Screening of central obesity among normal-weight children and adolescents in Shandong, China.

The prevalence of central obesity in the total population has been reported in numerous studies. However, information on the prevalence of central obesity within normal-category BMI is scant. In the present study, we examined the profiles of central obesity among normal-weight children and adolescents. A total of 29 516 (14 226 boys and 15 290 girls) normal-weight children and adolescents (excluding underweight, overweight and obesity) aged 7-18 years were included in the final analysis. Central obesity was defined by the international age- and sex-specific cut-offs of waist circumference (WC) and threshold of waist:height ratio (WHtR ≥ 0·5). All subjects were classified into four groups (Q1-Q4) according to the age- and sex-specific quartiles of BMI, those in the upper fourth (Q4) were defined as 'high-normal BMI' and those in the lower fourth (Q1) were defined as 'low-normal BMI'. The prevalence of central obesity as measured by WC was 9·90 (95 % CI 9·41, 10·39) % for boys and 8·11 (95 % CI 7·68, 8·54) % for girls; by WHtR was 2·97 (95 % CI 2·69, 3·25) % for boys and 2·44 (95 % CI 2·20, 2·68) % for girls. Subjects in the Q4 group had a much higher prevalence of central obesity than their counterparts in the Q1 group (P < 0·01). Our findings suggest that the health risks of children with normal-weight central obesity may be missed when BMI is used alone as a measure; it is meaningful to include WC in clinical practice and to include the simple message 'Keep your waist to less than half your height'.

Profiles of body mass index and blood pressure among young adults categorised by waist-to-height ratio cut-offs in Shandong, China.

Background: Waist-to-height ratio (WHtR) is proposed as a valid measure of abdominal obesity and health risks in practice. The present study examined the profiles of weight status and blood pressure (BP) among young adults categorised by WHtR cut-offs.Methods: A total of 4226 college students (2107 males and 2119 females) aged 19-22 years participated in the study. The body mass index (BMI) cut-offs recommended by the Working Group on Obesity in China (WGOC) were used to define underweight, normal weight, overweight and obesity. The BMI and BP profiles within each WHtR category were examined.Results: For both males and females, 'the high WHtR group' (WHtR ≥ 0.5) had the highest, and 'the low WHtR group' (WHtR < 0.4) had the lowest BMI and BP levels. In the WHtR = 0.30-0.34 sub-group, 66.10% of males and 66.67% of females were underweight; in the WHtR ≥ 0.55 sub-group, 91.49% of males and 83.33% of females were obese; in the WHtR = 0.40-0.44 sub-group, 88.88% of males and 89.85% of females were normal weight. The prevalence of high BP in the WHtR < 0.5 group was 9.99% in males and 2.19% in females; the corresponding figures were 28.92% (males) and 14.06% (females) in the WHtR ≥ 0.5 group; the latter is significantly higher than the former (p < 0.01).Conclusion: Individuals with low WHtR were underweight and those with high WHtR were obese with high BP. Results from this study support WHtR as a simple and effective screening tool for abdominal obesity and high BP in practice.

Trends in the prevalence of elevated skinfold thickness among children and adolescents in Shandong Province, China, 1995-2014.

OBJECTIVE: There are abundant data on secular trends in BMI; however, information on the change in subcutaneous fat is limited. The present study examined the trends in the prevalence of elevated skinfold thickness among children and adolescents over the past 19 years (1995-2014) in Shandong Province, China. DESIGN: Data for the study were obtained from two cross-sectional surveys of schoolchildren carried out in 1995 and 2014. Triceps and subscapular skinfold thicknesses (SFT) of all participants were measured. The sum of triceps and subscapular SFT (SSFT) was applied. Children and adolescents with SSFT above or equal to the national age- and sex-specific 85th percentile were defined as 'high SFT'. SETTING: Shandong Province, China. SUBJECTS: A total of 16 917 students aged 7-18 years were included. RESULTS: For both boys and girls, an increasing trend in 'high SFT' was observed between 1995 and 2014. The overall prevalence of 'high SFT' increased from 10·31 % for boys and 13·40 % for girls in 1995 to 33·94 % for boys and 29·30 % for girls in 2014 (P<0·01). CONCLUSIONS: There are more children and adolescents with very high levels of SFT. These trends describe very unfavourable changes in the body composition and should give cause for concern.

Profiles of blood pressure among children and adolescents with different body mass index categories in Shandong, China.

BACKGROUND: The International Obesity Task Force recently developed an extended body mass index (BMI) cut-offs for screening thinness, overweight and obesity among children and adolescents. The present study examined the profiles of blood pressure (BP) among children and adolescents with different BMI categories in Shandong, China. METHODS: Data for this study were obtained from a large cross-sectional survey of schoolchildren. A total of 44,630 students (22,404 boys and 22,226 girls) aged 7-18 years participated in this study. The grades of body weight (thinness grade 1-3, normal weight, overweight and obesity grade 1-3) was defined by the international BMI cut-offs. Systolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured on one occasion. High BP was defined as SBP and/or DBP ≥95th percentile for age and gender. RESULTS: The overall prevalence of thinness (grade 1-3), overweight and obesity (grade 1-3) were 7.80, 18.74 and 8.56% for boys and 11.16, 13.53 and 3.70% for girls, respectively, boys had a lower prevalence of thinness and higher prevalence of overweight and obesity than girls (p < .01). Urban boys and girls had a lower prevalence of thinness and higher prevalence of overweight and obesity than their rural counterparts (p < .01). Children and adolescents with high BMI had a higher BP levels than their counterparts with normal and low BMI. CONCLUSION: High BMI is strongly related to elevated BP. Our findings emphasize the importance of the prevention of overweight/obesity to prevent future-related problems such as hypertension in children and adolescents.

Truncal pattern of subcutaneous fat distribution is associated with obesity and elevated blood pressure among children and adolescents.

BACKGROUND: The association between elevated blood pressure (BP) and childhood obesity has been documented in several studies. However, little is known the difference in BP levels among children and adolescents with different patterns of fat distribution. The present study examined the association of subcutaneous fat distributional pattern with obesity and elevated BP among children and adolescents. METHODS: A total of 38,687 students (19,386 boys and 19,301 girls) aged 7-17 years participated in the study. Body mass index (BMI) cutoff points recommended by the International Obesity Task Force (IOTF) were used to define overweight and general obesity. Abdominal obesity was defined as waist-to-height ratio (WHtR) ≥ 0.5. Relatively high BP (RHBP) status was defined as systolic blood pressure (SBP) and/or diastolic blood pressure (DBP) ≥ 95th percentile for age and gender. All individuals were classified into four groups (Q1-Q4) according to the age and sex-specific quartiles of subscapular to triceps skinfold thickness ratio (STR), the prevalence rates of overweight, general obesity, abdominal obesity and RHBP among the four groups were compared. RESULTS: In both boys and girls, significant differences in the prevalence rates of overweight, general obesity, abdominal obesity and RHBP were observed among the four groups, an increasing trend was observed from the Q1 (STR <25 th) group to the Q4 (STR ≥ 75th) group (p < 0.01). Children and adolescents with high STR had higher prevalence of overweight, obesity and RHBP than their counterparts with low STR (p < 0.01). CONCLUSION: Truncal pattern of subcutaneous fat distribution is associated with obesity and elevated BP among children and adolescents. Public health attention should not only focus on the amount of body fat, but also on the distributional pattern of body fat.

Trends in the Prevalence of Morbid Obesity among Children and Adolescents in Shandong, China, 1995-2014.

Background: Childhood obesity has increased dramatically during the past decades; however, data on the prevalence of morbid obesity is limited. The present study examined the prevalent trends in morbid obesity among children and adolescents during the past 19 years (1995-2014) in Shandong, China. Methods: Data for this study were obtained from five cross-sectional surveys (1995, 2000, 2005, 2010 and 2014) of schoolchildren in Shandong Province, China. A total of 41 500 students aged 7-18 years were included in this study. Body mass index cutoffs recommended by the International Obesity Task Force were used to define morbid obesity. Results: The prevalence of morbid obesity was increasing continuously during the past 19 years (1995-2014), from 0.25% for boys and 0.11% for girls in 1995 to 2.73% for boys and 1.29% for girls in 2014. Boys had higher prevalence of morbid obesity than girls (p<0.01). Regional socioeconomic status (SES) inequalities in morbid obesity were observed; children and adolescents from high SES district had a rapid increase in the prevalence of morbid obesity than their counterparts from moderate SES and low SES districts in the past 19 years. Conclusion: Although the current prevalence of morbid obesity was at a relatively low level, a continuous increasing trend was observed between 1995 and 2014. We should not relax our vigilance, and policymakers and experts should pay more attention to the monitoring and prevention of morbid obesity among children and adolescents in the future decades.

Recent Trends in Body Mass Index and Waist Circumference among Children and Adolescents in Shandong China.

BACKGROUND: The present study examined the recent trends in body mass index (BMI) and waist circumference (WC), and the prevalence of general and abdominal obesity among children and adolescents in Shandong, China. METHODS: Data for this study were obtained from two cross-sectional surveys of schoolchildren carried out in 2010 and 2014 in Shandong Province, China. A total of 72 755 students aged 7-18 years were included in this study. The BMI cutoff points recommended by the International Obesity Task Force were used to define overweight and general obesity. Abdominal obesity was defined as waist-to-height ratio (WHtR) ≥ 0.5. Both BMI and WHtR were used to define three types of obesity as follows: general obesity only, abdominal obesity only and combined obesity. RESULTS: For both boys and girls, an increasing trend in BMI and WC was observed between 2010 and 2014 (p < 0.01), WC has increased faster than BMI. The sum of the prevalence of the three types of obesity increased from 16.63% (boys) and 8.13% (girls) in 2010 to 20.37% (boys) and 11.61% (girls) in 2014 (p < 0.01). CONCLUSION: WC and abdominal obesity increased faster than BMI and general obesity among children and adolescents between 2010 and 2014. This study also suggested that distinguishing the types of obesity and examining the prevalence of various types of obesity are useful in practice.

Prevalence of thinness among children and adolescents in Shandong, China.

PURPOSE: Thinness in children and adolescents poses a considerable public health problem globally, especially in developing countries. The present study examined the prevalence of thinness among children and adolescents in Shandong, China. METHODS: Data for this study were obtained from a large cross-sectional survey of schoolchildren. A total of 42,348 students (21,248 boys and 21,100 girls) aged 7-18 years participated in this study. Stature and weight of all subjects were measured; body mass index (BMI) was calculated from their stature and weight. International BMI cutoffs were used to define thinness. RESULTS: The overall prevalences of thinness grade 1, grade 2 and grade 3 among children and adolescents aged 7-18 years were 7.74, 1.43 and 0.61 % for boys and 11.51, 2.54 and 1.03 % for girls, respectively; these figures were all significantly higher in girls than in boys (P < 0.01). Thin children and adolescents had lower stature levels than their counterparts in not thin group in all age groups (7-18 years). CONCLUSION: The prevalence of childhood thinness is still wide in Shandong Province, and public health and nutritional strategies must give attention to the intervention for thinness, including periodic monitoring, education on pattern of nutrition and healthy dietary behavior.

Changes in the nutritional status of children and adolescents in Shandong, China.

OBJECTIVE: Nutritional status during childhood plays an important role in the human life cycle. The present study examined the prevalence trends in different grades of nutritional status (thinness, normal weight, overweight and obesity) among children and adolescents in Shandong, China. DESIGN: Data for the study were obtained from six cross-sectional surveys of schoolchildren carried out in 1985, 1995, 2000, 2005, 2010 and 2014. Height and weight of all children were measured; BMI was calculated from their height and weight. International BMI cut-offs were used to define thinness, overweight and obesity. SETTING: Shandong Province, China. SUBJECTS: A total of 56 045 students aged 7-18 years were included in the current analysis. RESULTS: In the past 29 years, the prevalence of thinness decreased from 18·22 % and 23·45 % in 1985 to 7·18 % and 9·49 % in 2014 for boys and girls, respectively. Conversely, the prevalence of combined overweight and obesity increased from 1·79 % and 1·66 % in 1985 to 31·12 % and 20·11 % in 2014 for boys and girls, respectively. CONCLUSIONS: The nutritional profile of Shandong children and adolescents had an obvious change over the past 29 years. Special attention should be paid to controlling the rapid rise of childhood overweight and obesity.

Prevalence of Overweight and Obesity among Children and Adolescents in Shandong, China: Urban-Rural Disparity.

BACKGROUND: The pattern of urban-rural disparity in childhood obesity varies across countries. The present study examined the change trend of urban-rural disparity in childhood overweight and obesity from 1985 to 2014 in Shandong, China. METHODS: Data for this study were obtained from four cross-sectional surveys of school children carried out in 1985, 1995, 2005 and 2014 in Shandong Province, China. In this study, 39 943 students aged 7-18 years were included (14 458 in 1985, 7198 in 1995, 8568 in 2005 and 9719 in 2014). Height and weight of all subjects were measured; body mass index (BMI) was calculated from their height and weight. The BMI cutoff points recommended by the International Obesity Task Force were used to define overweight and obesity. RESULTS: The prevalence of overweight and obesity was increasing continuously both in urban and rural areas over the past 29 years (1985-2014). The prevalence of combined overweight and obesity was significantly higher in urban than in rural children and adolescents in 1985, 1995 and 2005 (p < 0.01). However, a rapid increase in the prevalence of combined overweight and obesity was observed in rural areas after 2005; as a result, the urban-rural disparity was getting narrower, and no significant urban-rural disparity was observed in 2014 (p > 0.05). CONCLUSION: The change trend of urban-rural disparity should be concerned in the future; policies and interventions focused on childhood overweight and obesity should pay attention to rural areas.

Distribution of subcutaneous fat and the relationship with blood pressure in obese children and adolescents in Shandong, China.

BACKGROUND: The association between elevated blood pressure (BP) and childhood obesity has been documented in several studies. However, the association between BP and body fat distribution in obese children remains poorly understood. We examined the distribution of subcutaneous fat and its association with BP in obese children and adolescents. METHODS: Data for this study were obtained from a large cross-sectional survey of school children. A total of 38,873 students (19,485 boys and 19,388 girls) aged 7-17 years participated in this study. Height, weight, BP, subscapular and triceps skinfold thicknesses (SFT) of all subjects were measured. Obesity was defined by using body mass index (BMI) criteria recommended by the Working Group on Obesity in China. A total of 3,579 obese children and adolescents (2,367 boys and 1,212 girls) were examined. RESULTS: Most of the obese children and adolescents had high subcutaneous fat. However, a small number of the obese individuals had a lower SFT levels. Obese children and adolescents with high SFT and central distribution had higher BP levels than those with low SFT and peripheral distribution. CONCLUSION: Obese children and adolescents assessed by BMI might not necessarily have a high SFT level. The BP level of obese individuals is associated with the level and distribution pattern of SFT. Additional measurement of SFT is better than BMI alone to help identify high BP risks.

Percentiles and regional distribution of skinfold thickness among children and adolescents in Shandong, China.

OBJECTIVE: Skinfold thicknesses (SFT) have long been considered important and valid measurements of subcutaneous fat. The present study reported the percentiles and regional distribution of SFT among children and adolescents in Shandong, China. METHODS: Data for this study were obtained from a large cross-sectional survey of schoolchildren. A total of 42,268 students (21,200 boys and 21,068 girls) aged 7-18 years from 16 districts participated in this study. Triceps, subscapular, and abdomen SFT of all subjects were measured. RESULTS: Shandong children and adolescents had a high SFT level and substantial regional disparities in SFT were observed. Boys and girls resident in high socioeconomic status (SES) districts had higher SFT level than those living in moderate and low SES districts. CONCLUSION: The SFT level of children and adolescents is associated with regional SES in Shandong, China. This may be interpreted as a result of geographic variation between the districts in the process of urbanization, living standards, nutritional conditions, dietary patterns, and public health.

Comparison of blood pressure levels among children and adolescents with different body mass index and waist circumference: study in a large sample in Shandong, China.

PURPOSE: Several anthropometric indicators [such as body mass index (BMI), waist circumference (WC), and waist-to-height ratio (WHtR)] have been used to investigate the association between adiposity and high blood pressure (BP) in both adults and children. The present study compared the BP levels among children and adolescents with different BMI and WC in a large population in Shandong, China. METHODS: A total of 38,822 students (19,456 boys and 19,366 girls) aged 7-17 years participated in this study. Height, weight, WC, and BP of all subjects were measured, and BMI was calculated. The prevalence of overweight and obesity was obtained according to the International Obesity Task Force (IOTF) cutoffs; central obesity was defined as WC ≥ 90th percentile (P 90); relatively high BP status was defined as systolic blood pressure (SBP) and/or diastolic blood pressure (DBP) ≥ 95th percentile for age and gender. RESULTS: Within each BMI categories (normal weight, overweight, and obesity), children and adolescents with WC ≥ P 90 had higher BP levels than those with WC < P 90 (p < 0.01). When BMI and WC were combined, the highest and lowest prevalences of relatively high BP were noted in obese with WC ≥ P 90 group (54.52% for boys and 48.71% for girls) and normal weight with WC < P 90 group (17.00% for boys and 14.13% for girls). CONCLUSION: Children and adolescents with high BMI and high WC might have an increased risk of elevated BP. Our results suggest that the additional measurement of WC is better than BMI alone to help identify high BP risks.

Distribution curve of waist-to-height ratio and its association with blood pressure among children and adolescents: study in a large population in an eastern coastal province, China.

Several studies have suggested that waist-to-height ratio (WHtR) is an accurate and easier index for evaluating abdominal obesity in both children and adults. The present study examined the distribution of WHtR and its association with blood pressure (BP) levels among children and adolescents in a large population in Shandong, China. A total of 38,810 students (19,453 boys and 19,357 girls) aged 7-17 years participated in this study. Height, waist circumference (WC), and BP of all subjects were measured, and WHtR was calculated. Abdominal obesity was defined as WHtR ≥0.5; high BP status was defined as systolic blood pressure (SBP) and/or diastolic blood pressure (DBP) ≥95th percentile for age and gender. Overall, 16.45% (95%CI: 15.93-16.97) and 7.80% (95%CI: 7.42-8.17) of boys and girls had a WHtR ≥0.5. WHtR was positively correlated with SBP and DBP in both boys and girls. The mean values of SBP and DBP for both boys and girls were all significantly higher in the WHtR ≥0.5 group than in the WHtR<0.5 group. Z-scores of BP and the prevalence of high BP increased with WHtR. The prevalence of high BP increased from 10.61 (boys) and 9.64% (girls) in the WHtR <0.34 group to 55.11 (boys) and 51.97% (girls) in the WHtR ≥0.58 group, an increase of 4.2- and 4.4-times. We conclude that children and adolescents with high WHtR might have an increased risk of elevated BP. These findings highlight the importance of the prevention of abdominal obesity in order to prevent future-related problems such as hypertension in children and adolescents.

Prevalence and regional disparities in abdominal obesity among children and adolescents in Shandong, China, surveyed in 2010.

BACKGROUND/AIMS: A rising prevalence of childhood obesity (assessed by body mass index) has been observed in China. However, there are very few published data on abdominal obesity among children and adolescents. The present study examined the prevalence and regional disparities in abdominal obesity among children and adolescents in Shandong, China. METHODS: Data for this study were obtained from a large cross-sectional survey. A total of 42,296 students (21,218 boys and 21,078 girls) aged 7-18 years from 16 districts participated in this study. Height and waist circumference (WC) of all subjects were measured; waist-to-height ratio (WHtR) was calculated from their height and WC. Abdominal obesity was defined as WHtR ≥0.5. All subjects were stratified by gender, age and the area of residence, and abdominal obesity frequencies were compared among different groups. RESULTS: Substantial regional, socioeconomic and urban/rural disparities exist in child and adolescent abdominal obesity. The overall prevalences of abdominal obesity among different groups of children and adolescents aged 7-18 years were 19.92% (urban boys), 11.94% (rural boys), 8.43% (urban girls) and 5.85% (rural girls). The prevalence of abdominal obesity varied from 24.98% in high-socioeconomic status (SES) urban boys to 4.58% in low-SES rural girls. Subjects living in coastal and high-urbanization districts had a higher prevalence of abdominal obesity than those living in inland and low-urbanization districts. CONCLUSIONS: Abdominal obesity among children and adolescents in China is associated with affluence and urban residence. Interventions and strategies to combat obesity should be based on this specific context, targeting high-SES urban areas.

Percentiles of waist-hip ratio and the relationship with blood pressure among children and adolescents in Shandong, China.

BACKGROUND: Anthropometric indices such as waist circumference (WC), waist-to-height ratio (WHtR) and waist-hip ratio (WHR) have been recognized as useful alternatives to visceral fat measurement in epidemiological studies. WHR has been used extensively in adults. However, there are very few published data for WHR among children and adolescents. AIM: The present study examined the distribution of WHR and the relationship with blood pressure (BP) among children and adolescents in Shandong, PR China. SUBJECTS AND METHODS: Data for this study were obtained from a large cross-sectional survey of schoolchildren carried out in 2010. A total of 38,822 students (19,456 boys and 19,366 girls) aged 7-17 years participated in this study. WC, Hip circumference (HC), systolic blood pressure (SBP) and diastolic blood pressure (DBP) of all subjects were measured; WHR was calculated as WC divided by HC. Abdominal obesity was defined by previously published WHR references based on Chinese children and adolescents living in Beijing. All subjects were divided into two groups (group 1 with WHR <85th; group 2 with WHR ≥85th) according to the percentiles of WHR and comparisons of the SBP and DBP between the two groups were made. RESULTS: The WHR levels in Shandong boys and girls were lower than those from German and Pakistani. The overall prevalence of abdominal obesity was 9.53% (95% CI = 9.12-9.95%) for boys and 9.82% (95% CI = 9.40-10.24%) for girls, no statistical differences between the two genders were observed (p > 0.05). In both boys and girls, the Z-scores of SBP and DBP were all significantly lower in group 1 than in group 2 (p < 0.01), indicating that children and adolescents with high WHR tended to have higher BP values. CONCLUSION: WHR is useful in identifying children and adolescents at risk of developing high BP. These findings, together with the known tracking of BP from adolescence into adulthood, highlight the importance of preventing overweight and obesity among children and adolescents in order to prevent the development of hypertension in adults.

Rural-urban comparison in prevalence of overweight and obesity among adolescents in Shandong, China.

BACKGROUND: Prevalence of overweight and obesity has increased in both developed and developing countries. The increasing global prevalence of overweight and obesity among children and adolescents constitutes a public health crisis. AIM: The present study assessed the rural-urban differences in prevalence of overweight and obesity among adolescents in Shandong Province, China from 1985-2010. SUBJECTS AND METHODS: The BMI of adolescents aged 7-18 years was calculated using data from five national repeated cross-sectional surveys on students' constitution and health carried out by the government in 1985, 1995, 2000, 2005 and 2010 in Shandong Province, China. The prevalence of overweight and obesity was obtained according to the WGOC (Working Group on Obesity in China) reference norm and the International Obesity Task Force (IOTF) cut-offs. RESULTS: In the past 25 years, The prevalence of overweight and obesity increased rapidly: The rate of overweight plus obesity by WGOC reference norm increased from 3.60% (Urban male), 3.03% (Urban female), 0.77% (Rural male) and 1.47% (Rural female) in 1985 to 36.57% (Urban male), 19.39% (Urban female), 29.59% (Rural male) and 18.76% (Rural female) in 2010, respectively. The increasing trend is similar using IOTF cut-offs. Differences in prevalence by year of overweight and obesity between urban and rural areas were observed. CONCLUSION: Overweight and obesity increased remarkably among Shandong adolescents from 1985-2010 and has become a serious public health problem. Comprehensive evidence-based strategies of intervention should be introduced, including periodic monitoring.

Comparison of body shape and physical activity among adolescents with normotensive and elevated blood pressure in Shandong, China.

BACKGROUND: Several studies have provided ample evidence that hypertension in adults has its onset in childhood; children and adolescents with elevated blood pressure (BP) are more likely to become hypertensive adults. Shandong province is one of the areas of China with higher prevalence of hypertension. However, no studies on the relationship between physique and BP have been reported in Shandong Province, China. AIM: The present study examined the difference in body shape and physical activity (PA) between adolescents with normotensive and elevated BP in Shandong, China. SUBJECTS AND METHODS: Data for this study were obtained from a large cross-sectional survey of schoolchildren carried out in 2010.A total of 28 039 students (14 084 boys and 13 955 girls) aged 10-17 years participated in this study. Height, weight, waist circumference (WC), BP, triceps and subscapular skinfolds of all subjects were measured and the sum of triceps and subscapular skinfold thickness was applied. Body mass index (BMI) of adolescents was calculated from their height and weight and the prevalence of overweight and obesity were obtained according to the International Obesity Task Force (IOTF) cut-offs. Elevated BP was defined as systolic blood pressure (SBP) and/or diastolic blood pressure (DBP) ≥ 95th percentile for age and gender. PA attitudes and behaviours were assessed by a standardized questionnaire. RESULTS: The mean values of BMI, WC and SFT for both boys and girls were all significantly higher in the elevated BP group than in the normal BP group in all age categories (p < 0.01). More adolescents with elevated BP were overweight or obese compared with normal BP subjects. Significant differences in PA were observed between the elevated and normal BP group, adolescents with elevated BP had poor PA attitudes and behaviours compared with normal BP subjects. CONCLUSION: Adolescents with elevated BP had high levels of BMI, WC, SFT and poor PA attitudes and behaviours. These findings reinforce the importance of preventing overweight and obesity and improving their attitudes towards physical activity.

Differences in development and the prevalence of obesity among children and adolescents in different socioeconomic status districts in Shandong, China.

BACKGROUND: There are wide-ranging differences in human growth, not only between ethnic groups but also between regions. Shandong is one of the most populous provinces in China, with inequalities of regional economic status. However, no studies on the differences in development among children and adolescents in different districts have been reported. AIM: This study assessed the differences in height, weight and prevalence of obesity among children and adolescents of different socioeconomic status (SES) districts in Shandong, China. SUBJECTS AND METHODS: Data for this study were obtained from a large cross-sectional survey of schoolchildren. A total of 42 286 students (21 222 boys and 21 064 girls) aged 7-18 years from 16 districts participated in this study. Height and weight of all subjects were measured and BMI was calculated from their height and weight. Prevalence rates of obesity and overweight were determined by comparing calculated BMIs (kg/m(2)) to International Obesity Task Force (IOTF) cut-offs. Each of the 16 districts was assigned an SES ranking (low, moderate, high) based on per capita GDP and income in urban and rural areas. Comparisons of height, weight and the prevalence of overweight and obesity among different groups were made. RESULTS: Significant differences between SES groups were observed for height, weight and the prevalence of overweight and obesity. Boys and girls from high SES group were taller, heavier and more likely to be obese than their peers from moderate and low SES groups. The prevalences of combined overweight and obesity in the three SES groups were 18.46%, 21.08% and 27.31% in boys and 10.43%, 12.42% and 15.18% in girls, respectively. CONCLUSION: There have been obvious regional variations in development and the prevalence of obesity in children and adolescents in Shandong, China, These variations in development and prevalence of obesity in children and adolescents among different SES districts being related to the local SES, process of urbanization, living environments, nutritional status, dietary pattern, physical activity and public health.

Prevalent trends in relatively high blood pressure among children and adolescents in Shandong, China.

BACKGROUND: Hypertension in adults remains a major public health problem. Several studies have provided ample evidence that hypertension in adults has its onset in childhood; children and adolescents with elevated blood pressure (BP) are more likely to become hypertensive adults. AIM: The present study examined the prevalent trend in relatively high BP among children and adolescents during the past 10 years in Shandong, China. SUBJECTS AND METHODS: Data for this study were obtained from three national surveys on students' constitution and health carried out by the government in 2000, 2005 and 2010 in Shandong Province, China. A total of 22 548 students aged 7-17 years old were included in this study (7776 in 2000, 7878 in 2005 and 6894 in 2010). Height, weight and BP of all subjects were measured. Relatively high BP status was defined as systolic blood pressure (SBP) and/or diastolic blood pressure (DBP) ≥ 95th percentile for age and gender. Body mass index (BMI) of adolescents was calculated from their height and weight and prevalence of overweight and obesity were obtained according to the screening criteria for overweight and obesity in Chinese students using BMI. RESULTS: In the past 10 years, the prevalence of relatively high BP increased. The overall prevalence of relatively high BP of children and adolescents aged 7-17 increased from 19.29% (boys) and 14.69% (girls) in 2000 to 26.16% (boys) and 19.77% (girls) in 2010, respectively. The prevalence of combined overweight and obesity increased from 22.26% (boys) and 12.23% (girls) in 2000 to 33.81% (boys) and 19.48% (girls) in 2010. CONCLUSION: The prevalence of relatively high BP among children and adolescents increased dramatically from 2000 to 2010 in Shandong, China. It has become a public health problem and comprehensive interference measures are urgently needed.