Trends and predictions in the physical shape of Chinese preschool children from 2000 to 2020.

Objective: To explore physical shape changes in preschool children from 2000 to 2020, and forecast development trends over the next 10 years. Method: The grey GM (1,1) prediction model was used to fit the physical shape indicators of preschool children in China from 2000 to 2020, and then the longitudinal change trend of physical shape was compared and analyzed. Finally, the development trend of physical shape in China in 2025 and 2030 was predicted. Results: (1) During the period from 2000 to 2020, the height, weight and chest circumference of Chinese preschool children all increased rapidly. Specifically, the weight of male and female children increased by 1.8 kg and 1.6 kg, their chest circumference increased by 1.6 cm and 1.5 cm, respectively, and both their heights increased by 3.6 cm. Among these indicators, the older the age, the greater the growth rate. It is expected that all the indicators will continue to grow rapidly over the next 10 years, but the growth rate will slow. (2) From 2000 to 2020, the growth rate of weight was higher than that of height, and BMI showed an increasing trend. The obesity detection rates in boys and girls increased by 5.6 and 2.8%, respectively. Over the next 10 years, the incidence of obesity is expected to increase by 3.8% in boys and 2.8% in girls. (3) Improvement in the growth and development of preschool children in China has a certain correlation with the rapid growth of China's economy,less physical activity, education and other factors. Conclusion: Over the past 20 years, the growth and nutritional status of Chinese preschoolers have improved dramatically, but overweight and obesity remain. Overweight and obesity rates are expected to continue to increase rapidly over the next 10 years, particularly among boys, and effective measures should be taken to control the obesity epidemic.

The Establishment of the Cut-off Value of Weight-for-Height for Preschool Children in China and an Empirical Study on the Influence of Overweight and Obesity on Physical Performance.

Background: We aimed to establish the cut-off value of weight-for-height for preschool children in China, and to explore the influence of overweight and obesity on the physical performance of preschool children. Methods: Data from 31 provinces in China monitored in 2010 and 2014, the standard deviation unit curves of WFH were established by using GAMLSS (generalized additive model for location, scale, and shape) method preschool children in China, and then the cut-off values of normal weight, overweight and obesity were divided. The research group tested 5 physical performance indicators of 5154 preschool children from April 2018 to June 2019 in Beijing and Zhejiang in China. We then compared physical performance differences between the normal-weight group and the overweight-obesity group. Results: A smooth and effective standard deviation unit curve of WFH was established. The overweight and obesity of Chinese preschool children were at a high level. Being overweight and obese reduced preschool children's relative strength, speed, sensitivity, coordination, and balance ability, but did not reduce preschool children's flexibility. In general, the physical performance of preschool children in the normal weight group was better than that in the overweight and obesity group. Conclusion: It is suggested to use the WFH criteria in this study to evaluate overweight and obesity in Chinese preschool children, and strengthen physical activity and take in energy substances properly of preschool children, to control the spread of overweight and obesity, to improve physical performance level.

The association between living environmental factors and adolescents' body weight: a cross-sectional study.

BACKGROUND: The effect of the living environment on public health has received increasingly scholarly attention. This study aims to explore the relationship between adolescents' body weight and their living environmental factors. METHODS: This cross-sectional study comprised 1362 middle-school students from Nanjing and 826 from Changzhou in China. We further collected information on living environmental factors based on their home address and ran multivariate logistic regressions to explore potential correlations after considering a range of potential confounding factors. RESULTS: Approximately 25% (n = 303) of students from Nanjing and 26% (n = 205) of students from Changzhou were excessive body weight. In Nanjing, students' BMI (Body Mass Index) showed a strong negative correlation with the number of sports venues in their neighborhood (Adjusted Odds Ratio (AOR): 0.64, 95%CI: 0.40-0.94) after controlling for other covariates. In Changzhou, we observed a positive correlation between adolescents' body weight and the number of bus stops in their neighbourhood (AOR:1.63, 95%CI:1.11-2.38). CONCLUSIONS: The living environment factors were independently associated with teenagers' excessive body weight. We hypothesis that the environmental risk factors might be associated with political management, which will consequently affect personal health outcomes. Further research and proactive measures are required to manage those potential risks and attenuate the problem.

Association between relative handgrip strength and hypertension in Chinese adults: An analysis of four successive national surveys with 712,442 individuals (2000-2014).

OBJECTIVES: This study aimed to identify the 15-year trends of handgrip strength-to-weight (relative HS) and assess the association between relative HS and hypertension among Chinese adults aged 20-69. METHODS: Using a complex, stratified, multistage probability cluster sampling, we analyzed data collected from 712,442 adults aged 20-69 years in four successive national surveys (2000-2014). We used a handheld dynamometer to measure strength and divided by body weight to calculate the relative HS. Blood pressure was recorded with a sphygmomanometer and hypertension was defined as resting systolic blood pressure at least 140 mmHg or diastolic at least 90 mmHg. The Mann-Kendall trend test examined trends in relative HS over time. We also computed odd ratios (OR) and 95% confidence intervals (95% CI) by tertile of relative HS and examined the association between relative HS and hypertension. RESULTS: The relative HS level decreased with the increase of age in both male and females (p trend <0.001). In each of four surveys, one interquartile decrease in relative HS was associated with an increased risk of hypertension by 44% (OR = 1.44, 95%CI: 1.40-1.47), 58% (OR = 1.58, 95%CI: 1.54-1.62), 48% (OR = 1.48, 95%CI: 1.45-1.52), 43% (OR = 1.43, 95%CI: 1.40-1.47), respectively. CONCLUSION: In the Chinese adult population, the relative HS level decreased from 2000 to 2014 across all ages in both males and females. A lower relative HS was associated with a higher risk of hypertension. The findings provided evidence for the association between muscle strength and hypertension in large-scaled population.

Chinese Preschool Children Growth Reference Standard and Related Curve: Based on GAMLSS Approach.

BACKGROUND: The current national growth and development standard of preschool children in China was formulated in 2003, which has many deficiencies. It is necessary to construct more scientific percentile curve and growth reference standards in order to evaluate more effectively the growth, development and health status of Chinese children. METHODS: Based on the physical and health data of 31 provinces in China measured in 2010 and 2014, the GAMLSS model was used to construct the growth reference standard and correlation curve. RESULTS: We obtained growth reference standards for percentile curve and Z-score curve of height-for-age, sitting height-for-age, Weight-for-age, Chest circumference-for-age of Chinese preschool children. The C50 percentile of all indicators showed an obvious increasing trend with aged 3.0 to 6.5. Such as, the height of boys and girls increased by 21.1cm and 20.3cm respectively, the sitting height boys and girls increased by 10.3cm and 10.1cm respectively, the weight of boys and girls increased by 7.1 kg and 6.3 kg respectively, the Chest circumference of boys and girls increased by 6cm and 5.2 cm respectively. CONCLUSION: The children's growth and development charts provided in this study provide effective monitoring and personalized evaluation tools for the growth and development assessment of preschool children, as well as for the reduction of malnutrition, prevention and control of childhood obesity. It is recommended to be used in some areas such as child health, medical treatment and public health.

Isoflavone combined with exercise on bone mineral density in postmenopausal women: A systematic review and meta-analysis of randomized controlled trials.

BACKGROUND: This meta-analysis of randomized control trials (RCTs) aimed to evaluate the effects of isoflavones supplementation combined with exercise training on bone mineral density (BMD) in postmenopausal women. METHODS: Two reviewers did a complete search of two electronic database (Medline, PubMed) records up to January 31, 2019. Risk of bias was classified based on the Cochrane Collaboration tool. The pooled standard mean difference (SMD) combined with 95% confidence interval (CI) was used as the effect size of BMD values. RESULTS: A total of four RCTs with 609 participants were included for meta-analysis. The BMD did not differ significantly between isoflavone supplementation combined with exercise training group and placebo group (sub-whole body: SMD = 0.00, 95% CI, -0.23 to 0.24; lumbar spine: SMD = 0.15, 95% CI, -0.30 to 0.60; total hip: SMD = 0.05, 95% CI, -0.18 to 0.298; femoral neck: SMD = 0.10, 95% CI, -0.23 to 0.43; trochanter: SMD = 0.09, 95% CI, -0.14 to 0.33; ward's triangle: SMD = -0.03, 95% CI, -0.24 to 0.30). In addition, combined intervention did not provide additive effects on BMD improvements compared with exercise or isoflavone supplementation alone. The trials included in this meta-analysis were small and some had methodological limitations. CONCLUSION: The present meta-analysis reveals that isoflavone supplements combined with exercise training do not significantly increase BMD in postmenopausal women. In addition, combined intervention does not provide additive effects on BMD improvements compared with exercise or isoflavone supplementation alone.

Physical activity and mortality in patients with colorectal cancer: a meta-analysis of prospective cohort studies.

The association between physical activity (PA) and colorectal cancer (CRC) patients' survival is inconsistent. We conducted a systematic review and meta-analysis to summarize published articles on this issue. We performed a comprehensive search of the PubMed, Embase, and Web of Science databases for relevant articles through 28 February 2018. The summary hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using a random-effects model. Eighteen prospective cohort studies were included in the meta-analysis, with a total of 9257 cases of total mortality (TM) and 4015 cases of colorectal cancer-specific mortality (CRCSM) among 31 873 CRC survivors and 557 150 general populations. Among CRC survivors, the highest versus the lowest levels of prediagnosis PA showed decreased risks of TM (summary HR = 0.81, 95% CI: 0.76-0.87, I = 1.8%) and CRCSM (summary HR = 0.85, 95% CI: 0.77-0.98, I = 0), respectively. Significant risk reductions for TM and CRCSM were also demonstrated for postdiagnosis PA (HR = 0.63, 95% CI: 0.54-0.74; and HR = 0.64, 95% CI: 0.47-0.88, respectively). The inverse association between prediagnosis PA and cancer mortality was more pronounced for colon cancer than that for rectal cancer (P = 0.08). The summary HRs (95% CIs) of TM were 0.89 (0.83-0.97) and 0.79 (0.69-0.90) per 10 metabolic equivalent task-h/week increase in prediagnosis and postdiagnosis PA, respectively. Our meta-analysis provides comprehensive evidence that PA performed before or after cancer diagnosis is related to reduced mortality risk among CRC survivors.

Development of Body Mass Index Growth Standard Chart for Chinese Preschool Children.

BACKGROUND: We aimed to establish a reference standard of Body Mass Index (BMI) for the growth of preschool children in China. METHODS: We monitored and obtained the height and weight of 50702 children aged 3-6 yr in 31 provinces in mainland China in 2014. The reference standard and percentile curve of BMI preschool children aged 3-6 yr old were formulated by using Lambda-Median-Sigma (LMS) method in China. RESULTS: The common grounds of the male and female children were as follows: the percentile maps were similar in shape; the graphs of children aged 4-6 were approximately horn shaped. The differences between male and female children were as follows: the BMI values of male children in the same age group and the same percentile were higher than those of the female children. The change pattern of male children was larger than that of female children. BMI of 3 yr old and 6 yr old children was larger than those of 4 yr old and 5 yr old. During the change from low percentile to high percentile, the BMI values of Chinese male children exceeded WHO to a larger extent, and the BMI values of Chinese female children were substantially consistent with WHO, but the high percentile greater than P95 exceeded WHO. CONCLUSION: The BMI growth chart developed can be applied in monitoring the growth and nutrition of preschool children in China. We recommend the promotion of the results in the field of preventive health care.

The association of physical growth and behavior change with Preschooler's physical fitness: From 10- years of monitoring data.

BACKGROUND: This study examined the trends of physical fitness among children aged 3-6 years old and identified the factors associated with the change of children's physical fitness. METHODS: Datum were from two cross-sectional surveys in 2005 and 2015. Children aged 3-6 years old in China Macao were recruited from 6 kindergartens. 6 kindergartens were selected from North, South and Central districts, and two kindergartens in each district using random cluster sampling in 2005. The same 6 kindergartens were selected in 2015. Physical fitness testing and a survey on children behavior were conducted for all children. RESULTS: Standing long jump, shuttle run, sit and reach, and continuous jump of children in Macao improved significantly in some age groups from 2005 to 2015 (P < 0.05). Results of general linear model showed that: (1) The effect of height and weight on physical fitness was less than test year effect (standing long jump: partial η2 of height = 4.5%, partial η2 of time = 8.5%); (2) after adjusted age, gender and parental education level, participating in sports clubs was associated with standing long jump(ß = 5.827,p = 0.048) and shuttle run (ß = -0.759, p = 0.042) in 2015. Less sedentary entertainment time and participating in sports club were two Interactive protecting factors of improving throwing ability (ß = 1.862, p = 0.045). CONCLUSIONS: The changes in height and weight were not the whole reason for the change of physical fitness among Macao preschoolers. The behaviors, including participating in sports clubs and the less time of watching TV were associated with children's running, jumping and throwing.

Soy and isoflavones consumption and breast cancer survival and recurrence: a systematic review and meta-analysis.

BACKGROUND: Some studies have investigated the association between soy and isoflavones consumption and breast cancer survival, but the results are far from conclusive. Accordingly, we performed a systematic review and meta-analysis to explore this issue. METHODS: We performed a comprehensive search of Web of Science, PubMed, and Embase from inception to January 2018. The summary hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using a random effects model. RESULTS: A total of 12 articles were included, which reported overall survival (OS), breast cancer specific survival (BCSS), and recurrence in 5770, 2386, and 1500 cases, respectively, among 37,275 women with breast cancer. The summary HR (95% CI) for the association (highest vs. lowest) of pre-diagnosis soy and isoflavones consumption with OS and BCSS was 0.84 (0.71-0.98) and 0.89 (0.74-1.07), respectively. Stratified analyses suggested that the reduced OS was more easily detected in studies that focused on post-menopausal patients. No significant association was found between post-diagnosis soy and isoflavones consumption with OS and BCSS, with summary HRs (95% CIs) of 0.80 (0.62-1.04) and 0.83 (0.64-1.07), respectively. Pre- and post-diagnosis soy isoflavones consumption were associated with reduced risk of recurrence. CONCLUSION: This study provides limited evidence that pre-diagnosis soy and isoflavones intake is associated with a small reduction in post-menopausal breast cancer OS.

Is economic environment associated with the physical activity levels and obesity in Chinese adults? A cross-sectional study of 30 regions in China.

BACKGROUND: Based on the 2014 survey of physical activity and physical fitness data of 20 - 69 year old Chinese, this study aims to investigate the relationship between economic development and people's physical activity in China. METHODS: A total of 43,389 adults from 30 different regions in mainland China were recruited. The GDP per capita of the 30 regions were determined based on the 2013 annual statistical report released by the national bureau of statistics of China and provincial level statistics bureaus. A questionnaire was used to determine the participants' exercise frequency, duration, and intensity. RESULTS: For the 30 regions surveyed, the correlation coefficients between GDP per capita and weekly activity were 0.23 for men and 0.15 for women. The correlation coefficients between GDP per capita and obesity rates were 0.52 for men and 0.39 for women. CONCLUSIONS: Although people in economically advanced regions in China currently engage in more physical activities than those in less economically developed regions, overweight and obesity persist as serious problems.

Relationship between spinal morphology and function and adolescent non-specific back pain: A cross-sectional study.

CONTEXT: Non-specific back pain has become a public health problem affecting adolescent health. OBJECTIVE: To examine the relationships between abnormalities in spinal morphology and non-specific back pain among adolescents. DESIGN: Cross-sectional study. SETTING: Junior and senior high schools. PATIENTS: Participants were screened using a questionnaire regarding back pain. Students in the pain group (n= 273, 121 boys and 152 girls) reported experiencing upper and/or lower back pain within the previous month, and those who did not report pain were assigned to the group without pain (n= 127, 63 boys and 64 girls). Participants who had experienced acute upper and/or lower back injuries within the previous month or received a definitive diagnose of disease were excluded. METHODS: The SpinalMouse® was used to measure the thoracic kyphosis angle (TKA), lumbar lordosis angle (LLA), sacrum/hip angle (SA), and incline angle (INA) in both the standing position and sitting position. The SpinalMouse® also was used to measure the sacral, thoracic, and lumbar range of motion (ROM) in the fully flexed position and fully extended position in the sagittal plane. The thoracic and lumbar ROM in left/right lateral flexion was recorded. The Matthiass test was used to assess changes in the measured angles upon loading. RESULTS: Among junior high school students, 47.0% of boys and 53% of girls had an abnormal TKA. Among senior high school students, 52.6% of boys and 46.99% of girls had an abnormal TKA. The incidence of LLA abnormality was significantly higher among junior high boys than girls (p< 0.05), as was the incidence of hypolordosis (p< 0.05). Significantly fewer senior high boys than girls had a normal LLA value (p< 0.05). An excessive TKA (p< 0.05, odds ratio = 1.236) and limited lumbar ROM (p< 0.01, odds ratio = 0.975) were correlated with back pain in adolescents. CONCLUSIONS: The incidences of TKA and LLA abnormality are high among Chinese adolescents, and an excessive TKA and insufficient total lumbar ROM may be risk factors for non-specific back pain in adolescents.

BMI, leisure-time physical activity, and physical fitness in adults in China: results from a series of national surveys, 2000-14.

BACKGROUND: Obesity, physical inactivity, and reduced physical fitness contribute to the rising burden of chronic diseases in China. We investigated these factors in Chinese adults over a 14-year period (2000-14) using data from randomised national surveys. METHODS: We did four national surveys in 2000, 2005, 2010, and 2014 among Chinese adults aged 20-59 years. We used BMI to assess underweight (<18·5 kg/m(2)), overweight (≥23·0 to <27·5 kg/m(2)), and obesity (≥27·5 kg/m(2)). Central obesity was defined as a waist circumference greater than 90 cm in men and greater than 85 cm in women. We assessed leisure-time physical activity (LTPA) by whether or not participants had completed the recommended minimum 150 min of moderate or 75 min of vigorous exercise per week. Indices for assessment of physical fitness were forced vital capacity, resting heart rate, hand grip strength, sit and reach distance, and time standing on one leg. FINDINGS: 151 656 (78%) of 193 440 adults responded to the survey in 2000, 163 386 (84%) in 2005, 154 931 (80%) in 2010, and 146 703 (76%) in 2014. The prevalence of obesity increased from 8·6% in 2000, to 10·3% in 2005, 12·2% in 2010, and 12·9% in 2014 (estimated increase 0·32% per year, 95% CI 0·30-0·33; p<0·0001). The equivalent estimates were 37·4%, 39·2%, 40·7%, and 41·2% for overweight (estimated increase 0·27% per year, 95% CI 0·25-0·30; p<0·0001) and 13·9%, 18·3%, 22·1%, and 24·9% for central obesity (estimated increase 0·78% per year, 0·76-0·80; p<0·0001). The prevalence of overweight, obesity, and central obesity increased with age (all p<0·0001) and was higher in men than in women (all p<0·0001). We noted a simultaneous decrease in the prevalence of underweight (estimated decrease of 0·06% per year, 95% CI 0·04-0·07; p<0·0001). The proportion of adults meeting the minimum LTPA recommendation increased over time (17·2% in 2000, 18·1% in 2005, and 22·8% in 2014), with the estimated prevalence change per year being 0·33% (95% CI 0·24-0·42; p<0·0001) for underweight people, 0·50% (0·47-0·53; p<0·0001) for normal-weight people, 0·37% (0·34-0·40; p<0·0001) for overweight people, and 0·06% (0·00-0·13; p=0·044) for obese people. We noted deteriorations over time in all measures of physical fitness in normal-weight adults (all p<0·0001), apart from resting heart rate (p=0·69). INTERPRETATION: Despite increased participation in LTPA, we noted increases in overweight or obesity and a decrease in physical fitness in Chinese adults. Continued nationwide interventions are needed to promote physical activity and other healthy lifestyle behaviours in China. FUNDING: National Physical Fitness Surveillance Center and Ministry of Science and Technology of the People's Republic of China.

[Level of different energy metabolism on constitution of women in Xi' an City].

OBJECTIVE: To analyze the relationship between different level of surplus energy and constitution health among middle-aged and elder females. METHODS: Multi-stage stratified random sampling method was used and 650 residents aged 40 - 60 years in Xi' an City were selected for measurement of body shape, function, blood biochemistry and psychology indicators and questionnaire survey of nutritional and physical activity status. The subjects were divided into the following four groups according to surplus energy (SE) classification by using of quartile method, When SE < P25 for the low surplus energy group, P25 ≤ SE < P50 for the moderate surplus energy group, P50 ≤ SE < P75 for the high surplus energy group, P75 < SE for higher surplus energy group. RESULTS: Body mass, waist circumference, hip circumference, arm skinfold thickness, abdominal skinfold thickness, leg skinfold thickness, body mass index, waist-hip ratio and body fat rate among surplus energy groups was statistically significant (P < 0. 05 or P < 0. 01). Cardiopulmonary function and mental health level of the high energy group and the moderate surplus energy group were better than the low surplus energy group and higher surplus energy group, it was statistically significant (P <0. 05), and the level of glucose, TG, TC, LDL declined significantly and the level of HDL increased remarkably (P < 0. 05). CONCLUSION: The energy intake of dietary and the energy consumption of physical activity are factors influencing the level of constitution health.

Step rate-determined walking intensity and walking recommendation in Chinese young adults: a cross-sectional study.

UNLABELLED: There is lack of data on the physiological characteristics of over ground walking and walking recommendations for Chinese young adult. The purpose of the study was to measure walking-related energy expenditure during field testing, to identify step-rate cut-point associated with moderate and vigorous intensity, and to translate physical activity (PA) guidelines into walking goals for Chinese young adults. DESIGN: Cross-sectional analytic study. SETTING: Two communities from Beijing and Shanghai in China. PARTICIPANTS: A sample of 226 Chinese adults (117 men, 109 women) with a mean age of 21.7 (±0.2) years, volunteered to participate in the study. All Participants were recreationally active without orthopaedic limitations, free of chronic diseases, not taking any medications that affect metabolism and non-smokers. OUTCOME MEASURES: All the participants completed four 6 minincremental over ground walking at different speeds of 3.8, 4.8, 5.6 and 6.4 km/h, respectively. Indirect calorimeter was used to measure energy expenditure at each speed. Receiver operating characteristic curves were used to determine the step-rate cut-points associated with moderate and vigorous intensity activity. RESULTS: At the same walking speed, step counts per minute were higher in women than in men. No significant differences were found in VO(2) per weight (ml/kg/min) between women and men. Step-rate cut-point associated with walking at 3 metabolic equivalents (METs) and 6METs were 105 and 130 step/min when analysing men and women together. There were slight differences on the cut-points between women and men if data were analysed separately. CONCLUSIONS: In order to meet PA guidelines, Chinese young adult should walk 30 min with at least 105 step/min or 3150 steps or 2 km with the same step-rate per day. Walking at a higher speed of 130 step/min might provide additional health benefit.

Anthropometric equation for estimation of appendicular skeletal muscle mass in Chinese adults.

The purpose of this study was to develop and cross-validate anthropometric equations for the estimation of appendicular skeletal muscle mass (ASM) in Chinese adults. A total of 763 adults aged 18-69 years (345 men and 418 women) were recruited from residents living in four regions (Jinan, Guangzhou, Xi'an and Chengdu) in China. ASM were measured by fan-beam dual energy x-ray absorptiometry. Participants' body weight, height, limb circumferences (upper arm, thigh, and calf), waist circumference, and skinfold thicknesses (triceps, thigh, and calf) were measured by trained testers. The participants were randomly assigned to two groups: a model-development group (MD group) and a cross-validation group (CV group). Prediction models were established using the data from the MD group, and cross-validated with the data of the CV group. The results suggested that the developed equations had satisfactory prediction qualities, and could be applied as a practical method of quantifying ASM in Chinese adults.