Original article
Comparison of Overweight, Weight Perception, and Weight-Related Practices Among High School Students in Three Large Chinese Cities and Two Large U.S. Cities

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Abstract

Purpose

The study compared differences in overweight prevalence, weight perception, and weight-related practices among high school students in five large Chinese and U.S. cities, and informed interventions for childhood obesity in China and the U.S.

Methods

The data used was collected in 2003 from a representative sample of high school students in Hong Kong, Macau, Taipei, New York and Los Angeles.

Results

The prevalence of overweight high school students in New York City and Los Angeles was about twice as high as in Hong Kong, Macau, and Taipei; however, the proportion of Chinese students perceiving themselves to be overweight was 15% higher than their U.S. counterparts. Independent of actual weight status, perceived overweight was significantly associated with weight control practices (p < .05). U.S. students showed higher levels of moderate and vigorous physical activity, but more hours of watching television than their Chinese counterparts.

Conclusion

The continuing pandemic of overweight among youth fosters weight dissatisfaction, which may increase unhealthy weight control practices. Interventions should be designed to prevent overweight without precipitating unhealthy weight control practices by emphasizing an increase in physical activity and a reduction in time watching television.

Section snippets

Sample and design

All high schools in these five cities were randomly selected with the probability proportional to school enrollment size without replacement, except Macau, in which all high schools were selected. Each city employed a two-stage cluster sampling design to produce representative samples of high school students. Students in grades nine through 11 were sampled in Hong Kong, Macau, and Taipei, and those in grades nine through 12 were sampled in New York City and Los Angeles. In the Chinese cities,

Results

Ninety-nine percent of sampled Chinese city students in grade nine through 11 were between the age of 14–18. The mean age was 16.1 (Standard Deviation: 1.2) in Hong Kong, 16.5 (SD: 1.2) in Macau, and 16.1 (SD: .9) in Taipei. Ninety-nine percent of sampled U.S. city students in grade nine through 12 were between the age of 14–18. The mean age was 15.9 (SD: 1.2) in New York City and 15.9 (SD: 1.2) in Los Angeles.

Discussion

This study presented similarities of gender differences in weight perception among high school students in large city schools of China and the U.S., as well as racial/ethnic differences in weight perception. This study also compared the prevalence of overweight among high school students in the selected cities. This study suggests that the proportion of overweight high school students in New York City and Los Angeles was about twice as high as same-age counterparts in Hong Kong, Macau, and

Acknowledgment

The authors would like to thank the following agencies for providing datasets: The Center for Health Education and Health Promotion at the Chinese University of Hong Kong, which provided the datasets for Hong Kong, Macau, and Taipei; the Division of Adolescent and School Health of the Centers for Disease Control and Prevention, which provided the dataset for Los Angeles; and the Bureau of Epidemiology Services, New York City Department of Health and Mental Hygiene, which provided the New York

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