TY - JOUR
T1 - School environment and policies, child eating behavior and overweight/obesity in urban China
T2 - The childhood obesity study in China megacities
AU - Jia, P.
AU - Li, M.
AU - Xue, H.
AU - Lu, L.
AU - Xu, F.
AU - Wang, Y.
N1 - Funding Information:
The present study is funded by research grant from the National Institute of Health (NIH, U54 HD070725). The U54 project (U54 HD070725) is funded by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) and the Office of the Director, National Institutes of Health (to OD). Dr Wang is the principal investigator of the projects. The content of the paper is solely the responsibility of the authors and does not necessarily represent the official views of the funders. We thank all the study participants and the school personnel who participated in the study and our collaborators who have contributed to the study. None of the authors has been paid to write this article by a pharmaceutical company or other commercial agencies.
Publisher Copyright:
© 2017 Macmillan Publishers Limited, part of Springer Nature. All rights reserved.
PY - 2017/5/1
Y1 - 2017/5/1
N2 - Objectives: Childhood obesity is rising rapidly in China, especially in urban areas. Knowledge about how school environment and policies (SEPs) may have contributed to the epidemic remains limited. We examined SEP and their associations with students' eating behaviors and overweight/obesity in urban China.Methods: Data were collected from 1648 students (plus their parents and schools) in 16 primary and middle schools (4 schools per city) in four megacities across China: Beijing, Shanghai, Nanjing and Xi'an. We examined nutrition-related SEP such as unhealthy food restriction, healthy food promotion, price control and nutrition guideline in school cafeterias (SCs), campus food stores (CFS), school vicinity food stalls (SVFS); SEP on physical activity, physical education (PE) and physical examination. Cluster robust regression models were fit to assess associations of SEP with child eating behaviors and overweight/obesity (defined based on body mass index, from measured weight and height).Results: All 16 schools had regular PE classes and annual physical examination. Most schools (n=12; 75%) had food policies in SC; few had policies on CFS (n=1; 6.25%) or SVFS (n=4; 25%). Local governments had a major role in regulating food prices, setting nutrition guidelines and regulating SVFS. Policies on CFS and SVFS were associated with less frequent intake of sugary beverage (odds ratio (OR)=0.54 (0.47-0.61); OR=0.70 (0.61-0.80)), snack (OR=0.84 (0.74-0.95); OR=0.78 (0.67-0.92)) and fast food (OR=0.58 (0.42-0.81); OR=0.56 (0.39-0.80)). The associations were stronger for boys. Policies on SC, CFS and SVFS were associated with lower likelihood for overweight/obesity (OR=0.60 (0.46-0.79); OR=0.74 (0.62-0.90); OR=0.51 (0.35-0.73)) and central obesity (OR=0.79 (0.70-0.89); OR=0.67 (0.48-0.92); OR=0.63 (0.48-0.84)) in boys. Policies on SC were associated with lower overweight/obesity odds (OR=0.48 (0.28-0.82)) for girls.Conclusions: SEP are heterogeneous in the four Chinese megacities, high-income areas. They affect child unhealthy eating and overweight/obesity, and are critical for fighting childhood obesity in China.
AB - Objectives: Childhood obesity is rising rapidly in China, especially in urban areas. Knowledge about how school environment and policies (SEPs) may have contributed to the epidemic remains limited. We examined SEP and their associations with students' eating behaviors and overweight/obesity in urban China.Methods: Data were collected from 1648 students (plus their parents and schools) in 16 primary and middle schools (4 schools per city) in four megacities across China: Beijing, Shanghai, Nanjing and Xi'an. We examined nutrition-related SEP such as unhealthy food restriction, healthy food promotion, price control and nutrition guideline in school cafeterias (SCs), campus food stores (CFS), school vicinity food stalls (SVFS); SEP on physical activity, physical education (PE) and physical examination. Cluster robust regression models were fit to assess associations of SEP with child eating behaviors and overweight/obesity (defined based on body mass index, from measured weight and height).Results: All 16 schools had regular PE classes and annual physical examination. Most schools (n=12; 75%) had food policies in SC; few had policies on CFS (n=1; 6.25%) or SVFS (n=4; 25%). Local governments had a major role in regulating food prices, setting nutrition guidelines and regulating SVFS. Policies on CFS and SVFS were associated with less frequent intake of sugary beverage (odds ratio (OR)=0.54 (0.47-0.61); OR=0.70 (0.61-0.80)), snack (OR=0.84 (0.74-0.95); OR=0.78 (0.67-0.92)) and fast food (OR=0.58 (0.42-0.81); OR=0.56 (0.39-0.80)). The associations were stronger for boys. Policies on SC, CFS and SVFS were associated with lower likelihood for overweight/obesity (OR=0.60 (0.46-0.79); OR=0.74 (0.62-0.90); OR=0.51 (0.35-0.73)) and central obesity (OR=0.79 (0.70-0.89); OR=0.67 (0.48-0.92); OR=0.63 (0.48-0.84)) in boys. Policies on SC were associated with lower overweight/obesity odds (OR=0.48 (0.28-0.82)) for girls.Conclusions: SEP are heterogeneous in the four Chinese megacities, high-income areas. They affect child unhealthy eating and overweight/obesity, and are critical for fighting childhood obesity in China.
KW - ITC-ISI-JOURNAL-ARTICLE
KW - n/a OA procedure
UR - http://www.scopus.com/inward/record.url?scp=85013191686&partnerID=8YFLogxK
UR - http://ezproxy.utwente.nl:2048/login?url=https://webapps.itc.utwente.nl/library/2017/isi/jia_sch.pdf
U2 - 10.1038/ijo.2017.2
DO - 10.1038/ijo.2017.2
M3 - Article
C2 - 28074059
SN - 0307-0565
VL - 41
SP - 813
EP - 819
JO - International journal of obesity
JF - International journal of obesity
IS - 5
ER -
