Trends in overweight and obesity among children and adolescents in China from 1981 to 2010: a meta-analysis

Abstract

Background: Overweight/obesity is a serious public health problem that affects a large part of the world population across all age and racial/ethnic groups. However, there has not been a meta-analysis of the prevalence of childhood and adolescent overweight/obesity in China during the past 30 years.

Methods: The China National Knowledge Infrastructure and Wanfang DATA, MEDLINE, EMBASE and Cumulative Index to Nursing and Allied Health Literature were searched for relevant studies published between January 1970 and June 2012. The prevalence of overweight/obesity over time was pooled using Stata/SE, version 9. Summary statistics (odds ratios, ORs) were used to compare sex-specific and urban-rural preponderance of overweight/obesity using Review Manager.

Results: After screening 1326 papers, we included 35 papers (41 studies), most of medium quality. The prevalence of overweight/obesity increased from 1.8% (95% confidence interval [CI], 0.4%-3.1%) and 0.4% (95% CI, -0.1% to -0.8%) respectively in 1981-1985 to 13.1% (95% CI, 11.2%-15.0%) and 7.5% (95% CI, 6.6%-8.4%) respectively in 2006-2010. The average annual increase was 8.3% and 12.4% respectively. Boys were more likely to be overweight/obese than girls (OR, 1.36; 95% CI, 1.24-1.49 and OR, 1.68; 95% CI, 1.52-1.86 respectively). The prevalence of overweight/obesity was higher in urban areas than in rural areas (OR, 1.66; 95% CI, 1.54-1.79 and OR, 1.97; 95% CI, 1.68-2.30 respectively). For age-specific subgroup analyses, both overweight and obesity increased more rapidly in the toddler stage than in other developmental stages. Sensitivity analyses showed that sample-size differences, study quality, overweight/obesity criteria and geographical distribution affected overweight/obesity prevalence.

Conclusions: Toddlers and urban boys were at particularly high risk; the prevalence in these groups increased more rapidly than in their counterparts. Public health prevention strategies are urgently needed to modify health behaviors of children and adolescents and control overweight/obesity in China.

Figure 1. Flow chart of article screening and selection process.

Figure 2. Forest plot of overweight in boys compared with girls (aged, 0–18 years).

Figure 3. Forest plot of obesity in boys compared with girls (aged 0–18 years).