To investigate associations between fruit consumption and lipid profiles, and to further explore a satisfactory level of frequency and daily fruit intake for children and adolescents. A national sample of 14,755 children and adolescents aged 5–19 years from seven provinces in China were recruited. Fasting blood samples were collected to test the lipid profile. Information regarding fruit consumption and other characteristics was collected by questionnaires. Logistic regression models adjusting for confounding covariates were applied to calculate the odds ratio (OR) and 95% confidence interval (95% CI). Participants who consumed fruits for 6–7 days per week had lower risks of high triglycerides (OR: 0.66, 95% CI: 0.58–0.75), dyslipidemia (OR: 0.77, 95% CI: 0.68–0.86), and hyperlipidemia (OR: 0.72, 95% CI: 0.63–0.81), compared to fruit consumption of 0–2 days per week. Risks of high triglycerides, dyslipidemia and hyperlipidemia of those who consumed fruits for 0.75–1.5 servings each day also decreased, compared to the insufficient fruit intake. The combined effects of high frequency and moderate daily intake of fruit on lipid disorders did not change essentially. The associations were more evident in girls, younger children and those whose families had higher educational levels. Moderate fruit consumption was associated with lower odds of lipid disorders, predominantly in girls, younger participants, and those came from higher-educated families. These findings supported the health effect of moderate fruit intake frequently to improve the childhood lipid profiles.

To investigate the associations between body fat percentage (BF%) with childhood blood pressure (BP) levels and elevated BP (EBP) risks, and further examine the validity of bioelectrical impedance analysis (BIA), we conducted a cross-sectional study of 1426 children and adolescents aged 7–17 years in Beijing, 2020. EBP, including elevated systolic BP (ESBP) and elevated diastolic BP (EDBP), was defined based on the age- and sex-specific 90th BP reference values of children and adolescents in China. BF% was measured by dual-energy X-ray absorptiometry (DEXA) and BIA devices, and was divided into four quartiles. Log-binomial models were applied to calculate odds ratios (ORs) and 95% confidence intervals (95%CI). Girls tended to have higher BF% levels than boys (p < 0.05). There was 41.0% of girls who developed EBP. High BF% was associated with increased BP levels with ORs of 0.364 (95%CI = 0.283–0.444) for SBP, 0.112 (95%CI = 0.059–0.165) for DBP, and 1.043 (95%CI = 1.027–1.059) for EBP, while the effects were more pronounced in girls and older-aged children. BIA devices agreed well with BF% assessment obtained by DEXA. High BF% might have negative effects on childhood BP. Convenient measurements of body fat might help to assess childhood obesity and potential risks of hypertension.

To investigate the relationship between breastfeeding duration and lipid profile among children and adolescents, a cross-sectional survey using random cluster sampling was performed, and a national sample of 12,110 Chinese children and adolescents aged 5–19 years were collected. Breastfeeding duration and sociodemographic factors were collected by questionnaires. Fasting blood samples were obtained to test the lipid profile. Linear regression and logistic regression models were employed to evaluate the association between breastfeeding duration and lipid profile. We found that prolonged breastfeeding was related with a low level of total cholesterol (TC), LDL-C, HDL-C, and TC/HDL-C in children and adolescents. With an increased duration of breastfeeding, the magnitude of the association between breastfeeding and lipid profile enlarged. The levels of TC, LDL-C, HDL-C, and TC/HDL-C in participants who were breastfed for more than 12 months decreased by 6.225 (95% CI: −8.390, −4.059), 1.956 (95% CI: −3.709, −0.204), 1.273 (95% CI: −2.106, −0.440) mg/dL, and 0.072 (95%CI: −0.129, −0.015), respectively, compared with those who were not breastfed. The corresponding risk of high TC declined by 43% (aOR: 0.570, 95% CI: 0.403, 0.808). The association was similar in both boys and girls, but only statistically significant in children and young adolescents aged 5–14 years. This suggested that prolonged breastfeeding duration was related with low lipid levels and decreased abnormal lipid risk, especially in children and young adolescents. These findings support the intervention of prompting a prolonged duration of breastfeeding to improve the childhood lipid profile.

This study was aimed to investigate the associations between breastfeeding duration and blood pressure (BP) levels, BP Z scores and high BP (HBP) in children and adolescents. A total of 57,201 participants including 29,491 boys and 27,710 girls aged 7–18 years were recruited from seven provinces in China in 2012. HBP was defined as BP levels of ≥95th percentiles of the referent age-, sex-, and height-specific population. Breastfeeding duration was divided into non-breastfeeding, 0–5 months, 6–12 months, and >12 months. Information on demographic, parental or family factors and dietary behaviors was collected through a self-administered questionnaire. Multivariable linear regression and logistic regression models were applied to assess the relationships of breastfeeding duration with BP levels and BP Z scores and with HBP, respectively. Stratified analyses were performed to further investigate the potential subgroup-specific associations. The reported prolonged breastfeeding (>12 months) rate was 22.53% in the total population. After full adjustment, compared to the non-breastfeeding group, breastfeeding for 6–12 months was correlated with 0.43 (95% CI: −0.75, −0.11) and 0.36 (95% CI: −0.61, −0.12) mmHg lower levels of SBP and DBP, respectively. Similar decrease trends were found for BP Z scores. Prolonged breastfeeding (>12 months) was associated with 1.33 (95% CI: 1.12, 1.58) and 1.12 (95% CI: 0.94, 1.33) higher odds of HBP in boys and girls, respectively. Based on nationally representative data, there was no evidence that a longer duration of breastfeeding is protective against childhood HBP. Breastfeeding for 6–12 months may be beneficial to BP, while prolonged breastfeeding durations might increase the odds of HBP in children and adolescents.

Limited evidence exists on the influence of dietary behaviors on the association of overweight/obesity between parents and offspring. This study aimed to investigate the influence of dietary behaviors on the association of overweight/obesity between two generations, and puts forward strategies for preventing childhood obesity. Data were obtained from a cross-sectional survey conducted in China; a total of 40,197 parent-offspring pairs were included. Overweight/obesity was defined based on the body mass index and waist circumstance; the association of overweight/obesity between two generations was evaluated by multivariate and binary logistic regression and stratified analyses. Compared with the offspring who were free of parental overweight/obesity, the ORs of offspring with both parental overweight/obesity reached 2.66, 1.72 and 4.04 for general, simple abdominal and compound obesity. The offset effect of dietary behaviors was observed on the association between parental obesity and the offspring’s general or simple abdominal obesity, with non-significant ORs when parents or/and offspring had healthy dietary behaviors. It was difficult for a healthy diet alone to offset the high heritability and intergenerational transmission of childhood obesity caused by parental obesity. Multifaceted improvement of lifestyle behaviors, and a combination of individual and family engagement, could be targeted measures to control childhood obesity.

Objective: To evaluate the associations between single-child status and metabolic syndrome (MS) and to identify the highest risk group of MS among single children.Methods: Differences in participants' characteristics by sex were examined by Student's t-test for continuous variables and Pearson's chi-squared test for categorical variables. Multivariate logistic regression analysis was performed to estimate the odds ratios (OR) and 95% confidence intervals (CI) for MS and its components according to the single-child status. Radar maps were used to compare the composition of different components in MS.Results: In total, 11,784 (5,880 boys) children and adolescents were included in this study, with a mean age of (11.3 ± 3.1) years. MS was observed in 7.1% of participants, with a higher prevalence in boys (8.2%) than girls (5.9%) (P < 0.05). The prevalence of MS, elevated blood pressure and abdominal obesity in single children were higher than that in children with siblings, particularly in boys (P < 0.001). Elevated risk of abdominal obesity was observed in single children [boys (1.56, 95% CI: 1.31, 1.85), girls (1.40, 95% CI: 1.19, 1.63)], however, increased ORs of elevated blood pressure and metabolic syndrome were observed in single-child boys only (1.19, 95% CI: 1.01, 1.40 and 1.76, 95% CI: 1.34, 2.31, respectively). Results showed that a statistically significant association between single child status and MS was mainly observed in urban boys (2.04, 95% CI: 1.33, 3.12) and rural boys (1.50, 95% CI: 1.05, 2.15), but not in girls. Among all the combinations of MS, two combinations were significantly associated with the single-child status, including the combination of elevated blood pressure, abdominal and low HDL-C (1.45, 1.04, 2.04) and the combination of elevated blood pressure, abdominal obesity, low HDL-C and hypertriglyceridemia (2.04, 1.40, 3.06) (P < 0.05).Conclusions: The present study found that single children and adolescents had a higher risk of MS, elevated blood pressure and abdominal obesity. The associations were stronger in urban boys. Further attention should be directed to the prevention and control strategies targeting the high-risk population of MS.