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Public Health. 2017 Aug 23;153:44-51. doi: 10.1016/j.puhe.2017.07.002. [Epub ahead of print]

Increased obesity risks for being an only child in China: findings from a nationally representative study of 19,487 children.

Author information

1
Systems-oriented Global Childhood Obesity Intervention Program, Department of Epidemiology and Environmental Health, University at Buffalo, State University of New York, Buffalo, NY, USA; Department of Sociology, University of Notre Dame, Notre Dame, IN, USA.
2
Department of Health Behavior and Policy, School of Medicine, Virginia Commonwealth University, USA.
3
Department of Sociology, Renmin University of China, Haidian District, Beijing, China.
4
Department of Sociology, University of Utah, UT, USA.
5
Fisher Institute of Health and Well-being, College of Health, Ball State University, Muncie, IN, USA. Electronic address: ywang26@bsu.edu.

Abstract

OBJECTIVES:

Given the rapid demographic transition and obesity growth in China, it is important to study how the large only-child population (≈100 million) might contribute to the obesity epidemic. This study evaluated associations of only-child status with weight and energy expenditure-related behaviors in China and examined how the associations may vary by sex and urbanicity.

STUDY DESIGN:

Secondary analyses of nationally representative cross-sectional data from China Education Panel Survey: Junior Cohorts 2013-14, which included 19,487 students from 112 middle schools in 28 regions across China.

METHODS:

We used propensity-score-weighted multilevel models to test associations between only-child status and weight outcomes.

RESULTS:

Compared with sibling-sons, only-sons had higher body mass index (BMI) (Beta = 0.32, P < 0.05) and higher risks of overweight (OR = 1.24, 95% CI = [1.07-1.45]) and obesity (OR = 1.29, 95% CI = [1.02-1.64]); and spent less time on TV watching (Incidence rate ratio (IRR) = 0.89, 95% CI = [0.81-0.98]), internet use (IRR = 0.87, 95% CI = [0.79-0.96]), after-school sports (IRR = 0.91, 95% CI = [0.83-0.99]), and household chores (IRR = 0.85, 95% CI = [0.80-0.92]). Overweight/obesity risks for only-sons were particularly pronounced in urban China, where only-sons were 36% more likely to be overweight and 43% more likely to be obese than sibling-sons. Only-daughters had a higher risk of obesity (OR = 1.43, 95% CI = [1.01-2.04]) than sibling-daughters. However, the association was not significant for either urban girls or rural girls examined separately. Only-daughters in rural areas spent less time helping with household chores (IRR = 0.88, 95% CI = [0.80-0.97]) than sibling-daughters.

CONCLUSIONS:

Future childhood obesity interventions should pay special attention targeting the large young only-child population in China.

KEYWORDS:

Child obesity; China; One child policy; Only child; Physical activity

PMID:
28843799
DOI:
10.1016/j.puhe.2017.07.002
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