Trends in Underweight and Overweight/Obesity Prevalence in Chinese Youth, 2004–2009

Dong-Chul Seo, Jingjing Niu

BACKGROUND: There is a paucity of recent data on Chinese childhood overweight and underweight prevalence especially since 2004. PURPOSE: The purpose of this study was to examine trends in underweight and overweight/obesity ("overweight" hereafter) prevalence and energy balance-related behaviors of Chinese youth from 2004 to 2009. METHODS: Data from the China Health and Nutrition Survey, 2004-2009 (N = 4,061 students aged 6-18 years), were analyzed. Trained health workers took anthropometric measures at the participant's house or at a local clinic following a reference protocol recommended by the World Health Organization. The international age- and sex-specific body mass index reference standard proposed by the International Obesity Task Force was used to define underweight and overweight children in this study. RESULTS: Among 6- to 11-year-old boys, underweight prevalence increased from 14.5 % (2004) to 20.1 % (2009, p = 0.068). Among 12- to 18-year-old boys, however, overweight prevalence increased from 7.5 to 12.6 % (p = 0.034). From 2004 to 2009, after-school sedentary behavior increased from 2.3 to 3.4 h/day for 6- to 11-year-olds (p < 0.001) and from 2.2 to 3.1 h/day for 12- to 18-year-olds (p < 0.01). Meanwhile, the total energy intake decreased 7 % for 6- to 11-year-olds (p < 0.05) and 10 % for 12- to 18-year-olds (p < 0.01). CONCLUSIONS: Both underweight and overweight Chinese students are increasing, with underweight increases more pronounced in 6- to 11-year-olds and overweight increases more pronounced in 12- to 18-year-olds. Nationwide efficacious interventions are needed that improve the diet, decrease sedentary behavior, and encourage a healthy and realistic body image in Chinese youth.