Abstract

Aims: This paper focuses on how social inequality is associated with overweight and obesity in children. There is a lack of research with a focus on an important distinction in social inequality, namely geography. The aim of this study was to reduce this knowledge gap by looking closely at the links between rurality and overweight. Methods: The findings in this paper are based on in-depth interviews with school nurses and teachers in rural Norway. The focus was on their experiences with and knowledge about overweight and obesity numbers in rural versus urban areas. Results: We used Bourdieu’s terminology to address the challenges related to urban–rural differences, and found that cultural factors connected to tradition, identity and courtesy play an important role in the rural overweight and obesity discourse. Conclusions: Actors and ‘experts’ working with overweight and obesity and national guidelines need to understand rural contexts and customs and address problems of the countryside on rural, not exclusively urban, premises. Different contexts imply different needs when it comes to reducing the inequalities between rural and urban areas regarding overweight and obesity.

Abstract

Aims: This paper focuses on how social inequality is associated with overweight and obesity in children. There is a lack of research with a focus on an important distinction in social inequality, namely geography. The aim of this study was to reduce this knowledge gap by looking closely at the links between rurality and overweight. Methods: The findings in this paper are based on in-depth interviews with school nurses and teachers in rural Norway. The focus was on their experiences with and knowledge about overweight and obesity numbers in rural versus urban areas. Results: We used Bourdieu’s terminology to address the challenges related to urban–rural differences, and found that cultural factors connected to tradition, identity and courtesy play an important role in the rural overweight and obesity discourse. Conclusions: Actors and ‘experts’ working with overweight and obesity and national guidelines need to understand rural contexts and customs and address problems of the countryside on rural, not exclusively urban, premises. Different contexts imply different needs when it comes to reducing the inequalities between rural and urban areas regarding overweight and obesity.

Abstract

Objective To examine the gender, age, and region of residence in the anthropometric and nutritional profiles of children and adolescents aged 6–18 in Henan Province, China's third most populous province. Design This cross-sectional study of the China National Nutrition and Health survey (2010–2013) used a multistage cluster sampling technique. The sample included Chinese schoolchildren and adolescents aged 6 to 18 years (1,660 boys and 1,561 girls). Multiple logistic regression models were used to estimate the associations between sociodemographic correlates and overweight or obesity and stunting. Setting. Nine districts/counties in Henan Province. Participants. 3,221 subjects completed the questionnaire. Sociodemographic information was obtained. Body weight and height were measured. Results There were statistically significant regional differences in average height and weight for boys in all age groups. Girls followed the same trends except for height when 15–18 years old. The urban-rural residence differences were found in relation to prevalence of stunting and weight status. Subjects in poor rural areas (15.43%) and ordinary rural areas (15.34%) had higher rates of stunting compared to their urban counterparts. Prevalence of overweight or obesity was highest in big city areas (15.71%) and lowest in ordinary rural areas (6.37%). Being a boy (OR = 1.69, 95% CI = 1.314–2.143), living in a big city (OR = 2.10, 95% CI = 1.431–3.073), or in a small-medium city (OR = 2.28, CI = 1.606–3.247), or being in a younger age group was associated with being overweight or obese. In addition, being a boy, living in a big city, or in a small-medium city, or being younger in age meant they were less likely to be stunted. Conclusions A substantial dual burden of malnutrition among children and adolescents in Henan Province was revealed. The urban-rural differences in nutritional status were found. Stunting was more prevalent in rural areas than in urban. In contrast, while the rising problem of childhood and adolescent obesity still exists in the big city, we also found a great spike in obesity in small-medium cities. Evidence also indicated that boys were more likely to be overweight or obese. Our findings suggest that nutrition education, as well as environmental and policy interventions, is needed to target specific geographic regions.

Abstract

Abstract Background: The urban–rural disparities in overweight and obesity among children and adolescents are narrowing, and there is a need for long-term and updated data to explain this inequality, understand the underlying mechanisms, and identify priority groups for interventions. Methods: We analyzed data from seven rounds of the Chinese National Survey on Students Constitution and Health (CNSSCH) conducted from 1985 to 2019, focusing on school-age children and adolescents aged 7–18 years. Joinpoint regression was used to identify inflection points (indicating a change in the trend) in the prevalence of overweight and obesity during the study period, stratified by urban/rural areas and sex. Annual percent change (APC), average annual percent change (AAPC), and 95% confidence interval (CI) were used to describe changes in the prevalence of overweight and obesity. Polynomial regression models were used to predict the prevalence of overweight and obesity among children and adolescents in 2025 and 2030, considering urban/rural areas, sex, and age groups. Results: The prevalence of overweight and obesity in urban boys and girls showed an inflection point of 2000, with AAPC values of 10.09% (95% CI: 7.33–12.92%, t = 7.414, P <0.001) and 8.67% (95% CI: 6.10–11.30%, t = 6.809, P <0.001), respectively. The APC for urban boys decreased from 18.31% (95% CI: 4.72–33.67%, t = 5.926, P = 0.027) to 4.01% (95% CI: 1.33–6.75%, t = 6.486, P = 0.023), while the APC for urban girls decreased from 13.88% (95% CI: 1.82–27.38%, t = 4.994, P = 0.038) to 4.72% (95% CI: 1.43–8.12%, t = 6.215, P = 0.025). However, no inflection points were observed in the best-fit models for rural boys and girls during the period 1985–2019. The prevalence of overweight and obesity for both urban and rural boys is expected to converge at 35.76% by approximately 2027. A similar pattern is observed for urban and rural girls, with a prevalence of overweight and obesity reaching 20.86% in 2025. Conclusions: The prevalence of overweight and obesity among Chinese children and adolescents has been steadily increasing from 1985 to 2019. A complete reversal in urban–rural prevalence is expected by 2027, with a higher prevalence of overweight and obesity in rural areas. Urgent action is needed to address health inequities and increase investments, particularly policies targeting rural children and adolescents.

Abstract

Objectives Overweight and obesity are harmful to human health. However, the latest trends of Chinese childhood overweight and obesity prevalence are not available. The aim of this study was to examine the trends from 2000 to 2019 among students in China. Methods We analyzed data of 66,072 students in the Chinese National Survey on Students' Constitution and Health from 2000 to 2019. Overweight and obesity were defined based on the standard formulated by the International Obesity Task Force (IOTF standard), the World Health Organization (WHO standard), and the Working Group on Obesity in China (WGOC standard), respectively. The χ2-test was used to test the trends of overweight and obesity prevalence and logistic regression was conducted to evaluate the prevalence odds ratios of boys vs. girls and urban vs. rural areas. Results The prevalence of obesity/overweight and obesity combined was 6.03/23.58% (IOTF standard), 10.56/25.88% (WGOC standard) and 10.75/29.69% (WHO standard) in 2019. From 2000 to 2019, according to the WGOC standard, the prevalence increased from 2.51 to 10.56% for obesity and increased from 9.81 to 25.88% for overweight and obesity combined (P for trend < 0.001). Obesity/overweight and obesity were greater problems in boys than girls and urban than rural areas, but urban-rural differences decreased over time. Conclusion Overweight and obesity prevalence increased significantly in children and adolescents in China from 2000 to 2019. The prevalence of overweight and obesity in rural areas may contribute to a large percentage of children with overweight and obesity.

Abstract

Abstract Background: The urban–rural disparities in overweight and obesity among children and adolescents are narrowing, and there is a need for long-term and updated data to explain this inequality, understand the underlying mechanisms, and identify priority groups for interventions. Methods: We analyzed data from seven rounds of the Chinese National Survey on Students Constitution and Health (CNSSCH) conducted from 1985 to 2019, focusing on school-age children and adolescents aged 7–18 years. Joinpoint regression was used to identify inflection points (indicating a change in the trend) in the prevalence of overweight and obesity during the study period, stratified by urban/rural areas and sex. Annual percent change (APC), average annual percent change (AAPC), and 95% confidence interval (CI) were used to describe changes in the prevalence of overweight and obesity. Polynomial regression models were used to predict the prevalence of overweight and obesity among children and adolescents in 2025 and 2030, considering urban/rural areas, sex, and age groups. Results: The prevalence of overweight and obesity in urban boys and girls showed an inflection point of 2000, with AAPC values of 10.09% (95% CI: 7.33–12.92%, t = 7.414, P <0.001) and 8.67% (95% CI: 6.10–11.30%, t = 6.809, P <0.001), respectively. The APC for urban boys decreased from 18.31% (95% CI: 4.72–33.67%, t = 5.926, P = 0.027) to 4.01% (95% CI: 1.33–6.75%, t = 6.486, P = 0.023), while the APC for urban girls decreased from 13.88% (95% CI: 1.82–27.38%, t = 4.994, P = 0.038) to 4.72% (95% CI: 1.43–8.12%, t = 6.215, P = 0.025). However, no inflection points were observed in the best-fit models for rural boys and girls during the period 1985–2019. The prevalence of overweight and obesity for both urban and rural boys is expected to converge at 35.76% by approximately 2027. A similar pattern is observed for urban and rural girls, with a prevalence of overweight and obesity reaching 20.86% in 2025. Conclusions: The prevalence of overweight and obesity among Chinese children and adolescents has been steadily increasing from 1985 to 2019. A complete reversal in urban–rural prevalence is expected by 2027, with a higher prevalence of overweight and obesity in rural areas. Urgent action is needed to address health inequities and increase investments, particularly policies targeting rural children and adolescents.

Abstract

Objective To examine the gender, age, and region of residence in the anthropometric and nutritional profiles of children and adolescents aged 6–18 in Henan Province, China's third most populous province. Design This cross-sectional study of the China National Nutrition and Health survey (2010–2013) used a multistage cluster sampling technique. The sample included Chinese schoolchildren and adolescents aged 6 to 18 years (1,660 boys and 1,561 girls). Multiple logistic regression models were used to estimate the associations between sociodemographic correlates and overweight or obesity and stunting. Setting. Nine districts/counties in Henan Province. Participants. 3,221 subjects completed the questionnaire. Sociodemographic information was obtained. Body weight and height were measured. Results There were statistically significant regional differences in average height and weight for boys in all age groups. Girls followed the same trends except for height when 15–18 years old. The urban-rural residence differences were found in relation to prevalence of stunting and weight status. Subjects in poor rural areas (15.43%) and ordinary rural areas (15.34%) had higher rates of stunting compared to their urban counterparts. Prevalence of overweight or obesity was highest in big city areas (15.71%) and lowest in ordinary rural areas (6.37%). Being a boy (OR = 1.69, 95% CI = 1.314–2.143), living in a big city (OR = 2.10, 95% CI = 1.431–3.073), or in a small-medium city (OR = 2.28, CI = 1.606–3.247), or being in a younger age group was associated with being overweight or obese. In addition, being a boy, living in a big city, or in a small-medium city, or being younger in age meant they were less likely to be stunted. Conclusions A substantial dual burden of malnutrition among children and adolescents in Henan Province was revealed. The urban-rural differences in nutritional status were found. Stunting was more prevalent in rural areas than in urban. In contrast, while the rising problem of childhood and adolescent obesity still exists in the big city, we also found a great spike in obesity in small-medium cities. Evidence also indicated that boys were more likely to be overweight or obese. Our findings suggest that nutrition education, as well as environmental and policy interventions, is needed to target specific geographic regions.

Abstract

Objectives Overweight and obesity are harmful to human health. However, the latest trends of Chinese childhood overweight and obesity prevalence are not available. The aim of this study was to examine the trends from 2000 to 2019 among students in China. Methods We analyzed data of 66,072 students in the Chinese National Survey on Students' Constitution and Health from 2000 to 2019. Overweight and obesity were defined based on the standard formulated by the International Obesity Task Force (IOTF standard), the World Health Organization (WHO standard), and the Working Group on Obesity in China (WGOC standard), respectively. The χ2-test was used to test the trends of overweight and obesity prevalence and logistic regression was conducted to evaluate the prevalence odds ratios of boys vs. girls and urban vs. rural areas. Results The prevalence of obesity/overweight and obesity combined was 6.03/23.58% (IOTF standard), 10.56/25.88% (WGOC standard) and 10.75/29.69% (WHO standard) in 2019. From 2000 to 2019, according to the WGOC standard, the prevalence increased from 2.51 to 10.56% for obesity and increased from 9.81 to 25.88% for overweight and obesity combined (P for trend < 0.001). Obesity/overweight and obesity were greater problems in boys than girls and urban than rural areas, but urban-rural differences decreased over time. Conclusion Overweight and obesity prevalence increased significantly in children and adolescents in China from 2000 to 2019. The prevalence of overweight and obesity in rural areas may contribute to a large percentage of children with overweight and obesity.

Abstract

Introduction over the past three decades, the number of overweight children in Africa has doubled. We aimed to determine the prevalence of overweight and obesity in children and investigate the associated factors in urban and rural areas of Cameroon. Methods this was a cross-sectional study on adolescents and children aged between 3 and 19 years, recruited at 22 multi-staged randomly selected schools in Yaounde (urban setting) and Mbouda (semi-urban setting), Cameroon, from December 2017 to June 2018. We collected socio-demographic data, relevant history, and anthropometric measurements. Overweight and obesity were diagnosed according to the International Obesity Task Force for children and adolescents. Associated factors were assessed through multivariate analysis with logistic regression and presented with their OR and 95% confidence interval. Results a total of 2398 students were included in the study. The median age was 15 years (IQR 12-17 years). The prevalence rates of overweight and obesity were 27.2% and 9.8% in the semi-urban area vs 27.3% and 30.4% in the urban area (p< 0.001). The prevalence of abdominal obesity was 19.7% in the semi-urban area vs. 15.2% in the urban area (p=0.004). The factors associated with overweight and obesity were increased waist circumference (aOR = 1.03, 95% CI = 1.02 - 1.05, p <0.001), an urban residence (aOR = 2.57, 95% CI = 1.84 - 3.59, p <0.001), increased number of meals per day (aOR = 1.11, 95% CI = 1.01 - 1.23, p =0.034), motorised transport to school (aOR = 1.49, 95% CI = 1.20 - 1.85, p <0.001). Conclusion the prevalence of childhood obesity is greater in urban than semi-urban areas of Cameroon. There are many factors associated with the onset of this pathology in our setting, the control of which could be the subject of prevention.

Abstract

Background Recent decades have shown a rapid increase in the prevalence of overweight and obesity among Chinese children based on several national surveys. Restrictions due to the coronavirus disease 2019 outbreak have worsened its epidemiology. This review updates the trends in the prevalence of overweight and obesity among Chinese children and adolescents and analyzes the underlying reasons to provide evidence for better policy making. Methods Studies published in English and Chinese were retrieved from PubMed, Google Scholar, China National Knowledge Infrastructure and Wanfang. Results The prevalence of overweight and obesity has been increasing for decades and varies with age, sex and geography but is more pronounced in primary school students. The increase in obesity in boys appeared to be slower, whereas that in girls showed a declining trend. The northern areas of China have persistently maintained the highest levels of obesity with a stable trend in recent years. Meanwhile, the prevalence in eastern regions has dramatically increased. Notably, the overall prevalence of obesity in children has shown a stabilizing trend in recent years. However, the occurrence of obesity-related metabolic diseases increased. The effect of migrants floating into east-coast cities should not be neglected. Conclusions The high prevalence of overweight and obesity among Chinese children and adolescents persists but with varying patterns. Obesity-related metabolic diseases occur more frequently despite a stable trend of obesity. Multiple factors are responsible for the changing prevalence. Thus, comprehensive and flexible policies are needed to effectively manage and prevent the burden of obesity and its related complications.

Abstract

Introduction over the past three decades, the number of overweight children in Africa has doubled. We aimed to determine the prevalence of overweight and obesity in children and investigate the associated factors in urban and rural areas of Cameroon. Methods this was a cross-sectional study on adolescents and children aged between 3 and 19 years, recruited at 22 multi-staged randomly selected schools in Yaounde (urban setting) and Mbouda (semi-urban setting), Cameroon, from December 2017 to June 2018. We collected socio-demographic data, relevant history, and anthropometric measurements. Overweight and obesity were diagnosed according to the International Obesity Task Force for children and adolescents. Associated factors were assessed through multivariate analysis with logistic regression and presented with their OR and 95% confidence interval. Results a total of 2398 students were included in the study. The median age was 15 years (IQR 12-17 years). The prevalence rates of overweight and obesity were 27.2% and 9.8% in the semi-urban area vs 27.3% and 30.4% in the urban area (p< 0.001). The prevalence of abdominal obesity was 19.7% in the semi-urban area vs. 15.2% in the urban area (p=0.004). The factors associated with overweight and obesity were increased waist circumference (aOR = 1.03, 95% CI = 1.02 - 1.05, p <0.001), an urban residence (aOR = 2.57, 95% CI = 1.84 - 3.59, p <0.001), increased number of meals per day (aOR = 1.11, 95% CI = 1.01 - 1.23, p =0.034), motorised transport to school (aOR = 1.49, 95% CI = 1.20 - 1.85, p <0.001). Conclusion the prevalence of childhood obesity is greater in urban than semi-urban areas of Cameroon. There are many factors associated with the onset of this pathology in our setting, the control of which could be the subject of prevention.

Abstract

We describe the development of a comprehensive proof-of-concept index of environmental exposures for children based on evidence-informed connections to health behaviours– the Healthy Environments Index for Children (HEIC) - with two sub-indices relating to the food environment (HEIC-FE) and physical activity environment (HEIC-PA) in Taranaki, New Zealand. Associations between this theory-informed index and health outcomes in a cohort of children and adolescents identified with overweight or obesity and enrolled in a community-based healthy lifestyle programme and randomised controlled trial were examined. The HIEC was developed using Geographic Information Systems (GIS) and 15 variables selected from a series of systematic literature reviews identifying environmental factors associated with childhood obesity. Activity spaces around each participant’s residential address, and the route to their nearest school were created and used to estimate environmental exposure. Health data from the Whānau Pakari randomised controlled trial (n = 179 at baseline, 121 at 12-months, 95 at 24-months) was integrated to test associations between HEIC and health outcomes. Statistical analyses included spearman rank correlations, multinomial linear regression, and geographically weighted regression. Higher HEIC scores (indicating health-promoting environments) tended to be clustered within the cities and towns, while rural areas had low HEIC scores. Strong and consistent associations were not identified between HEIC indices and health outcomes in our study population. However, higher HEIC food environments were associated with increased water intake and decreased sweet drink intake at 24-months. The theory-informed HEIC and its two subindices may be useful tools for policy and practice aiming at improving child health outcomes. However, they require validation in larger studies in other areas of New Zealand.

Abstract

We describe the development of a comprehensive proof-of-concept index of environmental exposures for children based on evidence-informed connections to health behaviours– the Healthy Environments Index for Children (HEIC) - with two sub-indices relating to the food environment (HEIC-FE) and physical activity environment (HEIC-PA) in Taranaki, New Zealand. Associations between this theory-informed index and health outcomes in a cohort of children and adolescents identified with overweight or obesity and enrolled in a community-based healthy lifestyle programme and randomised controlled trial were examined. The HIEC was developed using Geographic Information Systems (GIS) and 15 variables selected from a series of systematic literature reviews identifying environmental factors associated with childhood obesity. Activity spaces around each participant’s residential address, and the route to their nearest school were created and used to estimate environmental exposure. Health data from the Whānau Pakari randomised controlled trial (n = 179 at baseline, 121 at 12-months, 95 at 24-months) was integrated to test associations between HEIC and health outcomes. Statistical analyses included spearman rank correlations, multinomial linear regression, and geographically weighted regression. Higher HEIC scores (indicating health-promoting environments) tended to be clustered within the cities and towns, while rural areas had low HEIC scores. Strong and consistent associations were not identified between HEIC indices and health outcomes in our study population. However, higher HEIC food environments were associated with increased water intake and decreased sweet drink intake at 24-months. The theory-informed HEIC and its two subindices may be useful tools for policy and practice aiming at improving child health outcomes. However, they require validation in larger studies in other areas of New Zealand.

Abstract

Objective: To identify major sugar-sweetened beverage (SSB) consumption patterns among Chinese children and adolescents and examine their associations with childhood overweight/obesity. Methods: Data were drawn from the Chinese Food Consumption Survey (2017–2020), including 7979 children and adolescents. SSB intake was assessed using a non-consecutive 3-day 24 h dietary recall and classified into nine types. Principal component analysis identified SSB consumption patterns. Nutritional status was defined using BMI Z-scores, following the World Health Organization growth standards. Multivariable logistic regression was used to assess the associations between SSB patterns and overweight/obesity, with subgroup analyses by sex, age, and residence area. Results: Three major SSB patterns were identified: (1) Carbonated Beverage and Milk Tea Pattern (dominated by carbonated beverages and milk tea); (2) Functional Beverages Pattern (dominated by coffee beverages and sports beverages); and (3) Plant Hybrid Pattern (dominated by plant protein beverages and plant-based beverages). Preschool-aged children exhibited lower scores across all three patterns. Higher pattern scores were observed among school-aged children and adolescents and those with lower parental education levels, parents working as unskilled labor or homemakers, lower family annual income per capita, and residence in rural areas. All three identified SSB consumption patterns demonstrated significant positive associations with overweight/obesity in children, where higher consumption levels corresponded to greater odds of overweight/obesity. Children exhibiting higher scores in two or more patterns had higher odds of being overweight/obese (Medium-high: OR = 1.249, 95% CI = 1.053, 1.482; High: OR = 1.256, 95% CI = 1.081, 1.459). Subgroup analysis further indicated that the association between the Plant Hybrid Pattern score and overweight/obesity varied significantly by sex. Conclusions: Three SSB consumption patterns were associated with a higher likelihood of overweight/obesity among Chinese children, particularly among those with preferences for multiple SSB types. Interventions should be tailored to SSB consumption habits and socioeconomic contexts, with special attention to rural populations.

Abstract

Objective: To identify major sugar-sweetened beverage (SSB) consumption patterns among Chinese children and adolescents and examine their associations with childhood overweight/obesity. Methods: Data were drawn from the Chinese Food Consumption Survey (2017–2020), including 7979 children and adolescents. SSB intake was assessed using a non-consecutive 3-day 24 h dietary recall and classified into nine types. Principal component analysis identified SSB consumption patterns. Nutritional status was defined using BMI Z-scores, following the World Health Organization growth standards. Multivariable logistic regression was used to assess the associations between SSB patterns and overweight/obesity, with subgroup analyses by sex, age, and residence area. Results: Three major SSB patterns were identified: (1) Carbonated Beverage and Milk Tea Pattern (dominated by carbonated beverages and milk tea); (2) Functional Beverages Pattern (dominated by coffee beverages and sports beverages); and (3) Plant Hybrid Pattern (dominated by plant protein beverages and plant-based beverages). Preschool-aged children exhibited lower scores across all three patterns. Higher pattern scores were observed among school-aged children and adolescents and those with lower parental education levels, parents working as unskilled labor or homemakers, lower family annual income per capita, and residence in rural areas. All three identified SSB consumption patterns demonstrated significant positive associations with overweight/obesity in children, where higher consumption levels corresponded to greater odds of overweight/obesity. Children exhibiting higher scores in two or more patterns had higher odds of being overweight/obese (Medium-high: OR = 1.249, 95% CI = 1.053, 1.482; High: OR = 1.256, 95% CI = 1.081, 1.459). Subgroup analysis further indicated that the association between the Plant Hybrid Pattern score and overweight/obesity varied significantly by sex. Conclusions: Three SSB consumption patterns were associated with a higher likelihood of overweight/obesity among Chinese children, particularly among those with preferences for multiple SSB types. Interventions should be tailored to SSB consumption habits and socioeconomic contexts, with special attention to rural populations.

Abstract

Background: Overweight and obesity have emerged as major public health challenges in China, with rising prevalence rates posing substantial burdens on healthcare systems. This study is a secondary analysis of data from the 2019 Chinese National Survey on Students’ Constitution and Health (CNSSCH), aimed to investigate the association of family and individual physical activity (PA) environments with overweight and obesity transition among children and adolescents, and to analyze subgroup differences by sex and urban–rural location as well as potential mechanisms. Methods: This was a one-year longitudinal study based on the 2019–2020 follow-up of 5008 children and adolescents. Family and individual physical activity environments were assessed as main exposures, and transitions to overweight and obesity were defined as outcomes. Multivariate logistic regression was applied to evaluate the association between family and individual PA environments and transitions to overweight and obesity, while also examining their moderating effects on unhealthy lifestyle behaviors. Results: A favorable family and individual PA environment was significantly associated with a reduced risk of obesity transition (OR = 0.78, p = 0.016). Subgroup analyses indicated that males (OR = 0.69, p = 0.009) and rural children and adolescents (OR = 0.70, p = 0.021) were more sensitive to supportive family and individual PA environments. Furthermore, a favorable environment was significantly correlated with a reduction in unhealthy behaviors such as skipping daily breakfast and consuming sugar-sweetened beverages (p < 0.001). Conclusions: A supportive family and individual PA environment was associated with a lower risk of obesity transition in children and adolescents, with more pronounced associations observed among males and those in rural areas.

Abstract

Background: Overweight and obesity have emerged as major public health challenges in China, with rising prevalence rates posing substantial burdens on healthcare systems. This study is a secondary analysis of data from the 2019 Chinese National Survey on Students’ Constitution and Health (CNSSCH), aimed to investigate the association of family and individual physical activity (PA) environments with overweight and obesity transition among children and adolescents, and to analyze subgroup differences by sex and urban–rural location as well as potential mechanisms. Methods: This was a one-year longitudinal study based on the 2019–2020 follow-up of 5008 children and adolescents. Family and individual physical activity environments were assessed as main exposures, and transitions to overweight and obesity were defined as outcomes. Multivariate logistic regression was applied to evaluate the association between family and individual PA environments and transitions to overweight and obesity, while also examining their moderating effects on unhealthy lifestyle behaviors. Results: A favorable family and individual PA environment was significantly associated with a reduced risk of obesity transition (OR = 0.78, p = 0.016). Subgroup analyses indicated that males (OR = 0.69, p = 0.009) and rural children and adolescents (OR = 0.70, p = 0.021) were more sensitive to supportive family and individual PA environments. Furthermore, a favorable environment was significantly correlated with a reduction in unhealthy behaviors such as skipping daily breakfast and consuming sugar-sweetened beverages (p < 0.001). Conclusions: A supportive family and individual PA environment was associated with a lower risk of obesity transition in children and adolescents, with more pronounced associations observed among males and those in rural areas.

Abstract

Background Non-communicable diseases (NCDs) are a growing concern in low- and middle-income countries, especially among adolescents. Recent data indicate a rise in NCD cases within this group. Despite the increasing prevalence of NCD risk factors, limited research has explored the relationship between perceived stress and NCDs. Study aim To compare adolescents aged 12 to 18 years who are at risk for NCDs with those who are not at risk, considering sex, school quintiles, and perceived stress. Settings The study involved 266 adolescents selected through stratified random sampling from seven schools in two Eastern Cape districts. Methods It assessed anthropometric and physiological measurements and perceived stress levels. Descriptive statistics were used to summarize data, while independent samples t-tests analyses were employed to compare groups. Logistic regression was utilized to predict probability. Results Most physical and physiological assessments were normal, except for females’ elevated BMI (24.52 ± 6.11), classifying them as overweight. Perceived stress did not differ significantly between at-risk and not-at-risk adolescents, although at-risk females reported higher stress levels than males. Perceived stress was consistently higher among adolescents from Quintiles 4–5 schools across both at-risk and not-at-risk groups. Logistic regression analysis indicated that sex was the significant predictor of NCD risk, with females being four times more likely to develop NCD risk factors than males, whereas school quintile was not a significant predictor. Conclusion The study highlights a greater risk of NCD development among female adolescents, who also experience elevated levels of perceived stress. Recommendations to address these findings include specific strategies that reduce this population’s risk factors.