Objective: To analyze the trends of overweight and obesity prevalence in Chinese children, aged from 6 to 15 years old among 4 provinces and cities from 2009 to 2019. Methods: Reviewed the national multi-center epidemiological survey data of children from the National Key Technology R&D Program of China during the Eleventh Five-Year Plan (2009 to 2010) and the National Key Research and Development Program of China during the Thirteenth Five-Year Plan (2017 to 2019). The participants' data were selected from four provinces,municipalities and autonomous region,including Beijing, Tianjin (Northern region), Zhejiang (Eastern region), and Guangxi (Southern region). Totally 14 597 pairs of 6-15 year-old children were surveyed. According to the body mass index (BMI) and standard deviation score (SDS) of children among different genders, ages, and regions, t test or chi-square test was used to evaluate the changes in overweight and obesity over a 10-year span. Results: Totally 7 721 pairs of boys and 6 876 pairs of girls were collectted in this study, whose mean age was (10.7±2.5) years. In the past 10 years, the overall BMISDS were 0.39±1.24 and 0.36±1.31 and the overall obesity rate were 11.8% (n=1 773) anel 12.5% (n=1 813) of children in the 4 administrative regions did not have statistically significant differences (all P>0.05). However, the overall overweight rate rose from 17.1% (n=2 496) to 19.1% (n=2 781) (χ²=18.657, P<0.01), and the average annual growth rate was 0.20%. The BMISDS in the Eastern region increased from 0.10±1.07 to 0.19±1.22 (t=-4.095, P<0.01), and the overweight rate and obesity rate increased by 3.8% (n=202) and 3.1% (n=169) respectively (both P<0.01); the BMISDS in the Northern region and the obesity rate did not have statistically significant differences(all P>0.05), but the overweight rate rose from 20.5% (n=1 233) to 22.8% (n=1 365) significantly (χ²=7.431, P<0.01); BMISDS in the Southern region was significantly decreased from 0.30±1.19 to 0.09±1.25 (t=1.426, P<0.01), and the rate of obesity decreased from 9.8% (n=315) to7.9% (n=256) (χ²=6.46, P<0.05), the overweight rate was not stafistically significant (P=0.10), respectively. The obesity rate of boys had risen from 16.4% (n=1 265) to 18.2% (1 407) (χ²=8.997, P<0.01) in the past 10 years, and the overweight rate had risen from 18.0% (n=1 393) to 20.5% (n=1 579) (χ²=14.26, P<0.01). The overweight+obesity rate rose from 34.4% (n=2 658) to 38.7% (n=2 986) (χ²=29.859, P<0.01), and the weight problem in the age group of 8 to 11 years was particularly severe (all P<0.01). The obesity rate of girls dropped from 6.8% (n=468) to 5.9% (n=406) (χ²=4.546, P<0.05), the overweight rate rose from 16.0% (n=1 103) to 17.5% (n=1 202) (χ²=5.006, P<0.05), and the overall overweight+obesity rate rose from 22.8% (n=1 571) to 23.4% (n=1 608) (χ²=0.53, P>0.05). Conclusions: The growth rate of obesity among children in China had slowed down from 2009 to 2019, but the overweight rate was still on the rise. The overall base of overweight and obesity population continued to expand. The weight problem of peri-adolescent boys was particularly prominent. The current status of obesity epidemics in different regions, ages, and genders are significantly different and had their own characteristics. It is necessary to establish a personalized prevention and control strategy.
目的： 分析中国6~15岁儿童的超重和肥胖2009至2019年的变化。 方法： 回顾2009年“十一五”国家科技支撑计划（2009年至2010年）、2017年“十三五”国家重点研发计划（2017年至2019年）两个全国多中心儿童流行病学调查数据，选取两次流调中地域、性别、年龄均匹配的北京和天津（北部地区）、浙江（东部地区）、广西（南部地区）4省、市、自治区共14 597对6~15岁儿童为研究对象，以2007年世界卫生组织儿童相关数据为参考标准判定超重与肥胖，利用最小均方算法计算体质指数标准差比值，通过t检验、χ²检验等分析其超重率和肥胖率在10年前后的变化。 结果： 两次流调中14 597对儿童中男7 721对、女6 876对，年龄（10.7±2.5）岁。体质指数标准差比值（BMISDS）在10年前后分别为0.39±1.24和0.36±1.31、总体肥胖率分别为11.9%（1 733名）和12.4%（1 813名），差异均无统计学意义（均P>0.05），但总体超重率由17.1%（2 496名）升至19.1%（2 781名）（χ²=18.657，P<0.01），年平均增长速度为0.20%。东部地区BMISDS从0.10±1.07增长至0.19±1.22（t=-4.095，P<0.01），超重率和肥胖率分别增长3.8%（202名）和3.1%（169名）（均P<0.01）；10年前后北部地区BMISDS和肥胖率差异均无统计学意义（均P>0.05），但超重率由20.5%（1 233名）增长至22.8%（1 365名）（χ²=7.431，P<0.01）；南部地区BMISDS从0.30±1.19显著下降至0.09±1.25（t=1.426，P<0.01），肥胖率从9.8%（315名）降至7.9%（256名）（χ²=6.46，P<0.05），超重率差异无统计学意义（P=0.10）。男孩在近10年间肥胖率由16.4%（1 265名）增长至18.2%（1 407名）（χ²=8.997，P<0.01），超重率由18.0%（1 393名）增长至20.5%（1 579名）（χ²=14.26，P<0.01），整体超重+肥胖率由34.4%（2 658名）增长至38.7%（2 986名）（χ²=29.859，P<0.01），8~11岁年龄段的体重问题尤为显著（均P<0.01）。女孩肥胖率由6.8%（468名）降至5.9%（406名）（χ²=4.546，P<0.05），超重率由16.0%（1 103名）增长到17.5%（1 202名）（χ²=5.006，P<0.05），整体超重+肥胖率由22.8%（1 571名）增长至23.4%（1 608名）（χ²=0.53，P>0.05）。 结论： 2009至2019年中国儿童及青少年肥胖率增长速度减缓，但超重率仍呈上升趋势，整体超重+肥胖人群基数继续扩大，尤其是肥胖中、高风险地区，围青春期男孩的体重问题尤为突出。不同地区、不同年龄、不同性别的肥胖流行现状差异显著且存在各自特点，需有针对性地制定个性化防控措施。.