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Disparities in economic development in Eastern China: impact on nutritional status of adolescents

Published online by Cambridge University Press:  02 January 2007

Therese Hesketh*
Affiliation:
Centre for International Child Health, Institute of Child Health, University College London, UK
Qu Jian Ding
Affiliation:
Institute for Population Studies, Zhejiang Medical University, Zhejiang, People's Republic of, China
Andrew M Tomkins
Affiliation:
Centre for International Child Health, Institute of Child Health, University College London, UK
*
*Corresponding author: Email hesketh@mail.hz.zj.cn
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Abstract

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Objective:

To compare the effects of disparities in economic development in urban and rural Eastern China on the nutritional status of adolescents.

Design:

A cross-sectional survey consisting of self-completion questionnaires, anthropometry and haemoglobin measurement.

Setting:

Twelve middle schools in an urban and a rural area of Zhejiang Province: Hangzhou, the capital, and Chunan, a poor mountainous area.

Subjects:

Some 4835 young adolescents (predominant age range 13–16 years).

Results:

The mean body mass index (BMI) was significantly higher in urban Hangzhou (P=0.01) Overweight affected 3.6% overall; adjusted odds ratios (ORs) showed male sex (OR 2.1, 95% confidence interval (CI) 1.1–3.4) and urban residence (OR 9.1, 95% CI 3.7–22) to be the most important risk factors. The prevalence of underweight was 18%, with no significant urban–rural difference. Predictors of underweight were male sex (OR 1.5, 95% CI 1.1–2.0) and low household income (OR, 1.3, 95% CI 1.1–1.5). Mean haemoglobin was significantly lower in the rural area. Anaemia was more common in girls, 51% compared with 21% of the boys, but rural residence was not an independent risk factor. Rural students exercised more and had a less varied diet than their urban counterparts. Around one-third of the respondents consumed dietary supplements on a regular basis.

Conclusions:

These results suggest that in urban areas of Eastern China a dual picture is emerging with the problems of excess (overweight and obesity) coexisting with underweight and anaemia. In rural areas the problems of relative nutritional deprivation predominate, but the long-term consequences of such marginal underweight and anaemia are not clear.

Type
Research Article
Copyright
Copyright © CABI Publishing 2002

References

1Chen, J. Dietary changes and disease transition in China. Nutrition 1999; 15(4): 330–1.Google ScholarPubMed
2Chen, CM. Nutritional status of the Chinese people. Biomed. Environ. Sci. 1996; 9: 8192.Google ScholarPubMed
3Popkin, BM, Paeratakul, S, Ge, K, Zhai, FY. Body weight patterns among the Chinese: results from the 1989–1991 China Health and Nutrition Surveys. Am. J. Public Health 1995; 85(5): 690–4.CrossRefGoogle Scholar
4Popkin, BM, Keyou, G, Zhai, F, Guo, X, Ma, H, Zohoori, N. The nutrition transition in China, a cross-sectional analysis. Eur. J. Clin. Nutr. 1993; 47: 333–46.Google Scholar
5Lin, WS, Chen, ACN, Su, JZX, Xiao, JW, Ye, GS. Secular change in the growth and development of Han children in China. Ann. Hum. Biol. 1992; 19(3): 249–65.CrossRefGoogle ScholarPubMed
6Smith, CJ. (Over)eating success: the health consequences of the restoration of capitalism in rural China. Soc. Sci. Med. 1993; 37: 761–70.CrossRefGoogle ScholarPubMed
7Shen, TF, Habicht, JP, Chang, Y. Effect of economic reforms on child growth in urban and rural areas of China. N. Engl. J. Med. 1996; 335: 400–6.CrossRefGoogle Scholar
8Wang, Y, Popkin, B, Zhai, F. The nutritional status and dietary patterns of Chinese adolescents 1991 and 1993. Eur. J. Clin. Nutr. 1998; 52: 908–16.CrossRefGoogle ScholarPubMed
9Dietz, WH. The obesity epidemic in young children. BMJ 2001; 322: 313–4.CrossRefGoogle ScholarPubMed
10Guo, N. Disheartening: more young hearts diseased. China Daily, 3 08 2000.Google Scholar
11National Bureau of Statistics. Comprehensive Statistical Data and Materials on 50 years of New China. Beijing: China Statistics Press, 1999.Google Scholar
12Ling, AMC, Horwath, C, Parnell, W. Validation of a short food frequency questionnaire to assess consumption of cereal foods, fruit and vegetables in Chinese Singaporeans. Eur. J. Clin. Nutr. 1999; 52(8): 557–64.CrossRefGoogle Scholar
13World Health Organization (WHO). Physical Status: The Use and Interpretation of Anthropometry. WHO Technical Report No. 854. Geneva: WHO, 1995.Google Scholar
14Cole, TJ, Bellizzi, MC, Flegal, KM, Dietz, WH. Establishing a standard definition for child overweight and obesity worldwide. BMJ 2000; 320: 1240–3.CrossRefGoogle ScholarPubMed
15Hesketh, T & Zhu, WX. The one child family policy: the good, the bad and the ugly. BMJ 1997; 314: 1685–7.CrossRefGoogle ScholarPubMed
16Bellizzi, MC, Deitz, WH. Workshop on childhood obesity: summary of the discussion. Am. J. Clin. Nutr. 1999; 70, 173S–5S.CrossRefGoogle ScholarPubMed
17Dietz, WH. Childhood weight affects adult morbidity and mortality. J. Nutr. 1998; 128, 411S–4S.CrossRefGoogle ScholarPubMed
18Liu, SM, Yuan, R. School students' nutritional status in Heilongjiang province, 1991–1993. Chin. Sch. Health 1995; 16: 158–60.Google Scholar
19Fan, KF, Guo, CX, Liu, ZX. School students' nutritional status at Luanchen County. Chin. Sch. Health 1995; 16: 352.Google Scholar
20Liu, J. A survey on school students nutritional status in Zibo City. Chin. Sch. Health 1996; 17: 143.Google Scholar
21Wang, M, Du, S, Liu, F. A survey on school students' nutritional status in Xuanwuqu, Beijing. Chin. Sch. Health 1995; 16, 37.Google Scholar
22Prentice, AM. Body mass index standards for children. BMJ 1996; 317: 1401–2.CrossRefGoogle Scholar
23Kurz, KM. Adolescent nutritional status in developing countries. Proc. Nutr. Soc. 1996; 55: 321–33.CrossRefGoogle ScholarPubMed
24Coates, RJ, Monteilh, CP. Assessments of food frequency questionnaires in minority populations. Am. J. Clin. Nutr. 1997; 65(Suppl.): 1108S–15S.CrossRefGoogle ScholarPubMed
25Sempos, CT. Invited commentary: some limitations of semi-quantitative food frequency questionnaires. Am. J. Epidemiol. 1992; 135: 1127–32.CrossRefGoogle Scholar
26Guldan, GS, Zhang, YP, Li, ZQ, Hou, YH, Fei, L, Pu, LY, Huang, JS. Designing appropriate nutrition education for the Chinese: the urban and rural nutrition situation in Sichuan. J. Trop. Ped. 1991; 37: 159–65.CrossRefGoogle Scholar
27Grantham-McGregor, S. A review of the studies of the effects of severe malnutrition on mental development. J. Nutr. 1995; 125(8): S22338.CrossRefGoogle ScholarPubMed
28Nelson, M. Anaemia in adolescent girls: effects on cognitive function and activity. Proc. Nutr. Soc. 1996; 55(1B): 359–67.CrossRefGoogle Scholar
29Hesketh, T, Zhu, WX. Traditional Chinese medicine: one country, two systems. BMJ 1997; 315: 115–7.CrossRefGoogle ScholarPubMed