[Knowledge of weight management among Chinese school-aged children in 2023 to 2024]

To assess the level and distribution of weight management knowledge among Chinese school-aged children at different educational stages.

Based on data from the 2023-2024 China Nutrition and Health Knowledge Survey of school-aged children, which covered 195 survey sites across 31 provinces(autonomous regions and municipalities), a multistage stratified cluster sampling design was applied. A total of 90 240 students from upper primary(grades 4-6), junior high, and senior high schools were included. Weighted analyses were performed according to the complex sampling design, with weights derived from sampling and post-stratification weights. Standard errors were estimated using the Taylor linearization method. Group differences were assessed by t or Wald F tests based on the complex sampling design.

The overall weighted correct response rate for weight management knowledge was 83.97%(95%CI 83.83%-84.10%). Female students scored significantly higher than male students(85.68% vs.82.49%, P<0.01). Senior high school students demonstrated the highest knowledge level(86.21%(95%CI 85.96%-86.45%)). Urban students performed better than rural students(85.44% vs.81.48%, P<0.01), and those in eastern regions scored higher(85.80%(95%CI 85.59%-86.00%)) than peers in central and western regions. Across knowledge domains, students showed higher mastery of "physical activity and sedentary behavior" and "dietary misconceptions"(weighted accuracy>88.00%), while "healthy food choices" was the weakest domain, particularly among upper primary and junior high students(70.15%(95%CI 69.75%-70.54%) and 70.75%(95%CI 70.29%-71.20%), respectively). Items such as "avoiding fried foods when eating out" and "making healthy dining-out choices" were common weak points across stages.

Chinese school-aged children demonstrated generally good knowledge of weight management, but boys, rural students, and those in central and western regions had relatively lower mastery. Knowledge related to healthy food choices remained the weakest across all stages.