Table of Content

10 February 2025, Volume 33 Issue 2

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Expert Commentary

Health report, prevention and control strategies for childhood obesity in China

HONG Ye, FU Junfen

2025, 33(2):  117-126.  DOI: 10.11852/zgetbjzz2025-0003

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The prevalence of overweight and obesity among Chinese children and adolescents has been rising over the past years, varying by age, geographical location and rural/urban areas. Primary school students have the highest prevalence of obesity, who need sufficient guidance of healthy living. The northern regions maintain the highest level of childhood obesity, but have shown a stable trend in recent years. Meanwhile, the prevalence of childhood obesity in eastern regions has risen dramatically. In both urban and rural areas, the prevalence of childhood obesity has been increasing, and the growth rate in rural areas is greater, possibly leading to a reversal between urban and rural areas in the future. The interaction of national and social environments, school and family factors, individual elements have promoted overweight and obesity in Chinese youth. The impacts of migration on regional obesity increase cannot be ignored. Lockdown and staying at home due to COVID-19 have triggered long-term influence on children′s health. The prevention and control of obesity among Chinese children and adolescents is challenging. National policies and academic regulations have been issued by government and organizations. Schools, families, communities and individuals should communicate and cooperate with each other to execute comprehensive prevention and control of obesity among children and adolescents in a systematic perspective.

Professional Forum

Exercise intervention for obese children and adolescents

ZHOU Yu, WANG Haijun

2025, 33(2):  127-131.  DOI: 10.11852/zgetbjzz2024-1457

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Insufficient physical activity and sedentary behavior are significant factors contributing to childhood overweight and obesity. Exercise offers numerous benefits to obese children in terms of their physical appearance, physical fitness, and mental well-being, making it a crucial component of comprehensive interventions for obese children. The mechanisms by which exercise exerts its effects include reducing adipose tissue, regulating cytokine and hormone levels, improving insulin resistance and inflammatory states, and promoting brain development. Although the specific dose-response relationship of exercise in obese children has not been clearly established, aerobic exercise or a combination of aerobic and resistance exercise is considered a more reasonable choice, and the application of high-intensity interval training in obese children is gradually increasing. In the future, there is a need to develop optimal forms of exercise that are effective, time-efficient and safe, and to explore whether new methods suitable for obese adults can be adapted for use in children and adolescents.

Clinical significance of milk fat globules for infant health

WEI Wei, WANG Zhixu, WANG Xingguo, MAO Meng

2025, 33(2):  132-135.  DOI: 10.11852/zgetbjzz2024-1399

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Breast milk is the natural food best suited to infants′ digestive and metabolic capabilities, fulfilling their comprehensive nutritional needs. Heightened attention and research on the components of breast milk have facilitated improvements in infant formula. The structure of breast milk fat globules is recognized as an important part of the breast milk biosystem. Clinical trials indicate that novel formulas containing structures mimicking breast milk fat globules exhibit safety and well tolerance, with body mass index development trajectories closer to those of breastfed infants. These formulas surpass traditional infant formulas in terms of average fecal fat content, phosphorus and calcium levels, and total fatty acids in stool samples, while also modulating infant gut microbiota. They promote infant cognitive development by enhancing the absorption of ω-3 long-chain polyunsaturated fatty acids.

Original Articles

Characteristics of serum lipid metabolism in obese children with nonalcoholic fatty liver disease

LIU Lujie, XU Dong, XIAO Yanfeng, YIN Chunyan

2025, 33(2):  136-141.  DOI: 10.11852/zgetbjzz2024-1277

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Objective To compare the clinical data and serum lipid profiles between obese children with nonalcoholic fatty liver disease (NAFLD) and those without NAFLD, and to explore the diagnostic value of lipid lipid metabolites in NAFLD in obese children. Methods A total of 12 obese children diagnosed with NAFLD and 16 obese children without NAFLD in the Pediatric Outpatient Department of Xi′an Jiaotong University Second Hospital from September to December in 2023 were enrolled in this study. Each child underwent a physical examination and blood biochemical tests. Multivariate statistical analysis of lipidomic data was conducted using Lipidsearch and MetaboAnalyst 6.0. Receiver operating characteristic (ROC) curve analysis was employed to evaluate the diagnostic value of lipid markers for NAFLD in obese children. Results Body mass index (BMI)(t=2.605)and alanine aminotransferase (ALT)(Z=2.351) levels were significantly higher in obese children with NAFLD compared to those without NAFLD (P<0.05). Partial least squares discriminant analysis (PLS-DA) indicated that lipidomics could effectively differentiate between the two groups. In the obese group with NAFLD, triglyceride (TG) levels were significantly elevated, while the subclasses of O-acyl-ω-hydroxy fatty acids (OAHFA) were significantly reduced compared to the obese group without NAFLD (P<0.05). Additionally, the levels of phosphatidylethanolamine (PE) (18:0e_22:5), phosphatidylcholine (PC) (37:4e), phosphatidylcholine (PC) (20:4e_15:0), phytosphingosine (phSM) (d20:0_16:0), monosaccharide ceramide (Hex1Cer) (t20:0_22:6), and cardiolipin (CL) (83:13) were significantly decreased in obese children with NAFLD(P<0.05). The ROC curve analysis revealed that the area under the curve for the six lipid candidate markers was significantly greater than that for ALT, indicating their potential diagnostic value for NAFLD in obese children. Conclusions There are significant differences in lipidomic profiles between obese children with and without NAFLD. Disorders in lipid metabolism are associated with the development of NAFLD in obese children, and the identified lipid metabolites possess important diagnostic value for NAFLD in this population.

Factors influencing preschool children′s obesity in two cities of Shandong Province

YAN Shiyu, LIU Yi, YIN Li, ZHANG Li, DUAN Xuexia, LIANG Bin, LI Yan, WANG Haijun

2025, 33(2):  142-148.  DOI: 10.11852/zgetbjzz2024-1460

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Objective To analyze the factors influencing obesity among preschool children and the relationships between these factors, so as to provide scientific evidence for the prevention and control of early childhood obesity. Methods A case-control study was conducted in Jinan and Weifang, Shandong Province from March to July 2024, involving 94 obese and 91 normal preschool children. Data on obesity risk factors were collected using a 3-day 24-hour dietary recall, questionnaires, and accelerometer monitoring.Chinese Diet Balance Index for Preschool Children(DBI_C)of each food was calculated.Differences between the two groups in terms of birth and early feeding practices, dietary behaviors and intake, physical activity, and sleep patterns were compared. Then a multivariate Logistic regression model was constructed. Interaction effects and mediation models were further analyzed. Results Multivariate analysis revealed that preschool children′s obesity was positively associated with maternal age (OR=1.12, 95%CI: 1.02 - 1.23), maternal overweight/obesity (OR=3.71, 95%CI: 1.62 - 8.49), food responsiveness score (OR=2.59, 95%CI: 1.56 - 4.31), food preference score (OR=1.79, 95%CI: 1.10 - 2.91), DBI_C scores for cereals (OR=1.18, 95%CI: 1.06 - 1.31) and animal foods (OR=1.07, 95%CI: 1.00 - 1.14),while it was negatively associated with emotional eating reduction score (OR=0.56, 95%CI: 0.32 - 0.98). Children′s birth, early feeding history, father′s age, parental education level, physical activity, or sleep was found not to be associated with obesity. There was an interaction between maternal age and weight status, and children′s dietary behaviors on their susceptibility to obesity. In the mediation model, it was found that the DBI_C scores for cereal and animal foods partially mediated the relationship between food responsiveness and obesityas well as food preference and obesity among preschool children. Conclusions Besides maternal factors, poor dietary behaviors and excessive intake of cereal and animal foods are the main modifiable factors contributing to preschool children′s obesity. Maternal factors interacted with poor dietary behaviors, and the excessive intake of cereal and animal foods partially mediates the association between poor dietary behaviors and obesity, which provides scientific evidence for the development of intervention measures for preschool children′s obesity.

Improvement effect of different weight loss on non-alcoholic fatty liver disease in obese children and adolescents

CHENG Guodong, ZHU Lin, QIN Yuling

2025, 33(2):  149-154.  DOI: 10.11852/zgetbjzz2024-0664

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Objective To investigate the effects of different levels of weight loss on body fat, blood lipids, blood glucose, liver function, and liver morphology in obese children and adolescents with non-alcoholic fatty liver disease (NAFLD). Methods From July to September 2023, seventy obese children and adolescents with NAFLD were recruited from a closed weight loss camp and underwent a 4-week weight loss intervention. Various test indicators were collected from the participants one day before the intervention and four weeks after the intervention. Based on the percentage of weight loss (WL) and clinical guideline recommendations, the participants were divided into a low WL group (WL<5%), a moderate WL group (5%≤WL<7%), and a high WL group (WL≥7%). The paired-sample t-test was used to compare changes in indicators within groups, one-way ANOVA was used to compare differences in improvement effects between groups, and a generalized regression model was used to analyze the relationship between weight change and blood glucose, blood lipids, and liver enzymes. Results A total of 61 participants were included in the analysis. After the 4-week weight loss intervention, there were significant decreases in body fat (BF) (t=6.471, 9.991, 13.351) and fat percentage (FP) (t=6.240, 5.549, 7.616) in the three NAFLD groups (P<0.05). Low-density lipoprotein cholesterol (LDL-C) significantly improved in all three groups (t=3.403, 9.218, 7.844, P<0.05), and the decrease in serum total cholesterol (TC) was statistically significant only in the 5%≤WL<7% and WL≥7% groups (t=7.114, 6.735,P<0.05). Serum gamma-glutamyltransferase (GGT) (t=5.082, 4.275, 5.003) and serum cholinesterase (ChE) (t=6.708, 9.254, 10.941) were significantly reduced (P<0.05). Alkaline phosphatase (ALP) (t=3.842, 4.584) and lactate dehydrogenase (LDH) (t=3.065, 3.869, P<0.05) decreased significantly in the 5%≤WL<7% and WL≥7% groups, and aspartate aminotransferase (AST) decreased significantly in the WL≥7% group (t=2.115, P<0.05). Using the percentage of weight change as the independent variable and a generalized linear regression model for trend testing, it was found that serum TC, ALP, LDL-C, TG, and ChE exhibited a linear trend across weight change groups (P<0.05). Conclusion Weight loss intervention can significantly improve glucose and lipid metabolism and liver function in obese children and adolescents with NAFLD, and with increasing amounts of weight loss, there is a trend of increased improvement in NAFLD liver enzymes.

Dose-response relationship between weight loss rate and changes in resting metabolic rate of obese adolescents

QIN Yuling, ZHU Lin, CHENG Guodong

2025, 33(2):  155-159.  DOI: 10.11852/zgetbjzz2024-0795

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Objective To investigate the dose-response relationship between weight loss rate and changes in resting metabolic rate(RMR) in adolescents with obesity, so as to provide scientific and accurate theoretical support for the prevention of weight rebound in adolescents with obesity. Methods From July to August 2023,sixty obese adolescents aged 10 - 17 were recruited and underwent a 4-week weight loss intervention.The weight loss rate was calculated as [(post-intervention weight after intervention －pre-intervention weight) ×(－1) /weight before intervention] ×100%. A gas metabolism analyzer was used to collect oxygen intake and carbon dioxide exhalation, which were then substituted into the Weir formula to determine RMR. The adjusted Δ relative resting metabolic rate(ΔRMR) per kilogram of body weight change was calculated as the difference between post-intervention and pre-intervention values. Paired-sample t-test was used to compare differences in weight and relative RMR before and after the weight loss intervention. Linear regression analysis was conducted to assess the dose-effect relationship between weight loss rate and ΔRMR, while restricted cubic spline(RCS) analysis was employed to examine threshold effects. Results Forty-nine obese adolescents were included in the statistical analysis,(including 26 males) with a mean age of(13.15±1.80) years and a mean body mass index(BMI) of(31.20±3.91) kg/m². Significant weight loss was observed after the 4-week intervention(t=20.486, P<0.05), while there was no significant change in relative RMR before and after the intervention(t=0.222, P>0.05). Linear regression analysis showed that for every 1% increase in weight loss rate, ΔRMR increased by 0.874kCal/(d·kg)(95%CI: 0.185 to 1.563, P<0.05). RCS results indicated a nonlinear dose-effect relationship between weight loss rate and ΔRMR among obese adolescents after adjusting for age, sex, and baseline weight(P-Nonlinear<0.05). Specifically, when the weight loss rate was ≤7.90%, each additional 1% of weight loss was associated with an increase in ΔRMR by 2.245kCal/(d·kg)(95%CI: 1.032 to 3.467, P<0.05). However, when the weight loss rate exceeded 7.90%, further increases in the weight loss rate did not significantly elevate ΔRMR(P>0.05). Conclusions There is a nonlinear dose-response relationship and threshold effect between 4-week weight loss and changes in RMR among obese adolescents. When the weight loss rate does not exceed 7.90%, there is a quantitative relationship with changes in RMR, such that increasing the weight loss rate gradually enhances changes in RMR. Once the weight loss rate exceeds 7.90%, the relationship between them is not significant.

Exploration of body fat status and appropriate obesity cut-offs in children based on body composition

HE Lu, ZHAO Yan, GONG Jinxin, ZHAO Lu, ZHANG Xiaolin, MAO Guanghui, MA Zhourui, SHI Xiaoyan, CAI Shizhong, YAN Xiangming

2025, 33(2):  160-165.  DOI: 10.11852/zgetbjzz2024-1233

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Objective To explore the body fat status in children using body composition, and to explore the cut-off values of fat mass index (FMI) and body fat percentage (PBF) for the diagnosis of obesity in children. Methods A cross-sectional design was adopted. From January 2017 to August 2022, body composition of 22 198 children who visited the outpatient department of Child Health Care of Children′s Hospital of Soochow University was measured by bioelectrical impedance analysis. Body mass index (BMI), fat mass (FM), fat-free mass (FFM),FMI and PBF of children were recorded. Results BMI, PBF and FMI of boys and girls showed a downward trend from 3 to 5 years old, and showed an increasing trend after 5 years old, while PBF and FMI of boys showed a downward or flat trend after 10 years old. ROC curve analysis showed that the AUC of FMI and PBF of sex and age in the diagnosis of obesity was greater than 0.900, and the specificity and sensitivity were basically greater than 90%. Conclusions FMI and PBF have high diagnostic value as clinical indicators for predicting obesity. The application of FMI or PBF can intuitively and accurately reflect the content and changes of body fat in children.

Correlation of eating and feeding behaviors of preschool children with weight based on network analysis

YANG Zhe, ZHANG Hao, ZHANG Haiyue, LIANG Ying, WANG Yue, ZHANG Wei, ZHANG Yuhai, SHANG Lei

2025, 33(2):  166-172.  DOI: 10.11852/zgetbjzz2024-0842

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Objective To explore the correlation of dietary behaviors and feeding behaviors with weight among preschool children using network analysis, and to identify key dietary and feeding behaviors that affect children′s weight. Methods Between January and July 2021, 5 to 10 kindergartens were selected from each of the seven prefecture-level cities in Shaanxi Province.A total of 9 629 the primary caregivers of preschool children aged 3 - 6 years were surveyed to assess dietary behaviors of preschool children and feeding behaviors of caregivers. The R software was used to construct a network of dietary behaviors, feeding behaviors and weight, and key behaviors were identified based on centrality indices such as strength, closeness, and betweenness of the network. Results Compared with children of normal weight, underweight children had higher scores for coercive feeding, unhealthy eating habits, overeating response, and emotional eating, while overweight and obese children hadsignificantly higher scores for weight concern, food responsiveness, and emotional eating(P<0.05). Network analysis revealed a strong positive correlation between responsive feeding and restriction of dietary content among feeding behaviors(r=0.45), and a negative correlation between unhealthy eating habits and initiative eating among dietary behaviors(r=-0.27). Emotional eating among dietary behaviors was positively correlated with weight concern among feeding behaviors(r=0.22). Children′s body mass index(BMI) was positively correlated with weight concern(r=0.14) and negatively correlated with overeating response(r=-0.10). The key behaviors in the network of dietary behaviors, feeding behaviors, and weight among preschool children included responsive feeding, unhealthy eating habits, and initiative eating. Conclusions Dietary behaviors and feeding behaviors among preschool children have a strong correlation with weight, with responsive feeding, unhealthy eating habits, and initiative eating being the key feeding and dietary behaviors that affect children′s weight. Developing effective intervention measures targeting these key behaviors is of great significance for promoting healthy growth and preventing obesity and underweight issues in preschool children.

Development of percentile reference values of kidney size in healthy children aged 6 - 12 years

LIU Qin, ZONG Xinnan, QIAO Ya′nan, REN Hongyan, WANG Mingxue, LIU Yumeng, LI Shaoli, XI Bo, LIU Junting

2025, 33(2):  173-179.  DOI: 10.11852/zgetbjzz2024-0741

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Objective To establish percentile reference standards for kidney dimensions by sex and age for healthy children aged 6 to 12 years,in order to provide reference for the assessment of child kidney development and diagnosis of related diseases. Methods A cross-sectional survey design was employed, and in May 2023, a cluster random sampling method was used to select healthy children aged 6 to 12 years from two primary schools in Tongzhou District, Beijing, as the study population. Color Doppler ultrasonography was used to measure the bilateral kidney dimensions of the participants. The Lambda-Mu-Sigma(LMS) method based on skewness, location, and variation smoothing, was used to establish percentile growth curve models for kidney length, width, and thickness by sex and age for both the left and right kidneys, thereby obtaining percentile reference values for kidney dimensions in healthy children aged 6 to 12 years. Results A total of 2 193 healthy children with a mean age of (9.0±1.7) years were included, among which 1 166(53.2%) were boys. Growth curve models for kidney dimensions in children were established using the LMS method, yielding percentile reference standards for kidney dimensions by sex and age for children aged 6 to 12 years, including length, width, and thickness for both the left and right kidneys. The length, width, and thickness of children′s kidneys increased with age. The length and thickness of the left kidney were greater than those of the right kidney, while the width was smaller. Conclusions This study developed percentile reference standards for kidney length, width, and thickness by sex and age for healthy children aged 6 to 12 years, which can be used for assessing kidney development levels and as an auxiliary diagnostic tool for related kidney diseases in children.

Screening of differential metabolites in the urine of obese boys

LIU Wei, DONG Jie, GAO Chaonan, QI Qianjin, KONG Yawei, MENG Xin, PENG Xiaoxia, YAN Yinkun

2025, 33(2):  180-184.  DOI: 10.11852/zgetbjzz2024-0654

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Objective To investigate the differences in urinary metabolite profiles between obese and normal-weight boys, in order to provide preliminary clues for understanding the pathogenesis of obesity. Methods A case-control study design was employed. From September to October 2021, children aged 6 - 14 years were recruited from three boarding schools in Changsha, Hunan. Participants were divided into obese and normal-weight groups based on their weight status. Ten normal-weight boys and ten obese boys were matched by age(1∶1 ratio).24-hour urine samples were collected continuously for three days, mixed, and 2mL of urine was taken for targeted detection. Orthogonal partial least squares discriminant analysis(OPLS-DA) was used to compare the overall differences in metabolite composition between the two groups, and a combination of t-test and fold change(FC) values was employed to screen for differential metabolites. Result The levels of Indole-3-methyl acetate, Indole-3-propionic acid, Indoleacetic acid, Cholic acid, Glycocholic acid, Sulfated lithocholic acid, 7-dehydrocholic acid, Methylcysteine, Proline, and Sebacic acid were significantly lower in the obese group compared to the normal-weight group(Log₂FC≤-0.5, P <0.05). Conclusion Differences in urine metabolites exist between obese and normal-weight male children, which may provide new clues for the prevention and control of obesity.

A single-center prospective cohort study on the physical growth status of small for gestational age preterm infants at 0 - 24 months of age

FU Yanhong, YAN Lina, WENG Xiaoqin

2025, 33(2):  185-190.  DOI: 10.11852/zgetbjzz2024-0526

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Objective To investigate the physical growth characteristics of small for gestational age(SGA) premature infants within the first 24 months after birth, so as to provide relevant references for clinical management and growth intervention of premature SGA infants. Methods A prospective cohort study design was adopted. A total of 60 premature(gestational age <37 weeks) SGA infants born in Jianyang People′s Hospital between January 2020 and February 2022 and who underwent regular follow-up physical examinations at the hospital within 2 years after birth were selected as the study subjects. Full-term(gestational age 37 - 40 weeks) SGA infants and premature appropriate for gestational age(AGA) infants during the same period were selected as the control groups in a 1∶2 ratio. Their weight, length, and head circumference were measured at birth and at 3, 6, 12, 18, and 24 months of age(corrected age for premature infants), and the Z-score method was used to assess their growth level and growth rate. Results A total of 276 infants completed the follow-up study, including 56 in the premature SGA group, 109 in the full-term SGA group, and 111 in the premature AGA group. The weight-for-age Z-scores(WAZ), length-for-age Z-scores(LAZ), and head circumference-for-age Z-scores(HCZ) of the premature SGA group and the full-term SGA group at 3, 6, 12, and 18 months of age were significantly lower than those of the premature AGA group(P<0.05). The WAZ of the premature SGA group at 3 and 6 months of age were lower than those of the full-term SGA group, the LAZ of the premature SGA group at 6 months of age was lower than that of the full-term SGA group, and the HCZ of the premature SGA group at 3, 6 and 12 months of age were lower than those of the full-term SGA group, with statistically significant differences(P<0.05). The peak catch-up growth in weight for the premature SGA group, full-term SGA group, and premature AGA group occurred at 12, 18, and 3 months of age, respectively. The length catch-up growth was significant within the first 12 months of age in all three groups, followed by a gradual increase. The head circumference showed catch-up growth in both the premature SGA and premature AGA groups, with peak catch-up occurring at 6 months and 12 months of age, respectively. There were statistically significant differences in weight growth velocity among the three groups at 3 months of age(P<0.05). Conclusions The overall level of physical development in the early life(first 12 months of age) of SGA infants is lower than that of AGA infants. The physical growth of full-term SGA infants is better than that of premature SGA infants. The corrected age of 0 - 3 months may be a window period of rapid growth changes in premature SGA infants. Strengthening nutritional intervention and feeding guidance during this stage can effectively ensure the growth rate of premature SGA infants.

Review

Correlation between overweight or obesity and common neurodevelopmental disorders in children

WANG Xifei, XUE Yang, JIA Feiyong, LI Honghua

2025, 33(2):  191-195.  DOI: 10.11852/zgetbjzz2024-0344

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With the escalating prevalence of obesity,it has emerged as a significant public health concern affecting children and adolescents both physically and mentally.There is growing evidence indicating a substantial co-occurrence of overweight and obesity alongside neurodevelopmental disorders,notably attention deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD).This paper reviews the literature exploring the correlation between childhood overweight,obesity,and prevalent neurodevelopmental disorders,with the aim of enhancing clinicians′ recognition of overweight or obesity in children diagnosed with neurodevelopmental disorders,thereby furnishing a foundation for integrated management strategies for these common conditions.

Research progress on the relationship between paternal factors and childhood obesity

HAN Rui, GUAN Ji, YU Jiaxin, XIANG Yuan, JU Xuemei, ZHOU Hongju, PAN Xingying

2025, 33(2):  196-202.  DOI: 10.11852/zgetbjzz2024-0710

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Fathers play an indispensable role in the growth of children and constitute an important force in nurturing children. Emphasizing the influence of fathers in parenting can enhance the effectiveness of family-based prevention and control of childhood obesity. This article reviews the current research status and father-related factors associated with childhood obesity, and proposes strategies to improve fathers′ involvement in the prevention and control of childhood obesity, aiming to draw researchers′ attention to the role of fathers in preventing and controlling childhood obesity and to provide assistance in formulating precise family-based prevention and control strategies for childhood obesity in China.

Impact of obstructive sleep apnea hypopnea syndrome on intellectual development in obese children

WANG Xiayan, LING Jizu, YE Xinhua, CAI Ganlu

2025, 33(2):  203-207.  DOI: 10.11852/zgetbjzz2024-0616

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Obstructive sleep apnea hypopnea syndrome (OSAHS) has a high incidence rate in children and negatively impacts their growth and development,behavior, and neurocognitive functions. Obesity can independently impact intellectual development and also increases the risk of OSAHS. With the annual rise in childhood obesity rates, research on cognitive dysfunction in obese children with OSAHS has become a hot topic in recent years. This review will summarize the advances in studies related to intellectual development in obese children with OSAHS.

Diagnosis and treatment of somatic symptom disorder in children and adolescents

LAI Qiankun, WANG Yanxia, OU Ping, YU Qiujuan, LI Yinzhi, GUO Jingmin, HUANG Xinxin

2025, 33(2):  208-213.  DOI: 10.11852/zgetbjzz2024-0804

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Somatic symptom disorder (SSD) in children and adolescents is a common psychological disorder that manifests as symptoms such as abdominal pain, headaches, nausea, and others, affecting patients′ life, learning and daily functioning. Early diagnosis of this disorder relies on detailed history-taking, physical examination, and the exclusion of other potential medical conditions. Its etiology may be related to biopsychosocial factors. In terms of intervention and treatment, cognitive-behavioral therapy involving both schools and families is an important therapeutic approach.

Meta Analysis

Meta-analysis of the effect of family-based exercise intervention on overweight and obesity in preschool children

LI Wang, CHEN Peiyou, WU Zhijian, YE Wei

2025, 33(2):  214-220.  DOI: 10.11852/zgetbjzz2024-0504

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Objective To explore the effect of family-based intervention on the body shape, dietary pattern, physical activity and sleep of preschool children with overweight and obesity, in order to provide refernec for obesity intervention. Methods A literature search was conducted in databases such as PubMed, Scopus, and CNKI up to July 20th, 2022, to collect articles on the impact of family-based interventions on overweight and obesity in preschool children. Data analysis was performed using STATA 14.0. Results A total of 24 articles were included, with 12 articles rated as high-quality(Grade A) and 12 as moderate-quality(Grade B). Meta-analysis results showed that after family-based interventions, there were significant decreases in body mass index(BMI)(WMD=-0.193), BMI-Z score(WMD=-0.241), BMI percentile(WMD=-1.258), weight(WMD=-0.639), energy intake(WMD=-139.266), fat intake(WMD=-1.170), saturated fat intake(WMD=-0.324), sugary beverage consumption(WMD=-1.313), television viewing time(WMD=-0.111), and sedentary behavior time(SMD=-1.491) among preschool children(P<0.05). Additionally, there were significant increases in fruit and vegetable intake (WMD=0.592) and fruit intake (WMD=1.052)(P<0.05). Conclusion Family-based interventions were effective in reducing BMI, BMI-Z score, BMI%, and body weight, improving dietary patterns, and reducing screen time and sedentary time in preschool overweight and obese children.

Clinical Research

Status and influencing factors of prepubertal bone mineral density of Han children in rural areas of eastern Henan Province

CHEN Huiyu, LIANG Zhidong, MA Pan, LIANG Jiazhi, SUN Yanyan

2025, 33(2):  221-226.  DOI: 10.11852/zgetbjzz2024-0503

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Objective To investigate the current status of bone density in prepubescent Han children in rural areas of East Henan and to explore the influencing factors, in order to provide reference for the development of physical health of rural children. Methods From July to September 2023, 318 prepubescent Han children from 12 primary schools in rural East Henan were randomly selected as subjects by stratified sampling. Their whole-body bone mineral density (BMD) (excluding the head) and daily physical activity levels were measured. Information was collected by means of questionnaire survey and telephone interview. Results Significant differences in bone density were observed among subjects based on age, body mass index (BMI), the highest educational attainment of one parent, family support for sports, whether they were an only child, and whether they were left-behind children (P<0.05). Correlation analysis revealed a significant positive correlation between BMD and moderate-to-vigorous physical activity time (r=0.890, P=0.033). Multivariate linear regression analysis indicated that age, BMI, the highest educational attainment of one parent, family support for sports, being an only child, being a left-behind child, and moderate-to-vigorous physical activity time were all factors affecting bone density (P <0.05). The explanatory power from greatest to least was being a left-behind child (β=1.05), moderate-to-vigorous physical activity time (β=0.91), being an only child (β=-0.74), the highest education level of one parent (β=-0.52),BMI (β=-0.51), age (β=0.39) and family support for sports (β=-0.25). Conclusion Cultivating health literacy among rural residents, caring for left-behind children, enhancing support for physical activities among rural children, and appropriately extending the duration of moderate-to-vigorous physical activity are important approaches to improving BMD of prepubescent children in rural areas.

Epidemiological survey on anemia and iron deficiency among children aged 6 months to 6 years in Xinjiang

GAO Yue, CUI Suxin, REZWANGULI·Mijiti, LIU Shuping, ZHANG Weichun, YAN Xiaojie, LYU Chunyan, LI Yi

2025, 33(2):  227-232.  DOI: 10.11852/zgetbjzz2024-0537

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Objective To investigate the current status of anemia, iron deficiency, and iron deficiency anemia among preschool children in Xinjiang. Methods In 2023, a multi-stage stratified sampling method was used to select 15 community health service centers(township health centers) in 5 prefectures(autonomous prefectures, cities) in Xinjiang. A total of 2 108 children aged 6 months to 6 years were surveyed in February 2023 and divided into three age groups: infants(6 - 11 months old), toddlers(12 - 35 months old), and preschoolers(3 - 6 years old). Basic information on children and their families was collected through questionnaires, physical measurements were conducted, and capillary blood was collected for hemoglobin(Hb) and serum ferritin testing. The χ² test and Logistic regression models were used to analyze the impact of factors such as ethnicity and region on the detection rates of anemia, iron deficiency, and iron deficiency anemia. Results Finally, 2 107 children were included, with 1 046 boys and 1 061 girls. The proportions of infants, toddlers, and preschoolers were 13.9%(292 cases), 28.5%(600 cases), and 57.6%(1 215 cases), respectively. The mean Hb level of children in Xinjiang was(126.7±16.7)g/L, and the mean serum ferritin(SF) level was(27.5±21.7)μg/L. The detection rates of anemia, iron deficiency, and iron deficiency anemia were 11.7%, 48.2%, and 7.0%, respectively. Logistic regression analysis showed that maternal education at the junior middle school level or below(OR=1.803), and being of Uyghur(OR=4.090), Hui(OR=2.361), or Kazakh(OR=3.493) ethnicity were risk factors for anemia among children(P<0.05). Residing in central Xinjiang(OR=0.413) and southern Xinjiang(OR=0.489) were protective factors against anemia(P<0.05). Residing in rural areas(OR=3.042), being in central Xinjiang(OR=5.225), having a family income of less than 50 000 Chinese yuan(OR=1.444), and being of Uyghur(OR=1.796) or Kazakh(OR=2.524) ethnicity were risk factors for iron deficiency among children(P<0.05). Maternal education at the junior middle school level or below(OR=3.371), and being of Uyghur(OR=6.875), Hui(OR=3.757), Kazakh(OR=8.146), or other ethnicities(OR=5.366) were risk factors for iron deficiency anemia among children(P<0.05). Conclusions Significant high-risk factors and regional differences exist in the occurrence of anemia, iron deficiency, and iron deficiency anemia among children aged 6 months to 6 years in Xinjiang. Further reducing these conditions among children in Xinjiang remains a priority for future child health management.