Gender Differences in the Prevalence of Overweight and Obesity, Associated Behaviors, and Weight-related Perceptions in a National Survey of Primary School Children in China

Abstract Objective To in vestigate potential gender differences in the odds of overweight/obese, weight-related perceptions, and behaviors among Chinese school children. Methods Height, weight, and a survey of weight-related perceptions and behaviors were measured in a nationally representative survey of 12,811 children in primary schools in China. Logistic regression analyses were used to assess gender differences, adjusting for confounders. Results Boys had higher odds of being overweight/obese compared to girls within both urban [adjusted odds ratio ( OR ) 2.30, 95% CI 2.00 to 2.65] and rural areas ( OR = 1.85, 95% CI 1.55 to 2.20). Girls reported healthier diets (e.g., daily vegetables OR = 0.79, 95% CI 0.73 to 0.85) whereas boys consumed fried food ( OR = 1.21, 95% CI 1.06 to 1.38) and sugar-sweetened drinks more often ( OR = 1.49, 95% CI 1.34 to 1.65). Gender differences included higher odds of boys perceiving themselves as overweight if they had more highly educated mothers ( OR = 1.35, 95% CI 1.09 to 1.68), less educated fathers ( OR = 0.79, 95% CI 0.63 to 0.99), and if they frequently consumed carbonated drinks ( OR = 1.48, 95% CI 1.07 to 2.05). Conclusion Childhood obesity prevention in China should be gender-focused, particularly for boys who reported an unhealthier diet but were less likely to see they were fat, even though more boys were overweight or obese than girls.