Background
Methods
Study design and participants
Key study variables
Health outcome variables
Fast food consumption
Other covariates
Statistical analysis
Results
Study participants’ characteristics
Characteristics | Overall (n = 1626) | Boys (n = 830) | Girls (n = 796) |
P-value |
---|---|---|---|---|
Child health outcomes | ||||
Obesity related variables | ||||
BMI, mean (SD) | 19.2 (3.9) | 19.7 (4.0) | 18.6 (3.8) | < 0.001 |
Waist circumference, mean (SD) | 66.0 (10.3) | 68.2 (11.1) | 63.7 (9.0) | < 0.001 |
WHtR, mean (SD) | 0.44 (0.06) | 0.45 (0.06) | 0.42 (0.05) | < 0.001 |
Blood pressure | ||||
Systolic blood pressure, mean (SD) | 106.0 (12.1) | 107.2 (12.4) | 104.8 (11.6) | < 0.001 |
Diastolic blood pressure, mean (SD) | 60.9 (7.9) | 60.4 (7.7) | 61.4 (8.1) | 0.017 |
Child characteristics | ||||
Age (in years), mean (SD) | 11.6 (2.0) | 11.6 (2.0) | 11.5 (2.1) | 0.917 |
Location, n (%) | 0.618 | |||
Beijing | 439 (27.0) | 213 (25.7) | 226 (28.4) | |
Shanghai | 400 (24.6) | 212 (25.5) | 188 (23.6) | |
Nanjing | 396 (24.4) | 204 (24.6) | 192 (24.1) | |
Xi’an | 391 (24.1) | 201 (24.2) | 190 (23.9) | |
School level, n (%) | 0.745 | |||
Primary school | 839 (51.6) | 425 (51.2) | 414 (52.0) | |
Middle school | 787 (48.4) | 405 (48.8) | 382 (48.0) | |
Their mothers’ characteristics | ||||
BMI, mean (SD) | 22.1 (3.2) | 21.9 (2.8) | 22.4 (3.4) | 0.001 |
Education level, n (%) | < 0.001 | |||
Elementary school or below | 402 (25.6) | 242 (30.5) | 160 (20.7) | |
Middle, high or vocational school | 452 (28.8) | 215 (27.1) | 237 (30.6) | |
College or above | 715 (45.6) | 337 (42.4) | 378 (48.8) |
Prevalence of fast food consumption and health outcomes
Characteristics | Had FFC each week (%) | Times of FFC per week (%) | Health outcomes, yes (%) | |||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
Western FFC | Chinese FFC | Western FFC | Chinese FFC | Overweight (including obesity) | Obesity | Central obesity | Hypertension | |||||
Not consumed | 1–2 time | ≥ 3 times | Not consumed | 1–2 times | ≥ 3 times | |||||||
All | 51.9 | 43.6 | 48.1 | 36.3 | 15.6 | 56.4 | 40.0 | 3.6 | 26.2 | 11.1 | 19.7 | 9.0 |
School | ||||||||||||
Primary school | 51.5 |
38.1
|
48.5
|
39.2
|
12.3
|
61.9
|
35.3
|
2.8
| 26.9 | 12.3 | 20.1 | 5.7 |
Middle school | 52.2 |
48.8
|
47.8
|
33.7
|
18.5
|
51.2
|
44.4
|
4.4
| 25.5 | 9.9 | 19.2 | 12.7 |
P-value | 0.756 |
< 0.001
|
0.001
|
< 0.001
| 0.529 | 0.134 | 0.625 | < 0.001 | ||||
Gender | ||||||||||||
Boys | 51.3 | 46.2 | 48.8 | 36.8 | 14.5 |
53.9
|
41.6
|
4.5
|
33.9
|
15.2
|
27.4
| 9.3 |
Girls | 52.4 | 41.3 | 47.6 | 35.8 | 16.6 |
58.8
|
38.5
|
2.7
|
18.2
|
6.9
|
11.7
| 8.8 |
P-value | 0.656 | 0.051 | 0.507 |
0.044
|
< 0.001
|
< 0.001
|
< 0.001
| 0.734 | ||||
City | ||||||||||||
Beijing | 49.8 | 44.5 | 50.2 | 31.7 | 18.1 |
55.5
|
40.3
|
4.2
| 28.9 | 11.9 | 19.1 | 9.1 |
Shanghai | 51.9 | 45.0 | 48.2 | 36.1 | 15.7 |
55.6
|
41.1
|
3.3
| 27.3 | 10.5 | 23.0 | 7.5 |
Nanjing | 55.1 | 46.1 | 44.9 | 38.5 | 16.6 |
53.9
|
40.5
|
5.6
| 21.7 | 10.6 | 20.7 | 11.9 |
Xi’an | 50.8 | 39.2 | 49.2 | 39.7 | 11.2 |
60.8
|
38.1
|
1.1
| 26.6 | 11.5 | 15.9 | 7.7 |
P-value | 0.464 | 0.235 | 0.059 |
0.039
| 0.108 | 0.907 | 0.080 | 0.117 |
Factors associated with fast food consumption
Western FFC each week (yes vs. no) OR (95% CI) | Chinese FFC each week (yes vs. no) OR (95% CI) | |
---|---|---|
Child factors | ||
Age | 1.07 (0.99–1.14) |
1.12 (1.02–1.23)**
|
Boy (vs. girl) | 0.94 (0.75–1.18) | 1.18 (0.94–1.49) |
City (vs. Beijing) | ||
Shanghai | 0.95 (0.56–1.60) | 1.01 (0.35–2.93) |
Nanjing | 1.08 (0.64–1.84) | 0.87 (0.30–2.52) |
Xi’an | 0.93 (0.54–1.60) | 0.71 (0.24–2.07) |
Maternal factors | ||
BMI | 1.00 (0.97–1.03) |
0.96 (0.93–1.00)*
|
Education level (vs. college or above) | ||
Elementary school or below |
1.49 (1.10–2.03)*
| 1.10 (0.79–1.53) |
Middle, high or vocational school | 1.22 (0.92–1.60) | 1.18 (0.89–1.56) |
Association between fast food consumption and health outcomes
Health outcomes | Overweight (Including Obesity, %) | Obesity (%) | Central obesity (%) | Hypertension (%) | ||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
FFC per week | All | Boy | Girl | All | Boy | Girl | All | Boy | Girl | All | Boy | Girl |
1) Western FFC | ||||||||||||
Ever consumed | ||||||||||||
No | 27.6 | 35.6 | 19.1 | 11.7 | 16.2 | 7.0 | 20.5 | 29.0 | 11.6 | 8.9 | 10.3 | 7.5 |
Yes | 24.9 | 32.6 | 17.1 | 10.7 | 14.6 | 6.8 | 19.1 | 26.5 | 11.7 | 9.3 | 8.5 | 10.0 |
P-value | 0.220 | 0.365 | 0.465 | 0.544 | 0.542 | 0.929 | 0.501 | 0.438 | 0.949 | 0.818 | 0.398 | 0.223 |
Times | ||||||||||||
0 | 27.6 | 35.6 | 19.1 | 11.7 | 16.2 | 7.0 | 20.5 | 29.0 | 11.6 | 8.9 | 10.3 |
7.5
|
1–2 | 26.0 | 31.6 | 20.0 | 10.6 | 13.3 | 7.9 | 18.6 | 24.5 | 12.5 | 10.5 | 8.8 |
12.1
|
≥ 3 | 22.0 | 34.5 | 10.8 | 11.0 | 18.1 | 4.6 | 19.9 | 31.0 | 10.0 | 6.5 | 7.8 |
5.4
|
P-value | 0.219 | 0.545 | 0.059 | 0.828 | 0.396 | 0.482 | 0.705 | 0.290 | 0.762 | 0.192 | 0.667 |
0.038
|
2) Chinese FFC | ||||||||||||
Ever consumed | ||||||||||||
No | 27.5 | 34.3 |
21.1
| 10.8 | 15.1 | 6.7 | 19.6 | 26.2 | 13.5 |
10.6
| 10.7 | 10.4 |
Yes | 24.8 | 34.1 |
14.2
| 11.8 | 15.7 | 7.4 | 20.2 | 29.5 | 9.6 |
7.1
| 7.6 | 6.5 |
P-value | 0.224 | 0.933 |
0.014
| 0.515 | 0.816 | 0.718 | 0.792 | 0.307 | 0.095 |
0.016
| 0.130 | 0.054 |
Times | ||||||||||||
0 | 27.5 | 34.3 |
21.1
| 10.8 | 15.1 | 6.7 | 19.6 | 26.2 | 13.5 | 10.6 | 10.7 | 10.4 |
1–2 | 24.3 | 33.4 |
14.3
| 11.5 | 15.4 | 7.3 | 19.6 | 28.9 | 9.3 | 7.1 | 7.2 | 7.0 |
≥ 3 | 26.3 | 36.1 |
9.5
| 15.8 | 19.4 | 9.5 | 22.8 | 30.6 | 9.5 | 7.0 | 11.1 | 0.0 |
P-value | 0.382 | 0.932 |
0.034
| 0.489 | 0.784 | 0.863 | 0.838 | 0.652 | 0.206 | 0.060 | 0.247 | 0.091 |
Obesity | Central obesity | Hypertension | |
---|---|---|---|
OR (95% CI) | OR (95% CI) | OR (95% CI) | |
1) Western FFC | |||
Times of FFC per week (vs. 0) | |||
1–2 | 0.96 (0.65–1.41) | 0.92 (0.68–1.26) | 1.17 (0.78–1.75) |
≥ 3 | 0.89 (0.53–1.49) | 0.99 (0.66–1.49) | 0.68 (0.35–1.31) |
Child factors | |||
Age | 0.92 (0.84–1.00) | 0.95 (0.88–1.03) |
1.33 (1.15–1.52)***
|
Boy (vs. girl) |
2.63 (1.79–3.89) ***
|
3.15 (2.31–4.31)***
| 1.21 (0.81–1.81) |
City (vs. Beijing) | |||
Shanghai | 0.95 (0.57–1.60) | 1.29 (0.78–2.12) | 0.81 (0.29–2.27) |
Nanjing | 0.75 (0.43–1.29) | 0.97 (0.58–1.62) | 1.73 (0.64–4.66) |
Xi’an | 0.95 (0.55–1.64) | 0.78 (0.45–1.34) | 0.89 (0.32–2.49) |
Maternal factors | |||
BMI |
1.11 (1.06–1.17)***
|
1.12 (1.07–1.17)***
|
1.09 (1.03–1.15)**
|
Education level (vs. College or above) | |||
Elementary school or below | 1.05 (0.66–1.67) | 1.05 (0.71–1.53) | 0.81 (0.46–1.44) |
Middle, high or vocational school |
1.71 (1.12–2.61)*
|
1.43 (1.00–2.03)*
| 1.34 (0.83–2.15) |
2) Chinese FFC | |||
Times of FFC per week (vs. 0) | |||
1–2 | 0.97 (0.68–1.40) | 0.94 (0.70–1.26) | 0.67 (0.44–1.02) |
≥ 3 | 1.21 (0.50–2.95) | 0.97 (0.46–2.07) | 0.92 (0.30–2.84) |
Child factors | |||
Age | 0.92 (0.84–1.00) | 0.96 (0.88–1.03) |
1.34 (1.17–1.54)***
|
Boy (vs. girl) |
2.64 (1.79–3.89)***
|
3.16 (2.31–4.32)***
| 1.24 (0.83–1.85) |
City (vs. Beijing) | |||
Shanghai | 0.96 (0.57–1.61) | 1.29 (0.78–2.13) | 0.81 (0.28–2.32) |
Nanjing | 0.75 (0.43–1.29) | 0.96 (0.57–1.62) | 1.71 (0.62–4.71) |
Xi’an | 0.96 (0.56–1.66) | 0.77 (0.45–1.34) | 0.89 (0.31–2.55) |
Maternal factors | |||
BMI |
1.11 (1.06–1.17)***
|
1.12 (1.07–1.17)***
|
1.09 (1.03–1.14)**
|
Education level (vs. College or above) | |||
Elementary school or below | 1.03 (0.65–1.65) | 1.04 (0.71–1.52) | 0.80 (0.45–1.43) |
Middle, high or vocational school |
1.70 (1.11–2.60)*
|
1.43 (1.00–2.03)*
| 1.33 (0.83–2.14) |