China Pays Price For Western Lifestyle With Soaring Childhood Obesity

Chinese beach scene with McDonald's shade umbrellas covering the beach

The prevalence of overweight and obesity is rising faster in children than (7 to 12 years) than adolescents (13 to 18 years),

China is paying the price of adopting a western lifestyle with soaring childhood obesity, shows a 29 year study in nearly 28 000 children and adolescents published today in the European Journal of Preventive Cardiology.1 Less than 1% of children and adolescents were obese in 1985 compared to 17% of boys and 9% of girls in 2014. The authors speculate that boys may be fatter than girls because of a societal preference for sons.

“This is extremely worrying,” said Professor Joep Perk, cardiovascular prevention spokesperson for the European Society of Cardiology. “It is the worst explosion of childhood and adolescent obesity that I have ever seen. The study is large and well run, and cannot be ignored. China is set for an escalation of cardiovascular disease and diabetes, and the popularity of the western lifestyle will cost lives.”

Data for the study was obtained from six national surveys in schoolchildren carried out by the Department of Education in Shandong Province, China, between 1985 and 2014. A total of 27 840 rural students aged 7 to 18 years had their height and weight measured. Body mass index (BMI) was calculated as kg/m2. Overweight and obesity were defined using cut-off points recommended by the Working Group on Obesity in China (WGOC), the International Obesity Task Force (IOTF), and the World Health Organization (WHO).

The prevalence of overweight and obesity in boys increased from 0.74% and 0.03% in 1985 to 16.35% and 17.20% in 2014, and in girls increased from 1.45% and 0.12% in 1985 to 13.91% and 9.11% in 2014, respectively.

“China is a large agricultural country and our findings have huge implications for the entire nation,” said Dr Ying-Xiu Zhang, leader of the investigation team at the Shandong Centre for Disease Control and Prevention, Shandong University Institute of Preventive Medicine, Jinan, Shandong, China. “The rises in overweight and obesity coincide with increasing incomes in rural households and we expect this trend to continue in the coming decades in Shandong Province and other regions of China.”

“China has experienced rapid socioeconomic and nutritional changes in the past 30 years,” continued Dr Zhang. “In China today, people eat more and are less physically active than they were in the past. The traditional Chinese diet has shifted towards one that is high in fat and calories and low in fibre.”

The authors speculated that boys are fatter than girls because they are given preferential treatment. The Chinese 2005 National Youth Risk Behaviour Surveillance reported that 4.3% of boys and 2.7% of girls frequently had soft drinks, while 12.7% of boys and 4.3% of girls spent more than two hours per day playing computer games.

Dr Zhang said: “Traditionally the societal preference, particularly in rural areas, has been for sons. That could result in boys enjoying more of the family’s resources. In addition, boys may prefer to have a larger body size than girls.”

“Computer games themselves are not the issue,” added Professor Perk. “The problem is that kids sit there with a two litre bottle of fizzy drink. To burn those calories they would need to walk 46 km but they don’t.”

The prevalence of overweight and obesity is rising faster in children than (7 to 12 years) than adolescents (13 to 18 years), which the authors say could be because teenagers are more concerned about their appearance. “Adolescents generally pay more attention to their body shape and do more exercise than children,” said Dr Zhang.

“Rural areas of China have been largely ignored in strategies to reduce childhood obesity,” said Dr Zhang. “This is a wake-up call for policymakers that rural China should not be neglected in obesity interventions.

We need to educate children on healthy eating and physical activity, and monitor their weight to check if these efforts are making a difference.”

Professor Perk said: “This calls for a catastrophe committee in China to stop the alarming rise in childhood and adolescent obesity. They need to return to their former nutritional habits instead of eating junk food. Parents must take some responsibility and point their children in the direction of healthier choices.”

Activity Schemes For Overweight Youngsters


Head of Health and Wellbeing Kiara Lewis addresses national Public Health England workshop on her research into activity schemes for overweight youngsters

AS the UK faces up to a growing obesity crisis among youngsters, a University of Huddersfield expert has told a major conference about a successful project which saw a large number of children not only lose weight but also gain in self-esteem and begin to enjoy exercise, which they had previously grown to hate.

Kiara Lewis (pictured right) is Head of the Division of Health and Wellbeing in the University’s School of Human and Health Sciences.  Her area of special expertise is the promotion of physical activity among overweight and sedentary people and she was invited to address a workshop organised in Durham by Public Health England.  The event dealt with issues arising from the National Child Measurement programme, which gathers data used to support public health initiatives.



One of six invited speakers, Kiara reported on her research, which includes analysis of interviews with overweight children and her evaluation of a scheme called Young PALS, run by Kirklees Council and now known as the Start scheme.

Children aged from five to 16 who belonged to the highest categories of obesity were invited to join the scheme, which included not only physical activity, but also sessions on nutrition and one-to-one motivational interviews.

“The children on the scheme were very successful in reducing the weight, but they also increased their self esteem and they became more active,” said Kiara.  “I have been researching what it was about the scheme that made them feel better about themselves and why they now enjoy exercising.  Beforehand they often disliked PE, but after they had been on the scheme they discovered they liked exercise and activity.

“In my presentation for Public Health England, I tried to explain what we can do to make these youngsters feel better about themselves and what helps them to like being physically active.”

During the period of evaluation by the University of Huddersfield, the Young PALS project involved more than 300 Kirklees children.  Some 60 per cent of them reduced their BMI.


That figure is comparable to the success rate of similar schemes, said Kiara Lewis, but what was more unusual was that 72 per cent of the participants recorded a rise in their self-esteem.

“Many of these children hadn’t had a positive experience of being physically active, so it was something they avoided.  But now they were saying that they were enjoying exercise and they wanted to be generally more active.”

Kiara added that key factors to emerge were that younger children enjoyed co-operative play not competitive team games and older children enjoyed independent activities such as gym, fitness and working towards personal goals rather than activities involving peer comparisons.

Another important element was the attitude of the staff.

“Rather than telling them off or shouting, they made the children comfortable, so the kids felt they had respect and understanding from the instructors.  They felt better about themselves because of the way they were treated.  This meant the experience was enjoyable, whereas at school sometimes they felt humiliated and useless in PE.”

Kiara Lewis is continuing her research in the field and has recently been conducting interviews with PE teachers and their pupils.

Food Marketing To Kids Evolves On Smartphones


Food marketers have been shifting more of their ad dollars to smartphones used by kids.

A U.S. government report released Friday found that food companies have ramped up their advertising to kids on mobile devices and social media even as they spend less money overall on youth marketing.

 In 2009, 48 food companies studied by the Federal Trade Commission spent $1.79 billion on food marketing to youth aged 2 to 17, including $122.5 million for new media such as online and phone advertising. In 2006, largely those same companies spent a total of $2.1 billion marketing food to kids, but just $76.6 million for new media, the FTC’s report says. Most of the overall decline came from less spending on TV ads aimed at kids.

Still, the FTC said that from 2006, when its first report on the issue was released, to 2009, the food industry has marketed slightly more nutritious foods to children, including cereals, soft drinks and fast food. Cereals marketed to children from ages 2-11 in 2009, for example, had less sugar and slightly more whole grain than in 2006.

It also called out media companies, saying that with few exceptions they haven’t limited licensing of children’s characters and placement of ads during children’s programming to more nutritious foods.

“The encouraging news is that we’re seeing promising signs that food companies are reformulating their products and marketing more nutritious foods to kids, especially among companies participating in industry self-regulatory efforts,” wrote FTC Chairman Jon Leibowitz. “But there is still room for improvement: We will look for continued progress by the food industry and greater participation by the entertainment industry.”

 The most recent data in the report are from 2009, just as the smartphone boom was taking off. As a result, the FTC report offers a dated picture of how food companies are responding to the surging popularity of mobile devices among children over the past few years.

By examining internal marketing plans from 2009 that food companies provided to the FTC, the agency found clues as to where things were heading.

“These online media are not necessarily as costly as display advertising, yet potentially have a farther, and more immersive, reach than display advertising,” the report concluded. “Finally, although hard data are scant, anecdotal evidence from marketing plans indicates that companies increasingly are reaching out to teens through their mobile devices.”

In September, The Wall Street Journal published a Page One article finding that makers of kids’ drinks and snacks were starting to build smartphone and tablet apps featuring their brands.

Several food-company executives said they saw these apps as a cost-effective and powerful ways to reach children—in some cases before they could even learn to read.

While some critics of the food industry’s advertising practices have called for more government regulation of how those companies advertise to kids, for now it is mainly up to the industry to police itself: Congress in 1980 barred the FTC from making broad new rules on food advertising to children.

Write to Anton Troianovski at

Studies Leave No Doubt About Sugary Drinks And Obesity Link

New research powerfully strengthens the case against soda and other sugary drinks as culprits in the obesity epidemic.

A huge, decades-long study involving more than 33,000 Americans has yielded the first clear proof that drinking sugary beverages interacts with genes that affect weight, amplifying a person’s risk of obesity beyond what it would be from heredity alone.

Sugary Drinks  This means that such drinks are especially harmful to people with genes that predispose them to weight gain. And most of us have at least some of these genes.

In addition, two other major experiments have found that giving children and teens calorie-free alternatives to the sugary drinks they usually consume leads to less weight gain.

Collectively, the results strongly suggest that sugary drinks cause people to pack on the pounds, independent of other unhealthy behavior such as overeating and getting too little exercise, scientists say.

That adds weight to the push for taxes, portion limits like the one just adopted in New York City, and other policies to curb consumption of soda, juice drinks and sports beverages sweetened with sugar.

Soda lovers do get some good news: Sugar-free drinks did not raise the risk of obesity in these studies.

“You may be able to fool the taste” and satisfy a sweet tooth without paying a price in weight, said an obesity researcher with no role in the studies, Rudy Leibel of Columbia University.

The studies were being presented Friday at an obesity conference in San Antonio and were published online by the New England Journal of Medicine.

The gene research in particular fills a major gap in what we know about obesity. It was a huge undertaking, involving three long-running studies that separately and collectively reached the same conclusions. It shows how behavior combines with heredity to affect how fat we become.

Having many of these genes does not guarantee people will become obese, but if they drink a lot of sugary beverages, “they fulfill that fate,” said an expert with no role in the research, Jules Hirsch of Rockefeller University in New York. “The sweet drinking and the fatness are going together, and it’s more evident in the genetic predisposition people.”

Sugary drinks are the single biggest source of calories in the American diet, and they are increasingly blamed for the fact that a third of U.S. children and teens and more than two-thirds of adults are obese or overweight.

Consumption of sugary drinks and obesity rates have risen in tandem —

both have more than doubled since the 1970s in the U.S.

But that doesn’t prove that these drinks cause obesity. Genes, inactivity and eating fatty foods or just too much food also play a role. Also, diet research on children is especially tough because kids are growing and naturally gaining weight.

Until now, high-quality experiments have not conclusively shown that reducing sugary beverages would lower weight or body fat, said David Allison, a biostatistician who has done beverage research at the University of Alabama at Birmingham, some of it with industry support.

State By State Obesity RatesHe said the new studies on children changed his mind and convinced him that limiting sweet drinks can make a difference.

In one study, researchers randomly assigned 224 overweight or obese high schoolers in the Boston area to receive shipments every two weeks of either the sugary drinks they usually consumed or sugar-free alternatives, including bottled water. No efforts were made to change the youngsters’ exercise habits or give nutrition advice, and the kids knew what type of beverages they were getting.

After one year, the sugar-free group weighed more than 4 pounds less on average than those who kept drinking sugary beverages.

“I know of no other single food product whose elimination can produce this degree of weight change,” said the study’s leader, Dr. David Ludwig of Boston Children’s Hospital and the Harvard School of Public Health.

The weight difference between the two groups narrowed to 2 pounds in the second year of the study, when drinks were no longer being provided. That showed at least some lasting beneficial effect on kids’ habits. The study was funded mostly by government grants.

A second study involved 641 normal-weight children ages 4 to 12 in the Netherlands who regularly drank sugar-sweetened beverages. They were randomly assigned to get either a sugary drink or a sugar-free one during morning break at their schools, and were not told what kind they were given.

After 18 months, the sugary-drink group weighed 2 pounds more on average than the other group.

The studies “provide strong impetus” for policies urged by the Institute of Medicine, the American Heart Association and others to limit sugary drink consumption, Dr. Sonia Caprino of the Yale School of Medicine wrote in an editorial in the journal.

The American Beverage Association disagreed.

“Obesity is not uniquely caused by any single food or beverage,” it said in a statement. “Studies and opinion pieces that focus solely on sugar-sweetened beverages, or any other single source of calories, do nothing meaningful to help address this serious issue.”

The genetic research was part of a much larger set of health studies that have gone on for decades across the U.S., led by the Harvard School of Public Health.

Researchers checked for 32 gene variants that have previously been tied to weight. Because we inherit two copies of each gene, everyone has 64 opportunities for these risk genes. The study participants had 29 on average.

Every four years, these people answered detailed surveys about their eating and drinking habits as well as things like smoking and exercise. Researchers analyzed these over several decades.

A clear pattern emerged: The more sugary drinks someone consumed, the greater the impact of the genes on the person’s weight and risk of becoming obese.

For every 10 risk genes someone had, the risk of obesity rose in proportion to how many sweet drinks the person regularly consumed. Overall calorie intake and lifestyle factors such as exercise did not account for the differences researchers saw.

This means that people with genes that predispose them to be obese are more susceptible to the harmful effects of sugary drinks on their weight, said one of the study leaders, Harvard’s Dr. Frank Hu. The opposite also was true — avoiding these drinks can minimize the effect of obesity genes.

“Two bad things can act together and their combined effects are even greater than either effect alone,” Hu said. “The flip side of this is everyone has some genetic risk of obesity, but the genetic effects can be offset by healthier beverage choices. It’s certainly not our destiny” to be fat, even if we carry genes that raise this risk.

The study was funded mostly by federal grants, with support from two drug companies for the genetic analysis.


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Coaching Childcare Providers Offers Leverage On Impacting Childhood Obesity

A B C – 1 2 3, But What Is Good for Me?

08 November 2012 Elsevier

Coaching Childcare Providers Offers Leverage On Impacting Childhood Obesity

Philadelphia, PA, November 8, 2012 – The National Health and Nutrition Examination Surveys revealed that over 21% of children 2 to 5 years old were considered overweight or obese. Child care settings can serve as a platform to teach children about nutrition in our fight against childhood obesity, as nearly 50% of children in the United States under age 5 are enrolled in child care. In a new study released in the November/December 2012 issue of the Journal of Nutrition Education and Behavior, training child care providers about their role in children’s healthful eating is an essential component of child care-based obesity prevention initiatives.

This study from Washington State University called the ENHANCE project, looked at 72 child care providers from 45 child care settings before and after a three-hour wellness retreat, and focused on feeding relationships, child nutrition education, and family communication. This forum provided tools and skills for providers to succeed in incorporating obesity prevention and healthful eating promotion within their child care setting. Based on observations and a survey before and one year after the wellness retreat, researchers found child care providers’ beliefs related to children’s healthful eating and feeding affected classroom practices. For example, if a child care provider felt confident in their ability to provide nutrition information, then they increased their nutrition education efforts and communicated more frequently with families about healthful eating and child feeding.

Jane D. Lanigan, PhD, the lead investigator from Washington State University, says, “Teachers did feel empowered to shape children’s food preferences and employed a variety of evidence-based practices during feeding. However, they felt uncertain about managing children’s intake or addressing child weight issues with parents. The current study suggests that the child care feeding environment can be improved by helping providers understand the negative consequences associated with feeding practices such as pressuring a child to eat, restricting highly palatable food, and using rewards to encourage children to eat healthful food or increase consumption.”

So why is this important for childcare? Dr. Lanigan says, “The potential for early learning professionals to contribute to the childhood obesity solution has yet to be fully realized. The ENHANCE project sought to position obesity prevention within the early learning philosophy of promoting the development of the ‘whole child’ and help child care providers connect child care feeding practices to children’s development of lasting beliefs about healthful eating.

“Incorporating child feeding training into state child care licensure, national certification, or as a requirement for participation in the Child & Adult Care Food Program are potential mechanisms for improving the child care feeding environment and addressing the childhood obesity epidemic.”

Attached files

  • child care providers can be part of the solution for childhood obesity, interview with study’s lead investigator, Jane D. Lanigan, PhD

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