Trends in the Prevalence of Morbid Obesity among Children and Adolescents in Shandong, China, 1995-2014.

Background: Childhood obesity has increased dramatically during the past decades; however, data on the prevalence of morbid obesity is limited. The present study examined the prevalent trends in morbid obesity among children and adolescents during the past 19 years (1995-2014) in Shandong, China. Methods: Data for this study were obtained from five cross-sectional surveys (1995, 2000, 2005, 2010 and 2014) of schoolchildren in Shandong Province, China. A total of 41 500 students aged 7-18 years were included in this study. Body mass index cutoffs recommended by the International Obesity Task Force were used to define morbid obesity. Results: The prevalence of morbid obesity was increasing continuously during the past 19 years (1995-2014), from 0.25% for boys and 0.11% for girls in 1995 to 2.73% for boys and 1.29% for girls in 2014. Boys had higher prevalence of morbid obesity than girls (p<0.01). Regional socioeconomic status (SES) inequalities in morbid obesity were observed; children and adolescents from high SES district had a rapid increase in the prevalence of morbid obesity than their counterparts from moderate SES and low SES districts in the past 19 years. Conclusion: Although the current prevalence of morbid obesity was at a relatively low level, a continuous increasing trend was observed between 1995 and 2014. We should not relax our vigilance, and policymakers and experts should pay more attention to the monitoring and prevention of morbid obesity among children and adolescents in the future decades.

Percentiles of waist-hip ratio and the relationship with blood pressure among children and adolescents in Shandong, China.

BACKGROUND: Anthropometric indices such as waist circumference (WC), waist-to-height ratio (WHtR) and waist-hip ratio (WHR) have been recognized as useful alternatives to visceral fat measurement in epidemiological studies. WHR has been used extensively in adults. However, there are very few published data for WHR among children and adolescents. AIM: The present study examined the distribution of WHR and the relationship with blood pressure (BP) among children and adolescents in Shandong, PR China. SUBJECTS AND METHODS: Data for this study were obtained from a large cross-sectional survey of schoolchildren carried out in 2010. A total of 38,822 students (19,456 boys and 19,366 girls) aged 7-17 years participated in this study. WC, Hip circumference (HC), systolic blood pressure (SBP) and diastolic blood pressure (DBP) of all subjects were measured; WHR was calculated as WC divided by HC. Abdominal obesity was defined by previously published WHR references based on Chinese children and adolescents living in Beijing. All subjects were divided into two groups (group 1 with WHR <85th; group 2 with WHR ≥85th) according to the percentiles of WHR and comparisons of the SBP and DBP between the two groups were made. RESULTS: The WHR levels in Shandong boys and girls were lower than those from German and Pakistani. The overall prevalence of abdominal obesity was 9.53% (95% CI = 9.12-9.95%) for boys and 9.82% (95% CI = 9.40-10.24%) for girls, no statistical differences between the two genders were observed (p > 0.05). In both boys and girls, the Z-scores of SBP and DBP were all significantly lower in group 1 than in group 2 (p < 0.01), indicating that children and adolescents with high WHR tended to have higher BP values. CONCLUSION: WHR is useful in identifying children and adolescents at risk of developing high BP. These findings, together with the known tracking of BP from adolescence into adulthood, highlight the importance of preventing overweight and obesity among children and adolescents in order to prevent the development of hypertension in adults.

[Study on waist circumference and hip circumference of 7 - 18 year-old children and adolescents in Shandong province].

OBJECTIVE: To study the development of waist circumference (WC) and hip circumference (HC) in children and adolescents in Shandong province, and to provide scientific data for developing related reference values for screening central obesity in Chinese children and adolescents. METHODS: Using data from 'Student physical fitness and health surveillance 2010 project' in Shandong province, a total of 42 275 students aged 7 - 18 years were selected to participate in this study. WC, HC, waist-to-hip ratio (WHR) and wrist-to-stature ratio (WSR) of subjects were measured. Comparison of data from the current study and other similar studies was made. RESULTS: The mean values of WC increased with age, and boys all significantly higher than girls in all age categories (P < 0.01). There were two crosses on gender regarding the HC curves: before the age of 11 years, with mean HC higher in boys than in girls, but girls were higher than boys between the age of 12 to 14 while boys were also higher than girls after the age of 15 years. The 50(th) percentiles (P(50)) of WC of children and adolescents aged 7 to 18 years in Shandong appeared above the figures by 1.3 - 3.1 cm (boys) and 1.2 - 2.0 cm (girls) from 15 provinces in China as well as above the data from Hong Kong by 1.9 - 5.4 cm (boys) and 2.0 - 6.5 cm (girls), respectively. Overall, 20.20% of the boys and 16.57% of the girls had a WC of ≥ 90(th) percentile and 15.73% and 7.38% of the boys and girls had a WHtR of ≥ 0.5 which both showed significant differences between genders (P < 0.01). CONCLUSION: Children and adolescents from Shandong province had a high level of WC.

[Status quo and characteristics of blood pressure among children and adolescents aged 7-17 years at normal weight but with abdominal obesity, in Shandong province].

OBJECTIVE: To study the prevalence and characteristics of blood pressure (BP) among children and adolescents at normal weight but with abdominal obesity. METHODS: Using data from the 'Student physical fitness and health surveillance 2010 project' in Shandong province, a total of 38 816 students aged 7-17 years were selected to participate in this study. Stature, body weight, waist circumference(WC), systolic blood pressure(SBP)and diastolic blood pressure(DBP) of these subjects were measured. Body weight status and abdominal obesity were defined by body mass index (BMI) and WC, respectively. RESULTS: In total, the proportions of thinness, normal weight, overweight and obesity defined by BMI were 5.37%, 72.47%, 12.92% and 9.24% respectively. 5.86% of the children and adolescents with normal weight had abdominal obesity, with normal weighted girls (7.19%) having higher prevalence of abdominal obesity than boys(4.33%)(P < 0.01). The Z-scores of SBP and DBP for both boys and girls were all significantly higher in the normal weight but with abdominal obesity groups than in both normal weight and WC groups (P < 0.01). CONCLUSION: Children and adolescents under normal weight but with abdominal obesity had higher BP level need to be identified and considered as high-risk individuals. Related intervention programs should also be targeted to this population.