Intervention for Childhood Obesity in Beijing, China

Abstract: Childhood obesity appears to be increasing throughout the world. China has joined the global epidemic. Childhood obesity is not only a chronic disease which is associated with lifestyle, but also a public health problem in children. Obesity intervention should become a public health priority in China. This thesis reports on intervention to treat and prevent childhood obesity. The field work was implemented in Beijing, China. This thesis is based on four papers: Paper I evaluated the feasibility and impact of family-based behavior treatment on obese children. Two years of intervention resulted in obese children with improvements in body mass index, total cholesterol, triglycerides, and blood pressure. Paper II assessed the effects of a school-based intervention on obesity among primary school children. After a three-year intervention, the prevalence of overweight and obesity were significantly lower in the intervention schools than in the control schools. Fewer non-obese children became obese in the intervention schools than in the control schools. Paper III explored the family related factors of overweight in 2- to 6-year-old children. Significant associations were observed between children’s overweight and parent characteristics for frequency of eating in restaurants, daily time spent viewing television, and engaging in physical activity. Child overweight was associated with parental overweight, low maternal education level and television watching >2h/d. Paper IV investigated how grandparents influence their young grandchildren’s eating behaviors in Chinese three-generation families, using qualitative method. Three domains identified through the seven themes included: (1) Grandparents as primary caretakers of children in the three-generation family, (2) Grandparents' attitudes to child nutrition and healthy eating habits, and (3) The role of food as an educational and emotional tool. The results showed that nutrition education involving grandparents is thus a potential framework for improving healthy dietary behaviors in young children.