Logo: to the web site of Uppsala University

Background: Childhood obesity has become a nutritional problem in China since the 1990s.

Aims: A family based behavioural treatment was developed and tested, to see if its use was feasible in China and to evaluate its impact on obese schoolchildren.

Methods: In a single school in Beijing, 33 obese children were randomly assigned to a treatment group and 35 to a control group. The treatment group participated in a family based behavioural treatment programme for two years. Height and weight were measured every six months for all participants. Blood pressure, cholesterol, and triglyceride levels were measured at baseline and after two years of programme implementation.

Results: Body mass index (BMI, kg/m²) was significantly reduced in the treatment group (from 26.6 (1.7) to 24.0 (0.9), 95% CI 2.06 to 3.18) but not in the control group (from 26.1 (1.5) to 26.0 (1.6)). Total cholesterol decreased 5.5% and triglycerides 9.7% in the treatment group. There was a significant correlation between change in BMI and change in triglycerides. There were no significant changes in plasma lipids in the controls. Blood pressure values also decreased significantly in the treatment, but not the control group.

Conclusions: A family based behavioural intervention was feasible to use in treating obesity in schoolchildren in Beijing, China. After two years of implementation, it successfully decreased the degree of obesity, reduced levels of blood pressure, and decreased serum lipids in treatment; there were no significant changes among control children.

Background: Childhood obesity has become a health problem in urban areas in China. Intervention to reduce childhood obesity should be of high priority. School-based intervention programmes are needed to deal with the growing prevalence of childhood obesity in China.

Methods: Five primary schools were selected randomly for this study in the Beijing urban area in China; two were allocated to the intervention group and three to the control group. A total of 2425 children (1029 children in intervention schools and 1396 children in control schools) took part in the study for 3 years. In the intervention group, children and their parents were involved in a programme of nutrition education and physical activity. Control school students followed their usual health and physical education curriculum with no extra intervention.

Results: After the 3-year intervention, the prevalence of overweight and obesity were significantly lower in the intervention schools than in the control schools (overweight: 9.8% vs. 14.4%, P < 0.01; obesity: 7.9% vs. 13.3%, P < 0.01). The prevalence of overweight and obesity decreased by 26.3% and 32.5% in intervention schools respectively after intervention. The prevalence of overweight and obesity increased in control schools. There was also significant difference in body mass index between intervention and control schools (18.2 ± 2.6 vs. 20.3 ± 3.4, P < 0.01) after intervention. More non-obese children became obese in the control schools (7.0%) than in the intervention schools (2.4%) at end line (P < 0.01). Among the children who were obese at baseline, 49.2% remained obese at end line in intervention schools while 61.9% remained obese in control schools (P < 0.01).

Conclusions: Our study showed that an intervention programme could be feasible in schools in Beijing, China. The prevalence of overweight and obesity was reduced in schoolchildren in Beijing through an intervention focused on nutrition education and physical activity. Overweight and obesity children as well as normal weight children and their parents should be involved in such an intervention programme.

Objective. To assess the prevalence of overweight among Chinese preschool children and to explore risk factors of childhood obesity focusing on parental characteristics, feeding practice and lifestyle. Methods. Data on 930 families with 2- to 6-year-old children in five kindergartens were obtained in a cross sectional study. Families were randomly selected from two of all six urban districts in Beijing, China. Information on parental characteristics, dietary habits, lifestyle habits, and feeding practice was collected by parental self-report questionnaires. The children's stature and weight were measured in light clothing and without shoes. Overweight and obesity were defined according to international cut-off values, as proposed by the International Obesity Task Force. Multivariate regression analysis was used to explore risk factors of child overweight. Results. The overall prevalence of overweight and obesity was 10.7% and 4.2%, respectively, and increased with age. The prevalence of child overweight was 14.1% and 7.5% in obese and non-obese families, respectively. Significant associations were observed between child and parent characteristics for overweight, frequency of eating in restaurant, television hours, and hours of physical activity. Child overweight was associated with parental overweight (Odds Ratio [OR] 2.43, 95% CI 0.78, 6.59), low maternal education level (OR 2.22, 95% CI 1.39, 3.55), food restriction (OR 2.68, 95% CI 1.64, 4.29), and television watching>2h/d (OR 1.56, 95% CI 1.17, 2.09), after adjusting for sex, age, family income and kindergarten (for cluster study design). Conclusions. Overweight prevalence among Chinese preschool children in Beijing is comparable to some European countries. Prevention strategies should include identified lifestyle risk factors.

Aim: To investigate how grandparents influence their young grandchildren's eating behaviors in Chinese three-generation families. Methods: This qualitative study used semi-structured in-depth interviews with 12 parents (3 male and 9 female) and 11 grandparents (4 male and 7 female) in Beijing, China. Results: Three domains emerged in this study: (1) grandparents were the primary caretakers of children in the three-generation families. They played an important role in planning and cooking family meals; (2) grandparents' attitudes influenced young children's nutrition and eating habits. They held the belief that children being heavy at a young age would assure that they had a good nutrition status and would become tall in the future. They showed a tendency towards urging the children to eat more meals and larger portions at served meals; (3) grandparents used food as an educational and emotional tool. They shaped the behavior of their grandchildren and expressed love and caring through food. Conclusions: Grandparents were dominant in shaping children's eating behavior in some three-generation families in Chinese urban areas. Nutrition education involving grandparents is a potential framework for developing a healthy dietary behavior in young children.