Drinking Behavior and Associated Factors among Middle School Students in Shanghai, China / 生物医学与环境科学（英文）

The purpose of our study was to assess drinking status in middle school students and to understand the associated factors. The adjusted drinking rates were 50.9%, 39.8%, and 15.1% for lifetime, past-year, and current drinking, respectively. Multivariable logistic regression revealed the following variables positively related to drinking during the past year: family income, maternal educational level, family members who drink, parents who support drinking, best friends who drink, friends who encourage drinking, frequently attending friends' parties, smoking, and actuation trend (P<0.05). The main risk factors were friends (OR=6.77, 95% CI: 6.17, 7.43) and smoking (OR=4.70, 95% CI: 3.44, 6.43). These results contribute to obtaining the potential associated factors and aid in targeted intervention into the drinking behavior of middle school students.

Daily intake of plain water and beverages of primary and middle school students in four cities of China / 中华预防医学杂志

<p><b>OBJECTIVE</b>To describe the daily consumption of plain water and beverages of primary and middle school students in four cities of China.</p><p><b>METHODS</b>A total of 5914 students from Beijing, Shanghai, Guangzhou and Chengdu were selected using multiple-stage random sampling method, and 5868 students completed the study from September to October 2011. The information on amounts and types of drinking water was recorded using a 24 hour measurement for seven consecutive days. The amount of plain water and beverages was analyzed for subjects in different gender, grades and cities.</p><p><b>RESULTS</b>The daily consumption of plain water of subjects was (744 ± 484) ml (68.3% of total drinking water) with statistically significant difference among the Guangzhou, Beijing, Shanghai and Chengdu ((869 ± 528), (818 ± 518), (702 ± 471), and (573 ± 333) ml; F = 113.74, P < 0.05). The amount of plain water in boys (809 ± 534) ml was significantly higher than in girls (683 ± 436) ml (Z = 9.58, P < 0.05) while higher in urban (792 ± 531) ml than in rural (695 ± 427) ml (Z = -6.09, P < 0.05). The consumption of plain water in high school students was the highest (829 ± 513) ml, and that in primary students was the lowest (672 ± 426) ml (F = 55.23, P < 0.05). The average daily consumption of beverages was (345 ± 287) ml (31.7% of total drinking water) and the highest in Shanghai (424 ± 304) ml, then in Beijing (347 ± 303) ml and in Guangzhou (316 ± 267) ml, the lowest in Chengdu (293 ± 255) ml (F = 58.94, P < 0.05). The consumption of beverages for students in urban areas (394 ± 301) ml was higher than that in rural areas (296 ± 264) ml (Z = -14.48, P < 0.05), but no significant difference between boys (348 ± 306) ml and girls (342 ± 269) ml (Z = -1.44, P > 0.05). The consumption of beverages of high school students (356 ± 309) ml and middle school students (360 ± 301) ml were higher than primary school students (328 ± 263) ml (F = 8.37, P < 0.05).</p><p><b>CONCLUSION</b>The major drinking water of primary and middle school students in four cities of China was plain water. The amounts of consumption of plain water and beverages varied in different cities, urban and rural and levels of education.</p>

The relationship between within-day drinking occasion and intake amount of water of primary and middle school students in four cities of China / 中华预防医学杂志

<p><b>OBJECTIVE</b>To investigate the number of drinking occasions per day and average amount consumed per drinking occasion of primary and middle school students in four cities of China, and understand the relationship among drinking occasion, average amount consumed per drinking occasion and total drinking water.</p><p><b>METHODS</b>A total of 5914 primary and middle school students from Beijing, Shanghai, Guangzhou and Chengdu were selected using multiple-stage random sampling method, and 5868 students completed the study from September to October in 2011. The detailed information of amounts and types of daily drinking water was recorded by subjects using a 24 hours measurement for seven consecutive days. Analysis of the relationship among drinking occasion, average amount consumed per drinking occasion and total drinking water was carried out.</p><p><b>RESULTS</b>The daily total drinking water of subjects was (1089 ± 540) ml; the daily number of drinking occasions was (4.7 ± 1.8) times, with 79.1% (4639/5868) of subjects reporting 6 or less drinking occasions. The amount consumed per drinking occasion was (239 ± 96) ml, plain water (231 ± 112) ml, and beverages (237 ± 112) ml. The number of drinking occasions of subjects was positively correlated with total drinking water (r = 0.614, P < 0.05), and negatively correlated with the average amount consumed per drinking occasion (r = -0.211, P < 0.05). Total drinking water and the average amount consumed per drinking occasion was positively correlated (r = 0.598, P < 0.05).</p><p><b>CONCLUSION</b>The number of drinking occasion of primary and middle school students more than 6 times was fewer in four cities of China, but the average amount of beverages consumed per drinking occasion was relatively more. With the increasing of drinking occasion, the average amount consumed per drinking occasion decreased, but total drinking water increased.</p>

Water intake of primary and middle school students in four cities of China / 中华预防医学杂志

<p><b>OBJECTIVE</b>To investigate total intake of drinking water of primary and middle school students in four cities of China, and to provide scientific evidence for developing standard of intake of drinking water for primary and middle school students in China.</p><p><b>METHODS</b>A total of 5914 primary and middle school students were selected from Beijing, Shanghai, Chengdu and Guangzhou using multi-stage random sampling method and 5868 subjects completed the survey. The information on the amounts of daily drinking water was recorded for seven consecutive days using a 24 hour measurement. The amounts of daily drinking water among different cities and ages and between boys and girls or urban and rural were analyzed.</p><p><b>RESULTS</b>The average daily total drinking water of subjects was (1089 ± 540) ml, with significant differences among the four cities ((1165 ± 549), (1126 ± 544), (866 ± 421), (1185 ± 568) ml in Beijing, Shanghai, Chengdu and Guangzhou, respectively; F = 114.28, P < 0.05). The average daily drinking water was significantly higher in boys (1157 ± 575) ml than in girls (1026 ± 498) ml (Z = 8.88, P < 0.05), and in urban (1185 ± 578) ml than in rural (991 ± 480) ml (Z = 13.94, P < 0.05). The difference among different ages was statistically significant (F = 91.53, P < 0.05) with ascending order in 7 - 10, 11 - 13 and 14 - 17 years old ((953 ± 483), (1134 ± 551) and (1170 ± 557) ml respectively).</p><p><b>CONCLUSION</b>The daily consumption of total drinking water is different in primary and middle school students among different cities, regions, genders and ages.</p>

Drinking in different periods of a day of primary and middle school students in four cities of China / 中华预防医学杂志

<p><b>OBJECTIVE</b>To investigate intake of water in different periods of a day of primary and middle school students in Beijing, Shanghai, Guangzhou and Chengdu of China.</p><p><b>METHODS</b>A total of 5914 primary and middle school students from Beijing, Shanghai, Guangzhou and Chengdu were recruited using multiple-stage random sampling method from September to October 2011. Among them, 5868 students completed the survey. The information of amounts and types of drinking in 8 time periods, morning, afternoon, night as well as in meal and non-meal time in 24 hours of a day was recorded by subjects for seven consecutive days using a quantitative measurement. This information was analyzed by different periods.</p><p><b>RESULTS</b>The amount of drinking water among 8 periods of a day was (99 ± 101), (130 ± 106), (191 ± 155), (96 ± 107), (246 ± 172), (90 ± 101), (188 ± 135) and (50 ± 81) ml, respectively for before breakfast, during breakfast, after breakfast, during lunch, after lunch, during dinner, after dinner, and midnight (F = 1679.77, P < 0.01). Based on three periods of a day, the amount of drinking water in the morning (420 ± 242) ml was the statistically significantly most, followed by afternoon (341 ± 199) ml, and the least in the evening (327 ± 195) ml (F = 325.23, P < 0.01). The distribution trend of plain water in three periods was the same as total drinking water, with (270 ± 209), (250 ± 179) and (224 ± 177) ml, respectively (F = 84.89, P < 0.01) ; but beverage consumption was the most in the morning(151 ± 133) ml, then in the evening (103 ± 122) ml, and the least in the afternoon (91 ± 199) ml (F = 373.56, P < 0.01). The daily plain water consumption in meal time was (316 ± 247) ml, while it in non-meal time was (773 ± 445) ml with statistically significant difference (Z = 65.2, P < 0.01). There was no significant difference in meal time between plain water (165 ± 194) ml and beverage (151 ± 152) ml (Z = 0.59, P = 0.56) whilst plain water (579 ± 408) ml in non-meal time was significantly higher than beverages (194 ± 204) ml (Z = 64.5, P < 0.01).</p><p><b>CONCLUSION</b>The amount of drinking water of primary and middle school students in different periods of a day was different in four cities of China.</p>

Report on childhood obesity in China (9): sugar-sweetened beverages consumption and obesity / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>To explore the associations between sugar-sweetened beverage (SSB) consumption and obesity as well as obesity-related cardiometabolic disorders among children in China.</p><p><b>METHODS</b>A total of 6974 (boys 3558, girls 3412) children aged 6-13 years participated in the study. Each participant's height, weight, waist circumference, fasting glucose, triglycerides, total cholesterol, high-density lipoprotein cholesterol, and low-density lipoprotein cholesterol were measured. The type of beverage consumption was determined using a self-administered questionnaire.</p><p><b>RESULTS</b>SSBs were consumed regularly by 46.1% of the children. The prevalence [adjusted odds ratio (95% confidence internal (CI)] of obesity was 7.6% [as the reference group (ref.)], 10.1% [1.36(1.07, 1.74)], and 11.6% [1.46(1.21, 1.75)], among children who regularly drank milk, other beverages and SSBs, respectively. Regularly drinking SSBs elevated the likelihood of abdominal obesity [adjusted odds ratio (95% CI): 1.36 (1.17, 1.59)]. The prevalence [adjusted odds ratio (95% CI)] of obesity among children who regularly drank sports/caloric beverages, carbonated beverages, sweet tea, and plant protein beverages was 16.8% [2.00(1.31, 3.07)], 12.7% [1.52(1.23, 1.88)], 11.5% [1.52(1.18, 1.95)], and 10.4% [1.41(1.03, 1.94)], respectively, which was higher than that of regular milk drinkers [7.6 % (ref.)]. The prevalence [adjusted odds ratio (95% CI)] of abdominal obesity among children who regularly drank sweet tea, fruit/vegetable juices, and carbonated beverages was 17.7% [1.55(1.26, 1.90)], 16.2% [1.36(1.09, 1.70)], and 15.3% [1.24(1.03, 1.50)], respectively, which was much higher than that of regular milk drinkers [12.8% (ref.)].</p><p><b>CONCLUSIONS</b>Regular SSB consumption was positively related to obesity and abdominal obesity. This relationship should be investigated further using a longitudinal study design.</p>

Report on childhood obesity in China (10): association of sleep duration with obesity / 生物医学与环境科学（英文）

<p><b>OBJECTIVES</b>To explore the association of sleep duration with obesity among children in urban areas of China.</p><p><b>METHODS</b>A total of 6 576 children (3 293 boys and 3 283 girls) aged 7-11 years were randomly selected from 36 primary schools in 6 metropolitan cities in China. A 7-day Physical Activity Recall was used to assess the sleep duration and physical activity level. The height, weight, waist circumference (WC) and percentage of body fat (%BF, as determined by bioelectrical impedance analysis technique) were measured by following the standardized operation procedures. The information on demography, lifestyle and eating habits was collected with a self-administered questionnaire from participants and their parents.</p><p><b>RESULTS</b>The average sleep duration per night in the children was 9.7 h with the decreasing trends along with the increase of age (P < 0.05). The sleep duration was negatively associated with body mass index (BMI) and WC in both boys and girls after adjustment for confounders (beta value -0.23 and -0.82 for boys, -0.24 and -0.91 for girls, respectively, P < 0.01). However, no significant association of sleep duration with %BF was found. Children who slept less than 9.0 h per night had a higher risk for overweight and obesity (OR = 1.29, 95% CI: 1.01, 1.64) and abdominal obesity (OR=1.38, 95% CI: 1.04, 1.83) as compared with those who slept for 10.0-10.9 h.</p><p><b>CONCLUSIONS</b>Short sleep duration is associated with obesity. It is important to ensure adequate sleep duration of children and foster their healthy lifestyle at an early stage of life.</p>

Association between high fat-low carbohydrate diet score and newly diagnosed type 2 diabetes in Chinese population / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>To study the association between high fat-low carbohydrate diet score and newly diagnosed type 2 diabetes in Chinese population.</p><p><b>METHODS</b>Data about 20 717 subjects aged 45-59 years from the cross-sectional 2002 China National Nutrition and Health Survey were analyzed. High fat-low carbohydrate diet was scored according to the energy of carbohydrate, fat, and protein.</p><p><b>RESULTS</b>Of the 20 717 subjects, 1 332 were diagnosed with hyperglycemia and 662 were newly diagnosed with type 2 diabetes. Multivariate adjusted analysis showed that the highest score of type 2 diabetes patients was 2.75 (95% CI: 2.09-3.61). The score of type 2 diabetes patients was 1.87 (95% CI: 1.35-2.58) after further adjustment for their socioeconomic status and physical activity. No significant difference was found in the odds ratio after further adjustment for BMI, blood pressure, lipid level, and energy intake. No evidence was observed for the relation between high fat-low carbohydrate-diet score in type 2 diabetes patients due to high family income, less education, physical activity, overweight, hypertension, high TG, or low HDL level.</p><p><b>CONCLUSION</b>High fat-low carbohydrate diets, far different from traditional Chinese diets, are associated with the high incidence of type 2 diabetes in Chinese population.</p>

Water intake of adults in four cities of China in summer / 中华预防医学杂志

<p><b>OBJECTIVES</b>To investigate total drinking water intake of adults in the four cities of China in summer.</p><p><b>METHODS</b>A total of 1483 adults aged 18 - 60 yrs from Beijing, Shanghai, Chengdu and Guangzhou were selected using multiple-stage random sampling method. The information of amounts and types of daily drinking water was recorded by subjects for seven consecutive days using a quantitative measurement. The amounts and types of daily drinking water among different cities and between men and women or urban and rural was analyzed.</p><p><b>RESULTS</b>The median of daily total drinking water of subjects was 1488 ml, with significant difference among the four cities (1579, 1793, 1150, 1467 ml in Beijing, Shanghai, Chengdu and Guangzhou city, respectively, χ(2) = 154.31, P = 0.000). The median of daily drinking water was significantly higher in men (1679 ml) than women (1370 ml) (Z = 8.34, P = 0.000), but no significant difference was found between urban (1514 ml) and rural (1466 ml) daily drinking water median (Z = -0.81, P = 0.420). The median of daily consumption of plain water, tea and beverages were 786, 109, 186 ml, respectively. Among four cities, the highest consumption of plain water was in subjects of Guangzhou (917 ml), while the highest tea consumption in Shanghai (257 ml) and the highest beverages consumption in Shanghai (323 ml) and Beijing (264 ml). Consumption of tea in men (229 ml) was significantly higher than that in women (57 ml) (Z = 7.52, P = 0.000). Subjects in urban (693 ml) had lower consumption of plain water than those in rural (914 ml). The proportion was 32.4% (480/1483) for subjects with water drinking less than 1200 ml per day.</p><p><b>CONCLUSION</b>The daily consumption of total drinking water, including plain water, tea and beverages is different in adults among different cities and is different in gender and regions. It is nearly 1/3 of subjects with daily total drinking water less than current Chinese recommended water intake (1200 ml).</p>

Knowledge on drinking water of adults in four cities of China / 中华预防医学杂志

<p><b>OBJECTIVE</b>To understand the status on knowledge of drinking water among adults aged 18 - 60 yrs in Beijing, Shanghai, Chengdu and Guangzhou of China.</p><p><b>METHODS</b>A total of 1483 adults aged 18 - 60 yrs from the four cities (Beijing, Shanghai, Chengdu and Guangzhou) were selected using multiple-stage random sampling method. The information was collected by face-to-face interview. Through face to face interview, investigators surveyed the daily water intake, the harm of dehydration, time of drinking water and healthy drinks knowledge using a questionnaire. Knowledge awareness was compared through χ(2) test for different cities, urban and rural, genders.</p><p><b>RESULTS</b>The unawareness rate of minimum drinking water volume (1200 ml/d) was 28.4% (421/1483). The rate in Chengdu was the highest (41.8%, 156/373). The rate in women (32.4%, 241/745) was significantly higher than that in men (24.4%, 180/738) (χ(2) = 11.55, P < 0.01). The unawareness rate of the harm of dehydration was 14.4% (213/1483). The rate in Chengdu (18.5%, 69/373) and Guangzhou (18.3%, 68/371) was higher than that in the other cities. The rate in rural (18.6%, 137/736) was significantly higher than that in urban (10.2%, 76/747) (χ(2) = 21.47, P < 0.01). The people who considered drinking water when they felt thirsty as healthy behavior accounted for 48.3% (716/1483). The rate in Chengdu was the highest (59.0%, 220/373). The unawareness rate of plain water being the best accounted for 18.9% (280/1483), while 17.9% (50/280) of them considered beverages as the best.</p><p><b>CONCLUSIONS</b>The knowledge of drinking water among 18 - 60 yrs residents in the four cities is not comprehensive. We should enhance propaganda of healthy drinking water.</p>

Water intake sources analysis of adults in four cities of China in summer / 中华预防医学杂志

<p><b>OBJECTIVE</b>To investigate the water intake sources of adults in the four cities of China in summer.</p><p><b>METHODS</b>A total of 64 adults aged 18 - 60 yrs from the four cities (Beijing, Shanghai, Chengdu and Guangzhou) were selected using convenient sampling method. The information on amounts and types of daily drinking water was recorded by subjects for three consecutive days using a quantitative measurement. The food samples were collected by using duplicate portion method and the water content of food samples were determined.</p><p><b>RESULTS</b>The median of daily total water intake of 63 subjects was 3045 ml, while daily total drinking water was 1600 ml, the median ratio of which accounting for 55.8% of total water intake. Water from food was 1157 ml, the median ratio of which accounting for 41.4% of total water intake. The median of daily total water intake (3566 ml) and the ratio of water from food (55.3%) of subjects in Chengdu was significantly higher than subjects in Guangzhou (2929 ml, 45.4%), Shanghai (2748 ml, 33.1%) and Beijing (2743 ml, 31.3%) (daily total water intake: χ² = 10.42, P = 0.015;the proportion of water: χ² = 28.48, P < 0.01). Daily total water intake in men (3302 ml) was significantly higher than that in women (2900 ml) (Z = 2.35, P = 0.019).</p><p><b>CONCLUSION</b>Daily total water intake of subjects in summer was more than the current Chinese recommended total water intake (2200 ml), with the main part of drinking water and water from food.</p>

Food water sources analysis of adults in four cities of China in summer / 中华预防医学杂志

<p><b>OBJECTIVE</b>To investigate the food water sources of adults in the four cities of China in summer.</p><p><b>METHODS</b>A total of 64 adults aged 18 - 60 yrs from four cities (Beijing, Shanghai, Chengdu and Guangzhou)were selected using convenient sampling method. The food samples were collected by using duplicate portion method and the water content of food samples were determined by using the national standard. The information on amounts and types of daily drinking soup was recorded by subjects using a quantitative measurement.</p><p><b>RESULTS</b>A total of 63 subjects had completed the investigation. The median of daily water from food of subjects was 1157 ml, while water from staple food was 480 ml, the median ratio of which accounting for 41.8% of water from food. Water from dishes was 427 ml, the median ratio of which accounting for 37.9% of water from food. Water from soups was 133 ml, the median ratio of which accounting for 13.8% of water from food. Water from snacks was 0 ml, the median ratio of which accounting for 6.4% of water from food. The medians of water from staple food (384, 388 and 435 ml, respectively) in Beijing, Shanghai and Guangzhou was significant lower than that of Chengdu subjects' (900 ml, χ(2) = 21.27, P = 0.000). But the median proportion of water from staple food of subjects in Beijing (47.7%) was significantly higher than that in Chengdu (43.2%), Shanghai (42.9%) and Guangzhou (33.9%) (χ(2) = 8.69, P = 0.034). The median of amount and proportion of water from soups of subjects in Guangzhou (267 ml, 24.4%) and Chengdu(278 ml, 15.7%) was significantly higher than that in Shanghai (133 ml, 9.0%) and Beijing (100 ml, 5.8%) (amount: χ(2) = 22.52, P = 0.000;proportion: χ(2) = 16.27, P = 0.001).</p><p><b>CONCLUSION</b>The staple food and dishes are the main sources of daily food water.</p>

Waist circumference distribution of Chinese school-age children and adolescents / 生物医学与环境科学（英文）

<p><b>BACKGROUND</b>Waist circumference (WC), a proxy measure of central body fat, is a better predictor than overall body fat for cardiovascular risk factors in both adults and children. WC cutoffs have been established in many countries, but the national WC reference has not been developed in China.</p><p><b>OBJECTIVE</b>To study the distribution of WC in a representative group of Chinese children for establishing Chinese WC cutoff points.</p><p><b>METHODS</b>Cross-sectional data obtained from 15 mainland provinces and Hong Kong were collected. There were 160,225 children and adolescents aged 7-18 years old in total. The subjects were divided into five regional groups namely costal city, other city, north rural, south rural, and Hong Kong, for analyzing the distribution of WC.</p><p><b>RESULTS</b>A large variation in WC distribution was found among the five groups for both sexes. Coastal city group had the highest P85 WC values consistently from the early school ages to 18-year-old compared with other groups. In contrast, south rural group had P85 values consistently lagged behind not only the city groups but also the north rural group. Hong Kong group had a high P85 WC at early ages, but because of the smaller increments of WC during adolescence, the P85 curve was gradually exceeded by the north rural groups. Catch-up trend was found in the two rural groups since the peak of puberty. These disparities were caused by not only socioeconomic and urban-rural factors but also north-south differences. Because of the regional variation of WC, a "gradient" prevalence of central obesity was prospected among these groups. Comparisons of WC distributions between the Chinese and the U.S.A. or Netherlands demonstrated the necessary of setting up China's own WC cutoffs. Sex and age-specific percentiles were obtained and smoothed by using LMS method.</p><p><b>CONCLUSION</b>The data obtained from this study could be used to develop national WC cutoff points for Chinese children and adolescents.</p>

Waist circumference reference values for screening cardiovascular risk factors in Chinese children and adolescents / 生物医学与环境科学（英文）

<p><b>OBJECTIVES</b>To explore the optimal threshold values of waist circumference (WC) for detecting cardiovascular (CV) risk factors among Chinese children and adolescents.</p><p><b>METHODS</b>Association of WC with CV risk factors was studied among 65,898 children aged 7-18 years whose data were pooled from nine previous studies in China. CV risk factors in this study included hypertension (blood pressure above 95 percentile levels), dyslipidemia (with one or more of the following three indexes: TG > or = 1.7 mmol/L, TC > or = 5.18 mmol/L, and HDL-C < or = 1.04 mmol/L) and elevated glucose level (fasting plasma glucose > or = 5.6 mmol/L). Receive-operating characteristic analysis (ROC) and logistic regression were employed to derive optimal age- and sex-specific waist circumference references for predicting CV risk factors.</p><p><b>RESULTS</b>A slight increasing trend of CV risk factors was observed starting from the 75th percentile of waist circumference in the study population, while a remarkable increasing trend occurred from the 90th percentile. The optimal waist circumference thresholds for predicting high blood pressures were at the 75th percentile for both boys and girls, which was at the 90th percentiles for detecting at least two of the above three CV risk factors. In comparison with children with waist circumference below the 75th percentile, the odds ratio of two CV risk factors doubled among children with waist circumference between the 75th and the 90th percentile, and increased by 6 times among children with waist circumference above the 90th percentile. The trend of high blood pressure increasing with waist circumference remained significant after having been stratified by BMI category.</p><p><b>CONCLUSION</b>The 75th and the 90th percentiles of WC are the optimal cut-off points for predicting an increased and a substantially increased risk of CV factors in Chinese children and adolescents, respectively.</p>

Relationship of body mass index, waist circumference and cardiovascular risk factors in Chinese adult / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>To compare the relative risk of waist circumference (WC) and/or BMI on cardiovascular risk factors.</p><p><b>METHODS</b>A cross-sectional data of 41 087 adults (19 567 male and 21 520 female) from the 2002 China National Nutrition and Health Survey were examined. According to the obesity definition of WGOC (BMI, 24 kg/m2 and 28 kg/m2; WC, male 85 cm and 95 cm for male, 80 cm and 90 cm for female), the study population were divided into 9 groups. The prevalence and odds ratio (ORs) of cardiovascular disease (CVD) risk factors (hypertension, high fasting plasma glucose and dyslipidemia) were compared among these 9 groups. Stepwise linear regression analyses were used to compare the likelihood of BMI and/or WC on CVD risk factors. RESULTS Both the indexes levels and the odds ratios of CVD risk factors were significantly increased (decreased for HDL-C levels) along with the increase of WC and/or BMI, even when the effect of age, sex, income, education, sedentary activity and dietary factors were adjusted. The variances (R2) in CVD risk factors explained by WC only and BMI only were quite similar, but a little bit larger when WC and BMI were combined. The standard beta was higher of BMI when predicting systolic BP and was higher of WC when predicting TG TC and HDL.</p><p><b>CONCLUSIONS</b>BMI and WC had independent effects on CVD risk factors and combination of BMI and WC would be more predictive. Findings from the present study provided substantive evidence for the WGOC recommendation of a combined use of BMI and WC classifications.</p>

Report on childhood obesity in China (8): effects and sustainability of physical activity intervention on body composition of Chinese youth / 生物医学与环境科学（英文）

<p><b>OBJECTIVES</b>To determine whether a large-scale physical activity intervention could affect body composition in primary school students in Beijing, China.</p><p><b>METHODS</b>The study design was one-year cluster randomized controlled trial of physical activity intervention (20 min of daily exercise in the classroom) with an additional year of follow-up among 4 700 students aged 8-11 years at baseline.</p><p><b>RESULTS</b>After the one-year intervention, BMI increased by 0.56 kg/m(2) (SD 1.15) in the intervention group and by 0.72 kg/m(2) (SD 1.20) in the control group, with a mean difference of -0.15 kg/m(2) (95% CI: -0.28 to -0.02). BMI z score decreased by -0.05 (SD 0.44) in the intervention group, but increased by 0.01 (SD 0.46) in the control group, with a mean difference of -0.07 (-0.13 to -0.01). After another year of follow up, compared to the control group, children in the intervention group had significantly lower BMI (-0.13, -0.25 to -0.01), BMI z score (-0.05, -0.10 to -0.01), fat mass (-0.27 kg, -0.53 to -0.02) and percent body fat (-0.53, -1.00 to -0.05). The intervention had a more pronounced effect on weight, height, BMI, BMI z score, and body composition among obese children than among normal weight or overweight children. Compared to the control group, the intervention group had a significantly higher percentage of children who maintained or reduced their BMI z score at year 1 (P=0.008) and year 2 (P=0.04).</p><p><b>CONCLUSIONS</b>These findings suggest that 20 min of daily moderate to vigorous physical activity during the school year is a feasible and effective way to prevent excessive gain of body weight, BMI, and body fatness in primary school students.</p>

The nutritional status of reproductive women at one year after the disaster of Earthquake in Wenchuan / 中华预防医学杂志

<p><b>OBJECTIVE</b>To evaluate the effects of Wenchuan Earthquake on the nutritional status and the prevalence of nutritional anemia, vitamin A deficiency (VAD) and vitamin D deficiency among reproductive women (15 - 44 years old) in the disaster areas one year after the Earthquake.</p><p><b>METHODS</b>A nutritional survey was conducted in 3 counties in April 2009, one year after the Earthquake. Two towns from each county were selected as study sites, and this survey recruited 58 pregnant, 66 lactating and 242 non-pregnant-non-lactating women. A comparison was made to the results of 2002 Chinese Nutrition and Health Survey.</p><p><b>RESULTS</b>The cereals and roots intakes of the pregnant, lactating and non-pregnant-non-lactating women living in the disaster area were (426.8 ± 271.8), (568.0 ± 306.1), and (483.0 ± 277.7) g/d respectively, which were almost the same results (486.8, 509.3 and 495.1 g/d, respectively) from 2002 National Nutrition and Health Survey. The fat and oil intakes were (41.9 ± 51.6), (55.5 ± 69.2), and (66.9 ± 125.7) g/d, respectively, which were also the same ad the results (45.2, 43.9 and 41.4 g/d, respectively) from 2002 National Nutrition and Health Survey. The intakes of meats and poultries were only (58.1 ± 67.7), (76.3 ± 218.7), and (23.9 ± 29.6) g/d respectively, which were much lower than the recommended food intakes from the Branch of Maternal and Child Nutrition of Chinese Nutrition Society. The vitamin A deficiency and marginal deficiency prevalence were 6.9% (24/347) and 18.2% (63/347), respectively. The deficiency and insufficiency of vitamin D was sum to 93.9% (323/344). The prevalence of anemia was 32.6% (112/344). 51.0% (171/335) reproductive women were iron deficient, and 61.6% (210/347) women were suffering zinc deficiency.</p><p><b>CONCLUSION</b>The study findings indicated that the dietary structure was seriously effected by the Earthquake. The sources from animal and legume products were relatively low. The micronutrients nutritional status was poor. The vitamin A, vitamin D, and iron, zinc deficiencies were highly prevalent in the disaster area.</p>

The nutritional status among children under 60 months year-old after one year of the Earthquake in Wenchuan / 中华预防医学杂志

<p><b>OBJECTIVE</b>To evaluate the effects of Wenchuan Earthquake on the nutritional status, growth, and the prevalence nutritional anemia, vitamin A deficiency (VAD) and vitamin D deficiency among children under 60 months old living in the disaster areas.</p><p><b>METHODS</b>A nutritional survey was conducted in April 2009. The survey recruited 466 under 60 months old children, including 162 children aged 0 months old and 304 children aged 24 - 59 months old. The children's growth status, prevalence of anemia, and the iron deficiency prevalence, vitamin A, D, B(12), folic acid status were measured. The study findings were compared to the results from 2002 Chinese Nutritional and Health Survey.</p><p><b>RESULTS</b>The exclusive breast milk feeding rate among infants under 6-months was 58.8% (30/51). Among the 0 - 23 months old children, only 10.7% (16/150) got breast feeding within one hour after delivery. Ninety-two per cent (149/162) 0 - 23 months old children never received any nutrient supplements. The average cereals and roots intakes of the 24 - 59 months old children living in the disaster area were (267.2 ± 154.3) g/d, higher than the result of rural children average (178.75 g/d) of 2002 National Nutrition and Health Survey (u = 9.995, P < 0.01). The average intakes of vegetables, aquatic products, meat and poultries were (63.6 ± 56.7), (2.6 ± 7.9), (19.4 ± 24.0) g/d, respectively, significantly lower than 2002 results 135.05, 8.82 and 32.23 g/d (u = 21.971, 13.728 and 9.321, P < 0.01). Fruits, dairy products and legumes intakes were (102.2 ± 110.8), (65.2 ± 123.8) and (20.5 ± 29.0) g/d, respectively, higher than 2002 results (32.81, 2.87 and 6.50 g/d; u = 10.919, 8.778 and 8.417, P < 0.01). The prevalence of vitamin A deficiency and marginal deficiency was 15.4% (29/188) and 30.3% (57/188), respectively. The sum of vitamin D deficiency and insufficiency was 92.0% (183/199). The prevalence of anemia of the 0-months old children and 24 - 59 months old children was 47.5% (77/162) and 21.5% (60/279), respectively. The prevalence of iron and zinc deficiencies was 45.7% (86/188) and 65.5% (127/197). The prevalence of stunt was 13.6% (38/279) among the 24 - 59 months old children.</p><p><b>CONCLUSION</b>The results indicated that the dietary structure of the children living in the disaster area was not ideal. Although, the intakes of energy and protein supporting foods could meet the requirements, but the dietary lacks of meats, poultries, dairy products, legume products, aquatic products and vegetables. The vitamin A, vitamin D deficiency, iron and zinc deficiencies are of a high prevalence in the disaster area.</p>

Waist circumference distribution of Chinese school-age children and adolescents / 中华流行病学杂志

Objective To study the distribution of waist circumference (WC) in a representative group of Chinese children for establishing the Chinese WC cut-off points. Methods Cross-sectional data obtained from 15 mainland provinces and Hong Kong were collected. There were 178 865 children and adolescents, aged 7-18 years-old in total. All subjects were divided into five regional groups- costal city, non-coastal city, northern rural, southern rural, and Hong Kong, for analyzing the distribution of WC. Results Large variations in WC distribution were found among the five groups for both sexes. The coastal city group had the highest P85 WC values consistently from the early school age to 18-year-old, when comparing with other groups. In contrast, southern rural group had P85 values consistently lagged behind, in both city group and in the north rural group. Hong Kong group had a high P85 WC at early ages, but because of the smaller increments of WC during adolescence, the P85 curve was gradually exceeded by the northern rural groups. Catch-up trend was found in the two rural groups since peak puberty. These disparities were caused not only by factors related to socioeconomic and urban-rural but also to the geographic differences between the noah and the south. Because of the regional variation of WC, a "gradient" prevalence of central obesity was prospected among these groups. Closed associations were found between WC and height, weight and BMI in all age period. Comparison on the WC distributions between people from China, U.S.A or the Netherlands demonstrated the necessity of setting up China's own WC cutoffs.Sex and age-specific percentiles were obtained and smoothed by using the LMS method.Conclusion Data obtained from this study could be used to develop the national WC cutoff points for Chinese children and adolescents.

Waist circumference reference values for screening cardiovascular risk factors in Chinese children and adolescents aged 7-18 years / 中华流行病学杂志

Objective To explore the optimal threshold values of waist circumference (WC) in detecting the risk on cardiovascular (CV) among the Chinese children and adolescents. Methods Association of WC and CV risk factors were studied among 65 898 children and adolescents aged 7-18 years whose data were pooled from nine studies carried out in China. Receive-operating characteristic analysis (ROC) and logistic regression were employed to derive optimal age- and sex-specific waist circumference references for predicting the CV risk factors. Results A slight increasing trend of CV risk factors was observed starting from the 75th percentile of waist circumference in the study population, while a remarkable increasing trend occurred from the 90th percentile. The optimal waist circumference thresholds for predicting high blood pressures were at the 75th percentile for both boys and girls, and at the 90th percentiles it could detect at least two of the above three CV risk factors. In comparison with children whose waist circumference was below the 75th percentile, the odds ratio of two CV risk factors doubled among children with waist circumference between 75th and 90th percentile, and increased by 6 times among children with waist circumference above the 90th percentile. The trend of high blood pressure increasing remained significant with waist circumference after having been stratified by BMI category. Conclusion The 75th and the 90th percentile of WC appeared to be the optimal cut-off points for predicting an increased and a substantially increased risk of CV factors in Chinese children and adolescents.