What Dietary Patterns Contribute to Obesity in Children and Adolescents Aged 3-17 years in China: A Systematic Review

Abstract

Background: China witnessed a dramatic growth in the prevalence of obesity in children due to a shift in dietary behavior during the last two decades. The aim is to systematically review the evidence among the eligible primary studies in which the relationship between dietary patterns and risk of obesity/overweight in children and/or adolescents aged 3-17 years in China was assessed. \n \nMethods: Bibliographic databases such as Medline, Embase, were searched. The quality of included studies was assessed using the Joanna Briggs Institute (JBI) Critical Appraisal Checklist for cross-sectional studies and the Newcastle-Ottawa Scale (NOS) for retrospective cohort studies. The adjusted ORs compared the highest quartile with the lowest quartile of Chinese traditional dietary pattern and western pattern were pooled in forest plots to visualize results. \n \nFindings: Among 7 studies included for final analysis, four indicate that greater adherence to a western dietary pattern were significantly positively associated with obesity in children/adolescents aged 3-17 years in China after adjustment of confounding factors. The magnitude of effect varied from study to study: the odds ratios and 95%CIs ranged from (Q4 vs Q1) OR=1.49, 95% CI: 1.21,1.84 to (Q4 vs Q1) OR = 3.10, 95% CI:1.52, 6.32. This positive association is demonstrated in the animal foods, fats, and condiments dominated pattern in a borderline trend (Q4 vs Q1) OR=5.88, 95% CI 1.39, 24.80). One study suggested that greater adherence to the Chinese traditional dietary pattern was significantly associated with a lower risk of obesity (Q4 vs Q1) OR = 0.19, 95%CI: 0.09, 0.40. \n \nInterpretation: This systematic review demonstrates western dietary patterns characterized by high fat, energy-dense, low dietary fiber, had a potential higher risk in obesity in children and adolescents aged 3-17 years in China. Fruits and vegetables dominated dietary patterns were less likely to cause obesity in children and adolescents aged 3-17 years. \n \nFunding: None to declare. \n \nDeclaration of Interest: None to declare.