Objective: Determining geographical distribution and local dietary patterns involved in being obese is useful for designing intervention strategies. Methods: We selected residents between 18 and 65 years old from 11 Chinese provinces to compare dietary patterns and BMI
from the China Health and Nutrition Survey packages in 2011. We used linear and logistic regression analyses to assess the strength of association among geographic variables, the obesity problem, and dietary patterns. Results: The overall prevalence of overweight and obesity in the
North was 10.51% higher than that in the South. Northern dietary patterns feature a high intake of wheat and soybeans, whereas southern dietary patterns feature a high intake of rice, vegetables, meat, and poultry. The estimated coefficient of regional variables on dietary score is 1.49, the
estimated coefficient of regional variables on the odds ratio for being overweight is 1.68 and for being obese is 2.04. Multivariate logistic regression including both variables of South-North areas and northern dietary patterns showed a significant correlation with being overweight or obese.
Conclusions: Northern areas and their local dietary patterns are more likely to contribute to overweight and obesity. Our study provides empirical evidence for policies that target the ''obesogenic'' environment and promote opportunities for persons to access healthy dietary patterns
and nutritional balance.
The first-born child's quality may be affected by a younger sibling in a family based on the quantity-quality trade-off theory. Using data from the China Health and Nutrition Survey, we examine the causal effect of having a younger sibling on the health of the first-born child aged 2-12 in China. We use instrumental variables to address the potential endogeneity of having a younger sibling in the extended regression model. We found that having a sibling significantly decreases the height-for-age z-scores of the first-born child, and the greater age gap may alleviate the effect. Further analysis shows that the effect is particularly strong for the preschool child under 6 years old and the child in a low-income family or the rural area. A sibling influences the first-born child's health by dietary pattern, physical activities, and medical services utilization. The robustness checks, based on individual fixedeffects model and propensity score matching approach, validate our findings, which suggest that future preventive intervention on the deterioration of first-born child's health during the implementation of the universal two-child policy.
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