OBJECTIVETo investigate sex difference on nutritional status, feeding practice and health care of rural children in western China.

METHODSData used in this study was from a large scale cross-sectional survey conducted in western rural areas of China. The total number of children younger than 3 years old was 14 532, in which 57.4% were boys. Logistic regression model was employed to control selected background factors for analysis of sex differential on nutritional status,feeding practice and health care of children.

RESULTSThe prevalence rates of stunting, underweight and wasting were close between both genders, regardless of north or south areas. After controlling of selected background factors, sex differentials in malnutrition happened only in north areas. It showed that boys having higher risk of being underweight than girls (OR = 1.27) in the families with one child and lower risk of being stunting than girls ( OR = 0.60). There was no sex differential found in stunting, underweight and wasting for any type of families in south areas. As for feeding practice egg was introduced to boys more frequently compared with girls,which was found in families with one child of south areas and ones with two children from the southern areas. More boys from families with two children of southern areas were exclusively breastfed within 4 months after birth. Data indicated boys had higher risk of being sick. Prevalence of anemia was 36.2% for boys,33.4% for girls. Prevalence of cold was 29.0% for boys,27.4% for girls. Prevalence of diarrhea was 19.0% for boys, 17.5% for girls. This sex differential persisted in the families of north areas after controlling for selected background factors.

CONCLUSIONSex differentials on nutritional status, feeding practice and health care exist in rural areas of western China, especially in north areas.

Child Nutritional Physiological Phenomena ; Child, Preschool ; China ; Cross-Sectional Studies ; Feeding Behavior ; Female ; Humans ; Infant ; Infant, Newborn ; Male ; Nutritional Status ; Rural Health ; Sex Factors

OBJECTIVETo study the hemoglobin status of children under the age of three years and the prevalence of anemia at high altitude.

METHODSCross-sectional study and randomly sampling were used. Blood was collected on tip of finger and the level of hemoglobin was measured using B-Hemoglobin photometer. We adjusted the hemoglobin based on altitude, using three methods of CDC, Direen's and Dallman's and then estimated the prevalence of anemia.

RESULTS(1) 1 127 children were examined. The findings indicated that the average hemoglobin was about 120 g/L. There was no significant difference for Hb between boys and girls. Urban children had a higher hemoglobin level (123.3 g/L) than rural children (119.9 g/L). Analysis of covariance indicated that, after controlling the factor of altitude, the mean content of hemoglobin of rural children was lower than that of urban children and hemoglobin varied among districts. (2) Different method used for correction of hemoglobin caused different prevalence rates of anemia but they were higher than un-corrected prevalences: 90.4% for CDC method, 72.3% for Dirren's method and 65.0% for Dallman's method respectively.

CONCLUSIONHigher altitude seemed to affect the levels of hemoglobin significantly. The prevalence of anemia in children might be higher, but current hemoglobin correction methods might not be suitable for correcting hemoglobin of Tibetan children. So we suggested that it was imperative to establish a relationship between altitude and hemoglobin of Tibetan children.

Age Factors ; Altitude ; Anemia ; blood ; epidemiology ; Child, Preschool ; Cross-Sectional Studies ; Female ; Hemoglobins ; analysis ; Humans ; Male ; Prevalence ; Rural Population ; Tibet ; epidemiology ; Urban Population

OBJECTIVETo investigate optimistic factors affecting nutrition status of infants under 3-year-old in rural areas of western China.

METHODSThe data used in this study came from a cross-sectional survey on primary health and maternal and child health care in western rural China. The method of stratified multistage cluster random sampling was used to obtain the sample of children. Composite index of anthropometric failure (CIAF) was used to classify the infants with normal nutrition or malnutrition. Logistic regression model was employed to investigate optimistic factors effecting nutrition of infants from 3 levels as family, mother and children themselves.

RESULTS14,532 qualified infants were obtained, 57.4% of them were boys. According to CIAF, 72.1% of children were found in normal nutritional status. Prevalence of malnutrition was 27.9% and 10.3% of children were both underweighted and retarded in growth. The result showed the children with better nutrition were from such families with high income, fathers with higher education and fewer children. Higher education for mothers and breastfeeding were optimistic factors effecting nutrition of infants under 6-month after family factors being controlled for. For children over 6 months old, the optimistic factors were heavy mother body weight and more education acquired, exclusive breast feeding within 4-month, introduction of foods containing more protein.

CONCLUSIONFamily factors strongly influence nutritional status of rural children. Improving mothers'education and adding protein intake for children older than 6 months make their nutrition status better.

Child, Preschool ; China ; Cross-Sectional Studies ; Factor Analysis, Statistical ; Growth Disorders ; epidemiology ; Humans ; Infant ; Nutritional Physiological Phenomena ; Nutritional Status ; ethnology ; Rural Population

OBJECTIVETo study the status of spontaneous abortion among reproductive Tibetan women aged 15 - 49 years.

METHODSA cross-sectional survey was conducted on reproductive history of Tibetan women and the sample was chosen under the stratified multistage cluster random sampling technique.

RESULTSA total number of 3741 women were studied with a total number of 10,245 pregnancies. There were 386 spontaneous abortions reported with an incidence rate of 3.9%. Women living in the urban area had a higher rate than living in the rural areas. Women living in area where altitudes were above 4500 m, had a 2-time risk of having spontaneous abortion than those living in areas below 3500 m. The risk of having spontaneous abortion increased among women aged > or = 35 and those with more than 3 pregnancies.

CONCLUSIONSHigh altitude could contribute to the increase of spontaneous abortions incidence, suggesting that improvement of maternal care and nutrition and reduction of the frequency of pregnancy had important roles to play in reducing the incidence of spontaneous abortion among Tibetan women. Despite the fact that retrospective study on reproductive history could underestimate the incidence of spontaneous abortion, the incidence rate among Tibetan women might not be much higher than women living in the lowland areas.

Abortion, Spontaneous ; epidemiology ; Adolescent ; Adult ; Altitude ; Cross-Sectional Studies ; Female ; Humans ; Incidence ; Maternal Age ; Maternal Nutritional Physiological Phenomena ; Middle Aged ; Parity ; Pregnancy ; Prenatal Care ; Risk Factors ; Rural Population ; statistics & numerical data ; Tibet ; epidemiology ; Urban Population ; statistics & numerical data ; Young Adult

Adult ; Anemia ; blood ; epidemiology ; China ; epidemiology ; Female ; Folic Acid ; blood ; Hemoglobins ; analysis ; Humans ; Rural Population ; Urban Population

OBJECTIVETo understand the current situation of maternal health care and the association between maternal health care and relevant factors.

METHODSAccording to a cross sectional study design, 1512 mothers having children under 3 years old were drawn under stratified random sampling method and interviewed at their households in 15 counties, Tibet Autonomous Region of China.

RESULTS77.6% of the pregnant women received at least one antenatal checkup with an average of 3.89 times while the rate of antenatal checkup over 5 times was 26.3%. The hospital delivery rate was 40.4% in this area. 83.9% of the women received education under the health care program during pregnancy and 66.2% of them were visited by health workers after delivery. Major factors of the antenatal checkups would include the resource of income, living in nomadic area, personal sanitation, antenatal health care education, mobilization of delivery at hospital, knowledge of antenatal health care etc.

CONCLUSIONSThere had been great improvement in women's health care in this area as compared with the status in 1999, but the frequency of receiving antenatal checkup was still not enough and the rate of hospital delivery was also low as compared with 46 counties in western areas of China. Poor knowledge of health care during pregnancy seemed to be the major factor that limited the utilization of antenatal health care. Knowledge on health and common sense of health care should be disseminated to improve the antenatal care and to enhance the hospital delivery rate.

Agriculture ; Cross-Sectional Studies ; Female ; Health Education ; statistics & numerical data ; Health Knowledge, Attitudes, Practice ; Health Services Accessibility ; Healthcare Disparities ; Humans ; Interviews as Topic ; Maternal Health Services ; statistics & numerical data ; Pregnancy ; Socioeconomic Factors ; Tibet ; Transients and Migrants

OBJECTIVETo understand the feeding status of Tibetan children aged below three years old.

METHODSCross-sectional study and randomly sampling were used. The information on complementary food was obtained through the recollection from mother of the child. Data of complementary food of Tibet children was compared with those of the children from the surveys of nine cities in China and 40 poor counties in western China.

RESULTSOne thousand six hundred and fifty-five children were studied. The findings indicated that the age of introduction of Zanba (a kind food of mixture of highland barley flour and butter) was 1.98 months after birth and the age of introduction of egg and meat was about 8 - 9 months. Boys were fed with Zanba earlier than girls but there was no significant difference in the introduction of other complementary food between sexes. Urban children were introduced with complementary food earlier than rural children, and children in the agricultural region earlier than those in the pasturing region. The proportion of no introduction of any complementary food by the age of 4 months was about 10.6% for urban children, but 21.7% for rural children while 14.2% for children in the agricultural region and 30.9% for children in the pasturing region. The proportion of no introduction of complementary food was 11.5% for Tibetan children compared with 45.2% for the children of 40 poor counties in western China. The proportions of introduction of the following complementary foods were 89.1% for Zanba, 22.1% for egg, 29.1% for fresh milk, 23.5% for meat, 17.5% for vegetable, 0.75% for bean products, 1.03% for fish and 3.35% for chicken respectively.

CONCLUSIONSThe main complementary foods for Tibetan children included Zanba, milk, mutton and beef. There was a small amount of vegetable in diet. The introduction of bean, chicken and fish was not common. Early and monotony seemed to be the character of introduction of complementary food for Tibetan children. Improving introduction of complementary food is important in enhancing the nutritional status of Tibetan children.

Child Nutritional Physiological Phenomena ; Child, Preschool ; Cross-Sectional Studies ; Feeding Behavior ; Female ; Humans ; Infant ; Infant Food ; Infant Nutritional Physiological Phenomena ; Male ; Nutrition Surveys ; Sampling Studies ; Tibet

Objective To investigate the distribution of hemoglobin(Hb)and prevalence of anemia in pregnant women living in the Tibetan Plateau area.Methods Random sampling method was used and fingertip blood sample was tested.Related sociodemographic information was collected.We adjusted the hemoglobin measurements based on the different levles of altitude,using three different methods from CDC.Dirren's and Dallman's to estimate the prevalence rates of anemia.Results Three hundred and eighty pregnant women were included.The mean Hb was 127.6 g/L.Tibetan had a lower Hb (126.6 g/L)than people from other ethnicities(134.6 g/L)with rural pregnant women having a higher Hb(130.4 g/L)than that of urban ones(125.9 g/L).After controlling the gestational age,results remained the same.Different method used for correction of hemoglobin would cause different prevalence rates of anemia which were all higher than the pre-adjusted prevalence rates:70.0% for CDC method,77.9% for Dirren's method and 41.3% for Dallman's method respectively.After analyzing the erythrocyte arameters,we could not conclude that population in our study was under the early stage of the iron deficiency anemia.Conclusion Higher altitude could affect the levels of hemoglobin concentration significantly.Currently adopted hemoglobin correction methods might not be suitable for Tibetan pregnant women.We suggested that it was imperative to establish a relationship between altitude and hemoglobin of Tibetan women during pregnancy in order to correctly evaluate the prevalence of anemia.

Objective To explore the dietary pattern of rural Tibetan women with children under 2 years of age.Methods A cross-sectional survey on dietary pattern together with a semiquantitative food frequency questionnaire was conducted among Tibetan women in rural Lhasa in 2008.Results 386 women were investigated with the average age as 28.5 years old and average schooling-years as 4.6.For each member in the woman's family,daily intake of vegetable oil was 25.9 g on average.Daily intake of butter,sugar and salt were 27.8 g,12.9 g and 14.8 g respectively,which were higher than figures from national nutrition and health survey (P＜0.01).Among 91 kinds of food under investigation,only 22 kinds with the frequencies of consumption more than 1 time per day.Three main factors were derived by factor analysis.The first factor represented vegetable pattern characterized with vegetables,grains,fruits and a few animal foods.It was a dominant pattern for the subjects,which explained nearly 10% variance.The second one was Tibetan style pattern in which Tibetan foods and a few vegetables were consumed.The last one called meats and milk products pattern also reflected the Tibetan dietary style.Daily intake of energy for women was 2097.02 kcal which met 91.2% of Chinese recommended nutrients intake (RNI).Daily intake of protein and fat reached 82% of RNI and vitamin A but only 34.7% on RNI.Daily intake of calcium,iron and zinc reached 64.6%,174.1% and 150.7% of RNI,receptively.Grains provided 65% of energy but only 7.4% of the energy and 15.5% of protein were from animal foods."Tsampa" provided 57.6% of iron.Conclusion Vegetable pattern had been the dominant dietary pattern among Tibetan women in rural Lhasa.Intake of energy,protein and some micronutrients were not sufficient.

Objective The objective of this study was to investigate the prevalence rate of abdominal obesity and to explore the associated risk factors in rural communities from Hanzhong area,Shaanxi province,and to providc baseline data for further targeted intervention programs.Methods A cross-sectional study was conducted among all the participants with questionnaires,interview and physical examination.Nine townships were selected in Hanzhong area,followed by one village randomly chosen from the selected township,using the stratified random sampling method.Results There were 3030 participants in this survey,among which 3021 samples were valid,including 1048 males and 1973 females.The overall prevalence rate of abdominal obesity was 38.9％(standardized rate as 33.4％ ) in rural communities of Hanzhong,and the prevalence rate on males abdominal obesity(35.0％ ) was significantly lower than that of females (40.9％).It was found that following factors as:being male,married,having more household wealth,frequent consumption of fried food,non-engagement of agricultural labor work,being nonsmoker or ex-smoker,spending longer time on watching-TV etc.were positively associated with the biggerr odds of having abdominal obesity when using the logistic regression analysis.Meanwhile,data from this study indicated that fctors as:at younger age,frequent participation in agricultural labor,under artificial feeding,with more years of education,less frequency of pregnancy etc.were negatively related to the prevalence of female abdominal obesity.Conclusion The prevalence rate of abdominal obesity in Hanzhong area,Shaanxi province was significantly higher than the national average level which called for the development of related intervention programs to prevent chronic diseases associated with gender related-obesity in Hanzhong.