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Background and Objectives: China's nutrition transition is characterized by dramatic increases in overweight and cardiometabolic (CM) risk. The burden of obesity, CM risk factors and dietary intake among Chinese children were explored. Methods and Study Design: Children 7-12 y old from the 2009 China Health and Nutrition Survey with available dietary intake data, anthropometry, blood pressure, and fasting blood samples were included (n=663). CM risk prevalence was calculated; logistic regression was used to investigate the association of nutrient intakes with CM risk, adjusting for age, gender, physical activity, area of residence and income. Results: 14% of Chinese school-aged children and ~20% of those from urban areas and higher income households had overweight/obesity (p<0.05). The prevalence of prehypertension was ~20% while hypertension was 14%. Around 20% of all children and >30% of those from urban areas and higher income households had impaired glucose/HbA1c (p<0.05). More than half of the studied children had pre-dyslipidemia (i.e. at least one lipid measurement above borderline levels) and 21% of children had dyslipidemia. Approximately 30% of all children had energy intakes above requirements and 38% of them had excessive proportions of dietary fat and saturated fat. Children with higher intakes of total daily energy and total and added sugars had a greater likelihood of having impaired blood pressure and glucose/HbA1c. Conclusions: Childhood overweight and CM risk is prevalent in urban and rural areas of China and across different socioeconomic groups although disparities between classes still pervade. Several dietary factors such as sugars were significant correlates of CM risk.
Key Words: obesity, cardiometabolic risk, dietary intake, children, China
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INTRODUCTION
Coincident with a rapid social and economic transition in China, the rates of childhood overweight and obesity have increased across all age and socioeconomic (SES) groups.1-3 These trends have been remarkably notable in highly urbanized areas,4 where traditional diets and patterns of physical activity have shifted more dramatically.5,6 China's eating patterns are currently moving towards higher intake of fat, animal-source and processed foods, away-from-home eating and snacking.6-8
Important increases in the prevalence of noncommunicable disease (NCD) risk factors have been documented in parallel with these changes.4,9-12 In 2009, around 42% of Chinese children and adolescents presented at least one cardiometabolic (CM) risk factor such...