A comparison study of prevalence,awareness,treatment and control rates of hypertension and associated factors among adults in China and the United States based on national survey data / 《全球健康杂志（英文）》

Objective:This study compared the prevalence,awareness,treatment and control of hypertension and associated factors in China and the United States(US).Methods:Adult data from nationally representative samples were derived from the Chronic Disease and Risk Factors Surveillance in 2010 and 2013 in China and the National Health and Nutrition Examination Survey in 2010 and 2013 in the US.Multivariable logistic and Poisson regression analysis were conducted to assess associations of the four outcomes with body weight status and behavioral factors.Results:Age-standardized prevalence rates of hypertension was 35.7％(95％confidence interval[CI]:35.4％to 36.1％)in 2010 and 29.8％(95％CI:29.4％to 30.2％)in 2013 in China,and 35.3％(95％CI:33.6％to 37.1％)in 2010 and 37.9％(95％CI:36.0％to 39.7％)in 2013 in the US.Among hypertensive participants,the age-standardized rates of treatment were 18.4％(95％CI:17.9％to 18.9％)in 2010 and 23.8％(95％CI:23.1％to 24.6％)in 2013 in China and 54.5％(95％CI:50.3％to 58.7％)in 2010 and 50.9％(95％CI:46.5％to 55.3％)in 2013 in the US;the age-standardized hypertension control rates were 3.2％(95％CI:3.0％to 3.5％)and 5.7％(95％CI:5.3％to 6.0％)in 2010 and 2013 in China and 50.6％(95％CI:46.2％to 55.0％)and 55.3％(95％CI:50.3％to 60.3％)in the US.Obesity was significantly associated with prevalence,awareness and control rates in both countries.Different from the US,obesity was negatively associated with hypertension control in China.Conclusion:Hypertension prevalence in China is similar to that in the US,but the control rate in China was significantly lower.Obesity was a critical risk factor for poor hypertension control in China.

Association between body mass index and body fat measured by dual-energy X-ray absorptiometry(DXA)in China:a systematic review and meta-analysis / 《全球健康杂志（英文）》

Objective:We examined the association between body mass index(BMI)and body fat percentage(BF％)measured by dual-energy X-ray absorptiometry(DXA)among adults and children in China.Methods:We searched four databases-PubMed,China National Knowledge Infrastructure,Wanfang,and Vip for studies published in the past 22 years.Meta-analysis was conducted using random-or fixed-effect models.Results:In total of 21 studies met inclusion criteria and were included in review,and 17 ot them in meta-analysis.They were conducted across China.Their sample size ranged from 62 to 5 726,and participants'age ranged from 6-80 years.Meta-analysis revealed strong associations between BMI and BF％measured by DXA in adults(pooled r=0.71,95％CI:0.66 to 0.74)and children(pooled r=0.60,95％CI:0.52 to 0.68).The association was stronger in Northern China than in East China in children(β=-0.40,95％CI:-0.65 to-0.14)and in Central China in adults(β=-0.25;95％CI:-0.51 to-0.01).Urban children's BMI was strongly associated with BF％than rural(β=0.19;95％CI:0.04 to 0.35),whereas it was stronger in adults living in rural than in urban(β=-0.35;95％CI:-0.66 to-0.05).Conclusions:BMI was strongly associated with BF％measured by DXA,and the association in children and adults in China varied by residence and region.

Association and potential mediators between socioeconomic status and childhood obesity in China:findings from a national cohort study / 《全球健康杂志（英文）》

Objective:Socioeconomic status(SES)is associated with childhood obesity,but the underlying factors remain unknown.This study aimed to identify mediators that may explain SES disparities in childhood obesity in China.Methods:Nationally representative longitudinal data from the China Education Panel Survey of 11 019 chil-dren(13.03±0.79)collected from 2013-2014 to 2016-2017 academic years.Overweight/obesity was de-fined using Chinese national body mass index cut-points.Principal component analysis was used to con-vert the four SES indicators(maternal and paternal education,and occupation)into one comprehensive vari-able.Mediation analysis for SES disparities in childhood obesity was conducted using structure equation models.Results:The prevalence of overweight/obesity was 12.8％,and was higher in boys than in girls(17.8％vs.7.6％,P＜0.001)at baseline.Among boys,relative risk(RR)of obesity was 1.23(95％CI:1.09 to 1.40,P＜0.001)for per unit change in SES.There was no significant association between obesity and SES among girls.Mediation analyses showed that among boys,birth weight,being the only child in the family and children's self-perceived weight status mediated 70.0％of the effects of SES on obesity.No mediation effect was detected in girls.Conclusions:Chinese boys are more likely to be overweight or obese than girls.SES may impact childhood obesity through birth weight,being the only child in the family and children's self-perceived body weight status in boys,but not in girls.More attention should be made to address childhood obesity in high SES families among boys.Interventions targeting at these mediators are needed.

Obesity intervention efforts in China and the 2022 World Obesity Day / 《全球健康杂志（英文）》

Obesity has become a serious public health problem globally.China has the world's largest number of people with obesity or overweight.More than 50％of adults and about 20％of children and adolescents in China are overweight or obese.Over the past 20 years,China has made many efforts in obesity intervention,while obesity rates continued rising.In recent years,China has taken more actions for obesity prevention.The World Obesity Day(WOD)was established in 2015 by the World Obesity Federation,and is a unified day of action calling for a cohesive,cross-sector response to fight obesity.WOD has drawn increasing attention in recent years.China formally joined the WOD activities this year,promoted by The Obesity Prevention and Control Section of Chinese Nutrition Society,which cooperated closely with other organizations in carrying out a series of activities during the 2022 WOD.These efforts aimed to encourage the whole society to pay attention to the obesity problem and take more practical actions.The activities include:(1)The 2022"World Obesity Day"China Summit;(2)a specifically developed WOD obesity prevention education video;and(3)the launch of The Expert Consensus on Obesity Prevention and Treatment in China.These can serve as examples for other organizations and countries to consider in future intervention efforts.To fight the global obesity epidemic,all counties and people need to act.Countries can learn from each other's successful practices.

Associations of sleep duration with childhood obesity:findings from a national cohort study in China / 《全球健康杂志（英文）》

Objective:Examine effect of sleep duration on children's risk of overweight and obesity;and study associations between activities in the last hour before bedtime and sleep outcomes(sleep duration,sleep quality,and sleep onset latency).Methods:Children's data were recruited using a questionnaire survey from a nationally representative sample of children(n=10 279)in China in 2013-2016.Mixed-effects models were used to test associations among variables stratified by sex.Results:Sleep duration was positively associated with BMI in boys(p=0.04,P=0.021).Girls with short sleep durations(＜8 h/d)tended to have higher BMI values than those with normal sleep durations(8-9 h/d)(β=0.12,P=0.063).The top three activities were playing electronic devices(Factor 1),doing homework,and reading(combined as Factor 2).Factors 1 and 2 were both significantly associated with sleep duration(β=0.17,P＜0.001;β=-0.26,P＜0.001,respectively).Conclusion:Sleep duration seems to affect BMI in Chinese children.Using electronic devices and reading before bedtime influenced sleep duration.Good bedtime habits and sleep duration can help weight management in children.

Effectiveness of a multifaceted intervention for the improvement of nutritional status and nutrition knowledge of children in poverty-stricken areas in Shaanxi Province,China / 《全球健康杂志（英文）》

Objectives:Compare the differences between the intervention and control groups in changes of primary outcomes(body mass index[BMI]and waist-to-height ratio[WHtR])and secondary outcomes(nutrition knowledge of children and parents),from baseline to the 6-and 12-month follow-ups;examine the associations of changes in nutrition knowledge of children and their parents with children's changes in BMI and WHtR.Data sources:Data collected from four schools in two poverty-stricken counties in northern Shaanxi Province in 2020-2021.Methods:A multifaced intervention program targeted children(promoting healthy diet and nutrition education)and their parents(promoting nutrition knowledge)was conducted in the interventional group.Four schools,with two in each group,were randomly allocated to the intervention or control group,with 814 eligible children aged 7.1 to 12.8 years.The control group conducted myopia promotion.Differences in changes of BMI and WHtR between groups were compared with t-test.Mixed-effects model was used to examine the associations between changes in nutrition knowledge of children and parents with changes in children's BMI and WHtR.Results:At the 6-month follow-up,the difference in changes in BMI between the intervention and control groups was 0.4 kg/m 2(P＜0.001).At the 12-month follow-up,the difference in changes in BMI and WHtR between intervention and control groups was 0.1 kg/m2(P＜0.001)and 0.01 kg/m2(P＜0.001).In the intervention group,the nutrition knowledge awareness rate of children increased from 16.9％(69/409)at baseline to 21.3％(87/409)at 6-month,and 22.7％(93/409)at 12-month.The awareness rate of nutrition knowledge of parents also fluctuated,from 5.6％(23/409)to 6.6％(27/409)and 5.4％(22/409).However,the difference in changes in nu-trition knowledge between intervention and control groups was non-significant.The 6-month follow-up changes in children's nutrition knowledge scores were negatively associated with changes in BMI in girls(β=-0.26,95％confidence interval[CI]:-0.38 to-0.14,P＜0.001),while positively associated with changes in WHtR in boys(β=0.003,95％CI:-0.0002 to 0.005,P=0.035).The 12-month follow-up changes in children's nutrition knowledge scores were positively associated with changes in children's WHtR(β=0.003,95％CI:0.0004 to 0.01,P=0.018).Conclusions:The intervention strategies did not reduce the BMI and WHtR of children,and the nutrition knowl-edge of children and parents increased after the intervention in intervention group.Changes in nutrition knowl-edge of children and their parents are associated with changes in children's BMI or WHtR.Interventions with a new focus on obesity are needed to help improve children's nutritional status in poverty-stricken areas in Shaanxi Province of China.