Trends and associated factors of overweight and obesity among children and adolescents in Macao from 2005 to 2020

<p xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" dir="auto" id="d4278867e118"> <b>Objective</b> To analyze the prevalence trends and associated factors of overweight and obesity among children and adolescents in Macao from 2005 to 2020, so as to provide evidence for developing health promotion strategies. </p><p xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" dir="auto" id="d4278867e123"> <b>Methods</b> Data were obtained from the Macao Citizen Physical Fitness Monitoring Database for the years 2005, 2010, 2015, and 2020 for participants aged 6-22 years. The <i>χ ² </i> test was employed to analyze trends in detection rates, while univariate and multivariate Logistic regression analyses were conducted to identify influencing factors. </p><p xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" dir="auto" id="d4278867e134"> <b>Results</b> The overweight rate among Macao’s children and adolescents increased from 10.4% in 2005 to 14.8% in 2020. The obesity rate rose from 6.8% to 12.1%, with the total detection rate increasing from 17.2% to 26.9%, and the differences were statistically significant (χ ² _trend=46.7, 87.5, 145.9, <i>P</i> <0.01). Notably, the overweight/obesity rate among boys showed rapid growth (χ ² _trend = 118.6, <i>P</i><0.01), while girls exhibited a declining inflection point in 2020. Multivariate Logistic regression analysis revealed that children and adolescents with the following characteristics faced higher risks of overweight/obesity: a physical education performance score of 3 points (overweight: <i>OR</i> = 2.34, 95% <i>CI</i> =1.10-4.96; obesity: <i>OR</i> = 2.39, 95% <i>CI</i> = 1.19-4.81), paternal obesity (overweight: <i>OR</i> = 2. 07, 95% <i>CI</i> = 1.38-3.11; obesity: <i>OR</i> = 1. 51, 95% <i>CI</i> = 1.01-2.27), and maternal obesity (overweight: <i>OR</i> = 1.69, = 1.08-2.63; obesity: <i>OR</i> = 1.77, 95% <i>CI</i>= 1.16-2.71) ( <i>P</i><0.05). Conversely, lower risks were observed in those who performed appropriate warm-up activities before exercise (obesity: <i>OR</i> = 0. 37, 95% <i>CI</i> = 0.15-0.95), participated in two academic/non-sports extracurricular classes (obesity: <i>OR</i> = 0.46,95% <i>CI</i> = 0.24-0.88), and reported moderate physical exertion during extracurricular exercise (obesity: <i>OR</i> = 0.60, 95% <i>CI</i> = 0.36-0.98) ( <i>P</i><0.05). </p><p xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" dir="auto" id="d4278867e218"> <b>Conclusions</b> Overweight and obesity among Macao’s children and adolescents remain severe, particularly among boys, while girls show early signs of improvement. It is recommended to establish a multi-sectoral collaborative prevention and control system to reduce childhood and adolescent obesity. </p><p xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="first" dir="auto" id="d4278867e224"> <b>【摘要】</b> <b>目的</b> 分析 2005—2020 年澳门儿童青少年超重肥胖现状、流行趋势以及相关因素, 为制定儿童青少年体质健康 改善策略提供依据。 <b>方法</b> 数据来源于 2005, 2010, 2015, 2020 年澳门市民体质监测数据库, 以 6~22 岁儿童青少年为研究 对象。采用; χ ² 检验分析超重肥胖检出率变化趋势, 采用单因素与多元Logistic回归分析探讨其相关因素。 <b>结果</b> 澳门儿 童青少年超重检出率从 2005 年的 10.4% 上升至 2020 年的 14.8%; 肥胖检出率从 6.8% 增至 12.1%; 总检出率由17.2%升至 26.9%, 差异均有统计学意义(X趋势值分别为 46.7, 87.5, 145.9, <i>P</i> 值均<0.01);其中男生超重肥胖率快速增加(χ ² _趋势= 118.6, <i>P</i><0.01), 女生超重肥胖率在2020年出现降低的拐点。多因素Logistic回归分析结果显示, 体育课表现得分 3 分(超重: <i>OR</i> = 2.34, 95% <i>CI</i> = 1.10~4.96; 肥胖: <i>OR</i> = 2. 39, 95% <i>CI</i> =1.19~4.81)、父亲肥胖(超重: <i>OR</i> = 2.07, 95% <i>CI</i> = 1.38~ 3.11; 肥胖: <i>OR</i> =1.51, 95% <i>CI</i> =1.01~2.27) 及母亲肥胖(超重: <i>OR</i> = 1.69, 95% <i>CI</i> = 1.08~2.63; 肥胖: <i>OR</i> = 1.77, 95% <i>CI</i> =1.16~2.71) 的儿 童青少年发生超重肥胖的风险均较高;运动前适当做准备活动(肥胖: <i>OR</i> = 0.37, 95% <i>CI</i> =0.15~0.95)、参加 2 项补习或非体 育兴趣班(肥胖: <i>OR</i> = 0.46, 95% <i>CI</i> =0.24~0.88) 和课外体育锻炼时身体感受适中(肥胖: <i>OR</i> = 0.60, 95% <i>CI</i> =0.36~0.98) 的儿 童青少年发生超重肥胖的风险均较低 ( <i>P</i> 值均<0.05)。 <b>结论</b> 澳门儿童青少年超重肥胖问题严峻, 男生尤为突出, 女生开 始出现下降拐点。建议构建多方协同防控体系, 以减少儿童青少年肥胖的发生。 </p>