Childhood is the key stage for the development of physical and mental health in the life cycle.The nutritional and health status of childhood are not only related to adulthood health,but also have effects on the long-term development of the country.Along with the rapid transitions in dietary patterns and lifestyle,the prevalence of childhood obesity in China showed an astonishing growing trend in the past few decades.Obesity is a kind of disease,moreover,it is the risk factor for a variety of chronic diseases.Obesity is a serious threat to people's health and brings huge social and economic burden.It is necessary to take effective measures to prevent and control childhood obesity.International organizations and many countries have formulated policies and launched projects to prevent and control obesity.In China,series of outline,guidance,blueprint,plans and projects has been developed and released,such as the Outline of the Programme for Food and Nutrition Development in China (2014-2020),Blueprint of Healthy China 2030,National Nutrition Plan (2017-2030),Healthy Lifestyle Campaign for All,and so on.Improving the obesogenic environment needs world cooperation:international economic agreements and policies should be formulated to prevent and control obesity;obesity prevention and control should be integrated into all policies to improve the obesogenic environment;mechanism with the lead of government,the cooperation of multisector and the engagement of public should be established;national childhood obesity surveillance system should be improved;actions to prevention and control of obesity should be initiated in early stage of life and impetrated in all life cycle;and three-tiered prevention for childhood obesity should be implemented.

Along with the transitions of social and economic development, dietary patterns, physical activity and life-styles, the prevalence of childhood overweight and obesity has increased at an astonishing rate in the past decades, and has become one of the most serious public health challenges. Meanwhile, the stunting rate has declined with slow pace, while millions of young people are still threatened by wasting all over the word. The present situation of double burden of malnutrition should be recognized clearly and addressed seriously, which refers to, the common presence of both obesity and underweight in the same populations, communities and even families. In order to provide guidance on the appropriate assessment and management of infants and children presenting to primary health-care facilities, and to reduce the risk of overweight and obesity among children, the guideline Assessing and Managing Children at Primary Health-care Facilities to Prevent Overweight and Obesity in the Context of the Double Burden of Malnutrition was developed and released by WHO in 2017 using the procedures outlined in the WHO handbook for guideline development. The WHO Guideline (2017) is intended primarily for use in low- and medium-resource settings where both under-nutrition and obesity are prevalent. In this guideline, there are three prioritized specific areas and questions for infants and children presenting to primary health-care facilities: anthropometric assessment, care of infants and children with acute or chronic malnutrition, and care of children who are overweight or obese. It is recommended that for infants and children aged < 5 years presenting primary health-care facilities, weight and length/height should be measured and evaluated adequately, general nutrition and physical activity counselling should be provided for the caregivers and families, identification and appropriate management plan should be developed at primary health-care level. The discrepancies of the recommendation on the three prioritized areas in different guidelines are compared in this paper. All the related guidelines emphasize the importance of anthropometric measurement and monitor of growth for primary care workers and suggestions of dietary and physical activity's counselling for obese people. Almost all the guidelines provide recommendations on breastfeeding and continued feeding counselling from the aspect of improving the status of acute or chronic malnutrition. The setting conditions should be carefully considered when taking the guidelines of different organizations and countries into practice.

Abstract Water has many physiological functions and is one of the essential substances for human survival and development. It is very important to take enough water and keep adequate hydration state. When children and adolescent are in physical activity, due to the different intensity of physical activity, energy consumption and environmental temperature and humidity, the water demand is also different. The risk of insufficient water intake and dehydration is higher among people in physical activity. However, the importance of water has not been paid enough attention, and the literacy on hydration state and health among children and adolescent needs to be improved. Children and adolescents generally had insufficient water intake and were dehydrated. Existing research showed that dehydration could reduce the cognitive ability of children and adolescents, and the cognitive ability could be improved after health education or water intake intervention. Scientific water supplement or electrolyte supplement and energy drink could help to improve the ability of physical activity. It is necessary to carry out more investigation on behavior of water intake and more researches on hydration state and health impacts among children and adolescent. It is also necessary to carry out water intake related health education children’s and adolescents’, so as to improve their the literacy on hydration state and health, and to promote sufficient water intake and reasonably choose on water type, to maintain appropriate hydration state, and then to promote their health.

Abstract Water is essential for human survival and development, and participates in many physiological functions. The three sources and four pathways of water maintain the dynamic balance of body water. Drinking water is the main source of water for the body, and urine excreted through the kidney is the main way for the body to excrete water. Water drinking behavior includes water intake and water type selection. Analyzing hydration state and health from the perspective of water intake and water type selection, the paper found that the research on water intake and widing behavior needed more attention in China. It is necessary to carry out more investigations on drinking water and voiding behaviors in China, and to explore the associations of water drinking and voiding behaviors with health. It will provide scientific data for revising the recommendation on adequate water intake for Chinese residents, to promote the formation of healthy water drinking and voiding behaviors, to maintain adequate hydration state, and to promote health ultimately.

Objective: To understand rural students’ perception and satisfaction of the Nutrition Improvement Program for Rural Compulsory Education Students (NIPRCES), and to provide basis for promoting students’ participation in the school feeding program and improving the acceptability of school feeding. Methods: In 3 national pilot counties and 2 local pilot counties of NIPRCES, 1 middle school and 1 primary school were randomly selected. Two classes of 2 364 students from grade 4 to grade 9 were randomly selected and investigated with questionnaires. Results: Students were aware of the policy, with 78.9% of the students reported to be familiar with NIPRCES. The awareness rate of students at the national pilot areas was higher than that in local pilot areas(P<0.05). Students showed positive attitude towards NIPRCES. The median score of students’ understandings of the influence of NIPRCES was 20.0 (18.0, 20.0) points. Students in national pilot areas showed a more positive attitude toward the program than those in local pilot areas(P<0.05). Moderate satisfaction was reported in school feeding, 78.7% of students thought that school provided adequate amount of food, and 60.9% of the students enjoyed the food very much. The main reasons for leftovers were too much in amount(27.4%), repetition of food types (22.8%) and food aversions(9.2%). Conclusion Students are quite aware of NIPRCES and show moderate satisfaction in school feeding. The awareness and satisfaction are relatively higher among students in national pilot areas than those in local pilot areas. Health promoting schools should be established and students and parents should be advocated to take part in the program, health education need to be promoted in schools. Experiences sharing between different places could help improve the quality and acceptability of school feeding program.

Objective: To investigate drinking behaviors in weekdays and weekends among college students in Hebei Province during spring, and to provide references for propaganda of water drinking. Methods: A total of 156 college students in Hebei Province were selected using simple random sampling method. The survey began in March 2017. 7-day 24hour recording method was applied to record the amount and type of water drinking during for consistent consecutive 7 days, duplicate portion method was used to weigh the food consumed during the consistent consecutive 3 days and to record the water contained in the food. Results: Water intake from food among subjects during weekdays was higher than that among subjects during weekends (1 191 mL vs 1 113 mL, P<0.01). Only 21.9% and 19.9% of subjects consumed sufficient water during weekdays and weekends, according to the recommendation of China on total fluids intake, respectively. The proportion of water intake from staple food among male subjects during weekdays was lower than that during weekends (28.6% vs 31.1%). The proportion of water intake in males from porridge, water intake from soup and vegetables among subjects during weekdays were higher than those among subjects during weekends (6.8% vs 0; 141 mL vs 0 mL; 699 mL vs 647 mL). Water intake from staple food and vegetables among females during weekdays was higher than that during weekends (256 mL vs 210 mL; 559 mL vs 536 mL). There were no statistically differences on plain water, milk and beverages among subjects during weekdays and weekends(P>0.05). Conclusion Water intake from food among college students in Hebei Province during weekdays in spring is higher than that during weekends. There is discrepancy on sources of water intake from food during weekdays and weekends, while no similar difference on sources of drinking water. Proportion of college students without sufficient daily water intake during weekdays and weekends is relatively high which warrants further notice.

Objective: To investigate drinking behaviors among college students in Hebei Province during 8 periods of a day(before breakfast, during breakfast, after breakfast, during lunch, after lunch, during super, after super, during night in spring, and to analyze the drinking behaviors during different time periods so as to provide the scientific reference for health progaganda of water drinking. Methods: A total of 156 college students in Hebei Province were selected using simple random sampling method. The information of frequency, types and patterns of daily water drinking during 8 time periods, including morning, afternoon and evening, during meal and non-meal time, were recorded using the 7-day 24-hour recording method. Results: During 8 time periods, the amount (325 mL) and the percentages (89.8%) of drinking water after dinner was highest(Z=774.72, P<0.01), while water drinking after lunch and dinner was more common(Z=839.05, P<0.01). The amount (439 mL) of water intake in the evening was highest(Z=45.14, P<0.01), while water intake during the afternoon and evening was more common(2.3 time on average)(Z=40.34, P<0.01). About 54.2% of participants drank water during meal, while 99.2% drank water during non-meal time. The amount of water intake, the percentage of total daily water intake and the number of water intake during meal time was lower than those during non-meal time(Z=-14.58, -15.07, P<0.01). Conclusion Drinking behaviors in different time period among college students in Hebei Province during spring varies significantly. The amount of water intake in non-meal time is generally higher than that in meal time. Further efforts are needed to increase drinking water availability and consumption, as well encourage consumption of water among college students.

Objective: To analyze the total fluids intake and sources of college students from Hebei in spring and summer, and to provide a scientific reference for appropriate fluids intake in different seasons. Methods: Subjects were recruited in a university in Baoding, Hebei Province, and investigations were conducted in April and June 2021. The number of people who completed both spring and summer investigations was 80. Quantitative instruments and 7 day 24 h Fluid Intake Questionnaire were used to investigate the total drinking fluids, and it was recorded for 7 consecutive days in spring and summer respectively. The duplicate portion method was used to investigate the water from food. The total fluids intake and sources among subjects were analyzed in spring and summer. Results: There was no statistical significance between the total drinking fluids and total fluids intake between spring and summer [1 141(715), 1 176(649)mL/d, (2 496±604)(2 458±554)mL/d] ( F=1.86, 0.59, P >0.05). Spring showed significantly higher water from food compared with summer [(1 318±274)(1 217±302)mL/d]( F=16.63, P <0.05). The proportions of total drinking fluids and water from food in spring were 46% and 54%, respectively, and both were 50% in summer, the differences were statistically significant ( F=12.97, 12.97, P <0.05). There were differences in total fluids intake,total drinking fluids and water from food of different genders in earch season ( t/Z =4.75, -3.63, 3.44; 4.80, -2.91, 4.01, P <0.05). There were differences in total water intake, total drinking fluids, the proportions of total drinking fluids and water from food of different BMI groups in each season ( F/H =8.08, 16.65, 3.03, 3.03; 7.11,17.97, 4.52, 4.52, P <0.05). In spring, only 13.8% of subjects achieved the recommended total drinking fluids of China, compared with 18.8% in summer. In spring and summer, the total fluids intake, total drinking fluids, the proportions of total drinking fluids in the group achieved the recommendation were all higher than those who did not reach the recommendation ( t/Z =6.64, -5.19, 5.79; 8.12, -5.97, 5.70, P <0.05). Conclusion Season is a factor that affects total fluids intake, and it should be taken into account when setting the recommendation on adequate water intake.

Objective: To investigate students’ satisfaction on school feeding program in 8 cities in China, and to provide the basis for improving school feeding management and lunch quality. Methods: Multi-stage random cluster sampling method was used to randomly select the second, fifth and eighth-grade students from 67 primary and middle schools in 8 cities including Beijing, Shanghai, Harbin, Shijiazhuang, Guangzhou, Changsha, Bengbu and Pinghu. Results: A total of 15 475 students participated in the survey, 15 170(98.0%) of which were valid questionnaires. A total of 13 297(87.7%) students had lunch in school. Twenty-six(38.8%), 14(20.9%) and 27(40.3%) schools served lunch by self-run canteens, custody canteens, and food delivery companies respectively. Twenty-one schools provided milk or yogurt for lunch, accounting for 31.3%. The reported rates of very satisfied, satisfied, moderate, dissatisfied, and extremely dissatisfied among students were 40.8%, 28.1%, 20.1%, 7.3%, and 3.6%, respectively. The satisfaction rate of the eighth-grade students was lower than that of the second-and fifth-grade(56.9% vs 77.1% vs 73.5%). The satisfaction rate among students from schools with self-run canteen was higher than that of custody canteens and food delivery companies(73.8% vs 60.5% vs 66.2%). The satisfaction rate of school lunch is highest in dining surrounding (75.3%), followed by amount of meals(71.6%), food hygiene(71.1%), food combination(65.4%), and the appearance of the food(60.5%), and food taste(55.9%). Conclusion The satisfaction rate of students for school lunch was acceptable. The food taste is the main factor for students’ dissatisfaction. Schools should be encouraged to provide lunch in the self-run canteens with tasty food while meeting the nutritional standard.

Objective: To investigate and analyze the amount and the type of fluid intake in spring among male college athletics in a university in Beijing, and to provide scientific basis and reference data for fluid intake-related education and formulating adequate water intake. Methods: A simple random sampling method was used to select 109 male sports crowd from a college in Beijing. The information on amount and types of fluid intake were recorded using the validated 7-day fluid specific diary. Results: The median amount of daily fluid intake among participants was 1 789 mL. The number of participants who reached the amount of adequate water intake for Chinese adult residents 60, which accounted for 55.1% of the total participants. There was difference on the amount of fluid intake among different participants after grouped by the quartiles of exercise consumption(χ2=9.20, P=0.03). There were also differences in the percentage of fluid intake reaching the recommended amount on adequate water intake(χ2=18.27, P=0.04). The median amount of plain water, dairy products, sports beverages, and other sugary beverages were 1 180, 40, 65, and 383 mL, respectively; which accounted for 67.1%, 2.2%, 3.7%, and 22.2% of daily fluid intake. There was difference on the amount of sports beverages among different participants after grouped by the quartiles of BF%(χ2=8.59, P=0.04). There was difference on the amount of sports beverages (χ2=8.25, P=0.00) and other sugar-sweetened beverages (χ2=8.57, P=0.02) among different participants after grouped by the quartiles of energy expenditure. Conclusion Among male sports population in a university in Beijing, the amount of fluid intake differed among different participants after grouped by the quartiles of exercise consumption. As the exercise consumption of participants increased, the water consumption increased. Participants mainly drink plain water, and there were differences on the types of fluid intake among participants with different BF% and different energy expenditure.