Multilevel Analysis of the Nutritional and Health Status among Children and Adolescents in Eastern China

Abstract

We aimed to identify multiple nutritional health problems and the relevant factors among children and adolescents aged 7–17 years. This study was part of the China Nutrition and Health Surveillance of Children and Lactating Mothers in 2016–2017, conducted in Jiangsu Province in eastern China. After sampling, 3025 school-age children and adolescents were enrolled into this study. Demographic information collections and anthropometric measurements were conducted by trained local Center for Disease Control and Prevention (CDC) staff. Venous blood in the amount of 6 mL was drawn from each participant in the morning and used for testing biochemical and nutritional indicators. Multivariate logistic regression analysis and Poisson regression analysis were used for overnutrition- and undernutrition-related disorders to test relevant personal, parental, and household factors. The prevalence of wasting, overweight, and obesity was 5.5%, 14.8%, and 12.7%, respectively. Metabolic syndrome (MetS) was prevalent among 5.1% of participants. Among the study participants, 29.5% had hyperuricemia. The overall prevalence of high low-density lipoprotein (LDL) and high total cholesterol (TC) of all participants was 4.8% and 7.4%, respectively. 0.9% of the participants had vitamin A deficiency (VAD) and 14.6% had marginal vitamin A deficiency; 25.1% had vitamin D deficiency (VDD) and 54.5% had inadequate vitamin D levels. Anemia was present in 4.0% of all participants. The prevalence of zinc deficiency was 4.8%. Demographic characteristics, behavioral characteristics, parents’ characteristics, and family characteristics were associated with these multiple malnutrition disorders. The double burdens of malnutrition, which includes overnutrition- and undernutrition-related diseases, were prevalent among the school-age children and adolescents in Jiangsu Province in eastern China. There were various factors related to different nutritional problems. Thus, health education focusing on behavior intervention and nutrition education are necessary in containing nutritional problems among children.

Systematic Literature Review of the Nutrient Status, Intake, and Diet Quality of Chinese Children across Different Age Groups

“…Anemia prevalence in 0–18-year-old children from China in national [ 30 , 31 , 47 ] and subnational studies (mostly covering the western region) ranged from 2.7 to 86%, and ID prevalence ranged from 7.3% to 62% [ 50 , 52 , 55 , 56 , 57 , 60 , 61 , 64 , 65 , 67 , 68 , 75 , 87 , 95 , 97 , 102 , 103 , 105 ]. The prevalence of anemia in children decreased with age ( Table 4 ).…”

“…The prevalence of zinc deficiency in children (6–11 years) from CHNS 2011-12 was reported at 10% [ 35 ]. A recent study by Tian et al, 2020, reported zinc deficiency in children (7–17 years) at 4.8% in Jiangsu province, eastern China [ 95 ].…”

“…The prevalence of Vitamin A deficiency (VAD) in children (0–17 years) ranged from 0 to 27% and Vitamin A insufficiency (VAI) from 15 to 58% [ 32 , 40 , 41 , 69 , 78 , 81 , 95 , 105 ]. A total of four studies reported VAD using CHNS 2011-12 data: for children 6–12 years, VAD was 6.6–8.0% (VAI 17–23%), and for children 12–17 years, it was 4.5–7.2% (VAI 14–21%) [ 33 , 40 , 41 ].…”

“…VAI appeared to peak in the 1–3-year-old group, between 43.3 and 54.1% [ 67 , 68 , 74 ], and to go down with age to approximately 14.32–21.13% ( Table 5 ) [ 32 , 40 , 41 , 95 , 105 ]. One study by Wang et al in central China reported a higher prevalence of VAD, namely 20% (VAI 41%) in children 0–12 years, compared with the CHNS studies mentioned above and other sub-national studies in western China [ 67 , 68 , 80 , 81 , 105 ].…”

Nutrient Patterns and Its Association and Metabolic Syndrome among Chinese Children and Adolescents Aged 7–17

“…Among those, the classifications of residence, age group, and Engel’s coefficient were consistent with our previous study [ 21 ]. Physical activity was grouped as low level (0–3 days/week), high level (≥4 days/week), and none [ 36 ]. Both the passive smoking and alcohol drinking status were divided into 2 groups (yes and no).…”