Evaluation of the growth and nutritional status of preschool children: a pilot study in the cold area of China
-
Nan Wang
Abstract
Objectives
The growth and development of children is influenced not only by heredity factors but also by environmental factors, including nutrition and temperature. The aim of this study was to evaluate the growth and nutritional status of preschool children in Daxing’anling, the coldest region of China.
Methods
A descriptive, cross-sectional survey was performed among preschool children aged 3–6 years by stratified cluster sampling in Daxing’anling. The children’s parents completed the questionnaires. Height, body weight and head circumference were measured, and Z scores for weight for height, weight for age, height for age and head circumference for age were evaluated. Anthropometric data were compared with World Health Organization standards and China’s growth references. The levels of vitamin A, E and 25-(OH)-D3 in serum were detected by high-performance liquid chromatography.
Results
A total of 305 children were recruited. The average height of the preschool children was lower than China’s growth reference but higher than the WHO standard. More than half of the preschool children ranged from −1 SD to +1 SD. Both the values of weight for height and of weight for age were positive and higher than the WHO standards (p<0.01), with a significant difference between boys and girls (p<0.01). The incidences of stunting, wasting, and underweight were 4.59%, 2.95%, and 2.30%, respectively, although the prevalence of overweight and obesity was high (18.03% and 6.89%, respectively). The rates of vitamin A and D deficiency were 7.54% and 88.85%, respectively. Vitamin A was also positively associated with 25-(OH)-D3.
Conclusions
The burden of malnutrition in preschool children exists in cold regions, and a cold climate may be an important factor. Therefore, we should pay attention to the nutrition and physical growth of local preschool children; in particular, vitamin D deficiency should be given high priority, and necessary nutritional interventions should be made.
-
Research funding: This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
-
Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission. X.C. and Y.Z. designed the study. N.W. and X.C. were the main investigators of the research. N.W., M.Y.S., and L.Y.M. performed the statistical analysis. Y.C., X.Z.D., and Y.Z. drafted and revised the manuscript.
-
Competing interests: The authors declare no conflicts of interest.
-
Informed consent: Written informed consent was obtained from the children’s parents/guardians.
-
Ethical approval: This study was conducted according to the guidelines of the Declaration of Helsinki, and all procedures involving human subjects were approved by the Harbin Medical University Ethics Committee.
References
1. Black, RE, Allen, LH, Bhutta, ZA, Caulfield, LE, de Onis, M, Ezzati, M, et al.. Maternal and child undernutrition: global and regional exposures and health consequences. Lancet 2008;371:243–60, https://doi.org/10.1016/s0140-6736(07)61690-0.Search in Google Scholar
2. Black, RE, Victora, CG, Walker, SP, Bhutta, ZA, Christian, P, de Onis, M, et al.. Maternal and child undernutrition and overweight in low-income and middle-income countries. Lancet 2013;382:427–51, https://doi.org/10.1016/s0140-6736(13)60937-x.Search in Google Scholar
3. Bhutta, ZA, Das, JK, Rizvi, A, Gaffey, MF, Walker, N, Horton, S, et al.. Evidence-based interventions for improvement of maternal and child nutrition: what can be done and at what cost? Lancet 2013;382:452–77, https://doi.org/10.1016/s0140-6736(13)60996-4.Search in Google Scholar
4. Sen, P, Bharati, S, Som, S, Pal, M, Bharati, P. Growth and nutritional status of preschool children in India: a study of two recent time periods. Food Nutr Bull 2011;32:84–93, https://doi.org/10.1177/156482651103200202.Search in Google Scholar PubMed
5. Lumeng, JC, Kaciroti, N, Frisvold, DE. Changes in body mass index z score over the course of the academic year among children attending head start. Acad Pediatr 2010;10:179–86, https://doi.org/10.1016/j.acap.2010.01.008.Search in Google Scholar PubMed PubMed Central
6. Gubbels, JS1, Kremers, SP, Goldbohm, RA, Stafleu, A, Thijs, C. Energy balance-related behavioural patterns in 5-year-old children and the longitudinal association with weight status development in early childhood. Publ Health Nutr 2012;15:1402–10, https://doi.org/10.1017/s1368980011003089.Search in Google Scholar
7. Corvalán, C, Uauy, R, Mericq, V. Obesity is positively associated with dehydroepiandrosterone sulfate concentrations at 7 y in Chilean children of normal birth weight. Am J Clin Nutr 2013;97:318–25, https://doi.org/10.3945/ajcn.112.037325.Search in Google Scholar PubMed PubMed Central
8. Coordinating Study Group of Nine Cities on Physical Growth and Development of Children, Capital Institute of Pediatrics. A national survey on growth of children under 7 years of age in nine cities of China, 2005. Zhonghua Er Ke Za Zhi 2007;45:609–14.Search in Google Scholar
9. Yang, Z, Duan, Y, Ma, G, Yang, X, Yin, S. Comparison of the China growth charts with the WHO growth standards in assessing malnutrition of children. BMJ Open 2015;5:e006107, https://doi.org/10.1136/bmjopen-2014-006107.Search in Google Scholar PubMed PubMed Central
10. De Onis, M, Blössner, M, Borghi, E. Global prevalence and trends of overweight and obesity among preschool children. Am J Clin Nutr 2010;92:1257–64, https://doi.org/10.3945/ajcn.2010.29786.Search in Google Scholar PubMed
11. Jiang, XX, Hardy, LL, Baur, LA, Ding, D, Wang, L, Shi, HJ. High prevalence of overweight and obesity among inner city Chinese children in Shanghai, 2011. Ann Hum Biol 2014;41:469–72, https://doi.org/10.3109/03014460.2014.910270.Search in Google Scholar PubMed
12. Ji, CY, Cheng, TO. Epidemic increase in overweight and obesity in Chinese children from 1985 to 2005. Int J Cardiol 2009;132:1–10, https://doi.org/10.1016/j.ijcard.2008.07.003.Search in Google Scholar PubMed
13. Zong, XN, Li, H. Secular trends in prevalence and risk factors of obesity in infants and preschool children in 9 Chinese cities, 1986-2006. PLoS One 2012;7:e46942, https://doi.org/10.1371/journal.pone.0046942.Search in Google Scholar PubMed PubMed Central
14. Song, Y, Ma, J, Wang, HJ, Wang, Z, Hu, P, Zhang, B, et al.. Secular trends of obesity prevalence in Chinese children from 1985 to 2010: urban-rural disparity. Obesity 2015;23:448–53, https://doi.org/10.1002/oby.20938.Search in Google Scholar PubMed
15. National Health and Family Planning Commission of the People’s Republic of China. The situation of Chinese residents’ nutrition and chronic disease in 2015. Beijing, China: People’s Medical Publishing House Press; 2015.Search in Google Scholar
16. Xu, Z, Etzel, RA, Su, H, Huang, C, Guo, Y, Tong, S. Impact of ambient temperature on children’s health: a systematic review. Environ Res 2012;117:120–31, https://doi.org/10.1016/j.envres.2012.07.002.Search in Google Scholar PubMed
17. Rasi, H, Kuivila, H, Pölkki, T, Bloigu, R, Rintamäki, H, Tourula, M. A descriptive quantitative study of 7-and 8-year-old children’s outdoor recreation, cold exposure and symptoms in winter in Northern Finland. Int J Circumpolar Health 2017;76:1298883, https://doi.org/10.1080/22423982.2017.1298883.Search in Google Scholar PubMed PubMed Central
18. Frank, DA, Roos, N, Meyers, A, Napoleone, M, Peterson, K, Cather, A, et al.. Seasonal variation in weight-for-age in a pediatric emergency room. Publ Health Rep 1996;111:366–71.Search in Google Scholar
19. World Medical Association. World medical association declaration of Helsinki: ethical principles for medical research involving human subjects. JAMA 2013;310:2191–4.10.1001/jama.2013.281053Search in Google Scholar PubMed
20. World Health Organization. Child growth standards. Geneva: WHO; 2006.Search in Google Scholar
21. Crookston, BT, Schott, W, Cueto, S, Dearden, KA, Engle, P, Georgiadis, A, et al.. Postinfancy growth, schooling, and cognitive achievement: young lives. Am J Clin Nutr 2013;98:1555–63, https://doi.org/10.3945/ajcn.113.067561.Search in Google Scholar PubMed PubMed Central
22. Holick, MF, Binkley, NC, Bischoff-Ferrari, HA, Gordon, CM, Hanley, DA, Heaney, RP, et al.. Evaluation, treatment, and prevention of vitamin D deficiency: an endocrine society clinical practice guideline. J Clin Endocrinol Metab 2011;96:1911–30, https://doi.org/10.1210/jc.2011-0385.Search in Google Scholar PubMed
23. Pramyothin, P, Holick, MF. Vitamin D supplementation: guidelines and evidence for subclinical deficiency. Curr Opin Gastroenterol 2012;28:139–50, https://doi.org/10.1097/mog.0b013e32835004dc.Search in Google Scholar
24. Holick, MF, Binkley, NC, Bischoff-Ferrari, HA, Gordon, CM, Hanley, DA, Heaney, RP, et al.. Guideliness for preventing and treating vitamin D deficiency and insufficiency revisited. J Clin Endocrinol Metab 2012;97:1153–8, https://doi.org/10.1210/jc.2011-2601.Search in Google Scholar PubMed
25. Holick, MF. Vitamin D deficiency. N Engl J Med 2007;357:266–81, https://doi.org/10.1056/nejmra070553.Search in Google Scholar
26. Hawamdeh, ZM, Ibrahim, AI. Physical growth and nutritional status of Jordanian preschool-aged children. Minerva Pediatr 2008;60:1375–83.Search in Google Scholar
27. Ferreira, AA, Welch, JR, Santos, RV, Gugelmin, SA, Coimbra, CEJr. Nutritional status and growth of indigenous Xavante children, Central Brazil. Nutr J 2012;11:3, https://doi.org/10.1186/1475-2891-11-3.Search in Google Scholar PubMed PubMed Central
28. Li, XQ, Zhang, WS, Liu, Y, Wu, GF, Yan, XF, Mao, XM. Growth status of children under 7 years in Wuzhong city, Ningxia Hui autonomous region, China and its influential factors. Zhong Guo Dang Dai Er Ke Za Zhi 2013;15:289–93.Search in Google Scholar
29. Chen, J, Chen, W, Zeng, G, Li, G. Secular trends in growth and nutritional outcomes of children under five years old in Xiamen, China. Int J Environ Res Publ Health 2016;13:1104, https://doi.org/10.3390/ijerph13111104.Search in Google Scholar PubMed PubMed Central
30. Nazri, C, Yamazaki, C, Kameo, S, Herawati, DMD, Sekarwana, N, Raksanagara, A, et al.. Factors influencing mother’s participation in posyandu for improving nutritional status of children under-five in Aceh Utara district, Aceh province, Indonesia. BMC Publ Health 2016;16:69, https://doi.org/10.1186/s12889-016-2732-7.Search in Google Scholar PubMed PubMed Central
31. Menezes, RC, Lira, PI, Oliveira, JS, Leal, VS, Santana, SC, Andrade, SL, et al.. Prevalence and determinants of overweight in preschool children. J Pediatr 2011;87:231–7, https://doi.org/10.2223/jped.2092.Search in Google Scholar PubMed
32. Gebremedhin, S. Prevalence and differentials of overweight and obesity in preschool children in Sub-Saharan Africa. BMJ Open 2015;5:e009005, https://doi.org/10.1136/bmjopen-2015-009005.Search in Google Scholar PubMed PubMed Central
33. Xiao, Y, Qiao, Y, Pan, L, Liu, J, Zhang, T, Li, N, et al.. Trends in the prevalence of overweight and obesity among Chinese preschool children from 2006 to 2014. PLoS One 2015;10:e0134466, https://doi.org/10.1371/journal.pone.0134466.Search in Google Scholar PubMed PubMed Central
34. De Coen, V, De Bourdeaudhuij, I, Verbestel, V, Maes, L, Vereecken, C. Risk factors for childhood overweight: a 30-month longitudinal study of 3 to 6-year-old children. Publ Health Nutr 2014;17:1993–2000, https://doi.org/10.1017/s1368980013002346.Search in Google Scholar
35. Chen, K, Zhang, X, Li, TY, Chen, L, Qu, P, Liu, YX. Coassessment of iron, vitamin A and growth status to investigate anaemia in preschool children in suburb Chongqing, China. World J Pediatr 2009;5:275–81, https://doi.org/10.1007/s12519-009-0052-z.Search in Google Scholar PubMed
36. Zhu, Z, Zhan, J, Shao, J, Chen, W, Chen, L, Li, W, et al.. High prevalence of vitamin D deficiency among children aged 1 month to 16 years in Hangzhou, China. BMC Publ Health 2012;12:126, https://doi.org/10.1186/1471-2458-12-126.Search in Google Scholar PubMed PubMed Central
37. Avagyan, D, Neupane, SP, Gundersen, TE, Madar, AA. Vitamin D status in preschool children in rural Nepal. Publ Health Nutr 2016;19:470–6, https://doi.org/10.1017/s136898001500083x.Search in Google Scholar
© 2022 Walter de Gruyter GmbH, Berlin/Boston
Articles in the same Issue
- Frontmatter
- Review Article
- Effects of vitamin D supplementation on glycemic control of children and adolescents with type 1 diabetes mellitus: a systematic review
- Original Articles
- A preliminary study on the relationship between environmental endocrine disruptors and precocious puberty in girls
- Tissue concentration of aldosterone in fetal adrenals of intrauterine death cases
- Complications of orthopedic treatment in patients diagnosed with X-linked hypophosphatemic rickets
- Comparison of insulin sensitivity indices for detection of double diabetes in Indian adolescents with type 1 diabetes
- Evaluation of the growth and nutritional status of preschool children: a pilot study in the cold area of China
- Arterial hypertension is associated with an increased risk of metabolic complications in pediatric patient with obesity
- From pregnancy to breastfeeding: adequate maternal body mass index is essential to prevent a high body mass index in your children
- Screening of non-syndromic early-onset child and adolescent obese patients in terms of LEP, LEPR, MC4R and POMC gene variants by next-generation sequencing
- The association between vitamin B12, folate, homocysteine levels, and carotid intima-media thickness in children with obesity: a cross-sectional study
- Comprehensive assessment of cardiovascular disease risk in children with short stature due to isolated growth hormone deficiency: a case-control study
- Visceral adiposity is related to insulin sensitivity and inflammation in adolescents with obesity and mild sleep disordered breathing
- Recurrent hypoglycemic seizure as a presenting symptom of post-TBI hypopituitarism in children: a case report, review and proposed protocol
- Evaluation of the etiological and clinical characteristics of pediatric central diabetes insipidus
- Case Reports
- Clinical and radiologic evaluation of a Turkish family with hypochondroplasia and a rare FGFR3 variant
- Rituximab therapy in ROHHAD(NET) syndrome
- Ectopic parathyroid hormone as a rare aetiology of hypercalcemia with rhabdomyosarcoma: a new treatment strategy with zoledronic acid and Denosumab
- A 2-bp deletion mutation in SMPD1 gene leading to lysosomal acid sphingomyelinase deficiency in a Chinese consanguineous pedigree
Articles in the same Issue
- Frontmatter
- Review Article
- Effects of vitamin D supplementation on glycemic control of children and adolescents with type 1 diabetes mellitus: a systematic review
- Original Articles
- A preliminary study on the relationship between environmental endocrine disruptors and precocious puberty in girls
- Tissue concentration of aldosterone in fetal adrenals of intrauterine death cases
- Complications of orthopedic treatment in patients diagnosed with X-linked hypophosphatemic rickets
- Comparison of insulin sensitivity indices for detection of double diabetes in Indian adolescents with type 1 diabetes
- Evaluation of the growth and nutritional status of preschool children: a pilot study in the cold area of China
- Arterial hypertension is associated with an increased risk of metabolic complications in pediatric patient with obesity
- From pregnancy to breastfeeding: adequate maternal body mass index is essential to prevent a high body mass index in your children
- Screening of non-syndromic early-onset child and adolescent obese patients in terms of LEP, LEPR, MC4R and POMC gene variants by next-generation sequencing
- The association between vitamin B12, folate, homocysteine levels, and carotid intima-media thickness in children with obesity: a cross-sectional study
- Comprehensive assessment of cardiovascular disease risk in children with short stature due to isolated growth hormone deficiency: a case-control study
- Visceral adiposity is related to insulin sensitivity and inflammation in adolescents with obesity and mild sleep disordered breathing
- Recurrent hypoglycemic seizure as a presenting symptom of post-TBI hypopituitarism in children: a case report, review and proposed protocol
- Evaluation of the etiological and clinical characteristics of pediatric central diabetes insipidus
- Case Reports
- Clinical and radiologic evaluation of a Turkish family with hypochondroplasia and a rare FGFR3 variant
- Rituximab therapy in ROHHAD(NET) syndrome
- Ectopic parathyroid hormone as a rare aetiology of hypercalcemia with rhabdomyosarcoma: a new treatment strategy with zoledronic acid and Denosumab
- A 2-bp deletion mutation in SMPD1 gene leading to lysosomal acid sphingomyelinase deficiency in a Chinese consanguineous pedigree
