Relationship of parental characteristics and feeding practices to overweight in infants and young children in Beijing, China.

BACKGROUND: Childhood obesity has become a major public health problem in many countries. To explore the risk factors of overweight in infants and young children might be helpful in developing an early overweight intervention strategy. OBJECTIVE: To assess the prevalence of overweight and the relationship of parental characteristics and feeding practices to overweight in infants and young children in Beijing, China. DESIGN: Data on weight and length/height were collected on 4654 children aged 1-35 months in twelve communities in Beijing from a cross-sectional study. Overweight was defined as weight-for-length/height > or = 2SD above the median of the WHO reference. Two hundred and fifteen families with overweight children and 215 families with normal-weight children were interviewed using a questionnaire to obtain feeding practices. RESULTS: The overall prevalence of overweight was 4.7%. Both parental overweight and low parental education were significantly higher among overweight than normal-weight children. The total energy intake was significantly higher in overweight than in normal-weight children at 12-35 months of age. Compared with normal-weight children, significantly fewer overweight children were breast-fed for at least 4 months. Overweight children were also more likely to have been introduced to infant formula and semi-solid foods during the first 4 months. CONCLUSION: Early prevention strategies should include feeding practices identified as putting children at risk of obesity. These include early cessation of breast-feeding and premature introduction of other foods.

Reliability and validity of standardized Chinese version of Urban Infant-Toddler Social and Emotional Assessment.

AIMS: To evaluate the reliability and validity of the Chinese version of Infant-Toddler Social and Emotional Assessment (CITSEA). STUDY DESIGN: A cross-sectional survey through parent self-administered questionnaires in Chinese urban communities. Fourteen cities from the Southern, Northern, Eastern, Western and Central China were involved. SUBJECTS: A total of 5323 healthy toddlers (2690 boys and 2633 girls) aged 12 to 36 months from the 14 cities recruited through a multi-stage sampling scheme. OUTCOME MEASURES: Self-administered questionnaire was employed to collect the social demographic data, and the Chinese translation of ITSEA was used to collect data on children's social and emotional behavior. RESULTS: The reliability and validity of CITSEA were examined by standard psychometric methods. 1) The test-retest reliability of four broad domains ranged from 0.78 to 0.89 at the significant level p<0.001; 2) Split-half reliability ranged from 0.82 to 0.90 (p<0.001); 3) The alpha coefficient was noticed to range from 0.79 to 0.88, which demonstrated good internal consistency. Furthermore, as is hypothesized, the score of CITSEA domains was significantly correlated with subscale's score of the Child Behavior Checklist 2/3 (CBCL2/3) and dimension's score of China Toddler Temperament. Confirmatory factor analysis demonstrated a good and reliable match of the model, indicating that CITSEA outlines the social and emotional development of Chinese urban children aged 12 to 36 months. CONCLUSION: The Chinese version of ITSEA is valid and the psychometric properties of this translated version (including its reliability and validity) are at an acceptable standard. It can be used as an instrument for assessing social and emotional problems, including delays in social-emotional competence for Chinese young children.