Nationwide Trends of Pediatric Obesity and BMI z-Score From 2017-2021 in China: Comparable Findings From Real-World Mobile- and Hospital-Based Data

Abstract

IntroductionLifestyle changes including COVID-19 lockdown cause weight gain and may change obesity trends; however, timely changes are largely unknown and monitoring measures are usually lack. This first large-scale study aimed to analyze the real-world national trends of obesity prevalence of Chinese children in the past five years, and the impact of COVID-19 pandemic on pediatric obesity development through both mobile- and hospital-based data.MethodsThis study included children aged 3 to 19 years old all over China from January 2017 to April 2021. Hospital-measured and parent-reported cases from XIGAO database were analyzed. Body mass index (BMI) z-score calculation and obesity status evaluation were made according to Chinese standards. We evaluated obesity/overweight prevalence over the past five years and the changes of BMI z-score during COVID-19 lockdown.ResultsA total of 656396 children from 31 provinces were involved, including 447481 hospital-measured cases and 208915 parent-reported cases. The obesity and overweight prevalence were 8.05% (95%CI 7.76%–8.39%) and 10.06% (95%CI 10.79%–11.55%), comparable to those of China National Nutrition Surveys during 2015–2019. Northern China had the highest obesity prevalence. Parent-reported data had higher obesity/overweight prevalence than hospital-measured data (18.3% [95%CI 17.7%–18.9%] vs. 21.7% [95%CI 20.7%–23.0%]). The trend of obesity prevalence remained stable with slight decrease, but COVID-19 lockdown caused a significant increase of 1.86% in 2020. Both mobile- and hospital-based data showed weight gain in the first half of 2020. High BMI z-score increase were found among primary and junior middle school children, and children in northeast area during lockdown.ConclusionWeight gain during COVID-19 among Chinese children had regional differences and mainly affect primary and junior middle school children, thus warrants targeted interventions. The mobile growth assessment based on parent-reported data was a feasible, efficient and timely way for obesity monitoring among Chinese children, especially during epidemic.

Analysis of Risk Factors for Otitis Media with Effusion in Children with Adenoid Hypertrophy

“…The overweight and obesity rates of AH children are higher than those of Chinese children reported by the recent nationwide research 13 (control group) ( p <0.05). For AH girls, there is no significant difference in overweight and obesity rates compared with the reported prevalence.…”

“…And we compared the growing development data of AH patients with the national survey of children. 13 The overweight and obesity rate of AH children was significantly higher than in the control group. 13 This is consistent with the previous studies that have suggested a possible association between obesity and adenotonsillar hypertrophy.…”

“… 13 The overweight and obesity rate of AH children was significantly higher than in the control group. 13 This is consistent with the previous studies that have suggested a possible association between obesity and adenotonsillar hypertrophy. 6 , 7 Adipose tissue deposited around the pharynx and neck, along with hypertrophic adenoids largely plays a part in obstructive sleep apnea(OSA) in obese children.…”

“…11 To explore whether overweight and obesity are related to AH and the occurrence of OME in AH children, the height and weight of each child were measured to calculate the weight-for-age z-score(WAZ), height-for-age z-score (HAZ) and BMI-for-age z-score (BAZ) by the WHO anthro and anthroplus package in R 4.2.1 software. 12 The BAZ of children reported in the study 13 that investigated the BAZ of Chinese children all over the country were included in the control group. The BAZ ≥1 was defined as overweight, and BAZ ≥2 was defined as obesity.…”

Impact of the COVID-19 kindergarten closure on overweight and obesity among 3- to 7-year-old children

“…The study seized kindergarten closure as an opportunity to observe the impact of lifestyle changes on the OWO rates in Chinese preschool-age children. Although there have been some studies, including Chinese studies, investigating the relationships between the COVID-19 pandemic and physical activity, screen time, and diets [ 35 , 56 ], few studies have examined the impact of kindergarten or school closures on the prevalence of OWO using large and high-quality school-based anthropometric data and have performed four years of repeated data analysis. The limitation of the study was that private kindergartens were not included, which might lead to selection bias.…”