Objective:To develop hemoglobin (Hb) percentiles and thresholds for defining anemia among infants aged 0-5 months in China. Methods:The National Nutrition and Health Systematic Survey for children aged 0 -17 years in China, a nationwide cross-sectional study, was conducted between 2019 and 2021. Hb levels were measured in infants using the HemoCue 201+ analyzer. Age- and sex-specific Hb distributions were constructed for "healthy infants", defined as those with adequate iron reserves at birth, exclusive breastfeeding, normal weight-for-age Z-score and weight growth velocity, normal neuropsychological development, and absence of acute or chronic diseases. A generalized additive model for location, scale, and shape was applied to fit the Hb percentiles. The 5th percentile of the Hb distribution was defined as the threshold for anemia. Results:A total of 10,174 infants aged 0-5 months participated in the study, among whom 2,155 healthy infants were included in the analysis. Hb levels peaked at birth, gradually decreased to a nadir around 60 days after birth, and then rose to a plateau. The Hb thresholds defining anemia were 102.7 g/L, 96.3 g/L, 92.8 g/L, 95.4 g/L, 97.1 g/L, and 95.8 g/L for the 0-, 1-, 2-, 3-, 4-, and 5-month age groups, respectively. Conclusion:This study establishes hemoglobin thresholds for defining anemia in infants aged 0-5 months based on a nationwide, population-based dataset in China.

The relationship between screen exposure and early childhood development requires further investigation, especially regarding the age at screen onset, daily screen duration, and potential gender-specific vulnerabilities. This study explored the associations between screen exposure before the age of two and domain-specific developmental outcomes, with particular emphasis on to age of onset, daily exposure duration, and gender differences. This cross-sectional study was conducted as part of the China National Nutrition and Health Systematic Survey for Children Aged 0–17 Years (CNHSC, 2019–2021). A total of 4617 children under the age of two were included. Parents reported their children’s screen exposure history, and developmental outcomes were assessed using the China Development Scale for Children (CDSC, WS/T580-2017). Propensity score matching was applied to minimize potential confounding and selection bias. Three-level linear mixed-effects models were used to assess associations with age at onset, daily screen time, and gender interactions. Among participants (49.7

Objective:This study aimed to describe 24-hour movement behaviors, including physical activity, sedentary behavior, and sleep period, among Chinese preschoolers using nationally representative data, and examine disparities by age, gender, and residence. Methods:A cross-sectional analysis was conducted using data from the China National Nutrition and Health Systematic Survey for Children (2019-2021), including 10,935 children aged 3-5 years. Daily total time of physical activity (TPA), total time of sedentary behaviors (TSB), and total sleep period (TSP) was collected via validated structured questionnaires. Physical inactivity was defined as < 180 minutes of TPA per day. Results:Median TPA was 121.4 ( IQR: 71.4-209.6) minutes/day, and TSB was 231.4 ( IQR: 175.0-304.3) minutes/day, with 11.46 ± 1.00 hours/day average TSP. Overall, 68.8% were physically inactive, with higher prevalence in rural (73.3%) versus urban areas (64.8%, P < 0.001). TPA and TSB increased with age, while TSP decreased (all P < 0.001). No significant gender differences were observed. Conclusion:Most Chinese preschoolers exhibit insufficient physical activity and excessive sedentary behaviors, with notable urban-rural disparities and an escalating trend of ageing. Continuous monitoring and targeted interventions, especially in rural areas, are urgently needed.

BACKGROUND:Selenium is essential for children's health and either deficiency or excess could pose serious health risks. However, nationwide data on selenium nutrition in Chinese children are still lacking, as current studies were primarily limited to historically deficient regions affected by Keshan disease and Kashin-Beck disease. OBJECTIVES:This study aims to investigate the relationship between the living environment, geographic factors, dietary intake, and the selenium status of Chinese children aged 3-17 y. METHODS:Data were derived from the National Nutrition and Health Systematic Survey for children aged 0-17 y (CNHSC), conducted between 2019 and 2021. Field surveys were conducted to collect general demographic information, and a food frequency questionnaire was used to assess dietary intake. Blood selenium concentrations were measured using inductively coupled plasma mass spectrometry (Agilent 7700x), with a cutoff value of 70 μg/L indicating inadequate selenium status. RESULTS:The results revealed that the blood selenium concentration of children aged 15-17 y (92.93 μg/L) was higher than that of other age groups. Additionally, children from rural western areas, with a selenium concentration of 83.28 μg/L, were significantly more vulnerable to inadequate selenium status compared with those from eastern cities [odds ratio (OR) = 20.56 (10.77-39.25)]. Dietary intake of dairy products [OR = 0.58 (0.44-0.75)], meats [≥7 times/wk: OR = 0.48 (0.36-0.64), 3-7 times/wk: OR = 0.65 (0.48-0.90)], and aquatic products [OR = 0.53 (0.37-0.75)] were identified as protective factors against inadequate selenium status (P < 0.001). CONCLUSION:This study suggests that children in rural western areas may be a priority population for future interventions to improve selenium status. A moderate increase in the consumption of selenium-rich foods, such as dairy products, meats, and aquatic products, is recommended to reduce the prevalence of inadequate selenium status in these regions.

Objectives: To analyze the prevalence and influencing factors of overweight and obesity among left-behind children (LBC) under 6 years old in China, and to provide a reference basis for their early prevention and control. Methods: The data were derived from the National Nutrition and Health Survey among children and lactating mothers (2016-2017). A total of 19,229 left-behind children under 6 years old in China were included in this study. The results were post-stratification weighted and adjusted using data from the Sixth National Population Census released by the National Bureau of Statistics of China in 2010. The Rao-Scott chi-square test with sampling design-weighted correction was used to test for statistical differences, and multivariate unconditional logistic regression analysis was conducted to explore influencing factors. Results: The prevalence of overweight and obesity among LBC under 6 years old in China were 6.68% and 2.22%, respectively. The overweight rate and obesity rate of boys were higher than those of girls (7.96% vs. 5.15%, 2.77% vs. 1.56%). Both the overweight rate and obesity rate showed a "U"-shaped trend with increasing age (p < 0.0001). LBC with migrant fathers had the highest overweight rate and obesity rate. Logistic regression analysis indicated that being male, being in infancy or preschool age, residing in eastern China, having a migrant father, and higher annual per capita household income were risk factors for overweight and obesity. Conclusions: Left-behind children under 6 years old in China are at risk of overweight and obesity. Among LBC under 6 years old in China, the issues of overweight and obesity are relatively prominent in boys, as well as those in infancy and preschool age. Additionally, LBC with fathers who migrate for work have relatively higher overweight/obesity rates. It is essential to pay attention to the problems of overweight and obesity among LBC under 6 years old in China, strengthen the monitoring of their growth and development, and incorporate the improvement of overweight and obesity in LBC into national nutrition improvement policies at all levels.

OBJECTIVE:To provide updated prevalence and associated factors of double burden of malnutrition(DBM) among children aged 6-17 months in China. METHODS:This study was a cross-sectional study. A multi-stage stratified randomized sampling method was used to recruit 25 791 children aged 6-71 months from 14 provinces in China between 2019 and 2021. A standardized questionnaire survey was used to collect basic information about children and their parents. All children were weighted using unified digital weight scales, and the length/height of all children was determined using unified instruments. Hemoglobin of all children was collected using a HemoCue 201+ system. The body mass index for age Z-scores and anemia were determined and used to evaluate the prevalence of double burden of overweight/obesity and anemia malnutrition. The chi-square test was used to compare the prevalence of malnutrition among children with different characteristics. The unconditional logistic regression model was used to examine factors associated with the malnutrition. RESULTS:This study included 25 791 children aged 6-71 months, including 5127 children aged 6-11 months, 6592 children aged 12-23 months, 3605 children aged 24-35 months, 3492 children aged 36-47 months, 3559 children aged 48-59 months, and 3416 children aged 60-71 months. The prevalence of double burden of overweight/obesity and malnutrition among children aged 6-71 months was 0.8%(n=210).12-23 months(OR=0.69, 95%CI 0.42-0.83), 24-35 months(OR=0.33, 95%CI 0.19-0.55), 36-47 months(OR=0.14, 95%CI 0.06-0.30), 48-59 months(OR=0.26, 95%CI 0.14-0.48), 60-71 months(OR=0.46, 95%CI 0.28-0.75), father&apos;s age of 40-44years(OR=0.40, 95%CI 0.17-0.97) and higher education levels of father(OR=0.40, 95%CI 0.17-0.97) were the protective factors for DBM(P&lt;0.05), whereas large-for-gestational-age infants(LGA)(OR=1.73, 95%CI 1.13-2.66), non-only-child(OR=1.58, 95%CI 1.14-2.19), central regions(OR=1.64, 95%CI 1.11-2.43) and rural area(OR=1.45, 95%CI 1.05-2.00)were the risk factors for DBM(P&lt;0.05). CONCLUSION:The prevalence of DBM among children aged 6-71 months in 14 provinces in China was at a relatively low level. The occurrence of overweight/obesity and anemia malnutrition was impacted by children age, LGA, non-only-child, age of father, education levels of father and regions.

OBJECTIVE:To explore the relationship between feeding patterns and physical growth of late preterm infants with 34-36 weeks of gestational age and 0-5 months of correction age. METHODS:The data were from the project "Nutrition and Health System Survey and Application for Children aged 0-18 Years in China". Multi-stage stratified random sampling was used to conduct the study at 28 survey sites in 7 regions of East China, North China, Central China, South China, Southwest, Northwest and Northeast China from February 2018 to January 2020. A self-designed structured questionnaire for infants aged 0-6 months was used by the investigators to ask infant mothers or other primary guardians face-to-face to retrospectively collect the basic characteristics and feeding status of infants, and measure the length, weight and head circumference of infants. Based on inclusion criteria and exclusion criteria, a total of 48 late preterm infants fed exclusively breastmilk and 53 late preterm infants fed formula aged 0-5 months of correction age were enrolled in this study. Using the corrected age and gender of late preterm infants fed exclusively breastmilk as matching variables, 48 full-term infants fed exclusively breastmilk aged 0-5 months were matched by propensity score as reference to evaluate the difference in growth and development between late preterm infants and full-term infants fed exclusively breastmilk. Z-scores and weight gain rate were used to evaluate the growth and development of infants. ANOVA was used to compare the growth and development of infants in the three groups. Multiple linear regression was used to adjust for potential confusing factors to analyze the effects of different feeding patterns on the growth and development of late preterm infants. RESULTS:There was no significant difference in length for age Z-score(LAZ), weight for age Z-score(WAZ), weight for height Z-score(WLZ), body mass index for age Z-score(BAZ) and weight gain rate between late preterm infants fed exclusively breastmilk and late preterm infants fed formula(P&gt;0.05), and there was also no significant difference between late preterm infants fed exclusively breastmilk and full-term infants fed exclusively breastmilk(P&gt;0.05). However, The WAZ and head circumference for age Z-score(HCZ) of late preterm infants fed formula were 0.41(P=0.03) and 0.44(P=0.02) higher than those of full-term infants fed exclusively breastmilk, but there was no significant difference in LAZ, WLZ, BAZ and weight gain rate between the two groups(P&gt;0.05). CONCLUSION:At 0-5 months of correction age, the growth and development of late preterm infants fed exclusively breastmilk were similar to that of full-term infants fed exclusively breastmilk. Formula supplementation may promote weight gain, but not length in late preterm infants.

OBJECTIVE:Meta-analysis was conducted to estimate the prevalence of malnutrition among the elderly in China. METHODS:According to the corresponding term in Chinese and English, such as malnutrition, underweight, elderly, China, etc. , literature searches were conducted on PubMed, Embase, Web of Science, Wanfang Digital Database and China National Knowledge Infrastructure Database from January 1, 2000 to December 31, 2023 for literature related to the nutritional status of the elderly(≥60 years old) in China. The design was cross-section study. RESULTS:53 articles, 22 in English and 31 in Chinese, were finally included which covered 701 434 elderly people aged 60 years or older, and the prevalence of malnutrition varied widely(2.4%-52.5%). The Meta-analysis showed that the prevalence of malnutrition among the older was 13.0%(95%CI 10.7%-15.7%). There was significant heterogeneity among the studies(I~2=99.9%, P&lt;0.01). The prevalence of malnutrition among male and female group were 11.2% and 12.2%, respectively, with a statistically significant difference(χ~2=152.68, P&lt;0.01). The prevalence of malnutrition among the elderly was 11.5% in urban areas, which was lower than that in rural areas(13.6%), with a statistically significant difference(χ~2=613.29, P&lt;0.01). The prevalence of malnutrition with BMI standard was significantly lower than that by other assessment tools(8.1% vs.24.1%, χ~2=33 675.29, P&lt;0.01). CONCLUSION:There is still a problem of malnutrition among the elderly over 60 years old in China, and the malnutrition rate is higher among women or in rural areas.

OBJECTIVE:To estimate the usual vitamin intake and the prevalence of inadequate intakes among Chinese adults in 2015, and to provide a scientific basis for developing nutrition intervention strategies and measures for target populations. METHODS:Data was drawn from the Chinese Nutrition and Health Surveillance 2015-2017, a nationally representative cross-sectional study. The multistage stratified whole-group random sampling method was used to draw participants from 298 surveillance sites in 31 provinces(autonomous regions and municipalities). Participants with no available information or abnormal energy intake were excluded, and finally, a total of 72 231 participants aged 18 years and older were included in the current study. The dietary data of the participants were collected by the 24-hour dietary recall method combined with the condiment weighing method for three consecutive days. The National Cancer Institute method was used to estimate the distribution of the usual intake of vitamin B_1(thiamine), vitamin B_2(riboflavin), niacin, vitamin C(ascorbic acid), and vitamin E(tocopherol), and the prevalence of inadequate intake was evaluated based on estimated average requirement or adequate intake from the Chinese Dietary Reference Intakes 2023. RESULTS:The usual intake of vitamin E, vitamin C, vitamin B_1, vitamin B_2 and niacin were 27.93 mg/d, 77.67 mg/d, 0.78 mg/d, 0.62 mg/d and 13.15 mg/d, respectively. The prevalence of inadequate intake was, in descending order, vitamin B_2(95.98%), vitamin B_1(86.73%), vitamin C(63.70%), niacin(39.81%), and vitamin E(21.17%). The prevalence of inadequate vitamin E, vitamin C, vitamin B_1 and niacin intake among females was higher than among males(P&lt;0.01). Overall, the prevalence of inadequate vitamin intake increased with age. Rural residents had a higher prevalence of inadequate intake of vitamin C, vitamin B_2 and niacin than urban residents(P&lt;0.01). Except for vitamin E, the prevalence of inadequate intake of vitamins decreased with increasing education levels. The prevalence of inadequate intake of these five vitamins was higher among participants with lower income levels than those with middle or high income(P&lt;0.01). Participants with normal weight had a higher prevalence of inadequate intake of vitamin E than those with overweight or obesity and had a higher prevalence of inadequate intake of vitamin C than those with obesity. However, participants with normal weight had a higher prevalence of inadequate intake of vitamin E than those with overweight or obesity, with the differences being statistically significant(P&lt;0.01). Except for vitamin E, the prevalence of inadequate intake of vitamins decreased with increasing physical activity intensity. CONCLUSION:In 2015, the usual intake of dietary vitamins of Chinese adults was low. There are differences in usual intakes of vitamins and prevalence of inadequate vitamin intake for adults aged 18 years and above in males and females, different age groups, urban and rural areas, education levels, household income levels, body mass index and physical activity intensity.

Objective: The aim of this study was to explore the relationship between breastfeeding duration and neurodevelopment in children aged 2 to 3 years in a Chinese population. Methods: This study was based on a cross-sectional survey. The data were from the National Nutrition and Health Systematic Survey for children in China which was conducted from 2019 to 2020. Characteristics of parents and children and the breastfeeding duration were obtained using interview-administered questionnaires. Children's neuropsychological development was assessed by a trained child health care physician using the Child Psychological Development Scale. A multivariable linear regression model was used to analyze the association between breastfeeding duration and neuropsychological development. Results: A total 1290 children aged 2-3 years were included in the present analysis. In multivariable linear regression models, after adjustment for potential confounders, children who were breastfed for 7-12 months had a 3.59-point increase in gross motor development ((3 = 3.59; 95% confidence interval [CI]: 1.23 to 6.34), a 3.73-point increase in fine motor development ((3 = 3.73; 95 % CI: 1.09 to 6.47), and a 2.87-point in language development ((3 = 2.87; 95 % CI: 1.12 to 5.31) compared with those who were never breastfed. Children who were breastfed for > 12 months had a 3.77-point increase in fine motor development ((3 = 3.77; 95 % CI: 0.98 to 6.86) compared with those who were never breastfed. Conclusions: Longer breastfeeding duration was associated with increased gross motor, fine motor, and language scores in our study population. Mothers in China should be encouraged to initiate and continue breastfeeding.

OBJECTIVE:To describe the change of sweet beverage and unhealthy food consumption among infant and young child aged 6-23 months in 2013, 2016-2017, China. METHODS:Data was from the China Nutrition and Health Surveillance among Children and Lactating Women in 2013, 2016-2017.9983, 20 423 children aged 6-23 months old were involved respectively. The sweet beverage and unhealthy food consumption was analyzed with WHO and UNICEF 2021 updated infant and young child feeding indicators. Data analyses were conducted using the complex weight based on national census from National Bureau of Statistics in 2010. Rao-Scott Chi-square was used test for statistical difference. RESULTS:The proportions of sweet beverage consumption among children aged 6-23 months was 20.2%(95%CI 16.0%-24.4%) in 2013; it was 29.6% in large cities, and 14.0% in poor rural areas, but there was no significant difference in different areas. Compared with 2013, the proportions of sweet beverage consumption increased significantly in 2016-2017, reaching 51.7%(95%CI 48.9%-54.4%); it was 54.1% in medium and small cities, and 44.3% in large cities. The proportions of unhealthy food consumption among children aged 6-23 months was 31.2%(95%CI 23.2%-39.3%) in 2013; it was 46.3% in medium and small cities, and 16.3% in poor rural areas. Compared with 2013, the proportions of unhealthy food consumption was 35.6%(95%CI 33.6%-39.3%) in 2016-2017, and no significant difference was observed(Rao-Scott χ~2=0.96, P=0.33); It was 38.6% in medium and small cities, and reached 30% in large cities and poor rural areas. For those 2 indicators at the same survey, no consistent differences were observed between boys and girls and there was significant difference in various months of age(P&lt;0.01). CONCLUSION:In China, the proportion of sweet beverage consumption among children aged 6-23 months has increased significantly, and the intake of unhealthy food is relatively stable. Children aged over 12 months and in rural areas need to be concerned about.

OBJECTIVE:To describe the feeding status and related factors of infant and young child aged 6-23 months in China.METHODS:Data was from the China Nutrition and Health Surveillance among 0-17 Years Old Children and Lactating Women in 2016-2017, and 20 423 children aged 6-23 months were involved in 275 surveillance sites from 31 provinces(autonomous regions and municipalities). The introduction of solid, semi-solid or soft foods, minimum dietary diversity, minimum meal frequency were analyzed with WHO and UNICEF 2021 updated infant and young child feeding indicators. Data analyses were conducted using the complex weight based on national census from National Bureau of Statistics in 2010. Rao-Scott Chi-square was used test for statistical difference.RESULTS:The percentage of infants 6-8 months of age who consumed solid, semi-solid or soft foods was 83.2%(95%CI 80.5%-85.9%) in 2016-2017. No significant difference were observed between boys and girls; there was significant difference in different areas(Rao-Scott χ~2=30.85, P&lt;0.01), it was 90.3% in medium and small cities, and reached 75.0% even in poor rural areas. The proportions of children aged 6-23 months meeting minimum dietary diversity(MDD) was 60.6%(95%CI 58.1%-63.1%). It was 71.1% in medium and small cities, and 50.5% in poor rural areas. Except for breast milk, the percentage of eggs(34.4%) and legumes(19.0%) consumption was low, the percentage of grains, vitamin A-rich fruits or vegetables consumption was 89.7%(95%CI 88.4%-91.1%). The percentage of consuming egg and/or flesh food was 76.4%(95%CI 74.2%-78.7%). The percentage of zero vegetables or fruits consumption was 9.1%(95%CI 7.8%-10.4%). The proportions of children aged 6-23 months meeting minimum meal frequency(MMF) was 72.4%(95%CI 70.1%-74.7%). It was over 70% in large cities, medium and small cities, general rural areas; and 60.2% in poor rural areas. The proportions of children aged 6-23 months meeting minimum acceptable diet was 43.4%(95%CI 40.7%-46.1%), it was over 50% in urban areas, and less than 40% in rural areas, 30.1% in poor rural areas. No consistent differences were observed between boys and girls for all 3 indicators(MDD, MMF and MAD), and there was significant difference in different areas and various months of age(P&lt;0.01).CONCLUSION:There was no gender difference in the feeding status of children aged 6-23 months in China, the complementary feeding was relatively timely, and the minimum dietary diversity and meal frequency of children were relatively ideal, but the minimum acceptable diet of children in poor rural areas was poor.

OBJECTIVE:To describe the breast milk intake of infants aged 0-5 months in China and its trends, and to analyze the effects of feeding mode, gender and regions on breast milk intake.METHODS:Data were extracted from Ministry of Science and Technology&apos;s basic resource survey project "China&apos;s 0-18-year-old children&apos;s nutrition and health system survey and application" project. Caregivers were face to face interviewed to collect the basic information of infants. Weighing method was used to measure 24 hourly breast milk intake of infants aged 0-5 months in China. The rank sum test was used to compare the differences in breast milk intake between groups, the Spearman rank sum test was used to analyze the trend of breast milk intake with increasing age, and the general linear regression model was used to analyze the effects of gender and region on breast milk intake.RESULTS:The mean breast milk intake of exclusively breastfed infants aged 0-5 months was 800.1 g/d, ranging from 696.4 to 937.7 g/d. Breast milk intake increased with age and remained stable at 5 months(β=29.6, P=0.009). There was a statistically significant difference in breast milk intake among infants in different month age groups(χ~2=17.96, P=0.003). Infants aged 0-5 months who are exclusively breastfed were fed 8 times in 24 hours, the breast milk intake per each time is 103.4-152.5 g, the duration of each feeding is 20.4-24.6 min, and the breast milk intake per minute is 4.4-7.0 g. Except for 5 months of age, there was no gender difference in the 24-hour breast milk intake of exclusively breastfed infants aged 0 to 4 months(P&gt;0.05). Except for 4-month-old exclusively breastfed infants, there was no regional differences in the breast milk intake of others(t=-4.25, P&lt;0.001). In the mixed feeding group, breast milk + complementary feeding group and breast milk + formula powder + complementary feeding group, the breast milk intake of infants aged 0-5 months were 341.1-496.7 g, 239.1-742.7 g and 90.0-508.0 g, respectively.CONCLUSION:In 2019-2021, infants aged 0-5 months in China Breast milk intake increased with age, and remained stable at 5 months. The breast milk intake of infants aged 0-5 months in different regions or genders is similar except for individual months. The introduction of formula or complementary food directly affects the intake of breast milk in infants.

Objective This study aimed to assess the relationship between the body composition of children aged 3-5 years and breastfeeding status and duration.Methods The study was conducted using data from the National Nutrition and Health Systematic Survey for children 0-17 years of age in China (CNHSC), a nationwide cross-sectional study. Breastfeeding information and potential confounders were collected using standardized questionnaires administered through face-to-face interviews. The body composition of preschool children was measured using bioelectrical impedance analysis. A multivariate linear regression model was used to assess the relationship between breastfeeding duration and body composition after adjusting for potential confounders.Results In total, 2,008 participants were included in the study. Of these, 89.2% were ever breastfed and the median duration of breastfeeding was 12 months (IQR 7-15 months). Among children aged 3 years, the height-for-age Z-score (HAZ) for the ever breastfed group was lower than that for never breastfed group (0.12 vs. 0.42, P = 0.043). In addition, the weight-for-age Z-score (WAZ) of the ever breastfed group was lower than that of the never breastfed group (0.31 vs. 0.65, P = 0.026), and the WAZ was lower in children aged 4 years who breastfed between 12 and 23 months than in those who never breastfed. Compared to the formula-fed children, the fat-free mass of breastfed infants was higher for children aged 3 years (12.84 kg vs . 12.52 kg, P = 0.015) and lower for those aged 4 years (14.31 kg vs. 14.64 kg, P = 0.048), but no difference was detected for children aged 5 years (16.40 kg vs. 16.42 kg, P = 0.910) after adjusting for potential confounders. No significant difference was detected in the weight-for-height Z-score (WHZ), body mass index (BMI)-for-age Z-score (BAZ), fat-free mass index, and body fat indicators in the ever breastfed and never breastfed groups and among various breastfeeding duration groups for children aged 3-5 years.Conclusion No obvious associations were detected between breastfeeding duration, BMI, and fat mass indicators. Future prospective studies should explore the relationship between breastfeeding status and fat-free mass.

OBJECTIVE:To analyze the intakes of main food among the children of 6-17 years in different regions of China from 2019 to 2021, and to provide a scientific basis for evaluation and guiding Chinese children to make reasonable diet.METHODS:Multistage stratified random sampling method was used to collect data in east China, north China, central China, south China, southwest, northwest and northeast seven areas of each random two provinces, randomly selected from each province one urban survey site and one rural survey site, 28 sites of the 13th Five Year National Science and Technology Basic Resources Survey Project-Chinese children aged 0-18 investigation and application of nutrition and health system in 14 provinces of China. The study included 6413 children aged 6 to 17. Three consecutive 24-hour recalls method combined with weighing were used to collect the information of food intake. According to the food classification in the standard version of the food composition list, the food was divided into cereals, tubers, fresh vegetables, fresh fruits, meat and poultry, fish and shrimp, eggs, milk, etc. , and the intake of various foods was calculated for boys and girls aged 6-8, 9-11, 12-14 and 15-17 in different regions.RESULTS:Compared with the average daily food intake of children of the same sex and age in the urban and rural, The average daily intake of cereals and tubers for boys aged 9-17, cereals for girls aged 9-17, tubers for girls aged 12-17, and fish and shrimp for boys of edible population aged 15-17 were higher in rural areas than in urban areas. There were differences in the average daily food intake and consumption rate of fresh vegetables, fresh fruits, meat and poultry, eggs and milk of the same sex and age, which were higher in urban than in rural areas(P&lt;0.05). Compared with the average daily food intake of children of the same sex and age in the south and the north, the average daily intake of cereals and eggs for boys aged 9-14, cereals for girls aged 6-8, and fresh fruits for boys and girls of edible population aged 6-17 were higher in the north than in the south. There were differences in average daily intake and consumption rates of tubers, fresh vegetables, meat and poultry, milk and fish and shrimp of the same sex and age, which were higher in the south than in the north(P&lt;0.05). Compared with the average daily food intake of children of the same sex and age in the eastern, central and western regions, the average daily intake of cereals for boys aged 6-14, cereals for girls aged 6-17, fresh fruits for boys and girls of edible population aged 6-17, and fish and shrimp for boys and girls of edible population aged 15-17 were lower in the eastern region than in the central and western regions. The average daily intake of tubers for boys aged 9-11 and 15-17, for girls aged 9-17 were higher in the western regions than the eastern and central regions. The average daily intake of eggs for boys and girls aged 12-17 was lower in western regions than the eastern and central regions. There were differences in average daily intake and consumption rates of fresh vegetables, meat and poultry and milk of the same sex and age, which were higher in the eastern region than in the central and western regions. (P&lt;0.05). The proportion of coarse grains to cereals was low, between 3.7% and 10.1%. The proportion of pork to meat and poultry was high, between 56.1% and 71.4%.CONCLUSION:In China, there are differences in daily intake of main food for children aged 6 to 17 years old in urban and rural areas, north and south areas, east, central and west areas.

The current study is to explore the association of the Chinese visceral adiposity index (CVAI) with hypertension, and to compare the predictive power of different adiposity indexes regarding hypertension among Chinese adults aged over 45 years. A total of 99,201 participants aged over 45 years from the China Nutrition and Health Surveillance 2015–2017 were included in this study. Multivariate adjusted logistic regression was used to calculate the odds ratio (OR) and 95% confidence interval (CI) of hypertension. Multivariate adjusted restricted cubic spline analyses were applied to explore the association of adiposity indexes with hypertension. Receiver operating characteristic (ROC) analyses were used to compare the predictive powers of different adiposity indexes of hypertension. All eight adiposity indexes included in this study were positively associated with hypertension. Compared with those in the lowest quartile of the CVAI, the participants in the highest quartile showed a significantly higher risk of hypertension (OR = 3.70, 95% CI = 3.54–3.86) after multiple adjustments. The ROC analyses suggested that the CVAI was the strongest predictor of hypertension compared to other adiposity indexes in both genders. The findings supported that the CVAI could serve as a reliable and cost-effective method for early identifying hypertension risk.

Objective:To survey the awareness status and its influencing factors among parents of preschool children.Methods:Data was collected from the National Nutrition and Health Systematic Survey for 0-18 Year Children in China. A total of 2 625 children aged 3-5 years and their parents living in northern and southern regions of China were randomly selected by multi-stage stratified cluster sampling. The physical measurements were performed for the children, including height and weight; and the body mass index (BMI) and age-for-BMI Z-score (BAZ) were calculated. The questionnaire survey was conducted for the parents, including the demographic characteristics of parents and their children, the perception of their child′s nutritional status (overweight/obesity, normal, wasting) etc. According to WHO standards, the nutritional status of the children was classified as wasting, normal and overweight/obesity. The awareness of parents on their children′s nutritional status was classified as underestimated, correct, overestimated and unclear. Parents′ inability to correctly judge children′s nutritional status was defined as cognitive bias, including underestimation bias and overestimation bias. Multivariate logistic regression model was used to analyze the influencing factors of parents′ underestimation or overestimation of children′s nutritional status.Results:Among 2 625 enrolled preschool children, there were 1 312 boys (50.0%) and 1 313 girls (50.0%); and 648 (24.7%), 944 (36.0%) and 1 033 (39.3%) children aged 3, 4 and 5 years, respectively. One parent (mother, farther or others) of each child was selected for survey, and most of them were mothers (1 998(76.1%)). The prevalence rate of overweight/obesity and wasting was 10.3% (270/2 625) and 1.4% (38/2 625), respectively; and 2 317 children (88.3%) were normal. Among all parents surveyed, 1 766 (67.3%) were correct about their children′s nutritional status (correct group), 612 (23.3%) underestimated their children′s nutritional status (underestimated group), 213 (8.1%) overestimated their children′s nutritional status (overestimated group) and 34 (1.3%) were not aware of their children′s nutritional status (unclear group). The multivariate logistic regression analysis showed that girls ( OR=0.817, 95% CI: 0.678-0.984), living in rural areas ( OR=0.801, 95% CI: 0.662-0.969), large birth weight of child ( OR=0.639, 95% CI: 0.420-0.970) were protective factors for parents underestimating children′s nutritional status. Living in the northern region ( OR=1.698, 95% CI: 1.260-2.290), large birth weight of children ( OR=1.826, 95% CI: 1.149-2.902), father with overweight/obesity ( OR=1.467, 95% CI: 1.089-1.977) and maternal overweight/obesity ( OR=1.778, 95% CI: 1.308-2.417) were the risk factors for parents to overestimate the nutritional status of children. Conclusions:The survey shows that parents of preschool children have a relatively high cognitive bias on the nutritional status of their children. Parents of girls, living in rural areas or having child with large birth weight are less likely to underestimate the nutritional status of children; parents living in northern regions, having a child with large birth weight, or with overweight/obese are likely to overestimate the nutritional status of children.

OBJECTIVE:To describe dietary intake of calcium, iron, zinc, selenium, vitamin A, vitamin B_1, vitamin B_2 and vitamin C and compare the intake between urban and rural areas among preschool children aged 2-5 years based on the data from the National Nutrition and Health Systematic Survey for Children 0-17 Years of Age in China.METHODS:Children from 14 provinces were selected by multi-stage stratified random cluster sampling, and the dietary data of preschool children aged 2-5 years were recorded using the 3 day 24-hour weighted food records method. SAS 9.4 was used to calculate dietary intake of these micronutrients based on the Chinese Food Composition Table and to compare the intake between urban and rural areas. The risk of insufficient or excessive intake of micronutrients among Chinese children aged 2-5 years was assessed according to the Chinese Dietary Reference Intakes(DRIs) 2013 edition.RESULTS:A total of 820 children aged 2 to 5 years were selected. The median daily dietary calcium intake of children aged 2-5 years in China was 433.7, 338.9, 356.4 and 347.4 mg, respectively. The median daily dietary intake of vitamin B_1 of children aged 2-5 years was 0.5 mg for all age groups. The median daily dietary vitamin B_2 intake of children aged 2-5 years was 0.7, 0.6, 0.6 and 0.6 mg, respectively. The median daily dietary intake of vitamin C of children aged 2-5 years was 37.9, 37.4, 44.0 and 40.0 mg, respectively. The median daily dietary selenium intake of children aged 2-5 years was 17.1, 20.5, 22.7 and 22.3 μg, respectively. Dietary calcium intake for aged 2-5 years, dietary vitamin B_2 intake for aged 2-4 years, dietary iron, selenium, zinc and vitamin B_1 intake for aged 2-3 years was significantly greater in urban children than rural children. Among all nutrients, the proportion of dietary calcium intakes below the estimated average requirement(EAR) was the highest in aged 2-5 years(61.4%, 76.4%, 91.4% and 91.5%, respectively). The proportions of dietary vitamin B_1, vitamin C and selenium intake lower than EAR of children aged 2-5 years in China were 52.4%-63.2%, 42.8%-50.2% and 46.6%-58.7%, respectively.COUCLUSION:The dietary calcium intake of children aged 2-5 years in China remains insufficient for these children, especially for rural children. Dietary vitamin B_1, vitamin C and selenium intake should be improved.

目的 探讨中国11～14岁儿童视屏时间与近视的关系,为儿童近视防控工作提供科学依据.方法 利用科技基础资源调查专项"中国0～18岁儿童营养与健康系统调查与应用"数据,采用多阶段分层随机抽样方法,在中国七大区域14个省、28个区/县调查点,对12 397名11～14岁儿童进行问卷调查并收集每日视屏时间和视力信息.结果 中国11～14岁儿童自我报告近视率为45.0％,其中女童高于男童、城市高于农村,且随年龄增加而增长(x2值分别为178.82,79.25,495.96,P值均＜0.01);12 397名儿童的平均每日视屏时间为40.0(30.0,60.0)min,男童[40.0(30.0,70.0)min]长于女童[35.0(30.0,70.0)min],城市儿童[40.0(30.0,70.0)min]长于农村儿童[33.0(30.0,60.0)min](x2 值分别为20.86,102.68,P值均＜0.01).每日视屏时间≥60 min男童自我报告近视率(42.5％)高于视屏时间＜60 min的男童(36.4％),每日视屏时间≥60 min女童自我报告近视率(55.6％)高于视屏时间＜60 min的女童(48.0％)(x2值分别为23.62,34.15,P值均＜0.01).经调整年龄、性别、地区、中高强度身体活动时间、含糖食品、含糖饮料摄入量和平均每日睡眠时长后,多因素Logistic回归模型分析显示,与每日视屏时间＜60 min比,≥60 min(OR=1.14,95％CI=1.03～1.27)的女童近视风险较高(P=0.01).调整混杂因素后,每日视屏时间和男童或女童的近视程度均无相关性(P值均＞0.05).结论 每天≥60 min视屏时间可能是11～14岁青春期女童近视的正性相关因素之一.鉴于影响视力的因素复杂,需要进一步研究验证两者之间的关系.

目的 了解0～23月龄婴幼儿大运动发育情况及其影响因素.方法 采用"儿心量表-Ⅱ"对全国20省市3 739名0～23月龄婴幼儿大运动发育商进行测查,同时采用问卷调查收集婴幼儿及其抚养人的相关信息.结果 出生体质量(β=-0.666,P=0.002)、主要抚养人(β=-0.395,P=0.000)、喂养方式(β=-0.250,P=0.011)、添加辅食(β=0.441,P=0.000)及家庭月均收入(β=0.189,P=0.005)与儿童大运动发育商的差异有统计学意义(P＜0.05).结论 低出生体质量不利于儿童大运动发育,母亲作为主要抚养人且家庭月均收入较高对孩子的大运动发育具有一定的促进作用.在喂养方面,坚持纯母乳喂养、适时添加辅食有助于大运动发育.