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Public Health Nutr. 2018 Aug;21(11):2056-2064. doi: 10.1017/S1368980018000290. Epub 2018 Feb 26.

What factors may contribute to sex differences in childhood obesity prevalence in China?

Author information

1
1The Robert F. Wagner Graduate School of Public Service,New York University,New York,NY,USA.
2
2Systems-oriented Global Childhood Obesity Intervention Program,Fisher Institute of Health and Well-being,College of Health,Ball State University,Muncie, IN,USA.
3
3Department of Health Behavior and Policy, School of Medicine,Virginia Commonwealth University, Richmond,VA,USA.
4
4Carolina Population Center,University of North Carolina,Chapel Hill,NC,USA.
5
5Nanjing Municipal Center for Disease Control and Prevention,Nanjing,People's Republic of China.
6
7National Institute for Nutrition and Health,Chinese Center for Disease Control and Prevention,Beijing,People's Republic of China.

Abstract

OBJECTIVE:

Previous studies in China showed large sex differences in childhood overweight and obesity (OW/OB) rates. However, limited research has examined the cause of these sex differences. The present study aimed to examine individual and parental/familial factors associated with sex differences in childhood OW/OB rates in China.

DESIGN:

Variables associated with child weight status, beliefs and behaviours, and obesity-related parenting practices were selected to examine their sex differences and association with a sex difference in child OW/OB outcomes using logistic regression analysis.

SETTING:

Cross-sectional data analysis using the 2011 China Health and Nutrition Survey.

SUBJECTS:

Children aged 6-17 years (n 1544) and their parents.

RESULTS:

Overall child OW/OB prevalence was 16·8 %. Adolescent boys (AB; 12-17 years) were about twice as likely to be overweight/obese as adolescent girls (AG; 15·5 v. 8·4 %, P<0·05). AB more likely had energy intake exceeding recommendations, self-perceived underweight, underestimated their body weight and were satisfied with their physical activity level than AG. AG more likely practised weight-loss management through diet and self-perceived overweight than AB. Mothers more likely identified AG's weight accurately but underestimated AB's weight. Stronger associations with risk of childhood OW/OB were found in boys than girls in dieting to lose weight (OR=6·7 in boys v. 2·6 in girls) and combined maternal and child perception of the child's overweight (OR=35·4 in boys v. 14·2 in girls).

CONCLUSIONS:

Large sex differences in childhood obesity may be related to the sex disparities in weight-related beliefs and behaviours among children and their parents in China.

KEYWORDS:

Children; China; Obesity; Parenting; Sex

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