Content of Original Research·Prevention and Control of Obesity in Children and Adolescents in our journal

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    Analysis of Trend in the Prevalence of Central Obesity among Children and Adolescents Aged 7-18 in Putuo District, Shanghai from 2018 to 2023
    ZHANG Yu, YU Shuo, WANG Bingqing, RAN Qingqing, ZHANG Xiayun
    Chinese General Practice    2024, 27 (33): 4168-4175.   DOI: 10.12114/j.issn.1007-9572.2024.0172
    Abstract479)   HTML16)    PDF(pc) (1860KB)(133)       Save
    Background

    With the improvement of economic level and changes in lifestyle of residents, the obesity among children and adolescents has become increasingly severe, threatening the healthy growth of children and adolescents. BMI was used as an evaluation index of obesity in most previous studies, which may underestimate the prevalence of central obesity. Therefore, it is urgent to evaluate the waist circumference (WC) and trend of the prevalence of central obesity among children and adolescents in Putuo District, in order to provide scientific basis for targeted proposed intervention.

    Objective

    To analyze WC and the trend in the prevalence of central obesity among children and adolescents aged 7-18 years in Putuo District, Shanghai, from 2018 to 2023.

    Methods

    Data on medical examinations of primary and secondary school students in Putuo District in 2018 and 2020 to 2023 were used to analyze the WC, the prevalence of central obesity and the trends. The 90th percentile (P90) age-specific children and adolescents of different genders was used as the cut-off point of high WC, and WC exceeding the P90 value was defined as central obesity. SPSS 22.0 and SAS 13.1 were used for statistical analysis and Excel 2021 was used for graphic plotting.

    Results

    A total of 280 648 primary and secondary school students participated in the medical examination in Putuo District, Shanghai, from 2018 to 2023, of which 146 334 (52.1%) were male students and 134 314 (47.9%) were female students, with an median age of 10.5 (8.7, 12.6) years. WC of male and female students from 2018 to 2023 showed fluctuating downward trends with a statistically significant difference (Hmale=209.785, Hfemale=373.076; P<0.001). WC of male students decreased from 65.2 (58.0, 74.0) cm in 2018 to 64.8 (56.9, 74.0) cm in 2023 and female students decreased from 60.5 (55.0, 67.0) cm to 59.8 (53.8, 66.2) cm. Comparison of the prevalence of central obesity among male and female students in each year showed statistically significant differences (χ2male=264.123, χ2female=448.289; P<0.001). The results of Cochran-Armitage trend test showed decreasing trends in prevalences of central obesity among male and female groups from 2018 to 2023 (Ztrend male=-10.974, Ztrend female=-15.218; Ptrend<0.001). The prevalence of central obesity among male students decreased from 28.8% (6 714/23 286) to 24.6% (7 935/32 227), while that among female students decreased from 21.9% (4 604/21 062) to 15.5% (4 604/29 695). The WC and prevalence of central obesity among male students were higher than that among female students (U=7 128 257 114.500、χ2=2 928.075, P<0.001). Prevalence of central obesity showed increasing trends with age for both sexes (Ztrend male=35.167, Ztrend female=6.533; Ptrend<0.001) .

    Conclusion

    This study suggests that WC and the prevalence of central obesity among children and adolescents aged 7-18 in Putuo District are fluctuating and decreasing. WC and the prevalence of central obesity of male students are high than those of female students of the same age. The prevalence of central obesity is increasing with age. Results of this study provide theoretical support for the targeted intervention of central obesity in children and adolescents.

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    Asset Assessment for Obesity Control among Middle School Students: a Qualitative Study
    LIN Yixi, PAN Shasha, ZHANG Youjie
    Chinese General Practice    2024, 27 (33): 4176-4181.   DOI: 10.12114/j.issn.1007-9572.2024.0143
    Abstract301)   HTML9)    PDF(pc) (1464KB)(185)       Save
    Background

    Adolescence is a high-risk period for obesity, and it is crucial and urgent to implement obesity control among adolescents. However, existing interventions commonly face challenges in sustainability and scalability. Asset assessment to identify and leverage existing community assets and strengths is essential to facilitate and maintain the implementation of these programs.

    Objective

    To assess assets for obesity control among middle school students, and to identify the advantages and deficiencies in the current policy, physical, social, and information environments, along with suggestions for improvements.

    Methods

    From 2023 to January 2024, purposive sampling method was adopted, face-to-face one-by-one interviews were conducted with 11 staff members involved in obesity control for middle school students from the Center for Disease Control and Prevention, Education Bureau, and three middle schools in a major city in East China. Additionally, eight parents and their children from each of the three schools were invited to participate in focus group discussions, with 6 groups and 8 participants per group. Thematic analysis was applied to analyze the interview data.

    Results

    This study found that the advantages in obesity control for middle school students primarily included policies and conditions ensured for obesity surveillance, nutritional school lunch and physical activity, along with media for health communication. The main deficiencies were the lack of specific policies for efficient obesity control, insufficient physical and social assets to support healthy eating and physical activity, and the quality and intensity of information assets supporting to facilitate changes in knowledge, attitude, and behaviors. In response to these challenges, participants suggested the implementation of both rigid regulations and flexible incentives, improvement of asset accessibility, encouragement of multi-stakeholder cooperation, and strengthening of health communication. Integrating existing assets and suggestions for improvement has formed an asset assessment checklist, corresponding to 10 assets from the policy environment, 8 from the physical environment, 20 from the social environment, and 12 from the information environment.

    Conclusion

    Several assets exist for obesity control among middle school students and identifies areas for improvement. Subsequent efforts in obesity control for middle school students should be made on promoting intervention strategies to better align with the context based on the asset assessment checklist to diagnose the current status of assets, thus enhancing the efficacy and sustainability of the program.

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    Intestinal Flora: an Important Participant in Childhood Obesity
    LUO Yu, LUO Dan, TANG Binzhi
    Chinese General Practice    2024, 27 (33): 4182-4189.   DOI: 10.12114/j.issn.1007-9572.2023.0809
    Abstract529)   HTML13)    PDF(pc) (1684KB)(420)       Save

    The increasing incidence of childhood obesity has emerged as a novel challenge in the realm of global public health. Studies have demonstrated that alterations in the composition of intestinal flora during the early stages of life contribute to the development of obesity by influencing nutrient absorption and metabolism, triggering inflammatory responses, and regulating the communication between the gut and brain. Currently, Bifidobacterium and Akkermansia muciniphila have been found to reduce body fat content, exhibit anti-inflammatory properties, and enhance intestinal barrier function, whereas Prevotella is strongly associated with improvements in individual glucose metabolism induced by dietary fiber. Translational application of specific intestinal flora benefits to body glycolipid metabolism is helpful for the early prevention and therapy of pediatric obesity. This review elucidates the impact of early-life changes in intestinal flora composition on childhood obesity explores the mechanisms by which intestinal flora contributes to obesity pathogenesis, and specifically focuses on recent advances in utilizing short-chain fatty acids for the regulation of intestinal flora and the amelioration of obesity, aiming to provide a theoretical foundation for the intervention of childhood obesity from the perspective of intestinal flora.

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