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Epidemiology and Population Health

Longitudinal effects of school policies on children’s eating behaviors and weight status: findings from the childhood obesity study in China megacities

International Journal of Obesity volume 47, pages 17–23 (2023)Cite this article

Subjects

Abstract

Objectives

To examine longitudinal effects of school policies on children’s weight status and eating behaviors, and study how these effects may vary by children’s age, sex, and baseline weight status in China.

Methods

Data were collected in 2015, 2016, and 2017 in an open cohort of 3298 children aged 6–17, their parents, and schools in five large cities across China (Beijing, Shanghai, Xi’an, Nanjing, and Chengdu). Children’s weight, height, and waist circumference were measured, and their eating behaviors were self-reported. The 1691 children with such repeated measures in ≥ two waves were included in longitudinal data analysis with mixed effects models, testing the associations.

Results

Having school vicinity food stall policy was associated with less frequent consumption of fast food (β = −0.14, p < 0.01) and snack (β = −0.84, p < 0.01). More significant associations were found between school policies and unhealthy eating behaviors for girls and children aged 6–11 than their counterparts. Among children without overweight or central obesity at baseline, having school cafeteria food policy was associated with lower risks for overweight and obesity (OR = 0.33, 95% CI: 0.17–0.63) and central obesity (OR = 0.47, 95% CI: 0.26–0.85). This existed for girls, but not for boys. School vicinity food stall policy was associated with lower BMI (β = −0.20, 95% CI: −0.37, −0.03) among all children and in girls (β = −0.28, 95% CI: −0.50, −0.05) without overweight at baseline.

Conclusions

School policies could reduce children’s unhealthy eating behaviors and obesity risk in megacities in China. Children’s age, sex, and baseline weight status modify the effects. School policies are important to fight the growing childhood obesity epidemic.

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Data availability

All data included in this study are available.

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Acknowledgements

This work was supported by the National Natural Science Foundation of China (42271433), Wuhan University Specific Fund for Major School-level Internationalization Initiatives (WHU-GJZDZX-PT07), and the International Institute of Spatial Lifecourse Health (ISLE). We want to thank all the collaborators and study participants in the Childhood Obesity Study in China Megacities (COCM).

Author information

Author notes

  1. These authors contributed equally: Yixin Ding, Lu Ma.

Authors and Affiliations

  1. Global Health Institute, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an, Shaanxi, China

    Yixin Ding, Lu Ma & Youfa Wang

  2. School of Resource and Environmental Sciences, Wuhan University, Wuhan, China

    Peng Jia

  3. International Institute of Spatial Lifecourse Health (ISLE), Wuhan University, Wuhan, China

    Peng Jia

  4. Department of Health Administration and Policy, George Mason University, Fairfax, VA, USA

    Hong Xue

  5. Nanjing Municipal Center for Disease Control and Prevention, Nanjing, China

    Fei Xu

  6. Department of Health Policy and Management, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China

    Li Zhao

  7. Institute of Nutrition and Food Safety Risk Monitoring, Shaanxi Center for Disease Control and Prevention, Xi’an, Shaanxi, China

    Bo Xue

  8. National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China

    Yun Wang

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  1. Yixin Ding
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Contributions

YXD, LM, PJ, HX, FX, LZ, BX, WY, and YFW contributed to the study design, data collection, and drafting the paper. YXD and LM contributed to the data analysis. YXD, LM, and PJ drafted the paper. YFW directed the data collection and provided administrative support for the project. All authors contributed to interpretation of the data, commented on and revised the paper, and approved the final version for publication.

Corresponding author

Correspondence to Youfa Wang.

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Ding, Y., Ma, L., Jia, P. et al. Longitudinal effects of school policies on children’s eating behaviors and weight status: findings from the childhood obesity study in China megacities. Int J Obes 47, 17–23 (2023). https://doi.org/10.1038/s41366-022-01206-z

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