The nutritional status and health related behaviour of school adolescents in Jinangsu Province China : a cross-sectional study

Abstract

Background: China is undergoing a rapid nutrition transition. While malnutrition is still a problem in rural and low-income urban groups, adolescent obesity is becoming a major nutrition problem in urban areas and is needing special attention. Research on adolescents nutrition in China is erratic and insufficient. No research has been reported in the field of weight concerns and related food habits. Objective: To collect information on nutritional status and associated factors such as diet, physical activity and smoking among adolescents as a basis for better health behaviour interventions in schools. Methods: In a cross-sectional study, 824 students aged 12-14 yrs from 8 schools in Jiangsu Province China had their height, weight and haemoglobin measured. Self administered questionnaires were used to collect information on food habits and life style. Results: Overnutrition seemed to be an increasing problem among adolescents in Jiangsu China both in urban and rural area, while the prevalence of undernutrition was very low. Only five percent of 12-14 years old students had body mass index (BMI) below 5th percentile of the NCHS/WHO reference. The prevalence of stunting was also low (2.9%). The prevalence of overweight and obesity was 8.7% and 4.9%, respectively. More boys were overweight than girls. More than 20% of the adolescents from the high educational level families were overweight. Household SES , family size, intake of western food, gender and parents education were related to overweight. The prevalence of anemia was 20% for both sexes and somewhat higher among girls (23.4%). No urban/rural or SES differences were observed. The differences among schools were however very significant. More than 70% of the students had three meals everyday plus sometimes a small eveningmeal. Breakfast skipping existed among both boys and girls. From 60% to 70% of the students ate fruits and vegetables daily. About 8% of the students ate hamburgers more than 4- 6 times per week. The urban students consumed more milk, animal foods, soft drinks and less vegetables than the rural students. About 28.5% of the students thought themselves as overweight. More boys were satisfied with their body weight than the girls. A quite high percentage of the girls perceived themselves as overweight even if they had a normal weight. Body image was strongly correlated with the desire to change weight (r=0.67; p<0.0001); overweight body image was positively correlated to wanting to lose weight. High level of study load was observed. Students spend about 11 hrs on study everyday during weekdays. Conclusions: Overnutrition in adolescents, combined with anemia are important nutritional problems in Jiangsu China. Intervention programs are needed to address these problems. Health education and health promotion activities to prevent eating problems and overweight in children should promote healthy eating and increased physical activity. The students should be encouraged to eat breakfast, fruits and vegetables daily in the future. The intake of western foods and snacks should be limited. The safeguarding of the traditional Chinese food habits should be at the core of a nutritional policy aiming at preventing overweight and chronic diseases.