of overweight, age group, and maternal education level. In addition, children born to overweight mothers had a 1.02-fold higher likelihood of being overweight/obese compared to children with mothers of normal weight (95% confidence interval: 1.00-1.03; p=0.0106). Upon adjustment for all potentially confounding variables, the odds ratios for the frequency of weekly candy consumption in children were negatively linked to overweight/obesity (0.98; 95% confidence interval: 0.96-1.00). In addition, gender-dietary habit interactions significantly influenced the risk of overweight/obesity in both positive and negative directions.
Our research on the prevalence and predictors of overweight/obesity in preschool children underscores the importance of recognizing and understanding early childhood obesity within its context. Obesity prevention efforts should target key risk factors, such as parental obesity and unhealthy early childhood lifestyles.
评估中国幼儿超重和肥胖的流行病学情况，并确定与之相关的风险因素。
我们收集了学龄前儿童的体重和身高测量数据，并计算了体重指数（BMI）。使用2005年中国BMI生长曲线来检查2至6岁儿童的超重和肥胖状况。采用世界卫生组织身长别体重（WFL）曲线来确定有幼儿期超重风险的儿童。通过问卷调查获取儿童超重/肥胖潜在风险因素的数据。进行多因素逻辑回归分析以确定风险因素与超重/肥胖之间的关联。
在13896名参与者中，婴幼儿超重率为7.5%，学龄前儿童超重率为18.4%，学龄前儿童肥胖率为10.3%。学龄前男孩的肥胖率（12.6%）显著高于学龄前女孩（7.7%，p<0.001）。我们的分析确定了九个与幼儿期超重或肥胖风险增加显著相关 的风险因素。这些因素包括监护人状况、父亲身高、每周食用糖果的频率、母亲体重、腿围、腰围、超重起始年龄、年龄组和母亲教育水平。此外，母亲超重的儿童超重/肥胖的可能性比母亲体重正常的儿童高1.02倍（95%置信区间：1.00-1.03；p=0.0106）。在对所有潜在混杂变量进行调整后，儿童每周食用糖果频率的优势比与超重/肥胖呈负相关（0.98；95%置信区间：0.96-1.00）。此外，性别-饮食习惯相互作用在正反两个方向上均显著影响超重/肥胖风险。
我们对学龄前儿童超重/肥胖患病率及预测因素的研究强调了在其背景下认识和理解幼儿肥胖的重要性。肥胖预防工作应针对关键风险因素，如父母肥胖和不健康的幼儿生活方式。
