Original Article

International Journal of Obesity (2017) 41, 964–970; doi:10.1038/ijo.2017.53; published online 21 March 2017


Time trends and factors in body mass index and obesity among children in China: 1997–2011

H Wang1, H Xue2, S Du3, J Zhang1, Y Wang2 and B Zhang1

  1. 1National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China
  2. 2Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, State University of New York, Buffalo, NY, USA
  3. 3Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

Correspondence: Dr B Zhang, National Institute of Nutrition and Food Safety, Chinese Center for Disease Control and Prevention, Room 505, No. 29, Nanwei Road, Beijing 100050, China. E-mail: zzhangb327@aliyun.com

Received 11 July 2016; Revised 7 February 2017; Accepted 19 February 2017
Accepted article preview online 27 February 2017; Advance online publication 21 March 2017





Research on the shift in children's body mass index (BMI) distribution is limited and conditional mean models used in the previous research have limitations in capturing cross-distribution variations in effects. The objectives are to analyze the shift in Chinese children’s BMI distribution and to test the associations between BMI distribution and other factors.



We analyzed data collected from children 7 to 17 years old from the China Health and Nutrition Survey (CHNS) conducted in 1997, 2000, 2004, 2006, 2009 and 2011, from 2814 participants with 6799 observations. Longitudinal quantile regression (QR) was used to explore the effect of several factors on BMI trends in 2015.



The BMI curves shift to the right in boys and girls, with the distributions becoming wider, indicating a higher proportion of children have become overweight. The 5th, 15th, 50th, 85th and 95th BMI percentile curves all shifted upward from 1997 to 2011, and the higher percentiles had greater increases. The prevalence of overweight and obesity increased in boys and girls between 1997 and 2011, from 6.5 to 15.5% in boys and from 4.6 to 10.4% in girls. Energy intake and parents’ BMI levels had a positive association with children’s BMI. Per capita income was positively associated with changes in BMI only at the upper percentiles of the BMI distributions in boys. Increased physical activity (PA) was associated with decreased BMI in girls.



Children in China are becoming increasingly overweight. Energy intake, parental BMI, PA and early menarche age in girls are associated with elevated BMI in children.

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