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Epidemiology

Sociodemographic disparity in the nutritional status among children and adolescents in Zhejiang Province

Abstract

Objective

To explore the sociodemographic disparity in the nutritional status including BMI, vitamin D and vitamin A status among children and adolescents in Zhejiang Province.

Methods

Weight, height serum 25-hydroxyvitamin D, and serum retinol were assessed in 2818 children and adolescents (6–17 years of age), using ten investigation sites in Zhejiang Province including urban and rural areas data from the China National Nutritional Study 2016–2017, which is a nationally representative cross-sectional study, to form provincial representative sample of Zhejiang Province. Sociodemographic disparity was explored.

Results

The prevalence of low weight, eutrophic, overweight and obese were 6.7%, 70.4%, 11.6%, and 11.2%, respectively. Significant difference was observed on BMI between males and females (P < 0.05), and between urban and rural areas (P < 0.05). The prevalence of vitamin D deficiency, inadequacy, normal and appropriate were 1.8%, 34.9%, 46.4% and 16.9%, respectively. Significant difference was observed on the concentration of 25‐hydroxyvitamin D (25(OH)D) both between genders and between living areas (P < 0.05). The prevalence of vitamin A deficiency, marginal deficiency and appropriate were 4.5%, 24.7%, and 70.9%, respectively. Significant difference was observed on the concentration of retinol between living area (P < 0.05).

Conclusions

Overweight and obesity, deficiency and inadequacy of vitamin D, deficiency and marginal deficiency of vitamin A were prevalent among children and adolescents. There were disparities between genders and between living areas on the nutritional status. Regional and sex-specific guidelines and public health policies for children and adolescent nutrition are needed.

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References

  1. 1.

    Han JC, Kimm SYS. Childhood obesity-2010: progress and challenges. Lancet. 2010;375:1737–48.

    Article  Google Scholar 

  2. 2.

    NCD Risk Factor Collaboration (NCD-RisC). Worldwide trends in body-mass index, underweight, overweight, and obesity from 1975 to 2016: a pooled analysis of 2416 population-based measurement studies in 1289 million children, adolescents, and adults. Lancet. 2017;390:2627–42.

  3. 3.

    Holick MF. The vitamin D deficiency pandemic: approaches for diagnosis, treatment and prevention. Rev Endocr Metab Disord. 2017;18:153–65.

    CAS  Article  Google Scholar 

  4. 4.

    West KP Jr. Extent of vitamin A deficiency among preschool children and women of reproductive age. J Nutr. 2002;132:2857S–66S.

  5. 5.

    GBD 2017 Causes of Death Collaborators. Global, regional, and national age-sex-specific mortality for 282 causes of death in 195 countries and territories, 1980−2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet. 2018;392:1736–88.

    Article  Google Scholar 

  6. 6.

    Mia MN, Rahman MS, Roy PK. Sociodemographic and geographical inequalities in under- and overnutrition among children and mothers in Bangladesh: a spatial modelling approach to a nationally representative survey. Public Health Nutr. 2018;21:2471–81.

    Article  Google Scholar 

  7. 7.

    Gong W, Liu A, Yao Y, Ma Y, Ding C, Song C. et al. Nutrient supplement use among the Chinese population: a cross-sectional study of the 2010-2012 China Nutrition and Health Surveillance. Nutrients. 2018;10:1733

    Article  Google Scholar 

  8. 8.

    WHO. Physical status: the use and interpretation of anthropometry; Report of a WHO Expert Committee. World Health Organization Technical Report Series no. 854; Geneva: WHO; 1995. p. 1–452.

  9. 9.

    Screening for overweight and obesity among school-age children and adolescents. Issued by the state health and Family Planning Commission of the people’s Republic of China. WS/T 586–2018.

  10. 10.

    Screening standard for malnutrition of school-age children and adolescents. Issued by the state health and Family Planning Commission of the people’s Republic of China. WS/T 456–2014.

  11. 11.

    Method for Vitamin A deficiency screening.Issued by the state health and Family Planning Commission of the people’s Republic of China WS/T 553–2017.

  12. 12.

    American Endocrine Association. Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society Clinical Practice Guideline. 2011;96:1911.

  13. 13.

    Qin W, Wang L, Xu L, Sun L, Li J, Zhang J, et al. An exploratory spatial analysis of overweight and obesity among children and adolescents in Shandong, China. BMJ Open. 2019;9:e028152.

    Article  Google Scholar 

  14. 14.

    Zhang X, Zhang F, Yang J, Yang W, Liu W, Gao L, et al. Prevalence of overweight and obesity among primary school-aged children in Jiangsu Province, China, 2014–7. PLoS ONE. 2018;13:e0202681.

    Article  Google Scholar 

  15. 15.

    Zou Y, Zhang RH, Xia SC, Huang LC, Fang YQ, Meng J, et al. The rural-urban difference in BMI and anemia among children and adolescents. Int J Environ Res Public Health. 2016;13:1020.

  16. 16.

    Song Y, Wang HJ, Ma J, Wang Z. Secular trends of obesity prevalence in urban Chinese children from 1985 to 2010: gender disparity. PLoS ONE. 2013;8:e53069.

    CAS  Article  Google Scholar 

  17. 17.

    Zhang J, Zhai Y, Feng XQ, Li WR, Lyu YB, Astell-Burt T, et al. Gender differences in the prevalence of overweight and obesity, associated behaviors, and weight-related perceptions in a National Survey of Primary School Children in China. Biomed Environ Sci. 2018;31:1–11.

    CAS  PubMed  Google Scholar 

  18. 18.

    Zhang T, Cai L, Ma L, Jing J, Chen Y, Ma J. The prevalence of obesity and influence of early life and behavioral factors on obesity in Chinese children in Guangzhou. BMC Public Health. 2016;16:954.

    Article  Google Scholar 

  19. 19.

    NCD Risk Factor Collaboration (NCD-RisC). Worldwide trends in body-mass index, underweight, overweight, and obesity from 1975 to 2016: a pooled analysis of 2416 population-based measurement studies in 128·9 million children, adolescents, and adults. Lancet. 2017;390:2627–42.

    Article  Google Scholar 

  20. 20.

    Yang L, Bovet P, Ma C, Zhao M, Liang Y, Xi B. Prevalence of underweight and overweight among young adolescents aged 12-15 years in 58 low-income and middle-income countries. Pediatr Obes. 2019;14:e12468.

    CAS  Article  Google Scholar 

  21. 21.

    Dong Y, Jan C, Ma Y, Dong B, Zou Z, Yang Y, et al. Economic development and the nutritional status of Chinese school-aged children and adolescents from 1995 to 2014: an analysis of five successive national surveys. Lancet Diabetes Endocrinol. 2019;7:288–99.

    Article  Google Scholar 

  22. 22.

    Song Y, Agardh A, Ma J, Li L, Lei Y, Stafford RS, et al. National trends in stunting, thinness and overweight among Chinese school-aged children, 1985-2014. Int J Obes. 2019;43:402–11.

    Article  Google Scholar 

  23. 23.

    Ogden CL, Lamb MM, Carroll MD, Flegal KM. Obesity and socioeconomic status in children and adolescents: United States, 2005–8. Nchs Data Brief. 2010;1:1–8.

  24. 24.

    Wang LL, Wang HY, Wen HK, Tao HQ, Zhao XW. Vitamin D status among infants, children, and adolescents in southeastern China. J Zhejiang Univ Sci B. 2016;17:545–52.

    CAS  Article  Google Scholar 

  25. 25.

    Hu Y, Chen J, Wang R, Li M, Yun C, Li W, et al. Vitamin D nutritional status and its related factors for Chinese children and adolescents in 2010–2. Nutrients. 2017;9:1024.

    Article  Google Scholar 

  26. 26.

    Pettifor JM. Calcium and vitamin D metabolism in children in developing countries. Ann Nutr Metab. 2014;64(Suppl 2):15–22.

    CAS  Article  Google Scholar 

  27. 27.

    Munasinghe LL, Yuan Y, Willows ND, Faught EL, Ekwaru JP, Veugelers PJ. Vitamin D deficiency and sufficiency among Canadian children residing at high latitude following the revision of the RDA of vitamin D intake in 2010. Br J Nutr. 2017;117:457–65.

    CAS  Article  Google Scholar 

  28. 28.

    Yang C, Chen J, Guo N, Liu Z, Yun C, Li Y, et al. Comparison on the status of vitamin A in 6- to 13- year-old children between 2002 and 2012 in China. Nutr J. 2016;15:50.

    Article  Google Scholar 

  29. 29.

    Zhang Y, Liu X, Chen J, Wang R, Piao J, Yang X, et al. Vitamin A nutritional status of Chinese rural children and adolescents in 2010–2. Wei Sheng Yan Jiu. 2017;46:345–9.

    PubMed  Google Scholar 

  30. 30.

    Song P, Wang J, Wei W, Chang X, Wang M, An L. The prevalence of vitamin A deficiency in Chinese CHildren: a systematic review and Bayesian meta-analysis. Nutrients. 2017;9:1285.

    Article  Google Scholar 

Download references

Acknowledgements

This work was supported by the National Key Research and Development Project (2018YFC1603103) and the Basic Public Welfare Research Plan of Zhejiang Province (LGF19H260002).

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Authors

Contributions

YZ and RZ were responsible for the study design. YZ was responsible for data collection and analysis, paper writing and revision. LH, DS, MH, YF, DZ, WW and DH took part in the field investigation and data collection.

Corresponding author

Correspondence to Ronghua Zhang.

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The authors declare that they have no conflict of interest.

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Zou, Y., Zhang, R., Huang, L. et al. Sociodemographic disparity in the nutritional status among children and adolescents in Zhejiang Province. Eur J Clin Nutr 75, 307–313 (2021). https://doi.org/10.1038/s41430-020-00704-5

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