Table of Content

10 October 2025, Volume 33 Issue 10

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Standards·Consensus·Guidelines

Construction and operation standard of nutrition education kitchen for infants and young children

WU Qiong, MU Lijuan, LIU Aihua, ZHANG Shuyi, YIN Yan, SONG Guochao, WU Yan, ZHAO Miaoqing, GUAN Hongyan, ZHANG Yanfeng, YANG Yufeng, ZHU Zonghan, ZHANG Ting

2025, 33(10):  1045-1051.  DOI: 10.11852/zgetbjzz2024-1520

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Nutrition education kitchen for infants and young children is a health education place providing both feeding knowledge and practical operation for caregivers of children.Recently, nutrition education kitchen has been set up in many health care institutions in China.However, there is a lack of standardized construction and operation guidance.The Capital Institute of Pediatrics, together with experts from pediatrics, child health care and nutrition, jointly developed the Construction and Operation Standard of Nutrition Education Kitchen for Infants and Young Children, which aims to provide professional recommendations for child care professionals in different levels of health care institutions, nursery institutions, and community child growth stations.The standard includes basic requirements, construction requirements, equipment and facilities, operation management, personnel, operation services, evaluation management, which could promote the construction of nutrition education kitchen throughout the country, and standardize the operation services to strengthen infant and young child feeding.

Expert Commentary

Three-dimensional mechanisms of immune-metabolic-mechanical interactions in metabolic diseases associated with childhood obesity from the perspective of multi-system interaction networks

GUO Xirong

2025, 33(10):  1052-1055.  DOI: 10.11852/zgetbjzz2025-0969

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Childhood obesity and its associated metabolic diseases (e.g., insulin resistance, dyslipidemia, metabolic dysfunction-associated fatty liver disease, etc.) have emerged as a significant public health concern.Previous studies often focused on changes at the single organ or tissue level, making it challenging to elucidate the dynamic changes across multiple tissues and organs during the progression of obesity.Metabolic disorders related to childhood obesity are essentially complex network diseases initiated by the dysfunction or collapse of adipose tissue function, involving deep interactions among multiple systems such as immune system dysregulation and the collapse of metabolic homeostasis.This study systematically reviews current research progress on the mechanisms underlying the association between childhood obesity and metabolic diseases, with a focus on three key pathological pathways: chronic inflammation mediated by immune cells, metabolite accumulation and metabolic reprogramming, and abnormal changes in adipose tissue biomechanics microenvironment.It is reported that T cells, B cells, and macrophages exhibit altered activity in adipose tissue with obesity, establishing a bidirectional feedback loop between immunity and metabolism.Metabolites such as branched-chain amino acids and non-esterified fatty acids can interfere with insulin signaling, inducing insulin resistance.Besides, extracellular matrix stiffening and increased mechanical stress further activate inflammatory pathways, forming an immune-metabolic-matrix composite network.Metabolic abnormalities associated with childhood obesity are characterized by early onset, multi-organ involvement, and long-term persistence.Future research should enhance the integration of multi-omics technologies with investigations into the mechanisms of multi-system interactions, promoting the clinical translation of personalized intervention strategies, and thereby improving the prevention and treatment outcomes of childhood obesity-related metabolic diseases.

Professional Forum

Identification and management of resistance to thyroid hormone syndrome

ZHANG Xingxing, LIAO Linying

2025, 33(10):  1056-1060.  DOI: 10.11852/zgetbjzz2025-0780

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Resistance to thyroid hormone (RTH) is a rare endocrine disorder caused by mutations in thyroid hormone receptors or abnormalities in thyroid hormone metabolism/transmission, characterized by decreased sensitivity to thyroid hormones in target tissues, elevated serum FT3/FT4 levels, and uncontrolled thyroid-stimulating hormone (TSH) production.RTH significantly impacts the development of various systems in children, presenting with highly heterogeneous clinical manifestations that are prone to misdiagnosis and missed diagnosis.This article focuses on the early identification, diagnosis, individualized treatment and long-term health management strategies of RTH based on the pathogenesis, aiming to provide reference for clinicians.

Pediatric Metabolic Diseases Column

Impacts of long-term exposure to low-level artificial light at night during pregnancy on offspring health

WANG Jiali, ZHANG Xuehong, WANG Wenli, HU Qingwen, XU Jian

2025, 33(10):  1061-1065.  DOI: 10.11852/zgetbjzz2025-0266

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The influence of prenatal maternal environment during pregnancy on offspring development has been an increasing concern.Exposure to artificial light at night (ALAN) during pregnancy, as a common but easily neglected environmental factor, has attracted increasing attention because of its interference with circadian rhythm and potential impact on offspring health.Low-level ALAN refers to low-intensity and sustained exposure to artificial light sources (e.g., street lights, electronic devices, indoor lighting, etc.) at night.Because light is a main external factor of circadian rhythm, abnormal exposure to light can affect the expression of circadian clock genes and related metabolic homeostasis through the neuro-endocrine signaling mediated by the suprachiasmatic nucleus, thereby affecting the healthy development and function of multiple systems in the human body.Studies showed that prenatal maternal exposure to ALAN could impair nervous system by inducing sleep and mood disorders and cognitive deficits, and is closely related to metabolic abnormalities, cardiovascular dysfunction and immune system imbalance in the offspring.ALAN during pregnancy may affect fetal programming by interfering with biorhythm-related mechanisms, increasing the risk of offspring multisystem dysfunction.This review summarizes the potential harms and possible mechanisms underlying the effects of ALAN during pregnancy on maternal and offspring circadian rhythm regulation, and functions of neurological, metabolic, cardiovascular, and immune systems, and looks forward to future research directions, so as to provide scientific basis for related public health prevention and control strategies.

Mechanisms of Bardet-Biedl syndrome protein complex in childhood obesity and associated metabolic diseases

ZHAN Shumin, FU Junfen

2025, 33(10):  1066-1069.  DOI: 10.11852/zgetbjzz2025-0283

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Bardet-Biedl syndrome protein complex (BBSome) is a complex composed of eight proteins associated with Bardet-Biedl syndrome (BBS) that plays a crucial role in ciliary function.It has emerged as an important regulator of energy balance and is closely linked to metabolic diseases such as obesity, type 2 diabetes, and non-alcoholic fatty liver disease.Research indicates that BBSome is involved in central energy metabolism, fatty acid metabolism, glucose homeostasis, and the transport of leptin receptors.While most studies have focused on adult models, the symptoms of BBS can be severe in childhood as well.Future research should enhance the understanding of metabolic diseases in early life to elucidate the complex role of BBSome in metabolic regulation.

Role of amino acids in regulating glucose and lipid metabolism in the development of fatty liver disease

ZHU Bowen, WANG Xingyun, GUO Xirong

2025, 33(10):  1070-1073.  DOI: 10.11852/zgetbjzz2025-0304

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Amino acids, as the basic building blocks of proteins and important metabolic signalling molecules, play a key role in the regulation of glycolipid metabolism.Studies have shown that metabolic disorders of branched-chain amino acids (BCAAs), aromatic amino acids and sulphur-containing amino acids are closely related to the development of non-alcoholic fatty liver disease (NAFLD).BCAAs induce oxidative stress and mitochondrial dysfunction through activation of the mTOR signalling pathway, which promotes insulin resistance and hepatic lipid deposition.In addition, leucine deficiency enhances insulin sensitivity and reduces hepatic glucose production through the GCN2 pathway, while methionine deficiency regulates lipid metabolism through FGF21 signalling.Clinical studies have found that serum BCAAs levels significantly correlate with fatty liver severity, suggesting their value as potential biomarkers.Although intervention strategies targeting amino acid metabolism, including BCAA-restricted diets, Branched-Chain α-Ketoacid Dehydrogenase Kinase (BCKDK) inhibitors, have shown promising results in improving hepatic metabolism, the metabolic side effects of treatments such as mTORC1 inhibitors suggest the complexity of the amino acid perception network.Current challenges include the regulation of the dynamic balance of amino acid metabolic networks, the long-term safety validation of interventions, and the prediction of differences in response to individualised treatments.Future studies need to incorporate multi-omics techniques to elucidate the tissue-specific mechanisms of amino acid sensing signalling pathways, develop individualised treatment plans based on metabolic typing, so as to provide new ideas for the precise prevention and treatment of NAFLD.

Progress on organoid models in the mechanism of the gut-liver- adipose axis in childhood obesity

WANG Tengfei, WANG Zerui, WANG Xingyun

2025, 33(10):  1074-1078.  DOI: 10.11852/zgetbjzz2025-0301

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The prevention and treatment of childhood obesity and related metabolic disorders face significant challenges due to mechanistic complexity and marked individual heterogeneity.Current research is hindered by the lack of in vitro models capable of precisely simulating pediatric metabolic characteristics and multi-organ interactions.With breakthroughs in organoid technology, its advantages in 3D structural reconstruction, genetic editing, and cross-organ co-culture have established highly biomimetic model systems for in vitro research.This review focuses on the research demands of childhood obesity, systematically summarizing the construction strategies and application advances of intestinal organoids, hepatic organoid, and adipose organoid.It further addresses critical bottlenecks, including insufficient model standardization, limitations in metabolic microenvironment simulation, and challenges in cross-scale data integration, aiming to provide novel multi-dimensional research strategies and translational pathways for elucidating mechanisms and enabling precision interventions in obesity-related metabolic diseases.

Super enhancers in obesity-related metabolic diseases

WANG Tongshuai, GUO Xirong

2025, 33(10):  1079-1081.  DOI: 10.11852/zgetbjzz2025-0299

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Super-enhancers (SEs) are specialized DNA elements that significantly enhance transcriptional efficiency, driving the expression of genes essential for cellular function.Each cell contains hundreds of SEs, which regulate key gene networks.Dysregulation of SEs has been implicated in the aberrant activation of pathogenic genes in diseases such as Alzheimer's, diabetes, inflammation, and cancer.Despite their significance, the role of SEs in metabolism-related diseases remains underexplored.Metabolic disorders often serve as foundational factors in the development of other chronic conditions.Understanding the involvement of SEs in the initiation and progression of metabolic diseases could provide critical insights and inform the development of effective prevention strategies.This review explores the emerging role of SEs in metabolic disorders and their potential as targets for therapeutic intervention.

Progress in genetic mechanisms of chromatin 3D structure and gene regulatory networks in pediatric metabolic disorders

GAO Jianfang, SHAN Xiaoyu, GUO Xirong

2025, 33(10):  1082-1085.  DOI: 10.11852/zgetbjzz2025-0302

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Gene expression is not solely determined by coding sequences but is also regulated by non-coding cis-regulatory elements.As a key epigenetic factor, the dynamic organization of chromatin in three-dimensional (3D) space plays a critical role in the onset and progression of disease.The 3D genome architecture enables distal cis-regulatory elements, such as promoters and enhancers, to be spatially juxtaposed, thereby orchestrating gene expression in essential metabolic pathways, including insulin secretion, adipocyte differentiation, and energy metabolism.This review summarizes the fundamental characteristics of chromatin 3D structure and highlights recent advances in its role in pediatric metabolic diseases.Particular attention is given to its regulatory mechanisms in obesity, diabetes, and nonalcoholic fatty liver disease.Understanding the interplay between 3D genome organization and gene regulation provides novel insights into the molecular basis of pediatric metabolic diseases.

Research progress of pediatric obesity from the perspective of cellular biomechanics

PENG Zhou, WANG Xiaoyu, GUO Xirong

2025, 33(10):  1086-1090.  DOI: 10.11852/zgetbjzz2025-0303

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In recent years, cellular biomechanics has gained increasing attention in the field of obesity prevention and management.Childhood obesity serves as a critical early intervention window for preventing adult metabolic diseases, and cellular biomechanics may offer novel strategies for addressing this issue.Traditionally, research has focused on macro-level exercise mechanics, but recent studies have delved deeper into cellular and molecular mechanisms.To explore advances in childhood obesity research from a cellular biomechanics perspective, a systematic search was conducted in PubMed, Web of Science, and CNKI databases using keywords such as cellular biomechanics and childhood obesity, covering publications from 2011 to 2025, with over 90% of the included literature from the past five years.This review introduces key biomechanical elements, summarizes findings related to dietary and exercise interventions as well as genetic factors, and discusses future directions for childhood obesity research from a cellular biomechanics standpoint.By exploring these insights, this article aims to inspire new research approaches and serve as a valuable resource for understanding pediatric obesity from a cellular biomechanic perspective.

Cross-species transmission in obesity

WANG Rui, GUO Xirong

2025, 33(10):  1091-1094.  DOI: 10.11852/zgetbjzz2025-0300

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Childhood obesity has constituted one of the global public health challenges of the 21st century.Changes in dietary structure not only contribute to excessive energy intake, but also regulate human metabolism through cross-species transmission of signal molecules, which plays an important role in the occurrence of childhood obesity.Humans and other species, such as microorganisms and plants, have frequently engaged in cross-species transmission of signal molecules during co-evolution.In addition to horizontal gene transfer, microRNAs, isoenzymes, and metabolites could be transferred across species through the medium of gut microbiota and extracellular vesicles to achieve cross-species regulation of human metabolism.In this study, the recent progress of cross-species transmission and the latest findings of cross-species transmission in obesity are systematically elaborated, in order to provide scientific basis and practical guidance for exploring mechanism of childhood obesity occurrence and formulating prevention and treatment strategies.

Association between body composition and elevated blood pressure among school-age children and adolescents

ZHANG Qun, JIANG Xiao, WANG Xi, ZHANG Liye, HAN Di, BAO Xinyu, HU Jiale, SHEN Hui, HU Jia

2025, 33(10):  1095-1100.  DOI: 10.11852/zgetbjzz2025-0134

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Objective To analyze the association between different body composition indicators and elevated blood pressure among school-age children and adolescents, in order to provide evidence for early prevention of hypertension in adulthood. Methods From September to November 2023, a stratified cluster random sampling method was used to select 3 444 school-age children and adolescents aged 7 - 17 from 12 schools in Suzhou.Measurements included height, weight, waist circumference, blood pressure, and body composition.Elevated blood pressure was used as the dependent variable.Logistic regression and restricted cubic spline (RCS) models were applied to analyze the relationship between different body composition indicators and elevated blood pressure. Results The detection rate of elevated blood pressure among children and adolescents aged 7 - 17 in Suzhou was 11.61% (400/3 444).The whole-body percentage body fat (PBF) was (23.25±8.82)%, fat mass index (FMI) was (4.81±2.73) kg/m², muscle mass index (MMI) was (13.84±2.06) kg/m², and body mass index (BMI) was (19.55±4.18) kg/m².All these indices were higher in the elevated blood pressure group compared to the normal blood pressure group (P<0.05).The whole-body percentage of muscle mass (PBM) was (72.06±8.36)%, which was lower in the elevated blood pressure group (P<0.05).RCS analysis revealed a nonlinear association of increasing PBF and PBM levels with elevated blood pressure (P _{for nonlinearity}<0.05), while FMI, MMI, and BMI showed a linear relationship with elevated blood pressure (P_{for nonlinearity}>0.05).Logistic regression analysis indicated that the associations of FMI, MMI, and PBF with elevated blood pressure were stronger in girls than in boys (P<0.05).Using the group with normal BMI and normal PBF as the reference, the group with normal BMI and overweight/obesity based on PBF (OR =3.467) and the group with overweight/obesity based on both BMI and PBF (OR=4.177) had an increased risk of elevated blood pressure (P<0.05), while no increased risk was observed in the group with overweight/obesity based on BMI and normal PBF (P=0.266). Conclusions Higher body fat percentage is positively associated with elevated blood pressure, while muscle mass percentage may have a protective effect.It is recommended to strengthen body composition monitoring, promote physical exercise, increase muscle mass percentage, and prevent elevated blood pressure in children and adolescents.

Effect of dietary branched-chain amino acids on dyslipidemia in children and adolescents

CHEN Yao, LIU Changqing, ZHU Qianrang, LIU Yiya, TIAN Meina, WANG Hongwei, YU Lianlong

2025, 33(10):  1101-1107.  DOI: 10.11852/zgetbjzz2025-0236

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Objective To analyze the relationship between dietary branched-chain amino acids (BCAAs) intake and the risk of dyslipidemia in children and adolescents aged 6 - 18 years, in order to provide new insights for the prevention and treatment of dyslipidemia. Methods Dietary survey and blood biochemical data of 11 019 children and adolescents aged 6 - 18 years in four provinces of the China Children and Lactating Women Nutrition and Health Surveillance (CCLWNHS) project were analyzed.Dietary BCAAs intake was calculated using food frequency questionnaires combined with the China Food Composition Table.Differences in the prevalence of dyslipidemia subtypes across different BCAAs intake levels were compared.Logistic regression models were used to assess the association between BCAAs and dyslipidemia, and multiplicative interaction models were employed to evaluate the effects of interactions between BCAAs and age, sex, or body mass index (BMI) on dyslipidemia. Results Among the participants, 9,389 were in the normal control group, while 1 630 had dyslipidemia, including 470 cases of hypercholesterolemia.The hypercholesterolemia prevalence was significantly higher in the high total BCAAs and high BCAAs density groups compared to the low-intake groups (χ²=9.554, 18.109, P<0.01).Stratified analysis showed that, compared to the low-intake group, the high BCAAs intake group (OR=1.781, 95% CI: 1.326 - 2.391) and high BCAAs density group (OR=2.011, 95% CI: 1.493 - 2.708) had increased hypercholesterolemia risk in the normal-weight subgroup (P<0.05).Compared to the low-intake group, females in the high BCAAs intake group (OR=1.721, 95% CI: 1.243 - 2.384) and high BCAAs density group (OR=1.899, 95% CI: 1.361 - 2.651) also exhibited elevated hypercholesterolemia risk (P<0.05).In the 6 - 12 age group, high BCAAs intake was associated with increased hypercholesterolemia risk (OR=1.447, 95% CI: 1.100 - 1.905) compared to the low-intake group, while high BCAAs density elevated hypercholesterolemia risk across all age groups (6 - 12 years old OR=1.636, 95% CI: 1.242 - 2.155; 13-18 years old OR=1.881, 95% CI: 1.170 - 3.024) (P<0.05).A significant interaction effect was observed between BCAAs density and BMI on hypercholesterolemia risk (P=0.027).Mediation analysis revealed heterogeneous mediating effects of BMI on the relationship among total BCAAs intake, BCAAs density, and hypercholesterolemia risk. Conclusions Increased BCAAs intake is an independent risk factor for hypercholesterolemia.Adjusting dietary patterns by reducing red meat and processed meat consumption to limit BCAAs intake may lower the risk of hypercholesterolemia.

Association between birth weight and the comorbidity of depressive symptoms and obesity

LIU Jingyao, CHEN Jing, YANG Yang, YANG Yihang, SHAN Rui, ZHANG Xiaorui, LIU Zheng

2025, 33(10):  1108-1113.  DOI: 10.11852/zgetbjzz2025-0388

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Objective To analyze the association between birth weight and the comorbidity of depressive symptoms and obesity, so as to provide scientific evidence for future personalized interventions targeting different risk groups. Methods Based on the China Family Panel Studies, 2 628 children and adolescents aged 10 - 17 years with complete data on depressive symptom, obesity, and birth weight in both the baseline survey (2012) and follow-up surveys (2016-2022) were included.Depressive symptoms were defined as a score of ≥17 on the Center for Epidemiological Studies Depression Scale.Obesity in children and adolescents was determined by BMI Z-score criteria, while adult obesity was defined as BMI ≥ 28.0 kg/m².Comorbid depressive symptoms and obesity were defined as the presence of both depressive symptoms and obesity.Non-comorbid cases were further categorized into healthy (no depressive symptoms and not obese), depressive symptoms dominant (had depressive symptoms but not obese), and obesity dominant (obese but no depressive symptoms).Multinomial logistic regression models were used to analyze the associations between birth weight (both as a continuous and categorical variable) and the risk of comorbid depressive symptoms and obesity.Stratified analysis were conducted by age and gender. Results Among individuals with birth weight <3 kg, each 1-kg increase in birth weight was associated with a decreased risk of depressive symptoms dominant (OR＝0.561, 95%CI: 0.356 - 0.885).Compared with individuals with normal birth weight, individuals with low birth weight had an increased risk of depressive symptoms dominant (OR＝1.489, 95%CI: 1.068 - 2.075), while those with macrosomia had an increased risk of obesity dominant (OR＝1.823, 95%CI: 1.122 - 2.963). Conclusion Abnormal birth weight may be associated with an increased risk of depressive symptoms, obesity, or comorbid depressive symptoms and obesity in children and adolescents, highlighting the potential significance of incorporating early-life factors into future interventions for comorbidity risk.

Screening and subtype identification of overweight and obesity in preschool children based on bioelectrical impedance analysis and decision tree modeling

MA Rui, SHEN Zhangyifei, LU Le, TANG Jinyang

2025, 33(10):  1114-1120.  DOI: 10.11852/zgetbjzz2025-0336

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Objective To develop a classification framework for overweight/obesity subtypes based on bioelectrical impedance analysis (BIA) and decision tree modeling, with the goal of identifying sensitive indicators and characteristic features of overweight/obesity subtypes among preschool children, so as to provide a basis for targeted interventions. Methods A convenience sample of 550 preschool children aged 3 - 6 years was recruited in Shanghai from March to December 2024.Body composition was measured using the INBODY J30 device.Differences in obesity detection between body mass index (BMI) and percent body fat (PBF) were compared.Key variables were selected through collinearity analysis.A classification and regression tree (CRT) algorithm was applied to construct subtype classification rules.Feature importance was evaluated using XGBoost, and model robustness was assessed via 10-fold cross-validation. Results The detection rate of overweight/obesity was 26.5% based on BMI criteria and 21.78% based on PBF criteria.Body composition analysis revealed 29 indicators that significantly differed between overweight/obese and normal-weight children.Stepwise regression was used to address multicollinearity, resulting in 10 variables being included in the decision tree model.The CRT-generated tree contained 17 nodes (9 terminal nodes) and classified obesity into three subtypes: lower-body fat-dominant (Node 10), low skeletal muscle mass (Node 16), and high muscle mass (Node 11).The overall accuracy of the model reached 97.5%. Conclusions A multidimensional screening model integrating BIA and decision tree analysis can accurately identify overweight/obesity subtypes in preschool children.The proposed subtype classification framework offers valuable insights for developing differentiated intervention strategies and has practical significance for optimizing early prevention and control measures for childhood obesity.

Construction and application of percentile reference values of body fat percentage in Chinese children aged 3 - 6 years

ZHEN Zhiping, BA Yi, XUE Yaqi, MA De, CHEN Shuo

2025, 33(10):  1121-1126.  DOI: 10.11852/zgetbjzz2024-1098

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Objective To establish percentile reference standards for body fat percentage (BFP) in Chinese children aged 3 - 6 years, and to determine BFP thresholds to complement BMI in obesity screening, so as to provide a scientific reference for the early identification of childhood obesity in China. Methods From 2020 to 2023, a stratified random sampling method was used to select 25 604 children aged 3 - 6 years from 120 kindergartens across 27 provinces in China.Physical and body composition measurements were conducted.The generalized additive model for location, scale, and shape (GAMLSS) was applied to establish percentile references for BFP.Receiver operating characteristic (ROC) curves were used to compare the sensitivity of different anthropometric indicators in reflecting BFP and to evaluate the performance of different BFP percentiles in identifying obesity.The optimal percentile for obesity screening in children aged 3 - 6 years was selected. Results 1) Boys had significantly greater height, weight, body mass index (BMI), and waist circumference than girls (P<0.01), while BFP was lower in boys (P<0.01).Height, weight, and waist circumference increased with age, whereas BFP and waist-to-height ratio generally decreased, and BMI showed minor fluctuations.2) Compared to height, weight, and waist circumference, BMI and weight-for-height (WFH) were more sensitive indicators of BFP in children aged 3 - 6 years.3) The 90th percentile of BFP (P₉₀) achieved the best balance between sensitivity and specificity and was identified as the most suitable threshold for obesity screening. Conclusions BMI and WFH are sensitive indicators of body fat levels in children.Percentile reference values for BFP specific to Chinese children aged 3 - 6 years were established.The P₉₀ percentile of BFP demonstrated the best performance in obesity screening for this age group and is recommended as a complementary threshold to BMI to improve screening accuracy and reduce misdiagnosis/underdiagnosis.

Effect of exercise on the dynamics of fat oxidation in obese children and adolescents

XIE Weijun, ZHU Lin, ZHENG Li, LIANG Manna

2025, 33(10):  1127-1131.  DOI: 10.11852/zgetbjzz2024-1118

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Objective To analyze the effects of a 4-week exercise intervention on substrate metabolism during exercise in children and adolescents with obesity, and to explore factors influencing exercise-induced changes in the maximal fat oxidation rate (MFO). Methods From July to August 2022, a total of 45 children and adolescents with obesity aged 10 - 16 years were recruited to participate in a 4-week structured exercise program.Substrate metabolism during graded exercise testing was assessed before and after the intervention using a gas metabolism analyzer (Cortex MetaMax 3B).Paired sample t-tests were employed to compare pre- and post-intervention differences. Results Forty-one participants were included in the final statistical analysis.After the 4-week exercise intervention, fat oxidation rates (t=3.103, 4.991, 5.671) and their energy contribution ratios (t=3.614, 4.621, 5.067) at speeds of 5 - 7km/h during graded exercise were significantly higher than those before the intervention (P<0.05).In contrast, carbohydrate oxidation rates (t=3.599, 3.397, 2.866) and their corresponding energy contribution ratios (t=3.614, 4.621, 5.067) were significantly lower (P < 0.05).The maximal fat oxidation rate increased significantly from (5.26±1.40) mg/(kg·min) to (6.47±2.13) mg/(kg·min) (t=3.900, P<0.01), the intensity at MFO (in METs) increased from 4.25±1.04 to 5.10±1.26 (t=3.809, P<0.01), and the heart rate at MFO increased from (133.26±16.89) beats/min to (142.74±14.61)beats/min (t=3.820, P<0.01).ΔMFO was positively correlated with the change of maximal oxygen uptake (ΔVO₂ max) (β =0.448, P<0.01) and negatively correlated with the change of body fat percentage (ΔBF%) (β=-0.513, P<0.05). Conclusions A 4-week exercise intervention effectively enhances fat oxidation utilization and reduces carbohydrate-dependent energy supply in children and adolescents with obesity.Maximal oxygen uptakeand body fat percentage are identified as significant factors influencing changes in maximal fat oxidation rate.

Correlation of pulmonary function with glycosylated hemoglobin in obese children

ZHANG Li′na, WAN Naijun

2025, 33(10):  1132-1137.  DOI: 10.11852/zgetbjzz2024-1090

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Objective To explore the correlation between pulmonary ventilation function and glycated hemoglobin (HbA1c) in obese children, in order to provide a new perspective for the comprehensive management of obese children. Methods A total of 255 obese children who visited the pediatric outpatient clinic of Beijing Jishuitan Hospital from January 2019 to December 2022 were included. Height, weight, serum HbA1c levels, and pulmonary ventilation function were measured. HbA1c levels were divided into three groups (Q1, Q2, Q3) based on tertiles. Pulmonary function indicators were compared among the different HbA1c groups. Multiple linear regression analysis was used to construct a model for the relationship between HbA1c and pulmonary function indicators. Receiver operating characteristic (ROC) curves were plotted to evaluate the predictive value of the model for changes in pulmonary function. Results Among the participants, 142 cases (55.69%) were in the mild-to-moderate obesity group, and 113 cases (44.31%) were in the severe obesity group. The forced vital capacity (FVC) in the mild-to-moderate obesity group was significantly lower than that in the severe obesity group (t=2.541, P=0.012), while the FEV1/FVC ratio, FEV1/FVC%, and expiratory flow at 50% of vital capacity (FEF50) were higher in the mild-to-moderate obesity group (t=2.277, 2.215, 2.075, P＜0.05). HbA1c levels were lower in the mild-to-moderate obesity group compared to the severe obesity group (t=3.097, P<0.05). Significant differences were observed in FEV1/FVC, FEV1/FVC%, FEF25, FEF50, FEF75, and maximal mid-expiratory flow (MMEF) among the different HbA1c groups (F=7.813, 7.804, 6.493, 8.209, 6.193, 6.855, P<0.01). All pulmonary function indicators in the Q1 group were superior to those in the Q2 and Q3 groups (P<0.05). Multiple linear regression analysis showed that HbA1c in obese children was negatively correlated with pulmonary function indicators FEF25, FEF50, FEF75, and MMEF (β=-0.186,-0.201,-0.148,-0.182, P<0.05). ROC curve analysis indicated that when HbA1c levels in obese children were ≥5.8%, pulmonary function indicators might be significantly affected. Conclusions Severe obesity in children is associated with higher serum HbA1c levels. HbA1c in obese children is linearly and negatively correlated with multiple pulmonary function indicators, and elevated HbA1c levels may lead to impaired small airway function. The multiple regression model of HbA1c and pulmonary function indicators demonstrates good predictive performance for assessing changes in pulmonary function in obese children.

Health Promotion

Effectiveness of pilot study on the Construction and Operation Standard of Nutrition Education Kitchen for Infants and Young Children on improving caregivers' feeding knowledge

LI Xuening, LIU Aihua, GONG Shimiao, SONG Guochao, YANG Yanyan, FENG Mian, CHEN Xiaorong, ZHENG Hefen, LIN Liqin, ZHU Xiaohong, HU Yuyan, WU Qiong, ZHANG Yanfeng

2025, 33(10):  1138-1144.  DOI: 10.11852/zgetbjzz2024-1522

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Objective To evaluate the effectiveness of infant and young child nutrition education kitchen on caregivers' feeding knowledge, and to assess the feasibility of implementing the Construction and Operation Standard of Nutrition Education Kitchen for Infants and Young Children in practical application, so as to provide a scientific basis for the nationwide promotion of such education kitchens. Methods A total of 171 caregivers of infants aged 3 - 11 months receiving services at 7 pilot nutrition education kitchens in Beijing and Ninghai County, Zhejiang Province, were included from August to November 2024.Each education kitchen conducted group-based parenting classes with 3 - 5 families per session.Depending on the infant's age, either a complementary feeding initiation course (3 - 6 months) or a complementary feeding advancement course (6 - 11 months) was provided.Each session consisted of 20 minutes of theoretical instruction and 20 minutes of hands-on food preparation practice.Caregivers' feeding knowledge was assessed before and after the sessions, and satisfaction surveys and focus group discussions were conducted post-intervention.Changes in knowledge levels were analyzed using chi-square and non-parametric tests. Results Among the 171 caregivers, 105 participated in the complementary feeding initiation course and 66 in the advancement course.After the sessions, significant improvements in feeding knowledge scores were observed in both groups (Z=9.12, 6.47, P<0.05).Compared to pre-session assessments, caregivers showed a 32% to 58% increase in correct responses to key complementary feeding knowledge points, including "recommendation to include at least 4 out of 7 food groups daily for infants aged 6 - 23 months", "continued of breastfeeding until 2 years or beyond after introducing complementary foods", "iron-rich and easily absorbable foods", and "preparing thick complementary foods" (all P<0.05).Caregiver satisfaction with course content, organization, and instructor quality exceeded 90%.Participants reported that previous counseling in clinical settings was often abstract, whereas the hands-on approach of the nutrition education kitchens allowed them to observe actual food preparation processes and textures, thereby deepening their understanding of complementary feeding practices. Conclusion The Construction and Operation Standard of Nutrition Education Kitchen for Infants and Young Children are feasible in practice and effectively improve caregivers' knowledge of infant and young child feeding.

Relationship between physical activity and sedentary behavior and functional constipation among secondary school students in Yinchuan City

YIN Ding, WANG Hui, CHEN Miao, ZHAI Suo

2025, 33(10):  1145-1150.  DOI: 10.11852/zgetbjzz2024-0758

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Objective To explore the association of physical activity (PA) intensity and sedentary behavior (SB) with functional constipation (FC) among middle school students, so as to provide evidence for rational daily PA planning and FC prevention in this population. Methods A total of 1 371 students in grades 7 - 9 (aged 13 - 15 years) from Yinchuan were selected using stratified cluster convenience sampling in March 2024.PA and SB levels were assessed according to the Assessment of Physical Activity Levels in Children and Adolescents Aged 7-18 (WS/T 10008-2023), and FC was diagnosed based on the Rome Ⅳ criteria for children/adolescents.Binary logistic regression was used to examine the association between PA duration and FC. Results Among the participants, 987 (71.99%) met the recommended daily moderate-to-vigorous physical activity (MVPA) level of ≥70 minutes, including 521 boys (74.86%) and 466 girls (69.04%), with no significant gender difference (χ² =2.69, P>0.05).FC was identified in 106 students (7.73%), including 50 boys (7.18%) and 56 girls (8.29%).Significant gender differences were observed across all age groups (χ²=7.45, 8.69, 8.51, all P<0.05).The Cochran-Armitage trend test indicated a significant linear trend between PA duration and FC prevalence (P<0.05).Binary logistic regression analysis revealed that both light physical activity (LPA) and MVPA duration were negatively associated with FC(OR＝0.751、0.893), while SB duration was positively associated with FC (OR＝1.035)(P<0.05). Conclusions LPA and MVPA are negatively correlated with FC, whereas SB is positively correlated with FC.Schools and families should promote increased duration and intensity of physical activity and reduce sedentary time according to the developmental characteristics and gender differences of middle school students, so as to support healthy adolescent development.

Association between body mass index and suspected insufficient hyperopia reserve in preschool children

LEI Jun, ZHOU Xiaoyan, HE Jianyong, LIU Lifang

2025, 33(10):  1151-1155.  DOI: 10.11852/zgetbjzz2025-0137

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Objective To investigate the association between body mass index (BMI) and suspected insufficient hyperopic reserve in preschool children, in order to provide evidence for developing myopia prevention strategies. Methods From May to June 2024, a randomized cluster sampling method was used to select 3 353 children from 23 kindergartens in urban Lishui.Physical examinations and refractive screenings were conducted following the Guidelines for Eye Health and Vision Examination in Children Aged 0 - 6 Years (Trial).The association between BMI categories and suspected insufficient hyperopic reserve was analyzed. Results Among 3 353 children, 620 (18.49%) showed suspected insufficient hyperopic reserve.The detection rate was higher in boys (19.94%, 352/1 765) than in girls (16.88%, 268/1 588) (χ²=5.216, P=0.022), though BMI distribution did not differ by sex (P>0.05).The mean hyperopia reserve of children in the emaciated group, the normal weight group, the hypertrophic group and the obese group was +1.26±0.43D, +1.26±0.75D, +1.18±0.48D, +1.17±0.74D, respectively, and post-hoc comparisons revealed higher reserves in normal-weight children versus overweight/obese groups (F=2.922, P=0.033) .Children with suspected insufficient reserve had greater mean weight and higher BMI values (F=5.812, 4.519, P<0.05).The detection rate of hyperopia reserve insufficiency was highest in obese children (85/378, 22.49%; H=7.916, P=0.048), particularly obese boys (60/199, 30.15%; χ²=14.161, P=0.001). Conclusions Preschool children's BMI is associated with suspected insufficient hyperopic reserve.Integrating weight management into primary myopia prevention strategies is recommended.

Current status and influencing factors of dietary behaviors among preschool children

LU Yaqian, LIU Tian, XIE Kunxia

2025, 33(10):  1156-1160.  DOI: 10.11852/zgetbjzz2025-0132

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Objective To analyze the current status and influencing factors of dietary behaviors among preschool children in Baota District, Yan′an City, in order to provide a theoretical basis for subsequent nutritional education and targeted interventions for caregivers. Methods From January 2021 to October 2022, a convenience sampling method was used to select 1 048 preschool-aged children (3 - 6 years) and their primary caregivers in Baota District.Data were collected using the Preschool Children's Dietary and Feeding Behavior Questionnaire, covering general demographic characteristics, current dietary behaviors, and related influencing factors. Results A total of 889 valid questionnaires were collected.Data analysis revealed that the detection rate of eating behavior problems among children aged 3 - 6 in Baota was 62.09%, with externally motivated eating (27.1%) and poor eating habits (25.4%) being the most common.Differences in the detection rates of eating behavior problems were observed among only children, those under responsible feeding, coercive feeding, and feeding with dietary behavior restrictions, all of which were statistically significant (all P<0.05).Binary logistic regression analysis showed that increasing age, primary caregivers' responsible feeding, and dietary behavior restriction were protective factors against eating behavior problems in children.In contrast, coercive feeding by primary caregivers was a risk factor for eating behavior problems.A total of 889 valid questionnaires were collected.The detection rate of problematic dietary behaviors among 3- to 6-year-old children in Baota District was 62.09%, with externally driven eating (27.1%) and poor eating habits (25.4%) being the most common.Significant differences were observed in the detection rates based on whether the child was an only child, whether responsible feeding was practiced, and whether coercive or restrictive feeding methods were used (P<0.05).Binary logistic regression analysis revealed that increasing child age, responsible feeding by primary caregivers (OR=0.70), and dietary restriction (OR=0.60) were protective factors against problematic dietary behaviors (P<0.05), whereas coercive feeding (OR=2.17) was a risk factor (P<0.05). Conclusions The detection rate of problematic dietary behaviors among preschool children in Baota District is significantly higher than the national average.Collaborative efforts among caregivers, schools, and pediatric healthcare professionals are needed to address these issues and promote healthy growth in children.