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Determinants of childhood obesity in China
Changzheng Yuan1, Yanhui Dong2, Hui Chen1
1School of Public Health, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Insights
China faces a significant childhood obesity epidemic, with the largest global child population affected. This review examines the causes and risk factors for childhood obesity in China, emphasizing school-aged children and multilevel determinants.
Area of Science:
- Public Health
- Epidemiology
- Nutrition Science
Background:
- China has undergone a significant nutritional transition over the last 40 years.
- This transition is marked by a growing burden of overnutrition among children.
- China now has the world's largest population of children experiencing obesity.
Purpose of the Study:
- To review the epidemiology of childhood obesity in China.
- To identify the determinants and risk factors contributing to this epidemic.
- To focus specifically on school-aged children and multilevel factors.
Main Methods:
- Literature review of epidemiological data on childhood obesity in China.
- Analysis of variations across age, gender, and region.
- Description of multilevel obesogenic determinants (macro, meso, micro levels).
Main Results:
- Substantial variations in childhood obesity prevalence exist across age, gender, and geographic regions in China.
- Multilevel factors, including social, cultural, environmental, school, community, family, and individual influences, contribute to obesity.
- The primary drivers are macro-level socio-economic and technological environments, coupled with obesogenic school, community, and family settings, and unhealthy behavior adoption.
Conclusions:
- Understanding the complex, multilevel drivers of childhood obesity in China is crucial.
- Effective prevention and intervention strategies require tailored, scalable approaches.
- Addressing the root causes within the broader environment is imperative for controlling childhood obesity.
Abstract:
Over the past four decades, China has witnessed an important nutritional transition, characterised by a heightened overnutrition burden among children. The country now has the largest population of children with obesity globally. In this paper, we review the epidemiology of childhood obesity in China, its determinants, and risk factors, with a particular focus on school-aged children. Evidence unveils substantial variations across age, gender, and region. We describe multilevel obesogenic determinants, including macro-level social, cultural, and environmental factors; meso-level factors related to schools and communities; and micro-level factors tied to families and individuals from the perinatal-infant stage to childhood and adolescence. The primary drivers of childhood obesity appear to be rooted in the broader macro-level social, economic, and technological environment; obesogenic factors, which have affected school, community, and family environments; and accelerated unhealthy behaviour uptake. Identifying and characterising the catalysts behind the rise in childhood obesity in China is imperative for the development of scalable, effective, and tailored prevention, control, and intervention strategies.
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