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Report on childhood obesity in china (4) Prevalence and Trends of Overweight and obesity in Chinese Urban School-age Children and Adolescents, 1985-2000

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Biomedical and Environmental Sciences 2007年第1期20卷 1-10页

作者： CHENG-YE JI 无 Institute of Child and Adolescent Health Peking Medical University Health Science Center 38 Xueyuan Road Beijing 100083 China cooperative study on childhood obesity： working group on obesity in china （wgoc）

Objective To describe the nationwide prevalence of childhood overweight/obesity, and their group variations and trends over the past 20 years in the Chinese urban population. Methods Data sets of boys and girls at the age of 7-18 years collected from the series of Chinese national surveillance on students＇ constitution and health （CNSSCH） between 1985 and 2000 were divided into five socioeconomic and demographic groups, while BMI classification reference proposed by working group on obesity in china （wgoc） was used as screening reference to calculate the prevalence and trends of overweight/obesity in these groups. Results In 2000, the prevalence of obesity and overweight in boys aged 7-18 years was 11.3% and 6.5% in Beijing, 13.2% and 4.9% in Shanghai, 9.9% and 4.5% in coastal big cities, and 5.8% and 2.0% in coastal medium/small-sized cities, respectively, while the prevalence of of obesity and overweight in girls of the same age group was 8.2% and 3.7% in Beijing, 7.3% and 2.6% in Shanghai, 5.9% and 2.8% in coastal big cities, and 4.8% and 1.7% in coastal medium/small-sized cities, respectively. The prevalence of obesity was low in most of the inland cities at an early stage of epidemic overweight. The epidemic manifested a gradient distribution in groups, which was closely related to status （SES） of the study population. However, a dramatic and steady increasing trend was witnessed among all sex-age subgroups in the five urban groups, and such a trend was stronger in boys than in girls, and much stronger in children than in adolescents. Conclusion Although china is at an early stage of epidemic obesity by and large, the prevalence of obesity in her urban population, particularly in coastal big cities has reached the average level of developed countries. The increasing trend has been rapid since early 1990s, and the increments in obesity and overweight are exceptionally high. The prospect of epidemic obesity in china is in no way optimistic. Therefore, preventive

关键词： obesity Overweight Prevalence Epidemic changes Chinese urban areas School-age children and adolescents

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Report on childhood obesity in china (7) Comparison of NCHS and wgoc

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Biomedical and Environmental Sciences 2008年第4期21卷 271-279页

作者： YI-QUN XU CHENG-YE JI 无 Institute of Child and Adolescent Health Peking University of Health Science Center Beijing 100083 China cooperative study ON childhood obesity： working group ON obesity IN china

Objective To test the validity of working group on obesity in china （wgoc） reference in screening childhood obesity using obesity-related metabolic syndrome （MS） and its components as disease risk evidence. Methods A total of 2020 adolescents （1007 boys and 1013 girls） aged 14-16 years were sampled in Beijing, china. Anthropometric and biochemical measurements, as well as blood pressure parameters were available. Prevalence of overweight/obesity and related MS risk factors were analyzed across different body mass index （BMI） categories. The sensitivity and specificity of the wgoc cut-offs were compared with those of National Central Health Statistics （NCHS）. Results Significantly high prevalence of MS and its components were found both in the obesity and overweight groups, which were classified by the wgoc and NCHS references. Similar distribution pattern of MS risk factors existed among different BMI categories, but the frequency and clustering of these factors in the obesity group classified by the NCHS were much higher. Owing to its irrelevant high cut-offs for overweight/obesity （especially for girls since the mid- adolescence）, the NCHS reference had a high specificity but a low sensitivity. By contrast, the wgoc reference with a high sensitivity （90.1% for boys and 89.2% for girls） and a relative high specificity （96.4% and 92.8% for obese boys and girls, 78.1% and 68.9% for overweight boys and girls respectively） was more suitable to support the need for early screening, intervention, and treatment of childhood obesity in china. Conclusion High sensitivity is more important than specificity in choosing appropriate screening tools for childhood obesity. Validity test demonstrates that it is rational to use the wgoc reference, established on the basis of the Chinese own reference population as a uniform screening tool for childhood obesity, which can effectively overcome the unnecessary treatment and psychosociai implications of stigmatization caused by misclas

关键词： Body mass index childhood obesity Overweight Metabolic syndromes Validity

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Effect of Body Mass Index on All-cause Mortality and Incidence of Cardiovascular Diseases─Report for Meta-Analysis of Prospective Studies on Optimal Cut-off Points of Body Mass Index in Chinese Adults

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Biomedical and Environmental Sciences 2002年第3期15卷 245-252页

作者： ZHOU BEI-FAN cooperative Meta-Analysis group of the working group on obesity in china

Objective To verify the optimal cut-off points for overweight and obesity in Chinese adults based on the relationship of baseline body mass index (BMI) to all-cause mortality, and incidence of cardiovascular diseases from pooled data of Chinese cohorts. Methods The prospective study data of existing cohort studies in china were collected, and the age-adjusted all-cause mortality stratified by BMI were estimated. The similar analysis was repeated after excluding deaths within the first three years of follow-up and after excluding smokers. The incidence of age-adjusted coronary heart disease (CHD) and stroke stratified by BMI were also analyzed. Multiple Cox regression coefficients of BMI for the incidence of CHD and stroke after controlling other risk factors were pooled utilizing the methods of weighting by inverse of variance to reveal whether BMI had independent effect and its strength on the incidence of CHD and stroke. Results The data of 4 cohorts including 76 227 persons, with 745 346 person-years of follow-up were collected and analyzed. The age-adjusted all-cause mortality stratified by BMI showed a U-shaped curve, even after excluding deaths within the first three years of follow-up and excluding smokers. Age-adjusted all-cause mortality increased when BMI was lower than 18.5 and higher than 28. The incidence of CHD and stroke, especially ishemic stroke increased with increasing BMI, this was consistent with parallel increasing of risk factors. Cox regression analysis showed that BMI was an independent risk factor for both CHD and stroke. Each amount of 2 kg/m2 increase in baseline BMI might cause 15.4%, 6.1% and 18.8 % increase in relative risk of CHD, total stroke and ischemic stroke. Reduction of BMI to under 24 might prevent the incidence of CHD by 11% and that of stroke by 15 % for men, and 22 % of both diseases for women. Conclusion BMI ≤18.5, 24-27.9 and ≥28 (kg/m2) is the appropriate cut-off points for underweight, overweight and obesity in C

关键词： Body mass index (BMI) All-cause mortality Coronary heart disease Stroke

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Predictive Values of Body Mass Index and Waist Circumference for Risk Factors of Certain Related Diseases in Chinese Adults - study on Optimal Cut-off Points of Body Mass Index and Waist Circumference in Chinese Adults

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Biomedical and Environmental Sciences 2002年第1期15卷 83-96页

作者： ZHOU BEI-FAN2cooperative Meta-Analysis group of the working group on obesity in china cooperative Meta-Analysis group of the working group on obesity in china

Objective For prevention of obesity in Chinese population, it is necessary to definethe optimal range of healthy weight and the appropriate cut-off points of BMI and waistcircumference for Chinese adults. The working group on obesity in china under the supportof International Life Sciences Institute Focal Point in china organized a meta-analysis on therelation between BMI, waist circumference and risk factors of related chronic diseases (e. g.,high diabetes, diabetes mellitus, and lipoprotein disorders). Methods 13 population studiesin all met the criteria for enrollment, with data of 239 972 adults (20-70 year) surveyed inthe 1990s. Data on waist circumference was available for 111411 persons and data on serumlipids and glucose were available for more than 80 000. The study populations located in21provinces, municipalities and autonomous regions in china's Mainland as well as inTaiwan. Each enrolled study provided data according to a common protocol and uniformformat. The Center for data management in Department of Epidemiology, Fu Wai Hospitalwas responsible for statistical analysis. Results and conclusion The prevalence ofhypertension, diabetes, dyslipidemia and clustering of risk factors all increased withincreasing levels of BMI or waist circumference. BMI at 24 with best sensitivity andspecificity for identification of the risk factors, was recommended as the cut-off point foroverweight, BMI at 28 which may identify the risk factors with specificity around 90 % wasrecommended as the cut-off point for obesity. Waist circumference beyond 85 cm for menand beyond 80 cm for women were recommended as the cut-off points for central *** of population attributable risk percent illustrated that reducing BMI to normalrange (<24) could prevent 45%-50% clustering of risk factors. Treatment of obese persons(BMI≥28)with drugs could prevent 15%-17% clustering of risk factors. The waistcircumference controlled under 85 cm for men and under 80 cm for women

关键词： Chinese adults Overweight obesity BMI Waist circumference

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Empirical Changes in the Prevalence of Overweight and obesity among Chinese Students from 1985 to 2010 and Corresponding Preventive Strategies

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Biomedical and Environmental Sciences 2013年第1期26卷 1-12页

作者： JI Cheng Ye CHEN Tian Jiao working group on obesity in china (wgoc) Institute of Child and Adolescent Health School of Public Health Peking University Health Science CenterBeijing 100191 China Institute of Child and Adolescent Health School of Public Health Peking UniversityHealth Science Center Beijing 100191 China' 3. WGOC.' Working Group on Obesity in China International LifeSciences Institute Focal Point in China wgoc: working group on obesity in china International LifeSciences Institute Focal Point in China

Objective To determine the extent of the obesity epidemic in school‐aged Chinese children in 2010 and track the increasing trend in different socioeconomic regions over the preceding 25 years. Strategies for preventing childhood obesity are suggested. Methods We used a dataset provided by the Chinese National Survey on Students’ Constitution and Health from 1985‐2010. Subjects were 7‐18‐year‐old students randomly selected from urban and rural areas in 30 provinces. Eight subgroups were created according to region and socioeconomic status. Results Increased rates of the epidemic （overweight and obesity combined） were greatest in large coastal cities‐32.6% and 19.1% among males and females, respectively. These rates has neared that of developed countries. Similar increases were found in all other regions, including the once poverty‐stricken rural west. The epidemic in most of the rural areas began after 2000, but has spread swiftly over the last decade. In 2010, it was estimated that 9.9% of Chinese school‐aged children and adolescents were overweight and that an additional 5.1% were obese, representing an estimated 30.43 million individuals. Conclusion The prognosis for china＇s childhood‐obesity epidemic is dire. To prevent childhood obesity, we suggest several strategies, including reasonable dietary intake, increase physical activity, a change in sedentary lifestyles and corresponding behavioral modifications.

关键词： obesity Chinese school‐aged children Prevalence Temporal changes Socioeconomic status

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Ethnic Differences in Body Mass Index and Prevalence of obesity in School Children of Urumqi City, Xinjiang, china

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Biomedical and Environmental Sciences 2006年第6期19卷 469-473页

作者： WEI-LI YAN YU-JIAN ZHENG JUN WU SHU-FENG CHEN XIAO-KAI TI LING LI XIAO-RUI LIU School of Public Health Xinjiang Medical University Urumqi 830054 Xinjiang China Division of Population Genetics and Prevention Fuwai Hospital Peking Union Medical College ＆ Chinese Academy of Medical Science 167 Beilishi Road Beijing 100037 China the Health Care Center for Primary and Senior School Students Urumqi 830002 Xinjiang China

Objective To investigate the prevalence of obesity and distribution of body mass index （BMI） in school children of four ethnic groups in Urumqi, Xinjiang, china. Methods A total of 55 508 school children of Han, Hui, Uygur and Kazak nationalities aged 8-18 years were selected by a cluster sampling from a districts of Urumqi City for anthropometrie measurement and demographic survey. Prevalence of obesity and overweight and distribution of body mass index （BMI） by gender, age, and nationality were analyzed and compared. Cutoff points of BMI for defining obesity and overweight were based on the proposal set by the working group on obesity in china （wgoc） to assess age-, gender- and nationality-specific prevalence of obesity and overweight. Results Prevalence of obesity was 5.34%, 6.78%, 3.39 %, and 1.22% for boys and 2.61%, 1.83%, 1.78%, and 1.40% for girls of Han, Hui, Uygur and Kazak nationalities, respectively. Prevalence of obesity tended to decrease with age overall, whereas that of overweight increased with age in Han children. Conclusions Prevalence of obesity in school children in Urumqi varies with their nationalities and is lower than that of an average national level and a level of western countries. obesity is more prevalent in boys than in girls of Urmuqi overall, which is just the opposite in Kazak children. Han boys and Hui girls have the highest prevalence of obesity and Kazak boys and girls have the lowest ones. Prevalence of obesity decreases with age, but that of overweight shows a different trend.

关键词： Child obesity Overweight Ethnicity Body mass index

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Report on childhood obesity in china (2) Verification of BMI Classification Reference for Overweight and obesity in Chinese Children and Adolescents

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Biomedical and Environmental Sciences 2006年第1期19卷 1-7页

作者： GUAN-SHENG MA YAN-PING LI XIAO-QI HU ZHAO-HUI CUI XIAO-GUANG YANG AND CHUN-MING CHEN National Institute for Nutrition and Food Safety Chinese Center for Disease Control and Prevention 29 Nan wei Road Beijing 100050 China Chinese Center for Disease Control and Prevention 27 Nan wei Road Beijing 100050 China

Objective To verify working group for obesity in china （wgoc） recommended body mass index （BMI） classification reference for overweight and obesity in Chinese children and adolescents using the data of 2002 china Nationwide Nutrition and Health Survey. Methods PediaWic metabolic syndrome （MetS） and abnormality of each risk factor for MetS were defined using the criteria for US adolescents. Definition of hyper-TC, LDL, and dyslipidemia in adults was applied as well. The average level and abnormality rate of the metabolic indicators were described by BMI percentiles and compared with general linear model analysis. Receiver operating characteristic analysis was used to summarize the potential of BMI to discriminate between the presence and absence of the abnormality of these indicators. Results There was neither significantly increasing nor significantly decreasing trend of biochemical parameter levels in low BMI percentile range （〈65th）. Slight increasing trend from the 75th and a significant increase were found when BMI≥85th percentile. In general, the prevalence of the examined risk factors varied slightly when BMI percentile〈75th, and substantial increases were consistently seen when BMI percentile≥75th. As an indicator of hyper-TG, hypertension and MetS, the sensitivity and specificity were equal at the point of BMI〈75th percentile, and the Youden＇s index of risk factors also reached peak point before 75th percentile except for MetS. When the BMI percentile was used as the screening indicator of MetS, Youden＇s index reached peak point at 85th percentile, just the point in the ROC graph that was nearest to the upper left comer. Conclusion The BMI classification reference for overweight and obesity recommended by wgoc is rational to predict and prevent health risks in Chinese children and adolescents. Lower screening cut-off points, such as 83th percentile or 80th percentile, should not be excluded when they are considered as overweight criteria in future interventi

关键词： BMI classification Verification Child china Obese

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Application of the WHO Growth Reference (2007) to Assess the Nutritional Status of Children in china

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Biomedical and Environmental Sciences 2009年第2期22卷 130-135页

作者： YAN-PING LI XIAO-QI HU JING-ZHAO XIAO-GUANG YANG AND GUAN-SHENG MA National Institute for Nutrition and Food Safety Chinese Center for Disease Control and Prevention Beijing 100050 China

Objective To assess the nutrition status of children and adolescents in china using the WHO growth reference （2007） in comparison with that defined by the International obesity Task Force （IOTF） and the working group on obesity in china （wgoc）. Methods Overweight and obesity were defined by age-, sex-, specific BMI reference developed by WHO （2007）, IOTF （2000）, and wgoc （2004）, respectively. Stunting and thinness were defined as height and BMI less than two standard deviations （SD） of the WHO growth reference （2007）, respectively. Data of children and adolescents aged 5 to 19 years （n=54 857, 28 273 boys, 26 584 girls） from the 2002 china National Nutrition and Health Survey （CNNHS） were used in the study. Results The prevalence of overweight, obesity, stunting and thinness among Chinese children and adolescents aged 5-19 years was 5.0%, 1.2%, 13.8%, and 7.4%, respectively when the WHO growth reference （2007） was used, whereas the estimated absolute total number affected by these 4 conditions were 14.6, 3.7, 40.6, and 21.8 million, respectively. The prevalence of overweight and obesity was 18.1% in large cities, while the stunting prevalence was 25.1% in rural 4. obesity prevalence assessed by the WHO growth reference was higher than that as assessed by the IOTF reference, and obesity prevalence assessed by the wgoc reference was lower than that as assessed by the IOTF reference. Conclusion The nutritional status of children and adolescents is not equal in different areas of china. Stunting is still the main health problem of the poor, while overweight and obesity are the main health problems in large cities.

关键词： WHO obesity Stunting Children Adolescents china

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2004年西安市11～17岁青少年超重和肥胖现状及其相关因素

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中国医学科学院学报 2006年第2期28卷 234-239页

作者：李明颜虹 Michael J.Dibley 常素英 David Sibbritt 西安交通大学医学院公共卫生系 Centre for Clinical Epidemiology and Biostatistics Faculty of HealthUniversity of NewcastleNewcastle NSW2300 Australia International Life Science Institute Focal Point Officein china Chinese Center for DiseaseControl and PreventionBeijing100050

目的了解西安市11～17岁青少年超重和肥胖的现状及其相关因素.方法通过多阶段整群抽样方法抽取西安市6城区30所中学1 804名学生（11～17岁）,测量其身高、体重并计算体质指数（BMI）,采用2000美国疾病预防控制中心（CDC）低体重标准... 详细信息

目的了解西安市11～17岁青少年超重和肥胖的现状及其相关因素.方法通过多阶段整群抽样方法抽取西安市6城区30所中学1 804名学生（11～17岁）,测量其身高、体重并计算体质指数（BMI）,采用2000美国疾病预防控制中心（CDC）低体重标准及中国肥胖工作组（wgoc）推荐的超重和肥胖判定标准计算低体重率、超重和肥胖率.出生体重、家庭住址、经济状况、家长学历、职业和身高、体重等信息通过家长填写问卷采集.结果西安市青少年总超重肥胖率为17.4%（超重率11.2%、肥胖率6.2%）,其中男性总超重肥胖率为20.2%,女性为14.4%.低体重率为2.7%.多元logistic回归显示：性别、年龄、家庭居住地、家庭经济状况及父母体重与青少年超重和肥胖显著相关（P＜0.05）.经性别、年龄调整后,城区青少年超重和肥胖的风险是郊区的2.7倍（95%可信区间1.8～4.0）;家庭富裕青少年的超重和肥胖风险是不富裕家庭的1.6倍（95%可信区间1.04～2.5）;父母超重或肥胖的青少年超重肥胖发病风险是父母体重正常的1.8倍（95%可信区间1.3～2.5）.结论超重和肥胖已经成为影响西安市青少年健康的一个主要公共卫生问题,多发于城区、经济富裕或父母肥胖的家庭,以男性居多.

关键词：现患率超重肥胖青少年经济因素体质指数

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