Skip to main content
Top
Published in: BMC Public Health 1/2017

Open Access 01-12-2017 | Research article

Fast food consumption and its associations with obesity and hypertension among children: results from the baseline data of the Childhood Obesity Study in China Mega-cities

Authors: Yaling Zhao, Liang Wang, Hong Xue, Huijun Wang, Youfa Wang

Published in: BMC Public Health | Issue 1/2017

Login to get access

Abstract

Background

China has seen rapid increase in obesity and hypertension prevalence and fast food consumption over the past decade. We examined status and risk factors for Western- and Chinese fast food consumption and their associations with health outcomes in Chinese children, and examined how maternal factors were associated with child health outcomes.

Methods

Data of 1626 students aged 7–16 (11.6 ± 2.0) years and their parents in four mega-cities across China (Beijing, Shanghai, Nanjing, and Xi’an) were collected in the 2015 baseline survey of the Childhood Obesity Study in China Mega-cities. Weight, height, waist circumference, and blood pressure were measured. Food intake was assessed using questionnaire. Mixed models were used to examine the associations.

Results

Among the children, 11.1% were obese, 19.7% were centrally obese, and 9.0% had hypertension. Obesity prevalence was much higher in boys than in girls (15.2% vs. 6.9% and 27.4% vs. 11.7%, respectively, both P < 0.001). About half (51.9% and 43.6%) of children consumed Western and Chinese fast food, respectively, over the past 3 months. Compared to those with college or above maternal education level, those with elementary school or below maternal education level were 49% more likely to consume Western fast food (odds ratio [OR] and 95% confidence interval [CI]: 1.49 [1.10–2.03]). Chinese fast food consumption rate increased by 12% with each year of increase in child’s age (OR and 95% CI: 1.12 [1.02–1.23]). No significant associations between fast food consumption and health outcomes were detected. Adjusting for Western fast food consumption, children with lower maternal education were 71% and 43% more likely to have obesity and central obesity (ORs and 95% CIs: 1.71 [1.12–2.61] and 1.43 [1.00–2.03], respectively), and maternal body mass index was positively associated with child obesity, central obesity, and hypertension (ORs and 95% CIs: 1.11 [1.06–1.17], 1.12 [1.07–1.17], and 1.09 [1.03–1.15], respectively). Results were similar when Chinese fast food consumption was adjusted for.

Conclusions

The prevalence of fast food consumption, obesity and hypertension is high among children in major cities in China. Maternal factors affect child outcomes.
Literature
1.
go back to reference Wang Y, Lobstein T. Worldwide trends in childhood overweight and obesity. Int J Pediatr Obes. 2006;1(1):11–25.CrossRefPubMed Wang Y, Lobstein T. Worldwide trends in childhood overweight and obesity. Int J Pediatr Obes. 2006;1(1):11–25.CrossRefPubMed
2.
go back to reference Wang Y, Mi J, Shan XY, Wang QJ, Ge KY. Is China facing an obesity epidemic and the consequences? The trends in obesity and chronic disease in China. Int J Obes. 2007;31(1):177–88.CrossRef Wang Y, Mi J, Shan XY, Wang QJ, Ge KY. Is China facing an obesity epidemic and the consequences? The trends in obesity and chronic disease in China. Int J Obes. 2007;31(1):177–88.CrossRef
3.
go back to reference Wang Y, Wang L, Qu W. New national data show alarming increase in obesity and noncommunicable chronic diseases in China. Eur J Clin Nutr. 2017;71(1):149–50.CrossRefPubMed Wang Y, Wang L, Qu W. New national data show alarming increase in obesity and noncommunicable chronic diseases in China. Eur J Clin Nutr. 2017;71(1):149–50.CrossRefPubMed
4.
5.
go back to reference Mi YJ, Zhang B, Wang HJ, Yan J, Han W, Zhao J, et al. Prevalence and secular trends in obesity among Chinese adults, 1991-2011. Am J Prev Med. 2015;49(5):661–9.CrossRefPubMedPubMedCentral Mi YJ, Zhang B, Wang HJ, Yan J, Han W, Zhao J, et al. Prevalence and secular trends in obesity among Chinese adults, 1991-2011. Am J Prev Med. 2015;49(5):661–9.CrossRefPubMedPubMedCentral
6.
go back to reference Li XY, Jiang Y, Hu N, Li YC, Zhang M, Huang ZJ, et al. Prevalence and characteristic of overweight and obesity among adults in China, 2010. Zhonghua Yu Fang Yi Xue Za Zhi. 2012;46(8):683–6.PubMed Li XY, Jiang Y, Hu N, Li YC, Zhang M, Huang ZJ, et al. Prevalence and characteristic of overweight and obesity among adults in China, 2010. Zhonghua Yu Fang Yi Xue Za Zhi. 2012;46(8):683–6.PubMed
7.
go back to reference Dong H, Yan Y, Liu J, Zhao X, Cheng H, Hou D, et al. Alarming trends in ideal cardiovascular health among children and adolescents in Beijing, China, 2004 to 2014. Int J Cardiol. 2017;231:264–70.CrossRefPubMed Dong H, Yan Y, Liu J, Zhao X, Cheng H, Hou D, et al. Alarming trends in ideal cardiovascular health among children and adolescents in Beijing, China, 2004 to 2014. Int J Cardiol. 2017;231:264–70.CrossRefPubMed
8.
go back to reference Zhai Y, Li WR, Shen C, Qian F, Shi XM. Prevalence and correlates of elevated blood pessure in Chinese children aged 6-13 years: a nationwide school-based survey. Biomed Environ Sci. 2015;28(6):401–9.PubMed Zhai Y, Li WR, Shen C, Qian F, Shi XM. Prevalence and correlates of elevated blood pessure in Chinese children aged 6-13 years: a nationwide school-based survey. Biomed Environ Sci. 2015;28(6):401–9.PubMed
9.
go back to reference Xi B, Zhang T, Zhang M, Liu F, Zong X, Zhao M, et al. Trends in elevated blood pressure among US children and adolescents: 1999-2012. Am J Hypertens. 2016;29(2):217–25.CrossRefPubMed Xi B, Zhang T, Zhang M, Liu F, Zong X, Zhao M, et al. Trends in elevated blood pressure among US children and adolescents: 1999-2012. Am J Hypertens. 2016;29(2):217–25.CrossRefPubMed
10.
go back to reference Wang Y, Wang L, Xue H, Qu W. A review of the growth of the fast food industry in China and its potential impact on obesity. Int J Environ Res Public Health. 2016;13(11):E1112. doi:10.3390/ijerph13111112. Wang Y, Wang L, Xue H, Qu W. A review of the growth of the fast food industry in China and its potential impact on obesity. Int J Environ Res Public Health. 2016;13(11):E1112. doi:10.​3390/​ijerph13111112.
12.
go back to reference Rosenheck R. Fast food consumption and increased caloric intake: a systematic review of a trajectory towards weight gain and obesity risk. Obes Rev. 2008;9(6):535–47.CrossRefPubMed Rosenheck R. Fast food consumption and increased caloric intake: a systematic review of a trajectory towards weight gain and obesity risk. Obes Rev. 2008;9(6):535–47.CrossRefPubMed
13.
go back to reference Braithwaite I, Stewart AW, Hancox RJ, Beasley R, Murphy R, Mitchell EA. Fast-food consumption and body mass index in children and adolescents: an international cross-sectional study. BMJ Open. 2014;4(12):e005813.CrossRefPubMedPubMedCentral Braithwaite I, Stewart AW, Hancox RJ, Beasley R, Murphy R, Mitchell EA. Fast-food consumption and body mass index in children and adolescents: an international cross-sectional study. BMJ Open. 2014;4(12):e005813.CrossRefPubMedPubMedCentral
14.
go back to reference Poti JM, Duffey KJ, Popkin BM. The association of fast food consumption with poor dietary outcomes and obesity among children: is it the fast food or the remainder of the diet? Am J Clin Nutr. 2014;99(1):162–71.CrossRefPubMed Poti JM, Duffey KJ, Popkin BM. The association of fast food consumption with poor dietary outcomes and obesity among children: is it the fast food or the remainder of the diet? Am J Clin Nutr. 2014;99(1):162–71.CrossRefPubMed
15.
go back to reference De Santo NG. Reduction of sodium intake is a prerequisite for preventing and curing high blood pressure in hypertensive patients - second part: guidelines. Curr Hypertens Rev. 2014;10(2):77–80.CrossRefPubMed De Santo NG. Reduction of sodium intake is a prerequisite for preventing and curing high blood pressure in hypertensive patients - second part: guidelines. Curr Hypertens Rev. 2014;10(2):77–80.CrossRefPubMed
16.
go back to reference Chateau-Degat ML, Ferland A, Dery S, Dewailly E. Dietary sodium intake deleteriously affects blood pressure in a normotensive population. Eur J Clin Nutr. 2012;66(4):533–5.CrossRefPubMed Chateau-Degat ML, Ferland A, Dery S, Dewailly E. Dietary sodium intake deleteriously affects blood pressure in a normotensive population. Eur J Clin Nutr. 2012;66(4):533–5.CrossRefPubMed
17.
go back to reference Zhang Z, Cogswell ME, Gillespie C, Fang J, Loustalot F, Dai S, et al. Association between usual sodium and potassium intake and blood pressure and hypertension among U.S. adults: NHANES 2005-2010. PLoS One. 2013;8(10):e75289.CrossRefPubMedPubMedCentral Zhang Z, Cogswell ME, Gillespie C, Fang J, Loustalot F, Dai S, et al. Association between usual sodium and potassium intake and blood pressure and hypertension among U.S. adults: NHANES 2005-2010. PLoS One. 2013;8(10):e75289.CrossRefPubMedPubMedCentral
18.
go back to reference Noh HM, Park SY, Lee HS, Oh HY, Paek YJ, Song HJ, et al. Association between high blood pressure and intakes of sodium and potassium among Korean adults: Korean National Health and nutrition examination survey, 2007-2012. J Acad Nutr Diet. 2015;115(12):1950–7.CrossRefPubMed Noh HM, Park SY, Lee HS, Oh HY, Paek YJ, Song HJ, et al. Association between high blood pressure and intakes of sodium and potassium among Korean adults: Korean National Health and nutrition examination survey, 2007-2012. J Acad Nutr Diet. 2015;115(12):1950–7.CrossRefPubMed
19.
go back to reference Ravi S, Bermudez OI, Harivanzan V, Kenneth Chui KH, Vasudevan P, Must A, et al. Sodium intake, blood pressure, and dietary sources of sodium in an adult south Indian population. Ann Glob Health. 2016;82(2):234–42.CrossRefPubMed Ravi S, Bermudez OI, Harivanzan V, Kenneth Chui KH, Vasudevan P, Must A, et al. Sodium intake, blood pressure, and dietary sources of sodium in an adult south Indian population. Ann Glob Health. 2016;82(2):234–42.CrossRefPubMed
20.
go back to reference Mohammadifard N, Khaledifar A, Khosravi A, Nouri F, Pourmoghadas A, Feizi A, et al. Dietary sodium and potassium intake and their association with blood pressure in a non-hypertensive Iranian adult population: Isfahan salt study. Nutr Diet. 2017;74(3):275–82.CrossRefPubMed Mohammadifard N, Khaledifar A, Khosravi A, Nouri F, Pourmoghadas A, Feizi A, et al. Dietary sodium and potassium intake and their association with blood pressure in a non-hypertensive Iranian adult population: Isfahan salt study. Nutr Diet. 2017;74(3):275–82.CrossRefPubMed
21.
go back to reference Lava SA, Bianchetti MG, Simonetti GD. Salt intake in children and its consequences on blood pressure. Pediatr Nephrol. 2015;30(9):1389–96.CrossRefPubMed Lava SA, Bianchetti MG, Simonetti GD. Salt intake in children and its consequences on blood pressure. Pediatr Nephrol. 2015;30(9):1389–96.CrossRefPubMed
22.
go back to reference Farajian P, Panagiotakos DB, Risvas G, Micha R, Tsioufis C, Zampelas A. Dietary and lifestyle patterns in relation to high blood pressure in children: the GRECO study. J Hypertens. 2015;33(6):1174–81.CrossRefPubMed Farajian P, Panagiotakos DB, Risvas G, Micha R, Tsioufis C, Zampelas A. Dietary and lifestyle patterns in relation to high blood pressure in children: the GRECO study. J Hypertens. 2015;33(6):1174–81.CrossRefPubMed
23.
go back to reference Appel LJ, Lichtenstein AH, Callahan EA, Sinaiko A, Van Horn L, Whitsel L. Reducing sodium intake in children: a public health investment. J Clin Hypertens (Greenwich). 2015;17(9):657–62.CrossRef Appel LJ, Lichtenstein AH, Callahan EA, Sinaiko A, Van Horn L, Whitsel L. Reducing sodium intake in children: a public health investment. J Clin Hypertens (Greenwich). 2015;17(9):657–62.CrossRef
24.
go back to reference Duffey KJ, Gordon-Larsen P, Jacobs DR Jr, Williams OD, Popkin BM. Differential associations of fast food and restaurant food consumption with 3-y change in body mass index: the coronary artery risk development in young adults study. Am J Clin Nutr. 2007;85(1):201–8.PubMed Duffey KJ, Gordon-Larsen P, Jacobs DR Jr, Williams OD, Popkin BM. Differential associations of fast food and restaurant food consumption with 3-y change in body mass index: the coronary artery risk development in young adults study. Am J Clin Nutr. 2007;85(1):201–8.PubMed
25.
go back to reference Duffey KJ, Gordon-Larsen P, Steffen LM, Jacobs DR Jr, Popkin BM. Regular consumption from fast food establishments relative to other restaurants is differentially associated with metabolic outcomes in young adults. J Nutr. 2009;139(11):2113–8.CrossRefPubMedPubMedCentral Duffey KJ, Gordon-Larsen P, Steffen LM, Jacobs DR Jr, Popkin BM. Regular consumption from fast food establishments relative to other restaurants is differentially associated with metabolic outcomes in young adults. J Nutr. 2009;139(11):2113–8.CrossRefPubMedPubMedCentral
26.
go back to reference Bezerra IN, Curioni C, Sichieri R. Association between eating out of home and body weight. Nutr Rev. 2012;70(2):65–79.CrossRefPubMed Bezerra IN, Curioni C, Sichieri R. Association between eating out of home and body weight. Nutr Rev. 2012;70(2):65–79.CrossRefPubMed
27.
go back to reference Thompson OM, Ballew C, Resnicow K, Must A, Bandini LG, Cyr H, et al. Food purchased away from home as a predictor of change in BMI z-score among girls. Int J Obes Relat Metab Disord. 2004;28(2):282–9.CrossRefPubMed Thompson OM, Ballew C, Resnicow K, Must A, Bandini LG, Cyr H, et al. Food purchased away from home as a predictor of change in BMI z-score among girls. Int J Obes Relat Metab Disord. 2004;28(2):282–9.CrossRefPubMed
28.
go back to reference Niemeier HM, Raynor HA, Lloyd-Richardson EE, Rogers ML, Wing RR. Fast food consumption and breakfast skipping: predictors of weight gain from adolescence to adulthood in a nationally representative sample. J Adolesc Health. 2006;39(6):842–9.CrossRefPubMed Niemeier HM, Raynor HA, Lloyd-Richardson EE, Rogers ML, Wing RR. Fast food consumption and breakfast skipping: predictors of weight gain from adolescence to adulthood in a nationally representative sample. J Adolesc Health. 2006;39(6):842–9.CrossRefPubMed
29.
go back to reference Fraser LK, Clarke GP, Cade JE, Edwards KL. Fast food and obesity: a spatial analysis in a large United Kingdom population of children aged 13-15. Am J Prev Med. 2012;42(5):e77–85.CrossRefPubMed Fraser LK, Clarke GP, Cade JE, Edwards KL. Fast food and obesity: a spatial analysis in a large United Kingdom population of children aged 13-15. Am J Prev Med. 2012;42(5):e77–85.CrossRefPubMed
30.
go back to reference French SA, Story M, Neumark-Sztainer D, Fulkerson JA, Hannan P. Fast food restaurant use among adolescents: associations with nutrient intake, food choices and behavioral and psychosocial variables. Int J Obes Relat Metab Disord. 2001;25(12):1823–33.CrossRefPubMed French SA, Story M, Neumark-Sztainer D, Fulkerson JA, Hannan P. Fast food restaurant use among adolescents: associations with nutrient intake, food choices and behavioral and psychosocial variables. Int J Obes Relat Metab Disord. 2001;25(12):1823–33.CrossRefPubMed
31.
go back to reference Boutelle KN, Fulkerson JA, Neumark-Sztainer D, Story M, French SA. Fast food for family meals: relationships with parent and adolescent food intake, home food availability and weight status. Public Health Nutr. 2007;10(1):16–23.CrossRefPubMed Boutelle KN, Fulkerson JA, Neumark-Sztainer D, Story M, French SA. Fast food for family meals: relationships with parent and adolescent food intake, home food availability and weight status. Public Health Nutr. 2007;10(1):16–23.CrossRefPubMed
32.
go back to reference Duncan JS, Schofield G, Duncan EK, Rush EC. Risk factors for excess body fatness in New Zealand children. Asia Pac J Clin Nutr. 2008;17(1):138–47.PubMed Duncan JS, Schofield G, Duncan EK, Rush EC. Risk factors for excess body fatness in New Zealand children. Asia Pac J Clin Nutr. 2008;17(1):138–47.PubMed
33.
go back to reference Shan XY, Xi B, Cheng H, Hou DQ, Wang Y, Mi J. Prevalence and behavioral risk factors of overweight and obesity among children aged 2-18 in Beijing, China. Int J Pediatr Obes. 2010;5(5):383–9.CrossRefPubMed Shan XY, Xi B, Cheng H, Hou DQ, Wang Y, Mi J. Prevalence and behavioral risk factors of overweight and obesity among children aged 2-18 in Beijing, China. Int J Pediatr Obes. 2010;5(5):383–9.CrossRefPubMed
34.
go back to reference Chiang PH, Wahlqvist ML, Lee MS, Huang LY, Chen HH, Huang ST. Fast-food outlets and walkability in school neighbourhoods predict fatness in boys and height in girls: a Taiwanese population study. Public Health Nutr. 2011;14(9):1601–9.CrossRefPubMed Chiang PH, Wahlqvist ML, Lee MS, Huang LY, Chen HH, Huang ST. Fast-food outlets and walkability in school neighbourhoods predict fatness in boys and height in girls: a Taiwanese population study. Public Health Nutr. 2011;14(9):1601–9.CrossRefPubMed
35.
go back to reference Andegiorgish AK, Wang J, Zhang X, Liu X, Zhu H. Prevalence of overweight, obesity, and associated risk factors among school children and adolescents in Tianjin, China. Eur J Pediatr. 2012;171(4):697–703.CrossRefPubMed Andegiorgish AK, Wang J, Zhang X, Liu X, Zhu H. Prevalence of overweight, obesity, and associated risk factors among school children and adolescents in Tianjin, China. Eur J Pediatr. 2012;171(4):697–703.CrossRefPubMed
36.
go back to reference Xu H, Short SE, Liu T. Dynamic relations between fast-food restaurant and body weight status: a longitudinal and multilevel analysis of Chinese adults. J Epidemiol Community Health. 2013;67(3):271–9.CrossRefPubMed Xu H, Short SE, Liu T. Dynamic relations between fast-food restaurant and body weight status: a longitudinal and multilevel analysis of Chinese adults. J Epidemiol Community Health. 2013;67(3):271–9.CrossRefPubMed
37.
go back to reference Hua J, Seto E, Li Y, Wang MC. Development and evaluation of a food environment survey in three urban environments of Kunming, China. BMC Public Health. 2014;14:235.CrossRefPubMedPubMedCentral Hua J, Seto E, Li Y, Wang MC. Development and evaluation of a food environment survey in three urban environments of Kunming, China. BMC Public Health. 2014;14:235.CrossRefPubMedPubMedCentral
38.
go back to reference Zhang X, van der Lans I, Dagevos H. Impacts of fast food and the food retail environment on overweight and obesity in China: a multilevel latent class cluster approach. Public Health Nutr. 2012;15(1):88–96.CrossRefPubMed Zhang X, van der Lans I, Dagevos H. Impacts of fast food and the food retail environment on overweight and obesity in China: a multilevel latent class cluster approach. Public Health Nutr. 2012;15(1):88–96.CrossRefPubMed
39.
go back to reference Xue H, Wu Y, Wang X, Wang Y. Time trends in fast food consumption and its association with obesity among children in China. PLoS One. 2016;11(3):e0151141.CrossRefPubMedPubMedCentral Xue H, Wu Y, Wang X, Wang Y. Time trends in fast food consumption and its association with obesity among children in China. PLoS One. 2016;11(3):e0151141.CrossRefPubMedPubMedCentral
40.
go back to reference Ji CY. Report on childhood obesity in China (1)--body mass index reference for screening overweight and obesity in Chinese school-age children. Biomed Environ Sci. 2005;18(6):390–400.PubMed Ji CY. Report on childhood obesity in China (1)--body mass index reference for screening overweight and obesity in Chinese school-age children. Biomed Environ Sci. 2005;18(6):390–400.PubMed
41.
go back to reference Meng LH, Mi J, Cheng H, Hou DQ, Zhao XY, Ding XY. Using waist circumference and waist-to-height ratio to access central obesity in children and adolescents. Chin J Evid Based Pediatr. 2008;3(5):324–32. Meng LH, Mi J, Cheng H, Hou DQ, Zhao XY, Ding XY. Using waist circumference and waist-to-height ratio to access central obesity in children and adolescents. Chin J Evid Based Pediatr. 2008;3(5):324–32.
42.
go back to reference Mi J, Wang TY, Meng LH, Zhu GJ, Han SM, Zhong Y, et al. Development of blood pressure reference standards for Chinese children and adolescents. Chin J Evid Based Pediatr. 2010;5(1):4–14. Mi J, Wang TY, Meng LH, Zhu GJ, Han SM, Zhong Y, et al. Development of blood pressure reference standards for Chinese children and adolescents. Chin J Evid Based Pediatr. 2010;5(1):4–14.
43.
go back to reference Xi B, Liang Y, Mi J. Hypertension trends in Chinese children in the national surveys, 1993 to 2009. Int J Cardiol. 2013;165(3):577–9.CrossRefPubMed Xi B, Liang Y, Mi J. Hypertension trends in Chinese children in the national surveys, 1993 to 2009. Int J Cardiol. 2013;165(3):577–9.CrossRefPubMed
44.
go back to reference Hsu YW, Johnson CA, Chou CP, Unger JB, Sun P, Xie B, et al. Correlates of overweight status in Chinese youth: an east-west paradox. Am J Health Behav. 2011;35(4):496–506.CrossRefPubMed Hsu YW, Johnson CA, Chou CP, Unger JB, Sun P, Xie B, et al. Correlates of overweight status in Chinese youth: an east-west paradox. Am J Health Behav. 2011;35(4):496–506.CrossRefPubMed
45.
go back to reference Adair LS, Popkin BM. Are child eating patterns being transformed globally? Obes Res. 2005;13(7):1281–99.CrossRefPubMed Adair LS, Popkin BM. Are child eating patterns being transformed globally? Obes Res. 2005;13(7):1281–99.CrossRefPubMed
Metadata
Title
Fast food consumption and its associations with obesity and hypertension among children: results from the baseline data of the Childhood Obesity Study in China Mega-cities
Authors
Yaling Zhao
Liang Wang
Hong Xue
Huijun Wang
Youfa Wang
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2017
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-017-4952-x

Other articles of this Issue 1/2017

BMC Public Health 1/2017 Go to the issue