There is growing concern over the double burden of over- and under-nutrition in individuals, especially in children and adolescents, which could dwarf their growth and development. This study aims to explore the rural-urban difference in BMI and anemia among children and adolescents. A stratified cluster sampling technique was employed. Dietary data were collected through interviews, and anthropometric values were measured. There were 1534 children and adolescents who participated in this study, including 775 male and 759 female participants. The prevalence of obesity among children living in a city, township and rural area was 10.3%, 8.5% and 5.5%, and that among adolescents was 1.4%, 2.9% and 2.8%. The prevalence of anemia among children and living in a city, township and rural area was 4.3%, 2.5% and 4.5%, while that among adolescents was 6.1%, 3.7% and 11.3%, respectively, with significant difference (χ² = 10.824, p = 0.004). The prevalence of being overweight, obesity and anemia was significant when comparing children with adolescents (χ² = 37.861, p = 0.000; χ² = 19.832, p = 0.000; χ² = 8.611, p = 0.003). Findings of this study indicate the double burden of malnutrition in Zhejiang province, characterized by a high prevalence of being overweight, obesity and anemia among children and a high prevalence of anemia among adolescents living in townships.

Objective: To explore the food and nutrient characteristics of children and adolescents with or without overweight/obesity and to provide scientific basis for the development of prevention strategies on overweight/obesity. Methods: This study included children and adolescents aged 6–17 years who participated in provincial nutrition surveillance which included 90 counties (cities and districts) in Zhejiang Province with a provincial representative. Food consumption was assessed using three consecutive days of 24 h dietary recall, and nutrient intake was calculated using dietary recall in conjunction with the China Food Composition Table. Overweight/obesity was also investigated. Associations were evaluated using ordinal regression models. Results: The analysis included a total of 1827 children and adolescents. The overweight prevalence was 14.0% and the obesity prevalence was 10.1%. Children and adolescents with overweight/obesity were observed to have a higher intake of carbohydrates, iron, sodium, potassium, and magnesium (F = 3.464, 5.232, 5.619, 3.469, 3.934, p < 0.05), as well as having a higher intake of the food group of cereals, tubers and beans, snacks, and salt (F = 7.348, 6.797, 3.413, p < 0.05) compared to children and adolescents without overweight/obesity. After adjusting for potential confounders via ordinal regression models, children and adolescents with overweight/obesity were observed to have a higher intake of carbohydrates (Wald χ² = 4.325, p < 0.05). There were significant differences concerning the daily energy provided by snacks, the daily carbohydrate intake provided by snacks, the daily sodium intake provided by snacks, and the proportion of snacks to the food group of cereals, tubers, and beans (F = 8.305 6.316, 13.955, 3.692, p < 0.05). Conclusion: Children and adolescents with overweight/obesity have presented a high consumption of carbohydrates, which is associated with the food group of cereals, tubers, and beans. Snacks are the main factor leading to the high intake of the food group of cereals, tubers, and beans among children and adolescents with overweight/obesity.

Background: Sedentary behavior may affect the types of food consumed in children and adolescents’ daily diets. Previous published studies are limited to local surveys. This study aimed to explore the relationship between sedentary behavior and food intake among children and adolescents. Methods: A stratified sampling technique was employed in the present cross-sectional study. Demographic characteristics, sedentary behavior, transportation modes, and food intake were investigated. Results: We found that children and adolescents who watched movies or TV programs online or on their smartphones on weekends and who chatted online on weekends, including on QQ (an instant messaging software service) and WeChat (an instant messaging software service), increased their intake of instant noodles and fried pasta (Spearman’s rho = 0.468, 0.575, 0.465, and 0.323; p < 0.05). Children and adolescents who chatted online on weekends, including on QQ and WeChat, increased their intake of tofu skin (Spearman’s rho = 0.461; p < 0.05), and those who browsed online on weekdays increased their intake of whole-fat liquid milk (Spearman’s rho = 0.455; p < 0.05). Children and adolescents who browsed and chatted online on weekends, including on QQ and WeChat, and who played computer or smartphone games, increased their intake of fried potato chips (French fries or other fried snacks) (Spearman’s rho = 0.568, 0.270, and 0.412; p < 0.05). With respect to modes of transportation used to travel to and from school, children and adolescents who took buses and subways increased their intake of rice, instant noodles, sweet potatoes, soybean milk, tofu skin, processed meat products (sausage, ham sausage, or lunch meat), fish, shrimp, vegetables, nuts, and sweet cookies (buns, cakes, Dim sum, and moon cakes) (Spearman’s rho = 0.394, 0.536, 0.630, 0.408, 0.485, 0.441,0.410, 0.424, 0.444, 0.541, and 0.366; p < 0.05). Conclusions: Sedentary behavior affects the types of food consumed in children and adolescents’ daily diets. Children and adolescents who browsed online on weekdays increased their intake of whole-fat liquid milk, but also increased their intake of foods with high fat, high salt, and low nutrient density. Children and adolescents taking buses and subways increased their intake of low-nutrition quality products. Public awareness efforts should focus on reducing the consumption of low-nutrition quality products and nutritional education.

Background: This study investigates the associations between lipid profiles, including triglycerides (TGs), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C), and vitamin A (VA) and vitamin D (VD) deficiencies among children and adolescents in Zhejiang Province, China. Methods: This cross-sectional study was conducted from 2022 to 2024 and included 9039 children and adolescents aged 6–17 years who participated in the provincial nutrition surveillance in Zhejiang Province. Blood samples were collected to measure the concentrations of TG, TC, HDL-C, LDL-C, VA and VD. Results: The prevalence of elevated TG, elevated TC, low HDL-C, and elevated LDL-C was 21.0%, 11.6%, 4.7% and 5.1% among children and adolescents aged 6–17 years, respectively. There were significant differences with respect to elevated TG and low HDL-C prevalence between sex (χ² = 10.303 and 7.27, p = 0.006 and 0.026). There were significant differences with respect to elevated TC and low HDL-C prevalence between urban areas and rural areas (χ² = 13.289 and 10.195, p = 0.001 and 0.006). There were significant differences with respect to elevated TG, elevated TC, low HDL-C, and elevated LDL-C prevalence among children with or without obesity/overweight (χ² = 209.828, 58.54, 171.972, and 146.256, p < 0.001). There were significant differences with respect to elevated TC and low HDL-C prevalence among children with or without vitamin D deficiency/vitamin D insufficiency (χ² = 33.37 and 56.848, p < 0.001). Ordinal regression analysis revealed that sex and obesity/overweight were associated with critical/abnormal TG (χ² = 340.03, p < 0.001), sex, age group, location and obesity/overweight were associated with critical/abnormal TC (χ² = 255.125, p < 0.001), age group, location, obesity/overweight and vitamin D deficiency/vitamin D insufficiency were associated with critical/abnormal HDL-C (χ² = 458.527, p < 0.001), and age group, obesity/overweight were associated with critical/abnormal LDL-C (χ² = 164.380, p < 0.001). Conclusions: Elevated TG, elevated TC, low HDL-C, and elevated LDL-C are prevalent in this population, with notable differences based on sex, urban vs. rural residence, and obesity/overweight status. Furthermore, vitamin D deficiency was linked to elevated TC and low HDL-C prevalence. Future interventions should focus on targeted public health strategies to mitigate these disparities and promote healthier lipid profiles in children and adolescents.