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Residential density and adolescent overweight in a rapidly urbanising region of mainland China
  1. Fei Xu1,
  2. JieQuan Li1,
  3. YaQiong Liang1,
  4. ZhiYong Wang1,
  5. Xin Hong1,
  6. Robert S Ware2,
  7. Eva Leslie3,
  8. Takemi Sugiyama4,
  9. Neville Owen4
  1. 1The Department of Non-Communicable Disease Control, Nanjing Municipal Center for Disease Control & Prevention, Nanjing, PR China
  2. 2School of Population Health, The University of Queensland, Brisbane, Australia
  3. 3School of Psychology, Deakin University, Geelong, Australia
  4. 4Cancer Prevention Research Centre, School of Population Health, The University of Queensland, Brisbane, Australia
  1. Correspondence to Dr Fei Xu, Nanjing Municipal Center for Disease Control & Prevention, 2, Zizhulin, Nanjing 210003 PR China; f_xufei{at}


Objective This study investigated the association of residential density with overweight among adolescents in an urban area of China.

Methods Using multistage proportional sampling methods, a population-based cross-sectional study was conducted in Nanjing between September and November 2004 (n=2375; mean age=13.9±1.0 years old; 46.2% boys; survey response rate=89.3%). Body mass index was calculated from self-reported body weight and height. Overweight, the main outcome variable, was defined as a BMI ≥85 percentile value for age- and gender-specific reference data according to the recommendation for Chinese adolescents. The primary explanatory variable was the residential density of the urban districts. Mixed-effects logistic regression models were used for the analysis.

Results Students in the higher and middle tertiles of residential density had a 2.17-fold (95% CI 1.41 to 3.33) and 1.89-fold (95% CI 1.22 to 2.92) higher likelihood of being overweight, respectively, compared with those in the lower tertile. The associations were slightly attenuated but still significant after adjusting for time spent in recreational physical activity and sedentary behaviour (viewing TV and sitting for academic study).

Conclusions Residential density was positively associated with overweight among urban Chinese adolescents. Our findings warrant further research examining attributes of urban environments associated with adolescents' obesity in China and potential mechanisms between them.

  • Residential density
  • overweight
  • adolescents
  • urbanisation
  • China
  • health related behaviour
  • obesity EPI
  • physical activity
  • urban health
  • urbanisation

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  • This paper was presented, in part, as an oral presentation at The 10th International Congress of Behavioral Medicine on 27–30 August 2008 in Tokyo, Japan.

  • Funding This study was funded by Nanjing Municipal Department of Health (2004-84-ZKX0418) and Nanjing Municipal Department of Science & Technology (2004-168-0414), PR China. NO and TS are supported by a Programme Grant (no 301200) from the National Health and Medical Research Council (NHMRC) of Australia, and by a Research Infrastructure Grant from Queensland Health, Australia. EL is supported by an NHMRC Public Health Fellowship (no 301261).

  • Competing interests None.

  • Ethics approval Ethics approval was provided by the Nanjing Municipal Center for Disease Control & Prevention, Nanjing, PR China.

  • Provenance and peer review Not commissioned; externally peer reviewed.