Objective: To analyze and predict the epidemic trend of overweight and obesity among children and adolescents aged 7-18 years in China from 1985 to 2019. Methods: Data were collected from the Chinese National Survey on Students Constitution and Health in 1985, 1995, 2000, 2005, 2010, 2014, and 2019 with the sample size of 409 945, 204 931, 209 209, 234 420, 215 317, 214 353, and 212 711, respectively. Overweight and obesity were evaluated according to the "classification standard of the weight index value of overweight and obesity screening for Chinese school-age children and adolescents" of the Working Group on Obesity in China (WGOC). The detection rate and average annual growth rate of overweight and obesity, and single obesity among children and adolescents aged 7-18 years were calculated, and ArcGis10.6 software was used to analyze the difference in the prevalence of overweight and obesity among children and adolescents in different regions in 2019. Polynomial regression function was used to fit the prevalence and average annual growth rate of overweight and obesity, and single obesity among children and adolescents from 1985 to 2019, and to predict the prevalence of overweight and obesity and single obesity among children and adolescents in China. Results: In 2019, the total prevalence of overweight and obesity among children and adolescents aged 7-18 years in China was 23.4%, and the prevalence of single obesity was 9.6%. The prevalence of overweight and obesity among urban children and adolescents was higher than that in rural areas (25.4% vs. 21.5%), and the prevalence in boys was higher than that in girls (28.4% vs. 18.4%) (both P values<0.001). In 2019, there was a large regional disparity in the prevalence of overweight and obesity in different provinces, with the lowest in Guangdong (12.2%) and the highest in Shandong (38.9%), and the high epidemic areas were mainly concentrated in North China and Northeast China. From 1985 to 2019, the prevalence of overweight and obesity among children and adolescents aged 7-18 years in China increased from 1.2% to 23.4%, with an increase of 18.1 times, while the prevalence of obesity alone increased from 0.1% to 9.6%, with an increase of 75.6 times. The prevalence of overweight and obesity in urban boys, urban girls, rural boys and rural girls increased from 1.3%, 1.5%, 0.5%, and 1.6% in 1985 to 31.2%, 19.4%, 25.6%, and 17.4% in 2019, with an increase of 22.3, 11.7, 54.2, and 10.1 times, respectively. According to the prediction model, the prevalence of overweight and obesity among children and adolescents aged 7-18 years in China will increase from 23.4% in 2019 to 32.7% in 2030, and the prevalence of obesity alone will increase from 9.6% in 2019 to 15.1% in 2030. The growth of rural children and adolescents is obvious. By 2025, the prevalence of overweight and obesity among rural children and adolescents in China will comprehensively exceed that of urban, and there will be an "urban-rural reversal" phenomenon. At the same time, the prevalence of children's obesity in China's low, medium and high epidemic areas will also continue to increase. By 2035, the prevalence of overweight and obesity among children and adolescents in medium epidemic areas will exceed that in high epidemic areas, and there will be a "provincial reversal" phenomenon. Conclusion: From 1985 to 2019, the overweight and obesity of children and adolescents in China will continue to grow rapidly with large regional differences.
目的： 分析1985—2019年中国7~18岁儿童青少年超重与肥胖流行趋势并进行预测。 方法： 利用 1985、1995、2000、2005、2010、2014、2019年的七次全国学生体质与健康调研数据进行分析，分别纳入 409 945、204 931、209 209、234 420、215 317、214 353和212 711名7~18 岁儿童青少年。根据中国肥胖问题工作组的《中国学龄儿童青少年超重、肥胖筛查体重指数值分类标准》判定儿童超重与肥胖，计算7~18岁儿童青少年超重与肥胖的检出率及年均增长值，采用ArcGis 10.6软件分析2019年不同地区儿童青少年超重与肥胖检出率的差异；采用多项式回归模型对1985—2019年的儿童青少年超重和仅肥胖检出率和年均增长值进行拟合，并预测7~18 岁儿童青少年超重与肥胖检出率的发展趋势。 结果： 2019年中国7~18岁儿童青少年超重与肥胖检出率为23.4%，仅肥胖检出率为9.6%，超重与肥胖检出率城市高于乡村（25.4%比21.5%），男生高于女生（28.4%比18.4%）（均P<0.001）。2019年各省份超重与肥胖检出率差异较大，最低为广东（12.2%），最高为山东（38.9%），高发区主要集中在华北和东北地区。中国7~18岁儿童青少年的超重与肥胖检出率由1985年的1.2%增长至2019年的23.4%，增长了18.1倍；仅肥胖检出率由1985年的0.1增长至1985年的9.6%，增长了75.6倍。城市男生、城市女生、乡村男生和乡村女生的超重与肥胖检出率分别由1985年的1.3%、1.5%、0.5%和1.6%增长至2019年的31.2%、19.4%、25.6%和17.4%，分别增长了22.3倍、11.7倍、54.2倍和10.1倍。多项式回归模型预测结果显示，我国7~18 岁儿童青少年超重与肥胖检出率将由2019年的23.4%增长至2030年的32.7%；仅肥胖检出率将由2019年的9.6%增长至2030年的15.1%，乡村儿童青少年增长明显；2025年全国乡村儿童青少年超重与肥胖检出率将全面超过城市，出现“城乡逆转”；我国低、中、高流行区儿童肥胖也将持续增长，2035年中流行区的儿童青少年超重与肥胖检出率将超过高流行区，出现“省份逆转”。 结论： 1985—2019年我国儿童青少年超重与肥胖检出率持续增长，增长趋势具有地区差异。.