title: Disparities in economic development in Eastern China: impact on nutritional status of adolescents.
abstract: OBJECTIVE
  To compare the effects of disparities in economic development in urban and rural Eastern China on the nutritional status of adolescents.
  
  
  METHODS
  A cross-sectional survey consisting of self-completion questionnaires, anthropometry and haemoglobin measurement.
  
  
  METHODS
  Twelve middle schools in an urban and a rural area of Zhejiang Province: Hangzhou, the capital, and Chunan, a poor mountainous area.
  
  
  METHODS
  Some 4835 young adolescents (predominant age range 13-16 years).
  
  
  RESULTS
  The mean body mass index (BMI) was significantly higher in urban Hangzhou (P = 0.01) Overweight affected 3.6% overall; adjusted odds ratios (ORs) showed male sex (OR 2.1, 95% confidence interval (CI) 1.1-3.4) and urban residence (OR 9.1, 95% CI 3.7-22) to be the most important risk factors. The prevalence of underweight was 18%, with no significant urban-rural difference. Predictors of underweight were male sex (OR 1.5, 95% CI 1.1-2.0) and low household income (OR, 1.3, 95% CI 1.1-1.5). Mean haemoglobin was significantly lower in the rural area. Anaemia was more common in girls, 51% compared with 21% of the boys, but rural residence was not an independent risk factor. Rural students exercised more and had a less varied diet than their urban counterparts. Around one-third of the respondents consumed dietary supplements on a regular basis.
  
  
  CONCLUSIONS
  These results suggest that in urban areas of Eastern China a dual picture is emerging with the problems of excess (overweight and obesity) coexisting with underweight and anaemia. In rural areas the problems of relative nutritional deprivation predominate, but the long-term consequences of such marginal underweight and anaemia are not clear.
authors.affiliation: Centre for International Child Health, Institute of Child Health, University College London, UK. hesketh@mail.hz.zj.cn
authors.forename: Therese
authors.initials: T
authors.lastname: Hesketh
authors.forename: Qu Jian
authors.initials: QJ
authors.lastname: Ding
authors.forename: Andrew M
authors.initials: AM
authors.lastname: Tomkins
mesh_terms: D000293:Adolescent; D017195:Adolescent Nutritional Physiological Phenomena; D000740:Anemia / Q000097:blood / Q000453:epidemiology; D000886:Anthropometry; D015992:Body Mass Index; D002681:China; D003430:Cross-Sectional Studies; D015444:Exercise / Q000502:physiology; D005247:Feeding Behavior; D005260:Female; D006454:Hemoglobins / Q000032:analysis*; D006801:Humans; D008297:Male; D009748:Nutrition Disorders / Q000453:epidemiology*; D009752:Nutritional Status; D016017:Odds Ratio; D015995:Prevalence; D012424:Rural Population; D012737:Sex Factors; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D014505:Urban Population
chemical_list: D006454:Hemoglobins