title: The double burden of under- and overnutrition and nutrient adequacy among Chinese preschool and school-aged children in 2009-2011.
abstract: OBJECTIVE
  Coincident with economic development, China has experienced a marked transition from undernutrition to overweight/obesity over the last few decades. We aimed to explore the burden of under- and overnutrition and nutrient adequacy among 2-12-year-old Chinese children.
  
  
  METHODS
  We included anthropometry, dietary intake and biomarkers from 2-12-year-olds who participated in the 2009-2011 China Health and Nutrition Survey (n=1191 in 2009; n=1648 in 2011). Dietary intakes were compared with the 2013 Chinese Dietary Recommended Intakes.
  
  
  RESULTS
  In 2011, ~19% of 2-6-year-old children were underweight, 4% were stunted, 10% were overweight and 12% were obese. Among 7-12-year-old children, stunting was almost 0%, whereas ~21% were underweight, 13% were overweight and 6% were obese in 2011. Overweight and obesity were more prevalent among children from urban areas and higher income households. In particular, 2-6-year-old children from urban areas and higher income households experienced the highest increase in obesity from 2009 to 2011 (P<0.05). Children from urban areas and higher income households had overall higher intakes of total daily energy and most macro- and micronutrients (P<0.05). However, a significant proportion of children did not meet the recommendations for important micronutrients.
  
  
  CONCLUSIONS
  Underweight and stunting currently coexist with overweight and obesity among Chinese children <12-year-old. We found critical disparities in the prevalence of under- and overweight/obesity, as well as in nutrient intakes and dietary adequacies between children from different incomes, revealing that the burden of childhood under- and overnutrition may constitute a public health concern in modern China.
authors.affiliation: Department of Nutrition, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Carolina Population Center, UNC, Chapel Hill, NC, USA.
authors.forename: C
authors.initials: C
authors.lastname: Piernas
authors.affiliation: Nestlé Research Center, Lausanne, Switzerland.
authors.forename: D
authors.initials: D
authors.lastname: Wang
authors.affiliation: Department of Nutrition, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Carolina Population Center, UNC, Chapel Hill, NC, USA.
authors.forename: S
authors.initials: S
authors.lastname: Du
authors.affiliation: National Institute for Nutrition and Health, China Center for Disease Control, Beijing, China.
authors.forename: B
authors.initials: B
authors.lastname: Zhang
authors.affiliation: Department of Nutrition, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Carolina Population Center, UNC, Chapel Hill, NC, USA.|National Institute for Nutrition and Health, China Center for Disease Control, Beijing, China.
authors.forename: Z
authors.initials: Z
authors.lastname: Wang
authors.affiliation: National Institute for Nutrition and Health, China Center for Disease Control, Beijing, China.
authors.forename: C
authors.initials: C
authors.lastname: Su
authors.affiliation: Department of Nutrition, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Carolina Population Center, UNC, Chapel Hill, NC, USA.
authors.forename: B M
authors.initials: BM
authors.lastname: Popkin
mesh_terms: D044466:Asian People; D002648:Child; D002675:Child, Preschool; D002681:China / Q000453:epidemiology; D003430:Cross-Sectional Studies; D002149:Energy Intake; D005191:Family Characteristics; D005260:Female; D006130:Growth Disorders / Q000453:epidemiology* / Q000209:etiology; D006801:Humans; D008297:Male; D044342:Malnutrition / Q000150:complications / Q000453:epidemiology*; D018977:Micronutrients / Q000008:administration & dosage / Q000032:analysis; D015596:Nutrition Assessment; D009749:Nutrition Surveys; D009752:Nutritional Status; D044343:Overnutrition / Q000150:complications / Q000453:epidemiology*; D050177:Overweight / Q000453:epidemiology* / Q000209:etiology; D063766:Pediatric Obesity / Q000453:epidemiology* / Q000209:etiology; D015995:Prevalence; D012424:Rural Population; D012959:Socioeconomic Factors; D013851:Thinness / Q000453:epidemiology / Q000209:etiology; D014505:Urban Population
chemical_list: D018977:Micronutrients