Family and Neighborhood Correlates of Overweight and Obesogenic Behaviors Among Chinese Children
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The prevalence of childhood obesity is increasing rapidly in China. However, research on its modifiable environmental determinants to inform preventive interventions is limited.
This paper reports a cross-sectional study that aimed to identify family and neighborhood environmental correlates of overweight and related health behavior among Chinese primary school-aged children in urban areas.
Routinely collected height and weight data of third year students (8–10 years) from four primary schools in socioeconomically distinct districts of two southern cities of China was obtained. Using the WHO 2007 reference values, children were categorized into overweight/obese or non-overweight. Parents of the same children completed a questionnaire, comprising mainly validated questions, about family and perceived neighborhood environments, parental physical activity habits, and the child's dietary and physical activity patterns. Multiple logistic regression analysis was performed to examine the association between these environmental factors and childhood overweight or whether or not the child engages in at least 1 h daily moderate to vigorous physical activity. Multiple linear regression analysis was undertaken to examine the association between environmental factors and the frequency of consumption of unhealthy snacks, fruit, and vegetables in children.
Data on 497 children were available. Children who were mainly cared for by their grandparents were over twice as likely to be overweight/obese (adjusted OR 2.03; 95 % CI 1.19–3.47) and to have higher consumption of unhealthy snacks and sugar-added drinks (B = 2.13, 95 % CI 0.87–3.40), compared with children who were mainly cared for by their parents or other adult. Children who lived with at least two grandparents in the household were at higher risk for being overweight/obese than children who lived without any grandparent (adjusted OR 1.72; 95 % CI 1.00–2.94). No evidence was found for associations between perceived neighborhood environmental characteristics and child's weight status and obesogenic behaviors in this study.
Children's family environment, particularly the living-in grandparents, should be targeted in future preventive interventions among China's southern urban populations.
KeywordsChildhood obesity China Diet Physical activity Environment Grandparents
We would like to thank the staff at the Unit of School Health and Hygiene (Guangzhou Education Bureau) and Hechi City Government for their support in the study's data collection in China. Our sincere thanks also go to all the participants (e.g., children, family members, and school staff) in Guangzhou and Hechi cities, for their time and cooperation.
- 4.Zhai FY, Ge KY, Jin SG. Summary report of China Health and Nutrition Survey. J Hyg Res. 1996;22:16–25.Google Scholar
- 5.Yu D, Zhang B, Zhao L. Snacks consumption in Chinese children and adolescents at the ages of 3–17 years. Chin J Healthc Res. 2008;37:710–3.Google Scholar
- 9.Yuan P, Luo L. Meta-analysis of risk factor on simple obesity of children under age 14 in China. Chin J Child Health Care. 2002;10:161–3.Google Scholar
- 10.Jing R, Han LT, Liu XD, Li L, Li XY, Yang SX. Meta-analysis of risk factors of childhood simple obesity among school age children in China. Chin J Hosp Stat. 2008;15:307–9.Google Scholar
- 11.Lin R, Du L, Liu WJ, Lin L, Wu JG, Liu W, et al. Influencing factors of overweight and obesity among children in Guangzhou urban district. Chin J Child Health Care. 2011;19:409–11.Google Scholar
- 18.Birch LL. Effects of peer models' food choices and eating behaviors on preschoolers' food preferences. Child Dev. 1980;51:489–96.Google Scholar
- 26.Fulkerson JA, Farbakhsh K, Lytle L, Hearst MO, Dengel DR, Pasch KE, et al. Away-from-home family dinner sources and associations with weight status, body composition, and related biomarkers of chronic disease among adolescents and their parents. J Am Diet Assoc. 2011;111:1892–7.PubMedCentralPubMedCrossRefGoogle Scholar
- 51.Godin G, Shephard RJ: Godin Leisure-Time Exercise Questionnaire. Med Sci Sports Exerc. 1997; S36-S38.Google Scholar
- 53.World Health Organization. Growth reference data for 5–19 years. Geneva: WHO Reference 2007; 2007.Google Scholar
- 54.Group of China Obesity Task Force: Body mass index reference norm for screening overweight and obesity in Chinese children and adolescents. Chin J Epidemiol. 2004; 97-102.Google Scholar
- 56.Jiang JX, Xia XL, Cui SZ, Song QS, Yuan QL. Influence of grandparents on eating behaviors of young children in Chinese three-generation families. Chin J Child Health Care. 2006;14:46–8.Google Scholar
- 57.Li Bai: Childhood Obesity Prevention In China: A Mixed-Methods Approach To Inform Development Of Theoretically Based Interventions. PhD Thesis. University of Birmingham; 2013.Google Scholar
- 60.Zhang J, Seo DC, Kolbe L, Middlestadt S, Zhao WH: Associated Trends in Sedentary Behavior and BMI Among Chinese School Children and Adolescents in Seven Diverse Chinese Provinces. Int J Behav Med. 2011; 1-9.Google Scholar