title: Time Trends in Fast Food Consumption and Its Association with Obesity among Children in China.
abstract: OBJECTIVE
  Study the trends in Western fast food consumption (FFC) among Chinese school-age children and the association between FFC and obesity using nationwide survey data.
  
  
  METHODS
  Cross-sectional and longitudinal analyses were conducted to study the trends in FFC and the associations between FFC and weight status (overweight, obesity and body mass index (BMI) z-score).
  
  
  METHODS
  Longitudinal data from families were collected in the 2004 and 2009 China Health and Nutrition Survey (covering nine provinces throughout China).
  
  
  METHODS
  The analysis included 2656 Chinese children aged 6 to 18 years (1542 and 1114 children in the 2004 and 2009 survey, respectively).
  
  
  RESULTS
  FFC (reported having consumed Western fast food in the past three months) has increased between 2004 and 2009, from 18.5% to 23.9% in those aged 6-18, and increased more rapidly among those aged 13-17, from 17.9% to 26.3%. The increase was significant in almost all groups by age, sex, family income, and residence. Our cross-sectional and longitudinal analyses did not detect a significant association between FFC and obesity/overweight or BMI z-score (e.g., for BMI z-score, boys: β = 0.02, 95% CI: -0.71, 0.75; girls: β = -0.14, 95% CI: -1.03, 0.75).
  
  
  CONCLUSIONS
  FFC has increased in Chinese school-age children, especially in older children, boys, and those from low- and medium-income families, rural areas, and East China, but decreased among those from high-income families during 2004-2009. The data did not show a significant association between FFC and obesity.
authors.affiliation: Systems-oriented Global Childhood Obesity Intervention Program, Department of Epidemiology and Environmental Health, University at Buffalo, State University of New York, Buffalo, New York, United States of America.
authors.forename: Hong
authors.initials: H
authors.lastname: Xue
authors.affiliation: Department of Health, Behavior and Society, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, United States of America.
authors.forename: Yang
authors.initials: Y
authors.lastname: Wu
authors.affiliation: Department of Health Policy and Management, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, United States of America.
authors.forename: Xiaoyu
authors.initials: X
authors.lastname: Wang
authors.affiliation: Systems-oriented Global Childhood Obesity Intervention Program, Department of Epidemiology and Environmental Health, University at Buffalo, State University of New York, Buffalo, New York, United States of America.|Department of Health, Behavior and Society, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, United States of America.
authors.forename: Youfa
authors.initials: Y
authors.lastname: Wang
mesh_terms: D000293:Adolescent; D000367:Age Factors; D002648:Child; D002681:China / Q000453:epidemiology; D003430:Cross-Sectional Studies; D057140:Fast Foods / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D009765:Obesity / Q000209:etiology*; D012737:Sex Factors