ORIGINAL / Obesidad

Prevalence of overweight and obesity among primary school children aged 5 to 14 years in Wannan area, China

La prevalencia del sobrepeso y la obesidad entre los niños de la escuela primaria de 5 a 14 años en Wannan area, China

Lianping He^1*, Xiaohua Ren^1*, Yan Chen^1*, Yuelong Jin¹, Rui Pan¹, Ningkai Wei², Shenwei Qiu², Wei Lu¹, Lingling Ding¹, Daoxia Guo¹, Linghong Wang¹, Zhonghua Nie¹ and Yingshui Yao¹

¹ School of Public Health, Wannan Medical College. Wuhu 241002, Anhui, People's Republic of China.
² Tongling municipal center for disease control and prevention of Anhui province, Tongling 244000, Anhui, People's Republic of China.

This research was supported by the National Natural Science Foundation of China (81072367), the Wannan Medical College Youth Fund (WKS201305), the Key Projects Universities of young talents Fund of Anhui provincial (2013SQRL056ZD), the Anhui Provincial Natural Science Foundation (090413126 and 1308085MH135), Provincial Natural Science Research Project of Anhui Colleges (KJ2014A265) and Wannan Medical key scientific research projects Engagement Fund (WK2013Z01 and WK2014Z05).

Correspondence

ABSTRACT

Background: Overweight and obesity are epidemic worldwide. The purpose of this research is to estimate whether the prevalence of obesity among primary school children is high, and to identify its potential determinants to optimize the methods of prevention to combat further increases in childhood overweight.
Methods: A cross-sectional study was designed to collect the routine health screening data for primary school children in Wannan area, China. Overweight and obesity status were determined using the International Obesity Task Force standard (IOTF) BMI cut-off points.
Results: A total of 67956 subjects (36664 male and 31292 female) aged 5-14 years were recruited in this study. Depending on the references used (IOTF), the overall prevalence of overweight, including obesity of the subjects was 17.85% , the prevalence of overweight, including obesity was 22.9% in male subjects and 11.9% in female subjects, respectively. The overall prevalence of obesity was3.7%, the prevalence of obesity was 5.2 % in male subjects and 1.8% in female subjects, respectively. An interesting observation made was that the prevalence of overweight was high in male subjects.
Conclusions: Overweight is prevalence among primary school children, especially in male children. The relate department of school and government should take some measure to reduce the prevalence of overweight and obesity.

RESUMEN

Antecedentes: El sobrepeso y la obesidad son epidemia en todo el mundo. El propósito de esta investigacion es estimar si la prevalencia de la obesidad entre los niños de la escuela primaria es alto, y a identificar sus posibles factores determinantes para optimizar los métodos de prevención para combatir nuevas subidas en sobrepeso infantil.
Métodos: Un estudio transversal fue diseñado para recoger los exámenes de salud de rutina datos para la escuela primaria los niños de 5 a 14 años en Wannan Area, China, el sobrepeso y la obesidad se determinaron utilizando la International Obesity Task Force Standard (IOTF) IMC puntos de corte.
Resultados: Un total de 67956 sujetos (36664 macho y 31239 hembra) de 5 a 14 años fueron reclutados en este estudio. Dependiendo de las referencias utilizadas (IOTF), la prevalencia de sobrepeso, incluyendo la obesidad de los sujetos fue 17,85%, la prevalencia de sobrepeso, incluyendo la obesidad fue del 22,9% en sujetos masculinos y el 11,9% en mujeres, respectivamente. La prevalencia global de la obesidad was 3,7%, la prevalencia de obesidad fue de 5,2% en sujetos masculinos y 1,8% de mujeres, respectivamente. Una observación interesante es que la prevalencia de sobrepeso fue alta en sujetos masculinos.
Conclusiones: El sobrepeso es la prevalencia entre los niños de la escuela primaria, especialmente en los niños varones. escuela y Departamento de Gobierno debería tomar algo de placer para reducir la prevalencia del sobrepeso y la obesidad.

Palabras clave: Indice de masa corporal, los niños de la escuela primaria, obesidad, sobrepeso, China.

Introduction

In recent decades, the prevalence of obesity risen steeply worldwide^{1, 2}, Obesity is associated with significant co morbidities and health problems such as breast cancer³, asthma^{4, 5},diabetes mellitus^{6, 7}, hypertension⁸, coronary artery disease⁹, attention deficit hyperactivity disorder¹⁰ and occupational injuries^{11, 12, 13}. Previous study showed that the prevalence of obesity in Chinese children and adolescents was considered to be still relatively low¹⁴, meanwhile, rapid increasing of both obesity and overweight, in both urban and rural areas would arouse special attention¹⁵.

In this study, the International Obesity Task Force standard (IOTF) body mass index cut-off points established for children was used to assess the prevalence of overweight and obesity among primary school children in Wannan area, Anhui province, China.

Methods

Subjects and Methods

Participants

A population-based cross-sectional study was conducted among primary school children for routine health screening in 2013 from Wannan area,China. The area is located in the south of Yangtze River in Anhui Province, which have an area of about 36500 square kilometers and a population of about 9970000. Including Wuhu, Ma'anshan, Tongling, Xuancheng, Chizhou and Huangshan city. By stratified random sampling, a total of 67956 subjects (36664 male and 31292 female) from urban area aged 5-14 years were recruited in this study. All subjects agreed to provide their personal information regarding the purpose and the procedures of our study, and written informed consent. This study was approved by local ethics committee.

Anthropometric measurements

Height and weight was measured by trained staffs and nurse .Height was measured to the nearest 0.1 cm with a standard stadiometer following study protocols, and weight in kilograms was measured in light clothing to the nearest 0.1 kg on an electronic scales. All anthropometric data were collected by trained staff and supervised by the school nurse. BMI was computed using the following standard equation: BMI=Weight in kg/height squared in meter.

Overweight and obesity were defined using the International Obesity Task Force standard (IOTF) body mass index cut-off points established for children²³. These cut-off points are based on health related adult definitions of overweight (>25 kg/m²) and obesity (>30 kg/m²) but are adjusted to specific age and sex categories for children²³.

Ethical consideration

All respondents agreed to take part in this study. According to local and international guidelines on ethics considerations in research involving human participants, this study was approved by local ethics committee.

Statistical analysis

Excel software was performed to describe the prevalence of overweight/obesity among primary school children. A line graph was draw for the prevalence of overweight and obesity among children by age.

Results

Discussion

In the present study, we use the IOTF body mass index cut-off points to evaluate the prevalence of the overweight and obesity. The results revealed that the overall prevalence of overweight, including obesity of the subjects was 17.85%, the prevalence of overweight, including obesity was 22.9% in male subjects and 11.9% in female subjects, respectively. However, the prevalence of overweight and obesity was lower than that of previous study¹⁴. An interesting observation made was that the prevalence of overweight was high in male subjects, which is similar to the other research²⁴. The cut-off points of BMI for overweight is varying from different standard .We should explore a more suitable standard in future study, for example, World Health Organization growth standard.

Previous study documented that girls in urban areas had higher prevalence of overweight and obesity than girls in rural settings. Among the boys, similar but less marked trends were found, except that the rural boys tended to be more overweight on average than their peers in urban area²⁵. Our result showed that the overweight and obesity are more prevalent in boys, the possible maybe that the parents may have more attention on nutrition of boys than that of girls.

Recent evidence suggests that the nutrition transition is accelerating and the outcome of this trend is a rapid increase in hypertension²⁶ and chronic diseases²⁷. Lifestyle transition and socio-economic improvement have contributed enormously to the escalating problem in developing countries²⁸. Especially, lifestyle²⁹ and food variety³⁰ may have an influence on obesity. Lack of health education and less physical training to primary school children may also be linked to its high prevalence. There are some limitations in our present study, lacking the data of type of feeding, characteristics of families and physical activity; we should collect more information in future study.

Conclusions

Conflict of Interest

None declared

Reference

1. Wang Y, Lobstein T: Worldwide trends in childhood overweight and obesity. Int J Pediatr Obes 2006, 1(1):11-25.         [ Links ]

2. Masuet-Aumatell C, Ramon-Torrell JM, Banque-Navarro M, Davalos-Gamboa Mdel R, Montano-Rodriguez SL: Prevalence of overweight and obesity in children and adolescents from Cochabamba (Bolivia); a cross-sectional study. Nutr Hosp 2013, 28(6):1884-91.         [ Links ]

3. Petekkaya I, Sahin U, Gezgen G, Solak M, Yuce D, Dizdar O, et al.: Association of breast cancer subtypes and body mass index. Tumori 2013, 99(2):129-33.         [ Links ]

4. Jensen ME, Wood LG, Gibson PG: Obesity and childhood asthma - mechanisms and manifestations. Curr Opin Allergy Clin Immunol 2012, 12(2):186-92.         [ Links ]

5. Fedele DA, Janicke DM, Lim CS, Abu-Hasan M: An examination of comorbid asthma and obesity: assessing differences in physical activity, sleep duration, health-related quality of life and parental distress. J Asthma 2014, 51(3):275-81.         [ Links ]

6. Das P, Bhattacharjee D, Bandyopadhyay SK, Bhattacharya G, Singh R: Association of obesity and leptin with insulin resistance in type 2 diabetes mellitus in Indian population. Indian J Physiol Pharmacol 2013, 57(1):45-50.         [ Links ]

7. o Hartaigh B, Jiang CQ, Bosch JA, Zhang WS, Cheng KK, Lam TH, et al.: Independent and combined associations of abdominal obesity and seated resting heart rate with type 2 diabetes among older Chinese: the Guangzhou Biobank Cohort Study. Diabetes Metab Res Rev 2011, 27(3):298-306.         [ Links ]

8. Rodilla E, Costa JA, Martin J, Gonzalez C, Pascual JM, Redon J: Impact of abdominal obesity and ambulatory blood pressure in the diagnosis of left ventricular hypertrophy in never treated hypertensives. Med Clin (Barc) 2014, 142(6):235-42.         [ Links ]

9. Bechlioulis A, Vakalis K, Naka KK, Bourantas CV, Papamichael ND, Kotsia A, et al.: Paradoxical protective effect of central obesity in patients with suspected stable coronary artery disease. Obesity (Silver Spring) 2013, 21(3):E314-21.         [ Links ]

10. Yang R, Mao S, Zhang S, Li R, Zhao Z: Prevalence of obesity and overweight among Chinese children with attention deficit hyperactivity disorder: a survey in Zhejiang Province, China. BMC Psychiatry 2013, 13:133.         [ Links ]

11. Kouvonen A, Kivimaki M, Oksanen T, Pentti J, De Vogli R, Virtanen M, et al.: Obesity and occupational injury: a prospective cohort study of 69,515 public sector employees. PLoS One 2013, 8(10):e77178.         [ Links ]

12. Richmond SA, Fukuchi RK, Ezzat A, Schneider K, Schneider G, Emery CA: Are joint injury, sport activity, physical activity, obesity, or occupational activities predictors for osteoarthritis? A systematic review. J Orthop Sports Phys Ther 2013, 43(8):515-B19.         [ Links ]

13. Lin TC, Verma SK, Courtney TK: Does obesity contribute to non-fatal occupational injury? Evidence from the National Longitudinal Survey of Youth. Scand J Work Environ Health 2013, 39(3):268-75.         [ Links ]

14. Ji CY, Sun JL: Analyses of the epidemiological status of overweight and obesity in Chinese students and the prevalence changes in recent 15 years. Beijing Da Xue Xue Bao 2004, 36(2):194-7.         [ Links ]

15. Ji CY, Sun JL, Chen TJ: Dynamic analysis on the prevalence of obesity and overweight school-age children and adolescents in recent 15 years in China. Zhonghua Liu Xing Bing Xue Za Zhi 2004, 25(2):103-8.         [ Links ]

16. Cheong SM, Kandiah M, Chinna K, Chan YM, Saad HA: Prevalence of obesity and factors associated with it in a worksite setting in Malaysia. J Community Health 2010, 35(6):698-705.         [ Links ]

17. Ferreira Marques CD, Ribeiro Silva Rde C, Machado ME, Portela de Santana ML, Castro de Andrade Cairo R, Pinto Ede J, et al.: The prevalence of overweight and obesity in adolescents in Bahia, Brazil. Nutr Hosp 2013, 28(2):491-6.         [ Links ]

18. Cerrillo I, Fernandez-Pachon MS, Ortega Mde L, Valero E, Martin FM, Jauregui-Lobera I, et al.: Two methods to determine the prevalence of overweight and obesity in 8-9 year-old-children in Seville, Spain. Nutr Hosp 2012, 27(2):463-8.         [ Links ]

19. Li XY, Jiang Y, Hu N, Li YC, Zhang M, Huang ZJ, et al.: Prevalence and characteristic of overweight and obesity among adults in China, 2010. Zhonghua Yu Fang Yi Xue Za Zhi 2012, 46(8):683-6.         [ Links ]

20. Seo DC, Niu J: Trends in Underweight and Overweight/Obesity Prevalence in Chinese Youth, 2004-2009. Int J Behav Med 2013.         [ Links ]

21. Jia L, Wang L, Shan R, Lin Y: Prevalence of overweight and obesity in primary school students from Wenzhou city and the analyses of the risk factors. Wei Sheng Yan Jiu 2013, 42(2):269-72.         [ Links ]

22. Ji CY, Chen TJ: Empirical changes in the prevalence of overweight and obesity among Chinese students from 1985 to 2010 and corresponding preventive strategies. Biomed Environ Sci 2013, 26(1):1-12.         [ Links ]

23. Cole TJ, Bellizzi MC, Flegal KM, Dietz WH: Establishing a standard definition for child overweight and obesity worldwide: international survey. BMJ 2000, 320(7244):1240-3.         [ Links ]

24. Mi J, Cheng H, Hou DQ, Duan JL, Teng HH, Wang YF: Prevalence of overweight and obesity among children and adolescents in Beijing in 2004. Zhonghua Liu Xing Bing Xue Za Zhi 2006, 27(6):469-74.         [ Links ]

25. Musa DI, Toriola AL, Monyeki MA, Lawal B: Prevalence of childhood and adolescent overweight and obesity in Benue State, Nigeria. Trop Med Int Health 2012, 17(11):1369-75.         [ Links ]

26. Lu X, Shi P, Luo CY, Zhou YF, Yu HT, Guo CY, et al.: Prevalence of hypertension in overweight and obese children from a large school-based population in Shanghai, China. BMC Public Health 2013, 13:24.         [ Links ]

27. Ahn S, Zhao H, Smith ML, Ory MG, Phillips CD: BMI and lifestyle changes as correlates to changes in self-reported diagnosis of hypertension among older Chinese adults. J Am Soc Hypertens 2011, 5(1):21-30.         [ Links ]

28. Chen C, Lu FC: The guidelines for prevention and control of overweight and obesity in Chinese adults. Biomed Environ Sci 2004, 17 Suppl:1-36.         [ Links ]

29. Villegas R, Xiang YB, Cai H, Elasy T, Cai Q, Zhang X, et al.: Lifestyle determinants of C-reactive protein in middle-aged, urban Chinese men. Nutr Metab Cardiovasc Dis 2012,22(3):223-30.         [ Links ]

30. Sea MM, Woo J, Tong PC, Chow CC, Chan JC: Associations between food variety and body fatness in Hong Kong Chinese adults. J Am Coll Nutr 2004, 23(5):404-13.         [ Links ]

Correspondence:
Yingshui Yao ]]> School of Public Health,
Wannan Medical College.
No.22 Road wenchangxi,
Yijiang district
Wuhu city, Anhui province.
241002 People's Republic of China.
E-mail: yingshuiyao@163.com

Recibido: 19-VI-2014.
Aceptado: 23-VII-2014.