The association between frequency of eating out with overweight and obesity among children aged 6-17 in China: A National Cross-sectional Study

The association between frequency of eating out with overweight and obesity among children aged 6-17 in China: A National Cross-sectional Study | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research article The association between frequency of eating out with overweight and obesity among children aged 6-17 in China: A National Cross-sectional Study Yanning ma, Weiyan Gong, Caicui Ding, Chao Song, Fan Yuan, Jing Fan, and 3 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-46043/v2 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 28 May, 2021 Read the published version in BMC Public Health → Version 2 posted 10 You are reading this latest preprint version Show more versions Abstract Background: In parallel with the increased prevalence of childhood overweight and obesity, the rate of eating out in China has increased dramatically in recent years. The purpose of the study was to explore the association between frequency of eating out with overweight and obesity among Chinese children. Methods: The representative sample of Chinese children aged 6-17 years (7685 boys; 7576 girls) was recruited from Chinese National Nutrition and Health Survey (CNNHS) in 2010-2012. Frequency of eating out was collected by interview-administered questionnaire and categorized as: less than once per week, once and twice per week, and three times or more per week. Height and weight were measured (body mass index was consequently calculated). Results： The prevalence of eating out among Chinese children aged 6-17 years old was 23.2%. Children who ate out 0, 1-2, ≥3 times per week were accounted for 76.8%, 10.9% and 12.3% respectively. Findings revealed that eating out three times per week or more was statistically significant associated with higher prevalence of overweight and obesity among boys (OR=1.20,95CI:1.04-1.38) compared with those ate out less than three times per week. However, no significantly association was observed among girls (OR=0.91, 95CI:0.78-1.01). In additional, Younger children, rural children, children from low income family, those with leisure exercises (certain physical activities regularly carried out such as swimming, walking, running, equipment fitness), leisure time sedentary behaviors (LTSB)(>2h/d) were relatively more likely to eat out. Conclusions: The results illustrated that eating out three times or more had a significantly positive effect on overweight and obesity among boys in China. Nutrition & Dietetics Pediatrics China eating out frequency overweight and obesity children Background The worldwide prevalence of overweight and obesity among children is becoming a global health problem[1][1,2]. Between 1980 and 2013, the prevalence of overweight and obesity among children has increased by 47.1 percent globally[3]. Increases were observed in both developed countries and developing societies [4]. The number of childhood overweight and obesity also increased dramatically over the past decades in China[5].A recently report among Chinese students aged 7-18 years old showed that the nationwide prevalence of overweight and obesity increased from 2.1% to 12.2%, 0.5% to 7.3% from 1985 to 2014, respectively, and this proportion was expected to reach 28% or affected 3496 million children by 2030[6]. The previous studies suggested that overweight and obesity children had an risk of adult obesity[7], which will result to an increased morbidity and mortality[8,9]. Childhood overweight and obesity correlate with heart disease, high blood pressure and other chronic disease[10]. Childhood overweight and obesity is attributed to complex interaction of genetic, environmental, social and behavior factors[11-12]. With rapid economic development, the dietary structure and eating behaviors have undergone great changes[13,14], eating out has become a continuously growing part of the Chinese dietary pattern. According to the statistics released by China's National Bureau of Statistics ,carting revenue increased from 74.03 billion RMB in 2002 to 441.99 billion RMB in 2012, which raised almost 5 times[15].In terms of eating out associate with higher intake of total energy, total fat, sodium, and sugar and lower intakes of fiber, vitamins, and minerals [16,17],the available data have suggested that eating at restaurant may increase the consumption of meat, sweet while reducing the intake of grains, vegetables and fruits[18]. Furthermore, a large numbers of literatures have indicated that eating out was associated with higher intake of energy[16-19], the increasing energy intake from restaurant drove overall increase in daily energy[20]. thus it may contribute to energy unbalanced that cause weight gain[16]. As number of eating out occasion continues to increase, more attention are paid to the relationship between eating out with overweight and obesity. Aristides[21] et al demonstrated that children who ate at restaurant had a 21% higher risk of being overweight than those who did not eat at restaurant. Many abroad studies were conducted by nationally representative or large cohort data from west countries. A research[22] of 3-12 years children in 9 areas of China found the positive relationship between eating out and risk of overweight and obesity or BMI, mainly due to the substantial contribute of eating out to increase the energy intake[23]. A study [24] of Guangzhou middle school students reported that those consuming restaurant food once a week or more was associated with a 38% higher prevalence, compared with those who never ate at restaurant after adjusting for age, single child family structure, household income, and culture of students’ parents. However, available data on the association between eating out and overweight and obesity among Chinese children are far from conclusive. Besides the data of previous published was not representative of the national children population. The objective of the current study was to examine the association between frequency of eating out with overweight and obesity in a nationally representative sample of children using the data of Chinese Nutrition and Health Surveillance (CNNHS) in 2010-2012., then to provide basic information to aid in developing eating out intervention strategies. Methods S tudy participants Data used in this study were from the Chinese Nutrition and Health Surveillance (2010–2012). The CNNHS was a nationally representative cross-sectional study conducted by the National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention (NINH, China CDC) to assess the health and nutrition status of Chinese residents. The 2010-2012 survey covered all 31 provinces, autonomous regions, and municipalities directly under the central government throughout China (except for Taiwan, Hong Kong, and Macao). The method of multi-stage stratification and population proportional cluster random sampling was adopted. In accordance with economic development, all county-level administrative units were divided into four categories: big cities, small and medium-sized cities, ordinary rural areas and poor rural areas. A total of 150 counties (districts) were selected from four categories of areas as study sites，including 34 big cities, 41small and medium-sized cities, 45 ordinary rural areas and 30 poor rural areas, respectively. The study selected 25 households randomly from each village/community and children aged 6 to 17 years in each family were involved. If the number of children was less than 20 children (10 boys and 10 girls) in each age group in each site, supplementary children would be selected from nearby primary and secondary schools to meet the minimum sample size. The specific sampling method can be referred in the published literature [25]. After excluding missing and abnormal data in height, weight, frequency of eating out and sedentary time, a total of 15261 participants (7685 boys, 7576 girls) aged 6 to 17years were recruited. This study was approved by the ethics review committee of the National Institute for Nutrition and Food Safety, Chinese Center for Disease Control and Prevention (No. 2013-018).All participants’ parents or legal guardian were fully informed the purpose and procedures of the study before enrolling and signed the informed consent. Data collection The interview-administered questionnaire was used to collect the information of basic socio-economics, sedentary duration and leisure exercise. The food frequency questionnaire (FFQ) was used to collect eating behaviors over the past week . Participants were asked “How many times have you had breakfast, lunch, or dinner in the past week (seven days)?” and subsequently “How many times in the past week have you had breakfast, lunch, or dinner at a restaurant or school canteen?”. All the questionnaires were collected by trained investigator by face-to-face interview, and the interviews were conducted at the homes of the participants. The children younger than 12 years old finished the questionnaire with the help of their parents or legal guardian. To ensure the reliability of data , evaluation indexes and quality control measures were made at the national, provincial and district levels, quality control was carried out in the early stage, later stage and period of field survey. Categories of Frequency of Eating Out In the current study, eating out was defined as eating a meal or more prepared by restaurants. Frequency of eating out was categorized as three levels: 0 time, 1-2 times, or 3 times and over per week. Anthropometric Measurements The height was measured with an accuracy of 0.1 cm and the fasting weight was measured with an accuracy of 0.1 kg. All measurements were conducted by well-trained investigators under standard operation procedure. Body mass index (BMI) was calculated as a division of weight in kilograms by the square of height in meters. Definition of Weight Status Overweight and obesity was classified based on age- and gender-specific BMI cutoff points among Chinese children[26]. In the meantime, national health standard of Screening standard for malnutrition of school-age children and adolescents was devoted to screen for underweight children[27]. Assessment of Sociodemographic Determinants Age groups were divided into two categories (6-12, 13-17 years). Participants were divided into four residency groups according to location (urban, suburban, rural and poor rural). Family income was classified into four levels (40,000 RMB/person, and unkown). Leisure exercise was defined as two levels (No/Yes). Sedentary duration status was grouped into two levels (≤2h/d and >2h/d). Statistical Analysis All statistical analyses were conducted using SPSS 22.0. The univariate descriptive statistics were conducted for each variable (frequency and percentage), and the frequency of eating out was expressed as a percentage. t tests were used to compare means between different gender, age,leisure exercise and leisure SB groups. Data were run to compare means of region, family-income and BMI status using Chi-square tests. Multivariate logistic regression analysis was used to analyze the relationship between eating out and overweight and obesity. After adjusting for age, region, logistic regression was employed to examine the association of eating out with overweight and obesity, where dependent variable was BMI status (obesity, overweight, normal weight and underweight), and adjusted odds ratios (OR) with 95% confidence intervals (CI) were obtained. Statistical significance was considered at p < 0.05. Results The distribution of the characteristics among participants The characteristics of participants were presented in Table 1. Children who ate out 0, 1-2 and ≥3 times per week were accounted for 76.8%, 10.9% and 12.3%, respectively. Although no significant gender difference in frequency of eating out was observed, we found that there was a trend that children from economic developed region and low income family eat out more often ( P 2h/d) were more likely to eat out ( P <0.05). In additional, table 1 shows the frequency distribution of eating out is significantly different among children with different weight status ( P <0.05). Table 1 Demographic characteristics of participant Variables Total Eating-out（times/ week） c² P 0 1-2 ≥3 N N（%） N（%） N（%） Total 15261 11724（76.8） 1668（10.9） 1869（12.3） Gender 3.47 0.177 Boys 7685 5887（50.2） 822（49.3） 976（52.2） Girls 7576 5837（49.8） 846（50.7） 893（47.8） Age（years） 98.52 <0.05 6-12 9436 7491（63.9） 956（57.3） 989（52.9） 13-17 5825 4233（36.1） 712（42.7） 880（47.1） Region 1127.52 <0.05 Urban 3987 2455（20.9） 696（41.7） 838（44.7） Suburban 4164 2996（25.6） 551（33.0） 617（33.0） Rural 5053 4455（38.0） 253（15.2） 345（18.5） Poor rural 2057 1818（15.5） 168（10.1） 71（3.8） Family income 362.46 <0.05 Low 9156 7469（63.7） 773（46.4） 914（48.9） Medium 2348 1645（14.0） 331（19.8） 372（19.9） High 672 386（3.3） 147（8.8） 139（7.4） Unknown 3085 2224（19.0） 417（25.0） 444（23.8） Leisure exercise 285.49 <0.05 No 8831 7219（61.6） 767（46.0） 845（45.2） Yes 6430 4505（38.4） 901（54.0） 1024（54.8） Leisure SB 150.01 2h/d 9381 6900（58.8） 1142（68.5） 1339（71.6） BMI status 35.34 <0.05 Obesity 1622 1212（10.3） 189（11.3） 221（11.8） Overweight 2015 1499（12.8） 231（13.9） 285（15.3） Normal 10692 8238（70.3） 1181（70.8） 1273（68.1） Underweight 932 775（6.6） 67（4.0） 90（4.8） Logistic regression analysis of the relationship between frequency of eating out with overweight and obesity The relationship between frequency of eating out with overweight and obesity are presented in table 2. In logistic regression model ,after adjustment for age, gender, region, family income, leisure exercise and leisure SB, those who ate out 3 times or more per week had a higher risk of overweight and obesity (OR =1.21, 95% CI: 1.03–1.41) in boys group, compared to those who ate out less than 3 times a week. No significant relationship was observed among girls(OR =0.91,95 CI: 0.78-1.01). Tale 2 Logistic regression analysis of frequency of eating out and overweight and obesity Variables Total Boys Girls OR（95%CI） P OR（95%CI） P OR（95%CI） P Eating-out（freq./ week） 0 Reference 1-2 1.04(0.92-1.18) 0.54 1.15(0.97-1.37) 0.10 0.96(0.74-1.11) 0.32 ≥3 1.09(0.96-1.23) 0.19 1.21(1.03-1.41) <0.05 0.92(0.76-1.12) 0.41 Age（years） 6-12 Reference 13-17 0.62(0.57-0.68) <0.05 0.56(0.50-0.63) <0.05 0.69(0.60-0.79) <0.05 Region urban Reference suburban 0.88(0.79-0.98) <0.05 0.78(0.68-0.89) <0.05 1.03(0.88-1.22) 0.72 rural 0.73(0.65-0.81) <0.05 0.64(0.56-0.74) <0.05 0.84(0.71-0.99) <0.05 Poor rural 0.65(0.56-0.75) <0.05 0.54(0.44-0.66) <0.05 0.81(0.65-1.04) 0.07 Family income Low Reference Medium 1.22(1.10-1.37) <0.05 1.32(1.14-1.53) <0.05 1.11(0.93-1.33) 0.23 High 1.26(1.05-1.51) <0.05 1.37(1.08-1.74) <0.05 1.07(0.79-1.45) 0.68 Leisure exercise No Reference Yes 1.19(1.10-1.29) <0.05 1.16(1.04-1.30) <0.05 1.19(1.05-1.35) 2h/d 1.11(1.02-1.21) <0.05 1.08(096-1.21) 0.19 1.16(1.01-1.32) <0.05 Discussion With rapid economic development, the dietary structure and lifestyle have changed greatly. The study found that more than half of children ate out, which was higher than the national average of 28.3% as reported by the China National Health and Nutrition Survey in 2002. In parallel with an increase in the prevalence of overweight and obesity among children, the rate of eating out has increased rapidly in recent years. The current study clearly demonstrated the significant association between overweight and obesity with higher frequency of eating outside among boys, similar results were observed in previous researches: as in Brazilian children[28], and had been found among children from Etiology of Childhood Obesity (ECHO) study[29], in children and adolescents aged 11-14 years in London Borough[30]，in Portugal children[21] and in US elementary schools students[31]. However, we did not observe a significant association between obesity and eating out in group of girls, which may due to boys’ greater preference for fatty food and girls pay more attention to their weight[32-34]. whereas, the result of the UK National Diet and Nutrition Survey (NDNS) indicated that no association between energy intake and frequency of consumption of meals out in children[35].The differences in research result may be partly due to the fact that lacking of uniform standard for the definition of eating out. The definition for our research was refer to restaurant only, not including take-away food, the scope is relatively limited. Moreover, at present, our research data are mainly from the results of the 2010–2012 survey, as the catering industry has developed rapidly in recent years. With the intensive distribution of restaurant and the convenience of online catering service, children have easy access to eat out. The frequency of eating out of children probably present a growing trend. Therefore, strategies and interventions are warranted to target children’s overall eating-out behavior, to prevent unhealthy eating behaviors among children, such as nutrition and health education. Consistent with previous studies [19,36], 6-12 years children were more likely to be overweight and obesity compared with 13-17 years children, which may be related to the fact that younger children tended to eat out. One possible explanation from previous research[37,38] suggested that the conception and behavior of healthy eating increases while children growing, older children tend to choose more healthy food. Thus, more researches are needed to provide dietary guidance of eating out on younger. Additionally, the study found that children from high-income household were associated with greater prevalence of overweight and obesity, the finding supported by previous researches [39 ,40]. Li Miao found that children from high income family with more pocket money were more likely to be overweight and obesity [41]. however, opposite to previous research[32] lower rate of frequency of eating out was found among children from high-income family, which may be related to the fact that the rate of overweight and obesity was higher among children from high-income family, then they were less likely to eat out . Furthermore, The study showed that in comparison with children in rural regions, children from urban regions tended to be overweight and obesity, and this difference was also found in other domestic studies[ 42,43], which was likely due to the convenience of eating out in the urban regions[44]. Similar result was founded in a survey conducted among Mexican children found that urban children[45] consumed more energy daily than those in the rural regions. Therefore, dietary nutrition education and intervention about healthy eating is necessary. As seen in the current study, children who do leisure exercise tended to eat out, this may be because doing exercise causes energy consumption, which leads children tend to foods produced and sold in restaurants with better taste, color, and flavor . leisure exercise was positive associated with high rate of overweight and obesity, which may be related to the fact that majority of childhood obesity prevention program conducted within obese rather than non-obese children [46], thus Obese children were more likely to participate in exercises[47]. We also found that children those had more leisure sedentary time tended to eat out. the similar result was found among Pakistan children aged 5 to 12 years showed that eating fast food had a significant association with sedentary behavior[48] and Matheson’s study[49]. Sedentary lifestyle that included television viewing and playing video game, television advertising of restaurant foods were attractive for children, which was the possible explanation of the higher rate of eating out. Preventive strategies and practical approaches may need to reduce children’s sedentary time. The main advantages of this study were that the sample was nationally representative, which can reflect the nutrition and health status of Chinese children. The data gave a general description of eating out behavior of Chinese children aged 6–17 years, and the result provided a reference for further research with similar situation. Additionally, as eating out has become an integral part of the daily life, there are many studies on relationship between eating out and dietary patterns among children, while, insufficient guidance exists on the maximum recommended frequency of eating out. The result of this study provide reference times for eating out by genders. However, the present study had several limitations. Firstly, as the definition of eating out which including restaurant only. It is possible to underestimate the frequency of eating out; secondly, this study was cross-sectional study, the causal relationship between the eating out and overweight and obesity cannot be determined; finally, The calculated intake of nutrients such as energy is a lack, Only the data in the interview-administered questionnaire table are analyzed. Therefore, the conclusion of the study still has practical significance. Conclusion In conclusion, the result of this study demonstrated that the prevalence of eating out was 23.3% among Chinese children. Younger children, urban children and children from low-income family were more likely to eat out. Thus, dietary nutritional education and intervention about healthy eating is necessary. Considering the higher risk overweight and obesity among boys, interventions regarding eating out should tailor messages appropriately to target specific subjects by genders. From a public health perspective, the result suggested that interventions are needed to strengthen the monitoring of the situation of children eating out, thus contributing to reduce the potential enormous economic costs that are associated with eating out behavior-related illnesses, such as overweight and obesity. Declarations Acknowledgments We thank all team members and participants for the China National and Health Survey (CHNHS 2010-2012). Funding The 2010-2012 CNNHS was supported by Medical Reform Major Program from the National Health and Family Planning Commission of the People’s Republic of China (No.20120212). Availability of data and materials The datasets generated and/or analyzed during the current study are not publicly available because some results are still being analyzed but are available from the corresponding author on reasonable request. Authors’ Contributions The authors’ contributions were as follows: Y.M. participated in the data clean, data check and analysis, wrote the manuscript. A.L. designed the study and revised the manuscript. W.G., C.D., C.S, F.Y., J.F.,G.F. and Z.C. collected and supervised the data. All authors red and approved the final manuscript. Ethics approval and consent to participate The protocol of the 2010-2012 CNNHS was approved by the Ethical Committee of NINH, China CDC (2013-018). Consent for publication Not applicable. Competing interests The authors declare that they have no competing interests. Author details Department of Nutrition and Health Education, National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, No. 27 Nanwei Road, Xicheng District, Beijing 100050, China. Abbreviations Chinese National Nutrition and Health Survey(CNNHS); World Health Organization(WHO); National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention (NINH, China CDC); Confidence Intervals (95% CIs); Etiology of Childhood Obesity (ECHO) ;UK National Diet and Nutrition Survey(NDNS)；Leisure time sedentary behaviors (LTSB) References World Health Organisation. Childhood overweight and obesity report. Report of a WHO consultation. WHO technical report series, no. 894. Geneva: World Health Organisation, 2015. http://www.who.int/dietphysicalactivity/childhood/en/ Sabin MA, Kao KT, Juonala M, Baur LA, Wake M: Viewpoint article: Childhood obesity--looking back over 50 years to begin to look forward . Journal of paediatrics and child health 2015, 51 (1):82-86. Ng M, Fleming T, Robinson M, Thomson B, Graetz N, Margono C, Mullany EC, Biryukov S, Abbafati C, Abera SF et al : Global, regional, and national prevalence of overweight and obesity in children and adults during 1980-2013: a systematic analysis for the Global Burden of Disease Study 2013 . Lancet (London, England) 2014, 384 (9945):766-781. Gupta N, Shah P, Nayyar S, Misra A: Childhood obesity and the metabolic syndrome in developing countries . Indian journal of pediatrics 2013, 80 Suppl 1 :S28-37. Sun H, Ma Y, Han D, Pan CW, Xu Y: Prevalence and trends in obesity among China's children and adolescents, 1985-2010 . PloS one 2014, 9 (8):e105469. Ma Guansheng, Mi Jie: Report on childhood obesity in China. People’s Health Publishing House : Beijing, China, 2017:12. Huang JY, Qi SJ: Childhood obesity and food intake . World journal of pediatrics : WJP 2015, 11 (2):101-107. Simmonds M, Burch J, Llewellyn A, Griffiths C, Yang H, Owen C, Duffy S, Woolacott N: The use of measures of obesity in childhood for predicting obesity and the development of obesity-related diseases in adulthood: A systematic review and meta-analysis . Health technology assessment (Winchester, England) 2015, 19 :1-336. Xu S, Xue Y: Pediatric obesity: Causes, symptoms, prevention and treatment . Experimental and therapeutic medicine 2016, 11 (1):15-20. Piernas C, Wang D, Du S, Zhang B, Wang Z, Su C, Popkin BM: Obesity, non-communicable disease (NCD) risk factors and dietary factors among Chinese school-aged children . Asia Pacific journal of clinical nutrition 2016, 25 (4):826-840. Silventoinen K, Rokholm B, Kaprio J, Sørensen TI: The genetic and environmental influences on childhood obesity: a systematic review of twin and adoption studies . International journal of obesity (2005) 2010, 34 (1):29-40. Janssen I, Katzmarzyk PT, Boyce WF, Vereecken C, Mulvihill C, Roberts C, Currie C, Pickett W: Comparison of overweight and obesity prevalence in school-aged youth from 34 countries and their relationships with physical activity and dietary patterns . Obesity reviews : an official journal of the International Association for the Study of Obesity 2005, 6 (2):123-132. Seguin RA, Aggarwal A, Vermeylen F, Drewnowski A: Consumption Frequency of Foods Away from Home Linked with Higher Body Mass Index and Lower Fruit and Vegetable Intake among Adults: A Cross-Sectional Study . Journal of environmental and public health 2016, 2016 :3074241. Bezerra IN, Curioni C, Sichieri R: Association between eating out of home and body weight . Nutrition reviews 2012, 70 (2):65-79. National Bureau of Statistics: China Statistical Yearbook. China Statistics Press : Beijing,China, 2012 Jaworowska A, Blackham T, Long R, Taylor C, Ashton M, Stevenson L, Davies I: Nutritional composition of takeaway food in the UK. Nutrition & Food Science 2014, 44:414. Powell LM, Nguyen BT: Fast-food and full-service restaurant consumption among children and adolescents: effect on energy, beverage, and nutrient intake . JAMA pediatrics 2013, 167 (1):14-20. Seguin RA, Aggarwal A, Vermeylen F, Drewnowski A: Consumption Frequency of Foods Away from Home Linked with Higher Body Mass Index and Lower Fruit and Vegetable Intake among Adults: A Cross-Sectional Study . Journal of environmental and public health 2016, 2016 :3074241. Larson N, Neumark-Sztainer D, Laska MN, Story M: Young adults and eating away from home: associations with dietary intake patterns and weight status differ by choice of restaurant . Journal of the American Dietetic Association 2011, 111 (11):1696-1703. Lachat C, Nago E, Verstraeten R, Roberfroid D, Van Camp J, Kolsteren P: Eating out of home and its association with dietary intake: a systematic review of the evidence . Obesity reviews : an official journal of the International Association for the Study of Obesity 2012, 13 (4):329-346. Machado-Rodrigues AM, Gama A, Mourão I, Nogueira H, Rosado-Marques V, Padez C: Eating away from home: a risk factor for overweight in children . European journal of clinical nutrition 2018, 72(12):1724-1727. Zhang Y, Wang J, Xue Y, Zheng Y, Wang P, Zhang Y: Investigation on relevant factors of eating out and fast food and overweight and obesity among 3-12 years old children in 9 areas of China. Zhong guo fu you bao jian = Maternal and Child Health Care of China 2014, 31:5132-5135. Giovanna CA, Maria FG, Maria L, Catarina MA and Renata BL: The consumption of ultra-processed foods according to eating out occasions . Public Health Nutrition 2020, 236 (3):1041-1048. Deng J, Yang S, Ao l, Li B, Zou Z, Li L, Gao Y, Li L: Influencing factors of family eating out and its correlation withoverweight and obesity among urban fresh middle school students in Guangzhou City. Xian dai yi yao wei sheng = Journal of Modern Medicine & Health 2019, 35(10):1455-1459. Zhao, L, Ma, G, Piao, J, Zhang, J, YU D, HE Y, Huo, J, HU X, Yang X: Scheme of the 2010-2012 Chinese nutrition and health surveillance]. Zhong hua yu fang yi xue za zhi = Chinese Journal of Preventive Medicine 2016, 50(3): 204–207. Group of China Obesity Task Force Correspondence: Body mass index reference norm for screening overweight and obesity in Chinese children and adolescents . Zhonghua liu xing bing xue za zhi = Chinese Journal of Epidemiology 2004, 25(2):97-102. Dong YH, Wang ZH, Yang ZG, Wang XJ, Chen YJ, Zou ZY, Ma J: Epidemic status and secular trends of malnutrition among children and adolescents aged 7-18 years from 2005 to 2014 in China . Bei jing yi ke da xue xue bao = Journal of Peking University Health sciences 2017, 49 (3) :424-432. Bezerra IN, de Moura Souza A, Pereira RA, Sichieri R: Contribution of foods consumed away from home to energy intake in Brazilian urban areas: the 2008-9 Nationwide Dietary Survey . The British journal of nutrition 2013, 109 (7):1276-1283. Fulkerson JA, Farbakhsh K, Lytle L, Hearst MO, Dengel DR, Pasch KE, Kubik MY: Away-from-home family dinner sources and associations with weight status, body composition, and related biomarkers of chronic disease among adolescents and their parents . Journal of the American Dietetic Association 2011, 111 (12):1892-1897. Patterson R, Risby A, Chan MY: Consumption of takeaway and fast food in a deprived inner London Borough: are they associated with childhood obesity? BMJ open 2012, 2 (3). Ayala GX, Rogers M, Arredondo EM, Campbell NR, Baquero B, Duerksen SC, Elder JP: Away-from-home food intake and risk for obesity: examining the influence of context . Obesity (Silver Spring, Md) 2008, 16 (5):1002-1008. Qiu C, Hou M: Association between Food Preferences, Eating Behaviors and Socio-Demographic Factors, Physical Activity among Children and Adolescents: A Cross-Sectional Study . Nutrients 2020, 12 (3). Kimura S, Endo Y, Minamimae K, Kanzaki S, Hanaki K: Gender differences in childhood food preference: evaluation using a subjective picture choice method . Pediatrics international : official journal of the Japan Pediatric Society 2014, 56 (3):389-394. Cooke LJ, Wardle J: Age and gender differences in children's food preferences . The British journal of nutrition 2005, 93 (5):741-746. Goffe L, Rushton S, White M, Adamson A, Adams J: Relationship between mean daily energy intake and frequency of consumption of out-of-home meals in the UK National Diet and Nutrition Survey . The international journal of behavioral nutrition and physical activity 2017, 14 (1):131. Adams J, Goffe L, Brown T, Lake AA, Summerbell C, White M, Wrieden W, Adamson AJ: Frequency and socio-demographic correlates of eating meals out and take-away meals at home: cross-sectional analysis of the UK national diet and nutrition survey, waves 1-4 (2008-12) . The international journal of behavioral nutrition and physical activity 2015, 12 :51. Rogers I, Emmett P: The effect of maternal smoking status, educational level and age on food and nutrient intakes in preschool children: results from the Avon Longitudinal Study of Parents and Children . European journal of clinical nutrition 2003, 57 (7):854-864. Dovey TM, Staples PA, Gibson EL, Halford JC: Food neophobia and 'picky/fussy' eating in children: a review . Appetite 2008, 50 (2-3):181-193. Lachat C, Khanh le NB, Khan NC, Dung NQ, Nguyen do VA, Roberfroid D, Kolsteren P: Eating out of home in Vietnamese adolescents: socioeconomic factors and dietary associations . The American journal of clinical nutrition 2009, 90 (6):1648-1655. Zang J, Luo B, Wang Y, Zhu Z, Wang Z, He X, Wang W, Guo Y, Chen X, Wang C et al : Eating Out-of-Home in Adult Residents in Shanghai and the Nutritional Differences among Dining Places . Nutrients 2018, 10 (7). Li M, Xue H, Jia P, Zhao Y, Wang Z, Xu F, Wang Y: Pocket money, eating behaviors, and weight status among Chinese children: The Childhood Obesity Study in China mega-cities . Preventive medicine 2017, 100 :208-215. Ma J, Cai C, Wang H, Dong B, Song Y, Hu P, zhang B: Trends in overweight and obesity among Chinese children of 7- 18 years old during 1985- 2010. Zhong hua yu fang yi xue za zhi = Chinese Journal of Preventive Medicine 2012, 46(9):776-780. Wang S, Dong Y, Wang Z, Zou Z, Ma J: Trends in overweight and obesity among Chinese children of 7- 18 years old during 1985- 2014 . Zhong hua yu fang yi xue za zhi = Chinese Journal of Preventive Medicine 2017, 51(4):300-305. Du WW, Zhang B, Wang HJ, Wang ZH, Su C, Zhang JG, Zhang J, Jia XF, Jiang HR: Gender difference in the association between food away-from-home consumption and body weight outcomes among Chinese adults . Public health nutrition 2016, 19 (16):2984-2990. Taillie LS, Afeiche MC, Eldridge AL, Popkin BM: The contribution of at-home and away-from-home food to dietary intake among 2-13-year-old Mexican children . Public health nutrition 2017, 20 (14):2559-2568. Xu F, Ware RS, Leslie E, Tse LA, Wang Z, Li J, Wang Y: Effectiveness of a Randomized Controlled Lifestyle Intervention to Prevent Obesity among Chinese Primary School Students: CLICK-Obesity Study . PloS one 2015, 10 (10):e0141421. Lu C, Wang Z, Dong Y, Ma J: Prevalence of weight-loss behaviors and the associations betweenweight-loss behaviors and weight-related perceptions among students in primary and middle schools in China. Chinese Journal of School Health 2017, 3, 330–333. Mushtaq MU, Gull S, Mushtaq K, Shahid U, Shad MA, Akram J: Dietary behaviors, physical activity and sedentary lifestyle associated with overweight and obesity, and their socio-demographic correlates, among Pakistani primary school children . The international journal of behavioral nutrition and physical activity 2011, 8 :130. Matheson DM, Killen JD, Wang Y, Varady A, Robinson TN: Children's food consumption during television viewing . The American journal of clinical nutrition 2004, 79 (6):1088-1094. Supplementary Files FoodFrequencyQuestionnaire.docx Cite Share Download PDF Status: Published Journal Publication published 28 May, 2021 Read the published version in BMC Public Health → Version 2 posted Review # 3 received at journal 06 Mar, 2021 Review # 2 received at journal 28 Feb, 2021 Reviewer # 3 agreed at journal 24 Feb, 2021 Review # 1 received at journal 24 Feb, 2021 Reviewer # 2 agreed at journal 23 Feb, 2021 Reviewers invited by journal 22 Feb, 2021 Reviewer # 1 agreed at journal 22 Feb, 2021 Editor assigned by journal 08 Oct, 2020 Submission checks completed at journal 07 Oct, 2020 Editor invited by journal 07 Oct, 2020 You are reading this latest preprint version Show more versions Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-46043","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research article","associatedPublications":[],"authors":[{"id":3326551,"identity":"d6b73bad-6f78-47ca-a18e-a858e1726143","order_by":0,"name":"Yanning ma","email":"","orcid":"","institution":"Chinese Center for Disease Control and Prevention National Institute for Nutrition and Health","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Yanning","middleName":"","lastName":"ma","suffix":""},{"id":3326552,"identity":"81317b17-1469-4049-95e3-585c3fbc78c5","order_by":1,"name":"Weiyan Gong","email":"","orcid":"","institution":"Chinese Center for Disease Control and Prevention National Institute for Nutrition and Health","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Weiyan","middleName":"","lastName":"Gong","suffix":""},{"id":3326553,"identity":"e496428d-832c-469a-bf8d-d0fe91a61e1c","order_by":2,"name":"Caicui Ding","email":"","orcid":"","institution":"Chinese Center for Disease Control and Prevention National Institute for Nutrition and Health","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Caicui","middleName":"","lastName":"Ding","suffix":""},{"id":3326554,"identity":"910c3cee-0105-40b5-8ee5-cc0d7cef8ee3","order_by":3,"name":"Chao Song","email":"","orcid":"","institution":"Chinese Center for Disease Control and Prevention National Institute for Nutrition and Health","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Chao","middleName":"","lastName":"Song","suffix":""},{"id":3326555,"identity":"57e6b049-60ee-4a75-878c-d3d23eb36df8","order_by":4,"name":"Fan Yuan","email":"","orcid":"","institution":"Chinese Center for Disease Control and Prevention National Institute for Nutrition and Health","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Fan","middleName":"","lastName":"Yuan","suffix":""},{"id":3326556,"identity":"d6c10460-2885-4b2f-9f57-51aff7249526","order_by":5,"name":"Jing Fan","email":"","orcid":"","institution":"Chinese Center for Disease Control and Prevention National Institute for Nutrition and Health","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Jing","middleName":"","lastName":"Fan","suffix":""},{"id":3326557,"identity":"406e6181-c81c-42ff-9fb2-97e4a9a3d761","order_by":6,"name":"Ganyu Feng","email":"","orcid":"","institution":"Chinese Center for Disease Control and Prevention National Institute for Nutrition and Health","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Ganyu","middleName":"","lastName":"Feng","suffix":""},{"id":3326558,"identity":"5009c4a6-c55c-4063-aa19-93c83b770f6e","order_by":7,"name":"Zheng Chen","email":"","orcid":"","institution":"Chinese Center for Disease Control and Prevention National Institute for Nutrition and Health","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Zheng","middleName":"","lastName":"Chen","suffix":""},{"id":3326559,"identity":"99bcaab8-b059-47d9-8fe8-10410564593c","order_by":8,"name":"Ailing Liu","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA1UlEQVRIiWNgGAWjYBACPmYg8aCCgYdBgoGBmcEAJJaAXwsbSEvCGZK0gIjENiAB1sJAjBZ2HsMPifPuyJhLNzB+Lii4I8/fnvyA4ecOfA7jMZZI3PaMx3LOAWbpGQbPDGeceWbA2HsGrxYDoJbDPAY3EkDsw4wbJHIYmBnb8NvyI3EOQos9MVrMJBIbEFoSidDCVmaRcAykJbFZGqglGeSXg714tPDzH95840PNYXuDG8kHP/P8OWzb35788MFPPFqQAGMDnHmAKA2jYBSMglEwCnACALURSJEwKxc8AAAAAElFTkSuQmCC","orcid":"https://orcid.org/0000-0001-6886-2158","institution":"","correspondingAuthor":true,"submittingAuthor":false,"prefix":"","firstName":"Ailing","middleName":"","lastName":"Liu","suffix":""}],"badges":[],"createdAt":"2020-07-20 11:23:43","currentVersionCode":2,"declarations":"","doi":"10.21203/rs.3.rs-46043/v2","doiUrl":"https://doi.org/10.21203/rs.3.rs-46043/v2","draftVersion":[],"editorialEvents":[{"content":"https://doi.org/10.1186/s12889-021-11104-0","type":"published","date":"2021-05-28T20:52:01+00:00"}],"editorialNote":"","failedWorkflow":false,"files":[{"id":13605032,"identity":"70310356-784c-4ae3-a2d8-9bfedf599500","added_by":"auto","created_at":"2021-09-17 06:02:18","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1511669,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-46043/v2/7bf78aee-2a6d-4790-830e-e9f53168bfbe.pdf"},{"id":3087785,"identity":"d901b2fd-ef81-4fde-98fa-92809c559ddd","added_by":"auto","created_at":"2020-10-20 16:54:40","extension":"docx","order_by":1,"title":"","display":"","copyAsset":false,"role":"supplement","size":13036,"visible":true,"origin":"","legend":"","description":"","filename":"FoodFrequencyQuestionnaire.docx","url":"https://assets-eu.researchsquare.com/files/rs-46043/v2/98e4933f6d50ac92d5d6da8c.docx"}],"financialInterests":"","formattedTitle":"The association between frequency of eating out with overweight and obesity among children aged 6-17 in China: A National Cross-sectional Study","fulltext":[{"header":"Background","content":"\u003cp\u003eThe worldwide prevalence of overweight and obesity among children is becoming a global health problem[1][1,2]. Between 1980 and 2013, the prevalence of overweight and obesity among children has increased by 47.1 percent globally[3]. Increases were observed in both developed countries and developing societies [4]. The number of childhood overweight and obesity also increased dramatically over the past decades in China[5].A recently report among Chinese students aged 7-18 years old showed that the nationwide prevalence of overweight and obesity increased from 2.1% to 12.2%, 0.5% to 7.3% from 1985 to 2014, respectively, and this proportion was expected to reach 28% or affected 3496 million children by 2030[6]. The previous studies suggested that overweight and obesity children had an risk of adult obesity[7], which will result to an increased morbidity and mortality[8,9]. Childhood overweight and obesity correlate with heart disease, high blood pressure and other chronic disease[10]. Childhood overweight and obesity is attributed to complex interaction of genetic, environmental, social and behavior factors[11-12].\u003c/p\u003e\n\u003cp\u003eWith rapid economic development, the dietary structure and eating behaviors have undergone great changes[13,14], eating out has become a continuously growing part of the Chinese dietary pattern. According to the statistics released by China's National Bureau of Statistics ,carting revenue increased from 74.03 billion RMB in 2002 to 441.99 billion RMB in 2012, which raised almost 5 times[15].In terms of eating out associate with higher intake of total energy, total fat, sodium, and sugar and lower intakes of fiber, vitamins, and minerals [16,17],the available data have suggested that eating at restaurant may increase the consumption of meat, sweet while reducing the intake of grains, vegetables and fruits[18]. Furthermore, a large numbers of literatures have indicated that eating out was associated with higher intake of energy[16-19], the increasing energy intake from restaurant drove overall increase in daily energy[20]. thus it may contribute to energy unbalanced that cause weight gain[16]. As number of eating out occasion continues to increase, more attention are paid to the relationship between eating out with overweight and obesity.\u003c/p\u003e\n\u003cp\u003eAristides[21] et al demonstrated that children who ate at restaurant had a 21% higher risk of being overweight than those who did not eat at restaurant. Many abroad studies were conducted by nationally representative or large cohort data from west countries. A research[22] of 3-12 years children in 9 areas of China found the positive relationship between eating out and risk of overweight and obesity or BMI, mainly due to the substantial contribute of eating out to increase the energy intake[23]. A study [24] of Guangzhou middle school students reported that those consuming restaurant food once a week or more was associated with a 38% higher prevalence, compared with those who never ate at restaurant after adjusting for age, single child family structure, household income, and culture of students\u0026rsquo; parents. However, available data on the association between eating out and overweight and obesity among Chinese children are far from conclusive. Besides the data of previous published was not representative of the national children population. The objective of the current study was to examine the association between frequency of eating out with overweight and obesity in a nationally representative sample of children using the data of Chinese Nutrition and Health Surveillance (CNNHS) in 2010-2012., then to provide basic information to aid in developing eating out intervention strategies.\u003c/p\u003e"},{"header":"Methods","content":"\u003cp\u003e\u003cstrong\u003eS\u003c/strong\u003e\u003cstrong\u003etudy participants\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eData used in this study were from the Chinese Nutrition and Health Surveillance (2010\u0026ndash;2012). The CNNHS was a nationally representative cross-sectional study conducted by the National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention (NINH, China CDC) to assess the health and nutrition status of Chinese residents. The 2010-2012 survey covered all 31 provinces, autonomous regions, and municipalities directly under the central government throughout China (except for Taiwan, Hong Kong, and Macao). The method of multi-stage stratification and population proportional cluster random sampling was adopted. In accordance with economic development, all county-level administrative units were divided into four categories: big cities, small and medium-sized cities, ordinary rural areas and poor rural areas. A total of 150 counties (districts) were selected from four categories of areas as study sites，including 34 big cities, 41small and medium-sized cities, 45 ordinary rural areas and 30 poor rural areas, respectively. The study selected 25 households randomly from each village/community and children aged 6 to 17 years in each family were involved. If the number of children was less than 20 children (10 boys and 10 girls) in each age group in each site, supplementary children would be selected from nearby primary and secondary schools to meet the minimum sample size. The specific sampling method can be referred in the published literature [25]. After excluding missing and abnormal data in height, weight, frequency of eating out and sedentary time, a total of 15261 participants (7685 boys, 7576 girls) aged 6 to 17years were recruited. This study was approved by the ethics review committee of the National Institute for Nutrition and Food Safety, Chinese Center for Disease Control and Prevention (No. 2013-018).All participants\u0026rsquo; parents or legal guardian were fully informed the purpose and procedures of the study before enrolling and signed the informed consent.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData collection\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe interview-administered questionnaire was used to collect the information of basic socio-economics, sedentary duration and leisure exercise. The food frequency questionnaire (FFQ) was used to collect eating behaviors over the past week . Participants were asked \u0026ldquo;How many times have you had breakfast, lunch, or dinner in the past week (seven days)?\u0026rdquo; and subsequently \u0026ldquo;How many times in the past week have you had breakfast, lunch, or dinner at a restaurant or school canteen?\u0026rdquo;. All the questionnaires were collected by trained investigator by face-to-face interview, and the interviews were conducted at the homes of the participants. The children younger than 12 years old finished the questionnaire with the help of their parents or legal guardian. To ensure the reliability of data , evaluation indexes and quality control measures were made at the national, provincial and district levels, quality control was carried out in the early stage, later stage and period of field survey.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCategories of Frequency of Eating Out \u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eIn the current study, eating out was defined as eating a meal or more prepared by restaurants. Frequency of eating out was categorized as three levels: 0 time, 1-2 times, or 3 times and over per week.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAnthropometric Measurements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe height was measured with an accuracy of 0.1 cm and the fasting weight was measured with an accuracy of 0.1 kg. All measurements were conducted by well-trained investigators under standard operation procedure. Body mass index (BMI) was calculated as a division of weight in kilograms by the square of height in meters.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eDefinition of \u003c/strong\u003e\u003cstrong\u003eWeight Status\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eOverweight and obesity was classified based on age- and gender-specific BMI cutoff points among Chinese children[26]. In the meantime, national health standard of Screening standard for malnutrition of school-age children and adolescents was devoted to screen for underweight children[27].\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAssessment of Sociodemographic Determinants\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAge groups were divided into two categories (6-12, 13-17 years). Participants were divided into four residency groups according to location (urban, suburban, rural and poor rural). Family income was classified into four levels (\u0026lt;20,000 RMB/person, 20,000\u0026ndash;40,000 RMB/person, \u0026gt;40,000 RMB/person, and unkown). Leisure exercise was defined as two levels (No/Yes). Sedentary duration status was grouped into two levels (\u0026le;2h/d and \u0026gt;2h/d).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eStatistical Analysis\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll statistical analyses were conducted using SPSS 22.0. The univariate descriptive statistics were conducted for each variable (frequency and percentage), and the frequency of eating out was expressed as a percentage. \u003cem\u003et\u003c/em\u003e tests were used to compare means between different gender, age,leisure exercise and leisure SB groups. Data were run to compare means of region, family-income and BMI status using Chi-square tests. \u0026nbsp;Multivariate logistic regression analysis was used to analyze the relationship between eating out and overweight and obesity. \u0026nbsp;After adjusting for age, region, logistic regression was employed to examine the association of eating out with overweight and obesity, where dependent variable was BMI status (obesity, overweight, normal weight and underweight), and adjusted odds ratios (OR) with 95% confidence intervals (CI) were obtained. Statistical significance was considered at \u003cem\u003ep\u003c/em\u003e\u0026lt; 0.05.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003e\u003cstrong\u003eThe distribution of the characteristics among participants\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe characteristics of participants were presented in Table 1. Children who ate out 0, 1-2 and \u0026ge;3 times per week were accounted for 76.8%, 10.9% and 12.3%, respectively. Although no significant gender difference in frequency of eating out was observed, we found that there was a trend that children from economic developed region and low income family eat out more often (\u003cem\u003eP\u003c/em\u003e\u0026lt;0.05). Compared with their counterparts, younger children, those with leisure exercise, leisure SB (\u0026gt;2h/d) were more likely to eat out (\u003cem\u003eP\u003c/em\u003e\u0026lt;0.05). In additional, table 1 shows the frequency distribution of eating out is significantly different among children with different weight status (\u003cem\u003eP\u003c/em\u003e\u0026lt;0.05).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 1\u003c/strong\u003e Demographic characteristics of participant\u003c/p\u003e\n\u003ctable border=\"1\" width=\"657\"\u003e\n\u003ctbody\u003e\n\u003ctr\u003e\n\u003ctd rowspan=\"3\" width=\"129\"\u003e\n\u003cp\u003eVariables\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd rowspan=\"2\" width=\"65\"\u003e\n\u003cp\u003eTotal\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd colspan=\"3\" width=\"301\"\u003e\n\u003cp\u003eEating-out（times/ week）\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd rowspan=\"3\" width=\"32\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd rowspan=\"3\" width=\"70\"\u003e\n\u003cp\u003ec\u0026sup2;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd rowspan=\"3\" width=\"59\"\u003e\n\u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"99\"\u003e\n\u003cp\u003e0\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"96\"\u003e\n\u003cp\u003e1-2\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"106\"\u003e\n\u003cp\u003e\u0026ge;3\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"65\"\u003e\n\u003cp\u003eN\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"99\"\u003e\n\u003cp\u003eN（%）\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"96\"\u003e\n\u003cp\u003eN（%）\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"106\"\u003e\n\u003cp\u003eN（%）\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"129\"\u003e\n\u003cp\u003eTotal\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"65\"\u003e\n\u003cp\u003e15261\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"99\"\u003e\n\u003cp\u003e11724（76.8）\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"96\"\u003e\n\u003cp\u003e1668（10.9）\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"106\"\u003e\n\u003cp\u003e1869（12.3）\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"32\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"70\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"59\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"129\"\u003e\n\u003cp\u003eGender\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"65\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"99\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"96\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"106\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"32\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"70\"\u003e\n\u003cp\u003e3.47\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"59\"\u003e\n\u003cp\u003e0.177\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"129\"\u003e\n\u003cp\u003eBoys\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"65\"\u003e\n\u003cp\u003e7685\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"99\"\u003e\n\u003cp\u003e5887（50.2）\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"96\"\u003e\n\u003cp\u003e822（49.3）\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"106\"\u003e\n\u003cp\u003e976（52.2）\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"32\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"70\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"59\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"129\"\u003e\n\u003cp\u003eGirls\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"65\"\u003e\n\u003cp\u003e7576\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"99\"\u003e\n\u003cp\u003e5837（49.8）\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"96\"\u003e\n\u003cp\u003e846（50.7）\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"106\"\u003e\n\u003cp\u003e893（47.8）\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"32\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"70\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"59\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"129\"\u003e\n\u003cp\u003eAge（years）\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"65\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"99\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"96\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"106\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"32\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"70\"\u003e\n\u003cp\u003e98.52\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"59\"\u003e\n\u003cp\u003e\u0026lt;0.05\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"129\"\u003e\n\u003cp\u003e6-12\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"65\"\u003e\n\u003cp\u003e9436\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"99\"\u003e\n\u003cp\u003e7491（63.9）\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"96\"\u003e\n\u003cp\u003e956（57.3）\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"106\"\u003e\n\u003cp\u003e989（52.9）\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"32\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"70\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"59\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"129\"\u003e\n\u003cp\u003e13-17\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"65\"\u003e\n\u003cp\u003e5825\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"99\"\u003e\n\u003cp\u003e4233（36.1）\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"96\"\u003e\n\u003cp\u003e712（42.7）\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"106\"\u003e\n\u003cp\u003e880（47.1）\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"32\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"70\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"59\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"129\"\u003e\n\u003cp\u003eRegion\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"65\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"99\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"96\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"106\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"32\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"70\"\u003e\n\u003cp\u003e1127.52\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"59\"\u003e\n\u003cp\u003e\u0026lt;0.05\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"129\"\u003e\n\u003cp\u003eUrban\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"65\"\u003e\n\u003cp\u003e\u0026nbsp;3987\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"99\"\u003e\n\u003cp\u003e2455（20.9）\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"96\"\u003e\n\u003cp\u003e696（41.7）\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"106\"\u003e\n\u003cp\u003e838（44.7）\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"32\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"70\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"59\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"129\"\u003e\n\u003cp\u003eSuburban\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"65\"\u003e\n\u003cp\u003e\u0026nbsp;4164\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"99\"\u003e\n\u003cp\u003e2996（25.6）\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"96\"\u003e\n\u003cp\u003e551（33.0）\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"106\"\u003e\n\u003cp\u003e617（33.0）\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"32\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"70\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"59\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"129\"\u003e\n\u003cp\u003eRural\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"65\"\u003e\n\u003cp\u003e\u0026nbsp;5053\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"99\"\u003e\n\u003cp\u003e4455（38.0）\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"96\"\u003e\n\u003cp\u003e253（15.2）\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"106\"\u003e\n\u003cp\u003e345（18.5）\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"32\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"70\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"59\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"129\"\u003e\n\u003cp\u003ePoor rural\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"65\"\u003e\n\u003cp\u003e\u0026nbsp;2057\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"99\"\u003e\n\u003cp\u003e1818（15.5）\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"96\"\u003e\n\u003cp\u003e168（10.1）\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"106\"\u003e\n\u003cp\u003e\u0026nbsp;71（3.8）\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"32\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"70\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"59\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"129\"\u003e\n\u003cp\u003eFamily income\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"65\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"99\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"96\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"106\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"32\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"70\"\u003e\n\u003cp\u003e362.46\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"59\"\u003e\n\u003cp\u003e\u0026lt;0.05\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"129\"\u003e\n\u003cp\u003eLow\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"65\"\u003e\n\u003cp\u003e9156\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"99\"\u003e\n\u003cp\u003e7469（63.7）\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"96\"\u003e\n\u003cp\u003e773（46.4）\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"106\"\u003e\n\u003cp\u003e914（48.9）\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"32\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"70\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"59\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"129\"\u003e\n\u003cp\u003eMedium\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"65\"\u003e\n\u003cp\u003e2348\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"99\"\u003e\n\u003cp\u003e1645（14.0）\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"96\"\u003e\n\u003cp\u003e331（19.8）\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"106\"\u003e\n\u003cp\u003e372（19.9）\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"32\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"70\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"59\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"129\"\u003e\n\u003cp\u003eHigh\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"65\"\u003e\n\u003cp\u003e\u0026nbsp;672\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"99\"\u003e\n\u003cp\u003e\u0026nbsp;386（3.3）\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"96\"\u003e\n\u003cp\u003e147（8.8）\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"106\"\u003e\n\u003cp\u003e\u0026nbsp;139（7.4）\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"32\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"70\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"59\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"129\"\u003e\n\u003cp\u003eUnknown\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"65\"\u003e\n\u003cp\u003e3085\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"99\"\u003e\n\u003cp\u003e2224（19.0）\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"96\"\u003e\n\u003cp\u003e417（25.0）\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"106\"\u003e\n\u003cp\u003e\u0026nbsp;444（23.8）\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"32\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"70\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"59\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"129\"\u003e\n\u003cp\u003eLeisure exercise\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"65\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"99\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"96\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"106\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"32\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"70\"\u003e\n\u003cp\u003e285.49\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"59\"\u003e\n\u003cp\u003e\u0026lt;0.05\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"129\"\u003e\n\u003cp\u003eNo\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"65\"\u003e\n\u003cp\u003e8831\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"99\"\u003e\n\u003cp\u003e7219（61.6）\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"96\"\u003e\n\u003cp\u003e767（46.0）\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"106\"\u003e\n\u003cp\u003e845（45.2）\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"32\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"70\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"59\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"129\"\u003e\n\u003cp\u003eYes\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"65\"\u003e\n\u003cp\u003e6430\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"99\"\u003e\n\u003cp\u003e4505（38.4）\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"96\"\u003e\n\u003cp\u003e901（54.0）\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"106\"\u003e\n\u003cp\u003e1024（54.8）\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"32\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"70\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"59\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"129\"\u003e\n\u003cp\u003eLeisure SB\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"65\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"99\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"96\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"106\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"32\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"70\"\u003e\n\u003cp\u003e150.01\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"59\"\u003e\n\u003cp\u003e\u0026lt;0.05\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"129\"\u003e\n\u003cp\u003e\u0026le;2h/d\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"65\"\u003e\n\u003cp\u003e5880\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"99\"\u003e\n\u003cp\u003e4824（41.2）\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"96\"\u003e\n\u003cp\u003e\u0026nbsp;526（31.5）\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"106\"\u003e\n\u003cp\u003e\u0026nbsp;530（28.4）\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"32\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"70\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"59\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"129\"\u003e\n\u003cp\u003e\u0026gt;2h/d\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"65\"\u003e\n\u003cp\u003e9381\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"99\"\u003e\n\u003cp\u003e6900（58.8）\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"96\"\u003e\n\u003cp\u003e1142（68.5）\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"106\"\u003e\n\u003cp\u003e1339（71.6）\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"32\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"70\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"59\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"129\"\u003e\n\u003cp\u003eBMI status\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"65\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"99\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"96\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"106\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"32\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"70\"\u003e\n\u003cp\u003e35.34\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"59\"\u003e\n\u003cp\u003e\u0026lt;0.05\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"129\"\u003e\n\u003cp\u003eObesity\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"65\"\u003e\n\u003cp\u003e1622\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"99\"\u003e\n\u003cp\u003e1212（10.3）\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"96\"\u003e\n\u003cp\u003e\u0026nbsp;189（11.3）\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"106\"\u003e\n\u003cp\u003e221（11.8）\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"32\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"70\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"59\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"129\"\u003e\n\u003cp\u003eOverweight\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"65\"\u003e\n\u003cp\u003e2015\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"99\"\u003e\n\u003cp\u003e1499（12.8）\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"96\"\u003e\n\u003cp\u003e\u0026nbsp;231（13.9）\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"106\"\u003e\n\u003cp\u003e\u0026nbsp;285（15.3）\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"32\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"70\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"59\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"129\"\u003e\n\u003cp\u003eNormal\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"65\"\u003e\n\u003cp\u003e10692\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"99\"\u003e\n\u003cp\u003e8238（70.3）\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"96\"\u003e\n\u003cp\u003e1181（70.8）\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"106\"\u003e\n\u003cp\u003e1273（68.1）\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"32\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"70\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"59\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"129\"\u003e\n\u003cp\u003eUnderweight\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"65\"\u003e\n\u003cp\u003e932\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"99\"\u003e\n\u003cp\u003e775（6.6）\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"96\"\u003e\n\u003cp\u003e67（4.0）\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"106\"\u003e\n\u003cp\u003e90（4.8）\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"32\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"70\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"59\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003eLogistic regression analysis of the relationship between frequency of eating out with overweight and obesity\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe relationship between frequency of eating out with overweight and obesity are presented in table 2. In logistic regression model ,after adjustment for age, gender, region, family income, leisure exercise and leisure SB, those who ate out 3 times or more per week had a higher risk of overweight and obesity (OR =1.21, 95% CI: 1.03\u0026ndash;1.41) in boys group, compared to those who ate out less than 3 times a week. No significant relationship was observed among girls(OR =0.91,95 CI: 0.78-1.01).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTale 2\u003c/strong\u003e Logistic regression analysis of frequency of eating out and overweight and obesity\u003c/p\u003e\n\u003ctable border=\"1\" width=\"608\"\u003e\n\u003ctbody\u003e\n\u003ctr\u003e\n\u003ctd rowspan=\"2\" width=\"106\"\u003e\n\u003cp\u003eVariables\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd colspan=\"2\" width=\"156\"\u003e\n\u003cp\u003eTotal\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"16\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd colspan=\"2\" width=\"152\"\u003e\n\u003cp\u003eBoys\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"21\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd colspan=\"2\" width=\"156\"\u003e\n\u003cp\u003eGirls\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"109\"\u003e\n\u003cp\u003eOR（95%CI）\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"47\"\u003e\n\u003cp\u003eP\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"16\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"103\"\u003e\n\u003cp\u003eOR（95%CI）\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"49\"\u003e\n\u003cp\u003eP\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"21\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"107\"\u003e\n\u003cp\u003eOR（95%CI）\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"49\"\u003e\n\u003cp\u003eP\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd colspan=\"2\" width=\"215\"\u003e\n\u003cp\u003eEating-out（freq./ week）\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"47\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"16\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"103\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"49\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"21\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"107\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"49\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"106\"\u003e\n\u003cp\u003e0\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"109\"\u003e\n\u003cp\u003eReference\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"47\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"16\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"103\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"49\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"21\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"107\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"49\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"106\"\u003e\n\u003cp\u003e1-2\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"109\"\u003e\n\u003cp\u003e1.04(0.92-1.18)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"47\"\u003e\n\u003cp\u003e0.54\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"16\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"103\"\u003e\n\u003cp\u003e1.15(0.97-1.37)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"49\"\u003e\n\u003cp\u003e0.10\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"21\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"107\"\u003e\n\u003cp\u003e0.96(0.74-1.11)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"49\"\u003e\n\u003cp\u003e0.32\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"106\"\u003e\n\u003cp\u003e\u0026ge;3\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"109\"\u003e\n\u003cp\u003e1.09(0.96-1.23)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"47\"\u003e\n\u003cp\u003e0.19\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"16\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"103\"\u003e\n\u003cp\u003e1.21(1.03-1.41)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"49\"\u003e\n\u003cp\u003e\u0026lt;0.05\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"21\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"107\"\u003e\n\u003cp\u003e0.92(0.76-1.12)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"49\"\u003e\n\u003cp\u003e0.41\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"106\"\u003e\n\u003cp\u003eAge（years）\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"109\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"47\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"16\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"103\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"49\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"21\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"107\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"49\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"106\"\u003e\n\u003cp\u003e6-12\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"109\"\u003e\n\u003cp\u003eReference\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"47\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"16\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"103\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"49\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"21\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"107\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"49\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"106\"\u003e\n\u003cp\u003e13-17\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"109\"\u003e\n\u003cp\u003e0.62(0.57-0.68)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"47\"\u003e\n\u003cp\u003e\u0026lt;0.05\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"16\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"103\"\u003e\n\u003cp\u003e0.56(0.50-0.63)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"49\"\u003e\n\u003cp\u003e\u0026lt;0.05\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"21\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"107\"\u003e\n\u003cp\u003e0.69(0.60-0.79)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"49\"\u003e\n\u003cp\u003e\u0026lt;0.05\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"106\"\u003e\n\u003cp\u003eRegion\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"109\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"47\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"16\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"103\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"49\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"21\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"107\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"49\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"106\"\u003e\n\u003cp\u003eurban\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"109\"\u003e\n\u003cp\u003eReference\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"47\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"16\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"103\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"49\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"21\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"107\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"49\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"106\"\u003e\n\u003cp\u003esuburban\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"109\"\u003e\n\u003cp\u003e0.88(0.79-0.98)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"47\"\u003e\n\u003cp\u003e\u0026lt;0.05\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"16\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"103\"\u003e\n\u003cp\u003e0.78(0.68-0.89)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"49\"\u003e\n\u003cp\u003e\u0026lt;0.05\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"21\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"107\"\u003e\n\u003cp\u003e1.03(0.88-1.22)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"49\"\u003e\n\u003cp\u003e0.72\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"106\"\u003e\n\u003cp\u003erural\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"109\"\u003e\n\u003cp\u003e0.73(0.65-0.81)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"47\"\u003e\n\u003cp\u003e\u0026lt;0.05\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"16\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"103\"\u003e\n\u003cp\u003e0.64(0.56-0.74)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"49\"\u003e\n\u003cp\u003e\u0026lt;0.05\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"21\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"107\"\u003e\n\u003cp\u003e0.84(0.71-0.99)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"49\"\u003e\n\u003cp\u003e\u0026lt;0.05\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"106\"\u003e\n\u003cp\u003ePoor rural\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"109\"\u003e\n\u003cp\u003e0.65(0.56-0.75)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"47\"\u003e\n\u003cp\u003e\u0026lt;0.05\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"16\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"103\"\u003e\n\u003cp\u003e0.54(0.44-0.66)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"49\"\u003e\n\u003cp\u003e\u0026lt;0.05\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"21\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"107\"\u003e\n\u003cp\u003e0.81(0.65-1.04)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"49\"\u003e\n\u003cp\u003e0.07\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"106\"\u003e\n\u003cp\u003eFamily income\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"109\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"47\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"16\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"103\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"49\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"21\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"107\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"49\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"106\"\u003e\n\u003cp\u003eLow\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"109\"\u003e\n\u003cp\u003eReference\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"47\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"16\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"103\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"49\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"21\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"107\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"49\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"106\"\u003e\n\u003cp\u003eMedium\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"109\"\u003e\n\u003cp\u003e1.22(1.10-1.37)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"47\"\u003e\n\u003cp\u003e\u0026lt;0.05\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"16\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"103\"\u003e\n\u003cp\u003e1.32(1.14-1.53)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"49\"\u003e\n\u003cp\u003e\u0026lt;0.05\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"21\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"107\"\u003e\n\u003cp\u003e1.11(0.93-1.33)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"49\"\u003e\n\u003cp\u003e0.23\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"106\"\u003e\n\u003cp\u003eHigh\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"109\"\u003e\n\u003cp\u003e1.26(1.05-1.51)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"47\"\u003e\n\u003cp\u003e\u0026lt;0.05\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"16\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"103\"\u003e\n\u003cp\u003e1.37(1.08-1.74)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"49\"\u003e\n\u003cp\u003e\u0026lt;0.05\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"21\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"107\"\u003e\n\u003cp\u003e1.07(0.79-1.45)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"49\"\u003e\n\u003cp\u003e0.68\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"106\"\u003e\n\u003cp\u003eLeisure exercise\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"109\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"47\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"16\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"103\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"49\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"21\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"107\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"49\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"106\"\u003e\n\u003cp\u003eNo\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"109\"\u003e\n\u003cp\u003eReference\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"47\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"16\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"103\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"49\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"21\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"107\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"49\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"106\"\u003e\n\u003cp\u003eYes\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"109\"\u003e\n\u003cp\u003e1.19(1.10-1.29)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"47\"\u003e\n\u003cp\u003e\u0026lt;0.05\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"16\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"103\"\u003e\n\u003cp\u003e1.16(1.04-1.30)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"49\"\u003e\n\u003cp\u003e\u0026lt;0.05\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"21\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"107\"\u003e\n\u003cp\u003e1.19(1.05-1.35)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"49\"\u003e\n\u003cp\u003e\u0026lt;0.05\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"106\"\u003e\n\u003cp\u003eLeisure SB\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"109\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"47\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"16\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"103\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"49\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"21\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"107\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"49\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"106\"\u003e\n\u003cp\u003e\u0026le;2h/d\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"109\"\u003e\n\u003cp\u003eReference\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"47\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"16\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"103\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"49\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"21\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"107\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"49\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"106\"\u003e\n\u003cp\u003e\u0026gt;2h/d\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"109\"\u003e\n\u003cp\u003e1.11(1.02-1.21)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"47\"\u003e\n\u003cp\u003e\u0026lt;0.05\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"16\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"103\"\u003e\n\u003cp\u003e1.08(096-1.21)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"49\"\u003e\n\u003cp\u003e\u0026nbsp;0.19\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"21\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"107\"\u003e\n\u003cp\u003e1.16(1.01-1.32)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"49\"\u003e\n\u003cp\u003e\u0026lt;0.05\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tbody\u003e\n\u003c/table\u003e"},{"header":"Discussion","content":"\u003cp\u003eWith rapid economic development, the dietary structure and lifestyle have changed greatly. The study found that more than half of children ate out, which was higher than the national average of 28.3% as reported by the China National Health and Nutrition Survey in 2002. In parallel with an increase in the prevalence of overweight and obesity among children, the rate of eating out has increased rapidly in recent years. The current study clearly demonstrated the significant association between overweight and obesity with higher frequency of eating outside among boys, similar results were observed in previous researches: as in Brazilian children[28], and had been found among children from Etiology of Childhood Obesity (ECHO) study[29], in children and adolescents aged 11-14 years in London Borough[30]，in Portugal children[21] and in US elementary schools students[31]. However, we did not observe a significant association between obesity and eating out in group of girls, which may due to boys\u0026rsquo; greater preference for fatty food and girls pay more attention to their weight[32-34]. whereas, the result of the UK National Diet and Nutrition Survey (NDNS) indicated that no association between energy intake and frequency of consumption of meals out in children[35].The differences in research result may be partly due to the fact that lacking of uniform standard for the definition of eating out. The definition for our research was refer to restaurant only, not including take-away food, the scope is relatively limited. Moreover, at present, our research data are mainly from the results of the 2010\u0026ndash;2012 survey, as the catering industry has developed rapidly in recent years. With the intensive distribution of restaurant and the convenience of online catering service, children have easy access to eat out. The frequency of eating out of children probably present a growing trend. Therefore, strategies and interventions are warranted to target children\u0026rsquo;s overall eating-out behavior, to prevent unhealthy eating behaviors among children, such as nutrition and health education.\u003c/p\u003e\n\u003cp\u003eConsistent with previous studies [19,36], 6-12 years children were more likely to be overweight and obesity compared with 13-17 years children, which may be related to the fact that younger children tended to eat out. One possible explanation from previous research[37,38] suggested that the conception and behavior of healthy eating increases while children growing, older children tend to choose more healthy food. Thus, more researches are needed to provide dietary guidance of eating out on younger. Additionally, the study found that children from high-income household were associated with greater prevalence of overweight and obesity, the finding supported by previous researches [39 ,40]. Li Miao found that children from high income family with more pocket money were more likely to be overweight and obesity [41]. however, opposite to previous research[32] lower rate of frequency of eating out was found among children from high-income family, which may be related to the fact that the rate of overweight and obesity was higher among children from high-income family, then they were less likely to eat out . Furthermore, The study showed that in comparison with children in rural regions, children from urban regions tended to be overweight and obesity, and this difference was also found in other domestic studies[ 42,43], which was likely due to the convenience of eating out in the urban regions[44]. Similar result was founded in a survey conducted among Mexican children found that urban children[45] consumed more energy daily than those in the rural regions. Therefore, dietary nutrition education and intervention about healthy eating is necessary. As seen in the current study, children who do leisure exercise tended to eat out, this may be because doing exercise causes energy consumption, which leads children tend to foods produced and sold in restaurants with better taste, color, and flavor . leisure exercise was positive associated with high rate of overweight and obesity, which may be related to the fact that majority of childhood obesity prevention program conducted within obese rather than non-obese children [46], thus Obese children were more likely to participate in exercises[47]. We also found that children those had more leisure sedentary time tended to eat out. the similar result was found among Pakistan children aged 5 to 12 years showed that eating fast food had a significant association with sedentary behavior[48] and Matheson\u0026rsquo;s study[49]. Sedentary lifestyle that included television viewing and playing video game, television advertising of restaurant foods were attractive for children, which was the possible explanation of the higher rate of eating out. Preventive strategies and practical approaches may need to reduce children\u0026rsquo;s sedentary time.\u003c/p\u003e\n\u003cp\u003eThe main advantages of this study were that the sample was nationally representative, which can reflect the nutrition and health status of Chinese children. The data gave a general description of eating out behavior of Chinese children aged 6\u0026ndash;17 years, and the result provided a reference for further research with similar situation. Additionally, as eating out has become an integral part of the daily life, there are many studies on relationship between eating out and dietary patterns among children, while, insufficient guidance exists on the maximum recommended frequency of eating out. The result of this study provide reference times for eating out by genders. However, the present study had several limitations. Firstly, as the definition of eating out which including restaurant only. It is possible to underestimate the frequency of eating out; secondly, this study was cross-sectional study, the causal relationship between the eating out and overweight and obesity cannot be determined; finally, The calculated intake of nutrients such as energy is a lack, Only the data in the interview-administered questionnaire table are analyzed. Therefore, the conclusion of the study still has practical significance.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eIn conclusion, the result of this study demonstrated that the prevalence of eating out was 23.3% among Chinese children. Younger children, urban children and children from low-income family were more likely to eat out. Thus, dietary nutritional education and intervention about healthy eating is necessary. Considering the higher risk overweight and obesity among boys, interventions regarding eating out should tailor messages appropriately to target specific subjects by genders. From a public health perspective, the result suggested that interventions are needed to strengthen the monitoring of the situation of children eating out, thus contributing to reduce the potential enormous economic costs that are associated with eating out behavior-related illnesses, such as overweight and obesity.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eAcknowledgments\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe thank all team members and participants for the China National and Health Survey (CHNHS 2010-2012).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u0026nbsp;\u0026nbsp; The 2010-2012 CNNHS was supported by Medical Reform Major Program from the National Health and Family Planning Commission of the People\u0026rsquo;s Republic of China (No.20120212).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u0026nbsp;\u0026nbsp; The datasets generated and/or analyzed during the current study are not publicly available because some results are still being analyzed but are available from the corresponding author on reasonable request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026rsquo; Contributions \u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors\u0026rsquo; contributions were as follows: Y.M. participated in the data clean, data check and analysis, wrote the manuscript. A.L. designed the study and revised the manuscript.\u003c/p\u003e\n\u003cp\u003eW.G., C.D., C.S, F.Y., J.F.,G.F. and Z.C. collected and supervised the data. All authors red and approved the final manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u0026nbsp;\u0026nbsp; The protocol of the 2010-2012 CNNHS was approved by the Ethical Committee of NINH, China CDC (2013-018).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that they have no competing interests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor details\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eDepartment of Nutrition and Health Education, National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, No. 27 Nanwei Road, Xicheng District, Beijing 100050, China.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cp\u003e\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; Chinese National Nutrition and Health Survey(CNNHS); World Health Organization(WHO); National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention (NINH, China CDC); Confidence Intervals (95% CIs); Etiology of Childhood Obesity (ECHO) ;UK National Diet and Nutrition Survey(NDNS)；Leisure time sedentary behaviors (LTSB)\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003e\u003cstrong\u003eWorld Health Organisation. Childhood overweight and obesity report. Report of a WHO consultation. WHO technical report series, no. 894. Geneva: World Health Organisation, 2015.\u0026nbsp;\u003c/strong\u003e\u003ca href=\"http://www.who.int/dietphysicalactivity/childhood/en/\"\u003e\u003cstrong\u003ehttp://www.who.int/dietphysicalactivity/childhood/en/\u003c/strong\u003e\u003c/a\u003e\u003c/li\u003e\n\u003c/ol\u003e\n\u003col start=\"2\"\u003e\n\u003cli\u003eSabin MA, Kao KT, Juonala M, Baur LA, Wake M: \u003cstrong\u003eViewpoint article: Childhood obesity--looking back over 50 years to begin to look forward\u003c/strong\u003e. \u003cem\u003eJournal of paediatrics and child health \u003c/em\u003e2015, \u003cstrong\u003e51\u003c/strong\u003e(1):82-86.\u003c/li\u003e\n\u003cli\u003eNg M, Fleming T, Robinson M, Thomson B, Graetz N, Margono C, Mullany EC, Biryukov S, Abbafati C, Abera SF\u003cem\u003e et al\u003c/em\u003e: \u003cstrong\u003eGlobal, regional, and national prevalence of overweight and obesity in children and adults during 1980-2013: a systematic analysis for the Global Burden of Disease Study 2013\u003c/strong\u003e. \u003cem\u003eLancet (London, England) \u003c/em\u003e2014, \u003cstrong\u003e384\u003c/strong\u003e(9945):766-781.\u003c/li\u003e\n\u003cli\u003eGupta N, Shah P, Nayyar S, Misra A: \u003cstrong\u003eChildhood obesity and the metabolic syndrome in developing countries\u003c/strong\u003e. \u003cem\u003eIndian journal of pediatrics \u003c/em\u003e2013, \u003cstrong\u003e80 Suppl 1\u003c/strong\u003e:S28-37.\u003c/li\u003e\n\u003cli\u003eSun H, Ma Y, Han D, Pan CW, Xu Y: \u003cstrong\u003ePrevalence and trends in obesity among China's children and adolescents, 1985-2010\u003c/strong\u003e. \u003cem\u003ePloS one \u003c/em\u003e2014, \u003cstrong\u003e9\u003c/strong\u003e(8):e105469.\u003c/li\u003e\n\u003cli\u003eMa Guansheng, Mi Jie: \u003cstrong\u003eReport on childhood obesity in China. \u003c/strong\u003e\u003cem\u003ePeople\u0026rsquo;s Health Publishing House\u003c/em\u003e: Beijing, China, 2017:12.\u003c/li\u003e\n\u003cli\u003eHuang JY, Qi SJ: \u003cstrong\u003eChildhood obesity and food intake\u003c/strong\u003e. \u003cem\u003eWorld journal of pediatrics : WJP \u003c/em\u003e2015, \u003cstrong\u003e11\u003c/strong\u003e(2):101-107.\u003c/li\u003e\n\u003cli\u003eSimmonds M, Burch J, Llewellyn A, Griffiths C, Yang H, Owen C, Duffy S, Woolacott N: \u003cstrong\u003eThe use of measures of obesity in childhood for predicting obesity and the development of obesity-related diseases in adulthood: A systematic review and meta-analysis\u003c/strong\u003e. \u003cem\u003eHealth technology assessment (Winchester, England) \u003c/em\u003e2015, \u003cstrong\u003e19\u003c/strong\u003e:1-336.\u003c/li\u003e\n\u003cli\u003eXu S, Xue Y: \u003cstrong\u003ePediatric obesity: Causes, symptoms, prevention and treatment\u003c/strong\u003e. \u003cem\u003eExperimental and therapeutic medicine \u003c/em\u003e2016, \u003cstrong\u003e11\u003c/strong\u003e(1):15-20.\u003c/li\u003e\n\u003cli\u003ePiernas C, Wang D, Du S, Zhang B, Wang Z, Su C, Popkin BM: \u003cstrong\u003eObesity, non-communicable disease (NCD) risk factors and dietary factors among Chinese school-aged children\u003c/strong\u003e. \u003cem\u003eAsia Pacific journal of clinical nutrition \u003c/em\u003e2016, \u003cstrong\u003e25\u003c/strong\u003e(4):826-840.\u003c/li\u003e\n\u003cli\u003eSilventoinen K, Rokholm B, Kaprio J, S\u0026oslash;rensen TI: \u003cstrong\u003eThe genetic and environmental influences on childhood obesity: a systematic review of twin and adoption studies\u003c/strong\u003e. \u003cem\u003eInternational journal of obesity (2005) \u003c/em\u003e2010, \u003cstrong\u003e34\u003c/strong\u003e(1):29-40.\u003c/li\u003e\n\u003cli\u003eJanssen I, Katzmarzyk PT, Boyce WF, Vereecken C, Mulvihill C, Roberts C, Currie C, Pickett W: \u003cstrong\u003eComparison of overweight and obesity prevalence in school-aged youth from 34 countries and their relationships with physical activity and dietary patterns\u003c/strong\u003e. \u003cem\u003eObesity reviews : an official journal of the International Association for the Study of Obesity \u003c/em\u003e2005, \u003cstrong\u003e6\u003c/strong\u003e(2):123-132.\u003c/li\u003e\n\u003cli\u003eSeguin RA, Aggarwal A, Vermeylen F, Drewnowski A: \u003cstrong\u003eConsumption Frequency of Foods Away from Home Linked with Higher Body Mass Index and Lower Fruit and Vegetable Intake among Adults: A Cross-Sectional Study\u003c/strong\u003e. \u003cem\u003eJournal of environmental and public health \u003c/em\u003e2016, \u003cstrong\u003e2016\u003c/strong\u003e:3074241.\u003c/li\u003e\n\u003cli\u003eBezerra IN, Curioni C, Sichieri R: \u003cstrong\u003eAssociation between eating out of home and body weight\u003c/strong\u003e. \u003cem\u003eNutrition reviews \u003c/em\u003e2012, \u003cstrong\u003e70\u003c/strong\u003e(2):65-79.\u003c/li\u003e\n\u003cli\u003eNational\u0026nbsp;Bureau of\u0026nbsp;Statistics: \u003cstrong\u003eChina Statistical Yearbook.\u003c/strong\u003e\u003cem\u003eChina Statistics Press\u003c/em\u003e: Beijing,China, 2012\u003c/li\u003e\n\u003cli\u003eJaworowska A, Blackham T, Long R, Taylor C, Ashton M, Stevenson L, Davies I: \u003cstrong\u003eNutritional composition of takeaway food in the UK.\u003c/strong\u003e\u003cem\u003eNutrition \u0026amp; Food Science \u003c/em\u003e2014, 44:414.\u003c/li\u003e\n\u003cli\u003ePowell LM, Nguyen BT: \u003cstrong\u003eFast-food and full-service restaurant consumption among children and adolescents: effect on energy, beverage, and nutrient intake\u003c/strong\u003e. \u003cem\u003eJAMA pediatrics \u003c/em\u003e2013, \u003cstrong\u003e167\u003c/strong\u003e(1):14-20.\u003c/li\u003e\n\u003cli\u003eSeguin RA, Aggarwal A, Vermeylen F, Drewnowski A: \u003cstrong\u003eConsumption Frequency of Foods Away from Home Linked with Higher Body Mass Index and Lower Fruit and Vegetable Intake among Adults: A Cross-Sectional Study\u003c/strong\u003e. \u003cem\u003eJournal of environmental and public health \u003c/em\u003e2016, \u003cstrong\u003e2016\u003c/strong\u003e:3074241.\u003c/li\u003e\n\u003cli\u003eLarson N, Neumark-Sztainer D, Laska MN, Story M: \u003cstrong\u003eYoung adults and eating away from home: associations with dietary intake patterns and weight status differ by choice of restaurant\u003c/strong\u003e. \u003cem\u003eJournal of the American Dietetic Association \u003c/em\u003e2011, \u003cstrong\u003e111\u003c/strong\u003e(11):1696-1703.\u003c/li\u003e\n\u003cli\u003eLachat C, Nago E, Verstraeten R, Roberfroid D, Van Camp J, Kolsteren P: \u003cstrong\u003eEating out of home and its association with dietary intake: a systematic review of the evidence\u003c/strong\u003e. \u003cem\u003eObesity reviews : an official journal of the International Association for the Study of Obesity \u003c/em\u003e2012, \u003cstrong\u003e13\u003c/strong\u003e(4):329-346.\u003c/li\u003e\n\u003cli\u003eMachado-Rodrigues AM, Gama A, Mour\u0026atilde;o I, Nogueira H, Rosado-Marques V, Padez C: \u003cstrong\u003eEating away from home: a risk factor for overweight in children\u003c/strong\u003e. \u003cem\u003eEuropean journal of clinical nutrition \u003c/em\u003e2018, 72(12):1724-1727.\u003c/li\u003e\n\u003cli\u003eZhang Y, Wang J, Xue Y, Zheng Y, Wang P, Zhang Y: \u003cstrong\u003eInvestigation on relevant factors of eating out and fast food and overweight and obesity among 3-12 years old children in 9 areas of China.\u003c/strong\u003e Zhong guo fu you bao jian = Maternal and Child Health Care of China 2014, 31:5132-5135.\u003c/li\u003e\n\u003c/ol\u003e\n\u003col start=\"23\"\u003e\n\u003cli\u003eGiovanna CA, Maria FG, Maria L, Catarina MA and Renata BL: \u003cstrong\u003eThe consumption of ultra-processed foods according to eating out occasions\u003c/strong\u003e. \u003cem\u003ePublic Health Nutrition \u003c/em\u003e2020, \u003cstrong\u003e236\u003c/strong\u003e(3):1041-1048.\u003c/li\u003e\n\u003cli\u003eDeng J, Yang S, Ao l, Li B, Zou Z, Li L, Gao Y, Li L: \u003cstrong\u003eInfluencing factors of family eating out and its correlation withoverweight and obesity among urban fresh middle school students in Guangzhou City.\u003c/strong\u003e Xian dai yi yao wei sheng = \u003cem\u003eJournal of Modern Medicine \u0026amp; Health \u003c/em\u003e2019, 35(10):1455-1459.\u003c/li\u003e\n\u003cli\u003eZhao, L, Ma, G, Piao, J, Zhang, J, YU D, HE Y, Huo, J, HU X, Yang X: \u003cstrong\u003eScheme of the 2010-2012 Chinese nutrition and health surveillance].\u003c/strong\u003e\u003cem\u003eZhong hua yu fang yi xue za zhi = Chinese Journal of Preventive Medicine\u003c/em\u003e 2016, 50(3): 204\u0026ndash;207.\u003c/li\u003e\n\u003cli\u003eGroup of China Obesity Task Force Correspondence: \u003cstrong\u003eBody mass index reference norm for screening overweight and obesity in Chinese children and adolescents\u003c/strong\u003e. \u003cem\u003eZhonghua liu xing bing xue za zhi = \u003c/em\u003e\u003cem\u003eChinese Journal of Epidemiology\u003c/em\u003e 2004, 25(2):97-102.\u003c/li\u003e\n\u003cli\u003eDong YH, Wang ZH, Yang ZG, Wang XJ, Chen YJ, Zou ZY, Ma J: \u003cstrong\u003eEpidemic status and secular trends of malnutrition among children and adolescents aged 7-18 years from 2005 to 2014 in China\u003c/strong\u003e. Bei jing yi ke da xue xue bao = \u003cem\u003eJournal of Peking University Health sciences \u003c/em\u003e2017, \u003cstrong\u003e49\u003c/strong\u003e(3) :424-432.\u003c/li\u003e\n\u003cli\u003eBezerra IN, de Moura Souza A, Pereira RA, Sichieri R: \u003cstrong\u003eContribution of foods consumed away from home to energy intake in Brazilian urban areas: the 2008-9 Nationwide Dietary Survey\u003c/strong\u003e. \u003cem\u003eThe British journal of nutrition \u003c/em\u003e2013, \u003cstrong\u003e109\u003c/strong\u003e(7):1276-1283.\u003c/li\u003e\n\u003cli\u003eFulkerson JA, Farbakhsh K, Lytle L, Hearst MO, Dengel DR, Pasch KE, Kubik MY: \u003cstrong\u003eAway-from-home family dinner sources and associations with weight status, body composition, and related biomarkers of chronic disease among adolescents and their parents\u003c/strong\u003e. \u003cem\u003eJournal of the American Dietetic Association \u003c/em\u003e2011, \u003cstrong\u003e111\u003c/strong\u003e(12):1892-1897.\u003c/li\u003e\n\u003cli\u003ePatterson R, Risby A, Chan MY: \u003cstrong\u003eConsumption of takeaway and fast food in a deprived inner London Borough: are they associated with childhood obesity?\u003c/strong\u003e\u003cem\u003eBMJ open \u003c/em\u003e2012, \u003cstrong\u003e2\u003c/strong\u003e(3).\u003c/li\u003e\n\u003cli\u003eAyala GX, Rogers M, Arredondo EM, Campbell NR, Baquero B, Duerksen SC, Elder JP: \u003cstrong\u003eAway-from-home food intake and risk for obesity: examining the influence of context\u003c/strong\u003e. \u003cem\u003eObesity (Silver Spring, Md) \u003c/em\u003e2008, \u003cstrong\u003e16\u003c/strong\u003e(5):1002-1008.\u003c/li\u003e\n\u003cli\u003eQiu C, Hou M: \u003cstrong\u003eAssociation between Food Preferences, Eating Behaviors and Socio-Demographic Factors, Physical Activity among Children and Adolescents: A Cross-Sectional Study\u003c/strong\u003e. \u003cem\u003eNutrients \u003c/em\u003e2020, \u003cstrong\u003e12\u003c/strong\u003e(3).\u003c/li\u003e\n\u003cli\u003eKimura S, Endo Y, Minamimae K, Kanzaki S, Hanaki K: \u003cstrong\u003eGender differences in childhood food preference: evaluation using a subjective picture choice method\u003c/strong\u003e. \u003cem\u003ePediatrics international : official journal of the Japan Pediatric Society \u003c/em\u003e2014, \u003cstrong\u003e56\u003c/strong\u003e(3):389-394.\u003c/li\u003e\n\u003cli\u003eCooke LJ, Wardle J: \u003cstrong\u003eAge and gender differences in children's food preferences\u003c/strong\u003e. \u003cem\u003eThe British journal of nutrition \u003c/em\u003e2005, \u003cstrong\u003e93\u003c/strong\u003e(5):741-746.\u003c/li\u003e\n\u003cli\u003eGoffe L, Rushton S, White M, Adamson A, Adams J: \u003cstrong\u003eRelationship between mean daily energy intake and frequency of consumption of out-of-home meals in the UK National Diet and Nutrition Survey\u003c/strong\u003e. \u003cem\u003eThe international journal of behavioral nutrition and physical activity \u003c/em\u003e2017, \u003cstrong\u003e14\u003c/strong\u003e(1):131.\u003c/li\u003e\n\u003cli\u003eAdams J, Goffe L, Brown T, Lake AA, Summerbell C, White M, Wrieden W, Adamson AJ: \u003cstrong\u003eFrequency and socio-demographic correlates of eating meals out and take-away meals at home: cross-sectional analysis of the UK national diet and nutrition survey, waves 1-4 (2008-12)\u003c/strong\u003e. \u003cem\u003eThe international journal of behavioral nutrition and physical activity \u003c/em\u003e2015, \u003cstrong\u003e12\u003c/strong\u003e:51.\u003c/li\u003e\n\u003cli\u003eRogers I, Emmett P: \u003cstrong\u003eThe effect of maternal smoking status, educational level and age on food and nutrient intakes in preschool children: results from the Avon Longitudinal Study of Parents and Children\u003c/strong\u003e. \u003cem\u003eEuropean journal of clinical nutrition \u003c/em\u003e2003, \u003cstrong\u003e57\u003c/strong\u003e(7):854-864.\u003c/li\u003e\n\u003cli\u003eDovey TM, Staples PA, Gibson EL, Halford JC: \u003cstrong\u003eFood neophobia and 'picky/fussy' eating in children: a review\u003c/strong\u003e. \u003cem\u003eAppetite \u003c/em\u003e2008, \u003cstrong\u003e50\u003c/strong\u003e(2-3):181-193.\u003c/li\u003e\n\u003cli\u003eLachat C, Khanh le NB, Khan NC, Dung NQ, Nguyen do VA, Roberfroid D, Kolsteren P: \u003cstrong\u003eEating out of home in Vietnamese adolescents: socioeconomic factors and dietary associations\u003c/strong\u003e. \u003cem\u003eThe American journal of clinical nutrition \u003c/em\u003e2009, \u003cstrong\u003e90\u003c/strong\u003e(6):1648-1655.\u003c/li\u003e\n\u003cli\u003eZang J, Luo B, Wang Y, Zhu Z, Wang Z, He X, Wang W, Guo Y, Chen X, Wang C\u003cem\u003e et al\u003c/em\u003e: \u003cstrong\u003eEating Out-of-Home in Adult Residents in Shanghai and the Nutritional Differences among Dining Places\u003c/strong\u003e. \u003cem\u003eNutrients \u003c/em\u003e2018, \u003cstrong\u003e10\u003c/strong\u003e(7).\u003c/li\u003e\n\u003cli\u003eLi M, Xue H, Jia P, Zhao Y, Wang Z, Xu F, Wang Y: \u003cstrong\u003ePocket money, eating behaviors, and weight status among Chinese children: The Childhood Obesity Study in China mega-cities\u003c/strong\u003e. \u003cem\u003ePreventive medicine \u003c/em\u003e2017, \u003cstrong\u003e100\u003c/strong\u003e:208-215.\u003c/li\u003e\n\u003cli\u003eMa J, Cai C, Wang H, Dong B, Song Y, Hu P, zhang B: \u003cstrong\u003eTrends in overweight and obesity among Chinese children of 7- 18 years old during 1985- 2010. \u003c/strong\u003e\u003cem\u003eZhong hua yu fang yi xue za zhi = Chinese Journal of Preventive Medicine\u003c/em\u003e 2012, 46(9):776-780.\u003c/li\u003e\n\u003cli\u003eWang S, Dong Y, Wang Z, Zou Z, Ma J: \u003cstrong\u003eTrends in overweight and obesity among Chinese children of 7- 18 years old during 1985- 2014\u003c/strong\u003e. \u003cem\u003eZhong hua yu fang yi xue za zhi = Chinese Journal of Preventive Medicine \u003c/em\u003e2017, 51(4):300-305.\u003c/li\u003e\n\u003c/ol\u003e\n\u003col start=\"44\"\u003e\n\u003cli\u003eDu WW, Zhang B, Wang HJ, Wang ZH, Su C, Zhang JG, Zhang J, Jia XF, Jiang HR: \u003cstrong\u003eGender difference in the association between food away-from-home consumption and body weight outcomes among Chinese adults\u003c/strong\u003e. \u003cem\u003ePublic health nutrition \u003c/em\u003e2016, \u003cstrong\u003e19\u003c/strong\u003e(16):2984-2990.\u003c/li\u003e\n\u003cli\u003eTaillie LS, Afeiche MC, Eldridge AL, Popkin BM: \u003cstrong\u003eThe contribution of at-home and away-from-home food to dietary intake among 2-13-year-old Mexican children\u003c/strong\u003e. \u003cem\u003ePublic health nutrition \u003c/em\u003e2017, \u003cstrong\u003e20\u003c/strong\u003e(14):2559-2568.\u003c/li\u003e\n\u003cli\u003eXu F, Ware RS, Leslie E, Tse LA, Wang Z, Li J, Wang Y: \u003cstrong\u003eEffectiveness of a Randomized Controlled Lifestyle Intervention to Prevent Obesity among Chinese Primary School Students: CLICK-Obesity Study\u003c/strong\u003e. \u003cem\u003ePloS one \u003c/em\u003e2015, \u003cstrong\u003e10\u003c/strong\u003e(10):e0141421.\u003c/li\u003e\n\u003cli\u003eLu C, Wang Z, Dong Y, Ma J: \u003cstrong\u003ePrevalence of weight-loss behaviors and the associations betweenweight-loss behaviors and weight-related perceptions among students in primary and middle schools in China. \u003c/strong\u003e\u003cem\u003eChinese Journal of School Health\u003c/em\u003e 2017, 3, 330\u0026ndash;333.\u003c/li\u003e\n\u003c/ol\u003e\n\u003col start=\"48\"\u003e\n\u003cli\u003eMushtaq MU, Gull S, Mushtaq K, Shahid U, Shad MA, Akram J: \u003cstrong\u003eDietary behaviors, physical activity and sedentary lifestyle associated with overweight and obesity, and their socio-demographic correlates, among Pakistani primary school children\u003c/strong\u003e. \u003cem\u003eThe international journal of behavioral nutrition and physical activity \u003c/em\u003e2011, \u003cstrong\u003e8\u003c/strong\u003e:130.\u003c/li\u003e\n\u003cli\u003eMatheson DM, Killen JD, Wang Y, Varady A, Robinson TN: \u003cstrong\u003eChildren's food consumption during television viewing\u003c/strong\u003e. \u003cem\u003eThe American journal of clinical nutrition \u003c/em\u003e2004, \u003cstrong\u003e79\u003c/strong\u003e(6):1088-1094.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-public-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"pubh","sideBox":"Learn more about [BMC Public Health](http://bmcpublichealth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/pubh/default.aspx","title":"BMC Public Health","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"China, eating out, frequency, overweight and obesity, children","lastPublishedDoi":"10.21203/rs.3.rs-46043/v2","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-46043/v2","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground:\u003c/strong\u003e In parallel with the increased prevalence of childhood overweight and obesity, the rate of eating out in China has increased dramatically in recent years. The purpose of the study was to explore the association between frequency of eating out with overweight and obesity among Chinese children.\u003c/p\u003e\u003cp\u003e\u003cstrong\u003eMethods: \u003c/strong\u003eThe representative sample of Chinese children aged 6-17 years (7685 boys; 7576 girls) was recruited from Chinese National Nutrition and Health Survey (CNNHS) in 2010-2012. Frequency of eating out was collected by interview-administered questionnaire and categorized as: less than once per week, once and twice per week, and three times or more per week. Height and weight were measured (body mass index was consequently calculated). \u003c/p\u003e\u003cp\u003e\u003cstrong\u003eResults：\u003c/strong\u003eThe prevalence of eating out among Chinese children aged 6-17 years old was 23.2%. Children who ate out 0, 1-2, ≥3 times per week were accounted for 76.8%, 10.9% and 12.3% respectively. Findings revealed that eating out three times per week or more was statistically significant associated with higher prevalence of overweight and obesity among boys (OR=1.20,95CI:1.04-1.38) compared with those ate out less than three times per week. However, no significantly association was observed among girls (OR=0.91, 95CI:0.78-1.01). In additional, Younger children, rural children, children from low income family, those with leisure exercises (certain physical activities regularly carried out such as swimming, walking, running, equipment fitness), leisure time sedentary behaviors (LTSB)(\u0026gt;2h/d) were relatively more likely to eat out.\u0026nbsp;\u0026nbsp;\u003c/p\u003e\u003cp\u003e\u003cstrong\u003eConclusions:\u003c/strong\u003e The results illustrated that eating out three times or more had a significantly positive effect on overweight and obesity among boys in China.\u0026nbsp;\u003c/p\u003e","manuscriptTitle":"The association between frequency of eating out with overweight and obesity among children aged 6-17 in China: A National Cross-sectional Study","msid":"","msnumber":"","nonDraftVersions":[{"code":2,"date":"2020-10-20 16:50:29","doi":"10.21203/rs.3.rs-46043/v2","editorialEvents":[{"type":"communityComments","content":0},{"type":"editorInvitedReview","content":"","date":"2021-03-07T00:00:00+00:00","index":3,"fulltext":"Recommendation: Reviewer's comments unavailable pending editorial decision\n"},{"type":"editorInvitedReview","content":"","date":"2021-03-01T00:00:00+00:00","index":2,"fulltext":"Recommendation: Reviewer's comments unavailable pending editorial decision\n"},{"type":"reviewerAgreed","content":"","date":"2021-02-25T00:00:00+00:00","index":3,"fulltext":""},{"type":"editorInvitedReview","content":"","date":"2021-02-25T00:00:00+00:00","index":1,"fulltext":"Recommendation: Reviewer's comments unavailable pending editorial decision\n"},{"type":"reviewerAgreed","content":"","date":"2021-02-24T00:00:00+00:00","index":2,"fulltext":""},{"type":"reviewersInvited","content":"","date":"2021-02-23T00:00:00+00:00","index":"","fulltext":""},{"type":"reviewerAgreed","content":"","date":"2021-02-23T00:00:00+00:00","index":1,"fulltext":""},{"type":"editorAssigned","content":"","date":"2020-10-08T12:00:00+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2020-10-07T12:00:00+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2020-10-07T12:00:00+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-public-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"pubh","sideBox":"Learn more about [BMC Public Health](http://bmcpublichealth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/pubh/default.aspx","title":"BMC Public Health","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}},{"code":1,"date":"2020-08-13 14:23:10","doi":"10.21203/rs.3.rs-46043/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Major revision","date":"2020-09-08T12:00:00+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2020-09-06T12:00:00+00:00","index":2,"fulltext":"Recommendation: Accept after minor essential revisions\nForm responses:\n---\n\nComments to Author:\n---\nManuscript Number: PUBH-D-20-04397R1\nFull Title: The association between frequency of eating out with overweight and obesity among children aged 6-17 in China: A National Cross-sectional Study\n\nGeneral comments:\n1. This is an interesting study that explores the association between frequency of eating out with overweight/obesity among Chinese children.\n2. A major strength of the study is that it utlilizes nationally representative data from the Chinese Nutrition and Health Surveillance (2010-85 2012).\n3. The study methods are appropriate, the data are valid and support the conclusions.\n\nAreas for improvement:\nA. Major issues- None\nB. Minor issues-\n1. Discussion: Page 11, line 202: The authors should consider replacing the word \"advantages\" in the sentence with \"strengths\".\n2. The language is generally good but it would be helpful to edit for minor corrections.\n* Publons Reviewer Recognition. Springer Nature can send verification of this review directly to Publons (a subsidiary of Clarivate Analytics). If you would like to take advantage of this service, please click on the “Yes” option below. Your name, email address, title of the reviewed manuscript, name of the journal, and date of your review submission (the “Review Data”) will then be transmitted to Publons upon publication of the manuscript. If you have already registered at Publons, they will notify you of the receipt of this review and update your profile as per your settings and their policy. If you are not registered with Publons, you will receive an email from them asking you to register in order for them to be able to recognize your review on your new profile page. Publons may use the Review Data to generate derivative metadata for the benefit of Publons and you as a reviewer, carefully considering the sensitivity of such information. For example, Publons may verify your record as a reviewer by updating your profile published on its webservice if you have registered for such service or help editors to identify candidate reviewers. Please find the details of processing in Publons’ privacy policy https://publons.com/about/terms: **Yes**\n* Declaration of competing interests: **I declare that I have no competing interests**\n* Reviewer Publication Consent. I agree for my report to be made available under an Open Access Creative Commons CC-BY License (http://creativecommons.org/licenses/by/4.0) if this manuscript is accepted for publication. Any comments that I do not wish to be included in the published report have been included as confidential comments to the editor, which will not be published.: **I agree to the terms of the CC-BY 4.0 license; please do not publish my name with my report. (default)**\n* Is the study design appropriate to answer the research question (including the use of appropriate controls), and are the conclusions supported by the evidence presented?: **Yes**\n* Are the methods sufficiently described to allow the study to be repeated?: **Yes**\n* Is the use of statistics and treatment of uncertainties appropriate?: **Yes**\n* Is the presentation of the work clear?: **Yes**\n* Are the images in this manuscript (including electrophoretic gels and blots) free from apparent manipulation?: **Yes**\n"},{"type":"editorInvitedReview","content":"","date":"2020-09-02T12:00:00+00:00","index":3,"fulltext":"Recommendation: Accept after minor essential revisions\nForm responses:\n---\n\nComments to Author:\n---\nThe title is ok. In the abstract you use the concept \" interviewer-administrated questionnaire\". It is unclear how you conducted the data collection. Did the 7000 boys and girls filled in questionnaires at school during class or at home? Or did you instructed \"trained investigators\" to perform face-to-face interviews with those students with parental consent? What did the students without consent do if you collected data in class? Data used in this study seem to be part of a larger data collection. What was the attrition rate? You inform about those recruited, not how many were eligible. \n\nYou claim that this is a representative sample of Chinese children aged 6-17. China has a huge population of children and I have problems understanding that this sample is representative for Chinese children in general. Did you restrict the data collection to a geographical region, for example?\n\nIn addition, I miss information about the potential confounding variables, for example, how were leisure exercise, sedentary duriation ect defined and and measured. \n\nThe introduction is ok. However, data are old, from 2010-12. Your 49 references are old, and I register only 2 out of 49 from 2018 and 2019. Why is that? You could update more references. A lot has happened in 10 years. Correct the list of referenes with upper cases in the names of the journals. \n\nThe discussion include many references to other studies. Keep in mind that you mainly should discuss your data, results and findings. Can we believe in your findings? It would be fine if you could discuss the validity of 10 year old data about nutrition. Discuss more why overveight was associated with high-income househoulds? In Europe, that association would not have been the typical, rather the opposide and perhaps you can discuss cultural and contextual issues and associatations with body image and so on? In addition, can you for real compare eating out in cities with rural districts? I suppose, that in cities, a youth can pop out to a restaurant nearby while in rural districts, you may need a car. So, be careful with the associations and your interpretations.\nUnfortunately, your design is weak. You have a cross-sectional study relying on only one informant. Data are old. Could you supplement the findings with any recent statistics from Statistics China, that could update and strengthen the discussion?\n\nFinally, it was nicely writtena and easy to follow the text. Overall, there were sober interpretations, but I miss a stronger focus on what is the new knowlegde and whether theses findings are strong enough to build on for prevention and interventions. \n\n\n\n* Publons Reviewer Recognition. Springer Nature can send verification of this review directly to Publons (a subsidiary of Clarivate Analytics). If you would like to take advantage of this service, please click on the “Yes” option below. Your name, email address, title of the reviewed manuscript, name of the journal, and date of your review submission (the “Review Data”) will then be transmitted to Publons upon publication of the manuscript. If you have already registered at Publons, they will notify you of the receipt of this review and update your profile as per your settings and their policy. If you are not registered with Publons, you will receive an email from them asking you to register in order for them to be able to recognize your review on your new profile page. Publons may use the Review Data to generate derivative metadata for the benefit of Publons and you as a reviewer, carefully considering the sensitivity of such information. For example, Publons may verify your record as a reviewer by updating your profile published on its webservice if you have registered for such service or help editors to identify candidate reviewers. Please find the details of processing in Publons’ privacy policy https://publons.com/about/terms: **Yes**\n* Declaration of competing interests: **I declare that I have no competing interests.**\n* Reviewer Publication Consent. I agree for my report to be made available under an Open Access Creative Commons CC-BY License (http://creativecommons.org/licenses/by/4.0) if this manuscript is accepted for publication. Any comments that I do not wish to be included in the published report have been included as confidential comments to the editor, which will not be published.: **I agree to the terms of the CC-BY 4.0 license; please publish my name with my report.**\n* Is the study design appropriate to answer the research question (including the use of appropriate controls), and are the conclusions supported by the evidence presented?: **Yes**\n* Are the methods sufficiently described to allow the study to be repeated?: **Yes**\n* Is the use of statistics and treatment of uncertainties appropriate?: **Yes**\n* Is the presentation of the work clear?: **Yes**\n* Are the images in this manuscript (including electrophoretic gels and blots) free from apparent manipulation?: **Yes**\n"},{"type":"editorInvitedReview","content":"","date":"2020-09-01T12:00:00+00:00","index":4,"fulltext":"Recommendation: Major revisions required\nForm responses:\n---\n\nComments to Author:\n---\nDear\nThanks for this important subjects, but there are several points need to be clarify !\nBackground\n\n* lines 70-73 the authors said: These studies were conducted by nationally representative or large cohort data from West countries. However, available data on the association between eating out and overweight and obesity among Chinese children are far from conclusive. while in lines 67-69 they said A research[22] of 3-12 years children in 9 areas of China found the positive relationship between eating out and risk of 69 overweight and obesity or BMI, mainly due to the substantial contribute of eating out to 70 increase the energy intake[23]. More clarification is needed !\n* If there was a previous study that conducted among Chines to to measure the association between obesity and eating out among Chinese, so what is the privilege of the current study ??\nMethods:\nMore details are needed for \"Data used in this study were from the Chinese Nutrition and Health Surveillance (2010- 2012)\". \u2028\nDid the authors measure the sample size, why they chose 15261 participants, according to which basis ?, What was the non response rate?\nWhat was the source of the questionnaire? did the authors develop the questions from the literature ? Did they measure the validity of the questionnaire ? what was the language of the questions, did they make a translation for the questions ??\n\nResults\n\nLines 141 -142, the authors said \" we found that there was a trend that children from economic developed region and high income family eat out more often (P\u003c0.05)\", while table 1 showing that those from low family income eating out \u003e=3 times per week represented 48.9 % compare to 7 % of high income who eating out \u003e=3 times per week ??!\u2028\nThe same point for children from rural and urban , table 1 revealed that children from urban region ate higher outside (44.7%) compare to those from rural region (18.5%) !! while the authors said those from rural ate at restaurant higher compare to those from urban region !! at the same the time, the logistic regression ( table 2) showing that OR for obesity among those from rural region was 0.64 compare to the reference ( those from urban region ) !! OR less than one indicating the rural region protective against the obesity !!\nSo these results need to be rewrite in more scientific and accurate way !\nThere is a need to clarify the relation between BMI and weight that was demonstrated in table 1\n\nDiscussion\nThe authors didn't discuss the result of table 1, why ??\nLines 182-183 they stated: Additionally, the study found that children from high-income household were associated with greater prevalence of overweight and obesity, the finding supported by previous researches [39 ,40], while the results of the tables of the current study revealed the opposite finding ! so need to clarify that !\u2028* Publons Reviewer Recognition. Springer Nature can send verification of this review directly to Publons (a subsidiary of Clarivate Analytics). If you would like to take advantage of this service, please click on the “Yes” option below. Your name, email address, title of the reviewed manuscript, name of the journal, and date of your review submission (the “Review Data”) will then be transmitted to Publons upon publication of the manuscript. If you have already registered at Publons, they will notify you of the receipt of this review and update your profile as per your settings and their policy. If you are not registered with Publons, you will receive an email from them asking you to register in order for them to be able to recognize your review on your new profile page. Publons may use the Review Data to generate derivative metadata for the benefit of Publons and you as a reviewer, carefully considering the sensitivity of such information. For example, Publons may verify your record as a reviewer by updating your profile published on its webservice if you have registered for such service or help editors to identify candidate reviewers. Please find the details of processing in Publons’ privacy policy https://publons.com/about/terms: **Yes**\n* Declaration of competing interests: **No funding was received**\n* Reviewer Publication Consent. I agree for my report to be made available under an Open Access Creative Commons CC-BY License (http://creativecommons.org/licenses/by/4.0) if this manuscript is accepted for publication. Any comments that I do not wish to be included in the published report have been included as confidential comments to the editor, which will not be published.: **I agree to the terms of the CC-BY 4.0 license; please publish my name with my report.**\n* Is the study design appropriate to answer the research question (including the use of appropriate controls), and are the conclusions supported by the evidence presented?: **Yes**\n* Are the methods sufficiently described to allow the study to be repeated?: **Yes**\n* Is the use of statistics and treatment of uncertainties appropriate?: **No**\n* Is the presentation of the work clear?: **Yes**\n* Are the images in this manuscript (including electrophoretic gels and blots) free from apparent manipulation?: **No**\n"},{"type":"editorInvitedReview","content":"","date":"2020-08-28T12:00:00+00:00","index":1,"fulltext":"Recommendation: Accept after minor essential revisions\nForm responses:\n---\n\nComments to Author:\n---\nWell written manuscript and good information for dissemination - not only in China but worldwide.\n\nThe only comment I have is that the authors should explain in more detail - in the methods section - the larger study, and how the data were collected for the larger study and how the data were extracted for this particular study. A more detailed explanation would be appropriate * Publons Reviewer Recognition. Springer Nature can send verification of this review directly to Publons (a subsidiary of Clarivate Analytics). If you would like to take advantage of this service, please click on the “Yes” option below. Your name, email address, title of the reviewed manuscript, name of the journal, and date of your review submission (the “Review Data”) will then be transmitted to Publons upon publication of the manuscript. If you have already registered at Publons, they will notify you of the receipt of this review and update your profile as per your settings and their policy. If you are not registered with Publons, you will receive an email from them asking you to register in order for them to be able to recognize your review on your new profile page. Publons may use the Review Data to generate derivative metadata for the benefit of Publons and you as a reviewer, carefully considering the sensitivity of such information. For example, Publons may verify your record as a reviewer by updating your profile published on its webservice if you have registered for such service or help editors to identify candidate reviewers. Please find the details of processing in Publons’ privacy policy https://publons.com/about/terms: **Yes**\n* Declaration of competing interests: **I declare that I have no competing interests**\n* Reviewer Publication Consent. I agree for my report to be made available under an Open Access Creative Commons CC-BY License (http://creativecommons.org/licenses/by/4.0) if this manuscript is accepted for publication. Any comments that I do not wish to be included in the published report have been included as confidential comments to the editor, which will not be published.: **I agree to the terms of the CC-BY 4.0 license; please publish my name with my report.**\n* Is the study design appropriate to answer the research question (including the use of appropriate controls), and are the conclusions supported by the evidence presented?: **Yes**\n* Are the methods sufficiently described to allow the study to be repeated?: **Yes**\n* Is the use of statistics and treatment of uncertainties appropriate?: **Yes**\n* Is the presentation of the work clear?: **Yes**\n* Are the images in this manuscript (including electrophoretic gels and blots) free from apparent manipulation?: **Yes**\n"},{"type":"reviewerAgreed","content":"","date":"2020-08-21T12:00:00+00:00","index":3,"fulltext":""},{"type":"reviewerAgreed","content":"","date":"2020-08-21T12:00:00+00:00","index":4,"fulltext":""},{"type":"reviewerAgreed","content":"","date":"2020-08-21T12:00:00+00:00","index":5,"fulltext":""},{"type":"reviewersInvited","content":"","date":"2020-08-20T12:00:00+00:00","index":"","fulltext":""},{"type":"reviewerAgreed","content":"","date":"2020-08-20T12:00:00+00:00","index":1,"fulltext":""},{"type":"reviewerAgreed","content":"","date":"2020-08-20T12:00:00+00:00","index":2,"fulltext":""},{"type":"editorAssigned","content":"","date":"2020-07-29T12:00:00+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2020-07-28T12:00:00+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2020-07-28T12:00:00+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-public-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"pubh","sideBox":"Learn more about [BMC Public Health](http://bmcpublichealth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/pubh/default.aspx","title":"BMC Public Health","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"4956b3be-46f7-40bf-8bee-0d83faf81834","owner":[],"postedDate":"October 20th, 2020","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[{"id":805486,"name":"Nutrition \u0026 Dietetics"},{"id":805487,"name":"Pediatrics"}],"tags":[],"updatedAt":"2021-07-27T20:52:01+00:00","versionOfRecord":{"articleIdentity":"rs-46043","link":"https://doi.org/10.1186/s12889-021-11104-0","journal":{"identity":"bmc-public-health","isVorOnly":false,"title":"BMC Public Health"},"publishedOn":"2021-05-28 20:52:01","publishedOnDateReadable":"May 28th, 2021"},"versionCreatedAt":"2020-10-20 16:50:29","video":"","vorDoi":"10.1186/s12889-021-11104-0","vorDoiUrl":"https://doi.org/10.1186/s12889-021-11104-0","workflowStages":[]},"version":"v2","identity":"rs-46043","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-46043","identity":"rs-46043","version":["v2"]},"buildId":"rHA-KDH7Qsr4HCuvH75dn","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}