Date Published: October 3, 2018
Publisher: Public Library of Science
Author(s): Xiao-Ying Yan, Qin Li, Bing-Xian Luo, Tian-Hui You, Hai-Jun Wang, Jacobus P. van Wouwe.
To examine trends in the prevalence of wasting, stunting, overweight, and obesity among children in Luoding, a lower-middle-income city in southern China, we collected height, weight and other information on 65,908 pre-school children aged 2 to 7 years from 23 kindergartens, in which health examinations were conducted annually between 2004 and 2013. We used the growth standards of the World Health Organization (WHO) to calculate Z-scores for height and body mass index (BMI), and used the cut-offs recommended by WHO to define wasting, stunting, overweight, and obesity for each child. From 2004 to 2013, the prevalence of overweight increased from 3.70% to 7.27% and of obesity increased from 1.04% to 2.08%. Meanwhile, the prevalence of wasting decreased from 0.91% to 0.72% and of stunting decreased from 9.29% to 5.22%. These trends suggest there was still a double burden of nutritional status there. The nutritional interventions focusing on pre-school children should be comprehensively elaborated in lower-middle-income areas such as Luoding.
A recent multi-country study predicts that in 2025, the prevalence of obesity will reach 18% in males and 21% in females respectively . One of the main disconcerting aspects of the global obesity epidemiology is the high prevalence of childhood overweight and obesity . It is well documented that overweight in childhood life is highly related to the increased risk of adulthood obesity and unfavorable cardio-metabolic outcomes, which may result in serious health and economic consequences .
From 2004 to 2013, the population of Luoding increased from 1.10 million to 1.25 million, while the proportion of newborn girls increased from 42.7% to 48.3%. At the same time, the GDP per capital increased from 5.6 thousand yuan to 13.6 thousand yuan (Table 1). A total of 71,059 children’s health examination data were collected in this period, involving 28,779 girls (40.5%) and 42,280 boys (59.5%). The number of children increased from 5,951 in 2004 to 8,749 in 2013. The proportion of girls gradually increased from 35.2% in 2004 to 44.2% in 2013. The average age was 5.1±1.1 years (Table 2).
The present study illustrates that in the last decade, the prevalence of overweight and obesity increased and the prevalence of wasting and stunting decreased in Luoding city, China. While the prevalence of overweight and obesity reached 7.27% and 2.08%, there were still 0.72% and 5.22% of children being wasting and stunting in 2013. The results indicate a double burden of overnutrition and undernutrition in Luoding, China. Comprehensive interventions should be implemented in similar lower-middle-income areas to control overweight and obesity and improve stunting and wasting.
In the past ten years, the prevalence of overnutrition (both overweight an obesity) showed tendency to ascend, meanwhile, the prevalence of undernutrition (both wasting and stunting) decreased in pre-school children aged 2 to 7 in Luoding city, China. There was a double burden of undernutrition and overnutrition. The results of the present study suggest that comprehensive nutritional interventions should be implemented for pre-school children in lower-middle-income areas.