OBJECTIVES

Childhood obesity has emerged as a significant public health challenge and there is an urgent need to improve the effectiveness of local government governance to curb its growth. We aimed to estimate the prevalence and changes of childhood overweight (including obesity) across China and its provinces from 2000 to 2019 and to project the prevalence by 2030, stratified by sex.

METHODS

This study utilized data from the Institute for Health Metrics and Evaluation (IHME), which generated local-, administrative-, and national-level estimates of overweight prevalence among children under 5 years of age at a 5 × 5 km resolution for several low- and middle-income countries (LMICs) between 2000 and 2019 using a model-based geostatistical approach. Temporal trends were analyzed by sex and region using Joinpoint Regression, while overweight prevalence in China and its provinces was projected up to 2030 using polynomial regression models.

RESULTS

Overweight prevalence among children under five years of age increased from 17.9% (95% CI: 14.9 to 21.3) in 2000 to 22.1% (95% CI: 14.9 to 30.9) in 2019, which was higher among boys than girls. Extrapolating from current growth trends, the forecast results showed approximately 25.1% (95% CI: 23.2 to 27.0) of children in China would be overweight by 2030. Only two of the 31 provinces (Shanxi and Inner Mongolia) were on track to meet China's obesity prevention and control targets by 2030. The overweight burden from 2000 to 2019 was assessed across 33 provincial-level administrative units, with the greatest burdens concentrated in northeastern China and the provinces of Hunan, Hong Kong, and Macao.

CONCLUSIONS

Childhood obesity in China has become a major public health problem with a steadily rising prevalence. This study underscores the urgent need for evidence-based policy and clinical interventions to stem the tide of obesity in Chinese preschool children.