Myopia in children and adolescents has become a serious public health concern, with a noticeable trend toward earlier onset. Visual impairments caused by refractive errors, amblyopia, strabismus, and congenital eye diseases have a profound negative impacts on children's learning abilities, cognitive development, psychological well-being, and long-term quality of life. Therefore, strengthening child eye care services to ensure early screening, diagnosis, and intervention for vision problems is essential to safeguard and promote visual health in children.To implement the relevant goals and requirements outlined in the National Program for Child Development(2021—2030) and the Five Health Promotion Action Plan for Children and Adolescents (2026—2030), the Child Health Care Branch of the Chinese Preventive Medicine Association convened an expert panel. This panel developed the present expert consensus by referencing international guidelines and integrating them with the current state of child healthcare services in China. This consensus was formulated by drawing upon international guidelines and contextualizing them within the current landscape of pediatric healthcare services in China. This consensus aims to provide standardized guidance and a practical basis for healthcare institutions at all levels to systematically deliver child eye care services and enhance the capacity building of child eye care specialties, thereby offering direction for the prevention and management of vision-related diseases in the child population.

Children and adolescents represent a uniquely vulnerable population because this life stage is characterized by rapid somatic growth, maturation of organ systems, and the establishment of behavioral patterns. Consequently, their health may be particularly susceptible to changes in the external environment. In recent years, the field has moved beyond the assessment of isolated environmental hazards toward a broader recognition that health effects are shaped by complex interactions across multiple exposures. Increasing attention has therefore been directed to both social and natural environmental determinants, including air pollution, environmental endocrine-disrupting chemicals, artificial light at night, the built environment, and residential greenness. Accumulating evidence suggests that air pollutants are associated not only with impaired lung function and elevated blood pressure, but also with early-life risks of obesity and metabolic syndrome. Endocrine-disrupting chemicals may alter pubertal timing through interference with neuroendocrine pathways. Artificial light at night may further increase obesity risk by disrupting sleep and circadian regulation. In contrast, exposure to green space and supportive built environments may confer health benefits by reducing pollution exposure, promoting physical activity, and alleviating psychological stress. Accordingly, the promotion of environmental health in children should shift from the control of single risk factors to an integrated strategy targeting multiple exposures. Health impact assessments for children should be embedded across urban planning, school construction, family-based care, and public health policy. Such efforts are needed to create safe, green, low-pollution, activity-promoting, and socially supportive environments for healthy growth and development.

Children are in a critical period of growth and development, and their physical and mental functions remain immature. From both physiological and behavioral perspectives, children are highly susceptible to adverse environmental exposures. In the new era shaped by rapid urbanization, new industrialization, and the deep integration of digitalization and networking, children experience multidimensional physical-chemical-social exposures characterized by widespread low-level exposure alongside localized high-level point-source exposure, with emerging environmental contaminants continuously increasing. Major exposure factors include physical stressors such as artificial light at night and noise; chemical pollutants including traditionalchemical contaminants (e.g., heavy metals, polycyclic aromatic hydrocarbons, and polychlorinated biphenyls) as well as emerging contaminants (e.g., perfluorinated compounds and microplastics); and socialstressors such as prenatal maternal stress, parenting stress, and pervasive digital media exposure. Children's child environmental health response system in China remains to be strengthened. Looking ahead, interdisciplinary collaboration should be promoted to develop comprehensive (e.g., governmental regulation and coordinated actions across families, schools, and healthcare services), precise (accurate assessment of exposure risk, sources, and levels), and dynamic response strategies. High-quality research is also needed to further elucidate the health effects and underlying mechanisms of emerging contaminants and combined exposures, thereby providing evidence to support evidence-based decision-making.

Objective To describe the temporal trends and spatial patterns of overweight and obesity among Chinese children aged 3 - 6 years from 2000 to 2020 across urban-rural settings and regions with different epidemic levels, and to examine associated factors and their interaction effects using cross-sectional data from 2020, so as to provide scientific reference for making strategies for the prevention and control of childhood obesity. Methods Data on children aged 3 - 6 years were obtained from five rounds of the National Physical Fitness Surveillance conducted in 2000, 2005, 2010, 2014, and 2020. Spatiotemporal trends in overweight and obesity were described. Multilevel logistic regression models were used to examine the associations of urbanization level, family environment, and individual behavioral factors with overweight/obesity, and to test interaction effects. Results From 2000 to 2020, the prevalence of overweight and obesity among Chinese children aged 3 - 6 years increased from 15.8% to 23.8%, while the prevalence of obesity alone rose from 3.9% to 7.2%. The increase was greater in rural than in urban areas, resulting in a gradual narrowing of the urban-rural gap. Substantial regional difference was observed: prevalence remained consistently high and increased steadily in high-prevalence regions, increased most rapidly in medium-prevalence regions, and rose more slowly in low-prevalence regions. Urbanization level was positively associated with the risk of overweight/obesity (OR=1.008, P＜0.05). Older age (OR=1.233), boys (OR=1.232), and longer screen time were all associated with a higher risk of overweight/obesity (P < 0.05). Compared with screen time of <20 min/d, screen time of 20 - 40 min/d(OR=1.128) and >40 min/d(OR=1.276) was significantly associated with an increased risk of overweight/obesity (P < 0.05). Interaction analysis further showed that the association between screen time and overweight/obesity was stronger in regions with an urbanization rate of ≥70%(P<0.05). Conclusions The prevalence of overweight and obesity among Chinese children aged 3 - 6 continues to rise, with significant disparities in growth rates observed across urban-rural areas and different geographic regions. Childhood obesity is driven by the interplay between urbanization-related environmental factors and individual behaviors. Future prevention and control strategies should prioritize household and individual interventions while strengthening structural environmental improvements, thereby promoting a comprehensive intervention pathway characterized by environment-behavior synergy.

Objective To investigate factors associated with attention-deficit/hyperactivity disorder (ADHD) in children, and to develop and validate a risk assessment model, so as to provide a scientific basis for early screening of high-risk children and the formulation of prevention and treatment strategies. Methods A retrospective case-control study was conducted, including 348 children diagnosed with ADHD at Dalian Women and Children's Medical Center from January to September 2024 as the case group, and 150 age- and sex-matched healthy controls by propensity score matching.Sociodemographic, household environment, and lifestyle information were collected via questionnaires. Univariate analysis and Lasso regression were used for preliminary variable screening, followed by multivariate logistic regression to identify associated factors. Finally, a Nomogram prediction model was constructed and validated using R software. Results Multivariate logistic regression analysis showed that non-parental rearing (OR=2.267,95%CI:1.089 - 4.719), primary consumption of bottled water (OR=1.960,95%CI: 1.206 - 3.185), reliance on air conditioning for indoor ventilation (OR=3.613,95%CI:1.368 - 9.540), moving into a newly renovated residence during infancy and early childhood (OR=1.781,95%CI:1.059 - 2.996), and use of solvent-based wall coatings in children's main activity areas (OR=2.067, 95%CI:1.268 - 3.368) were positively associated with ADHD, whereas moving into a residence at least 2 years after renovation was negatively associated with ADHD (OR = 0.399, 95%CI: 0.230 - 0.692). The Nomogram model developed using these six variables demonstrated acceptable discrimination (AUC=0.73, 95%CI: 0.69 - 0.78) and good calibration (Hosmer-Lemeshow test, P=0.220). Conclusions Childhood ADHD is associated with family rearing patterns, lifestyle characteristics, and indoor environmental exposure factors. The Nomogram model developed in this study shows moderate predictive performance and may serve as a useful tool for the early identification and targeted intervention among children at increased risk of ADHD.

Objective To explore the associations of parental educational anxiety, parental burnout, reflective functioning with emotional and behavioral problems in preschool children so as to provide recommendations for the prevention and intervention of such issues. Methods In April 2025, a convenience sampling method was used to recruit 500 parents of children from seven kindergartens in Fuyang, Anhui Province.The Parental Educational Anxiety Content Scale (PEACS), the ChineseShort version Parental Burnout Assessment (S-PBA), the Parental Reflective Functioning Questionnaire (PRFQ), and the Strengths and Difficulties Questionnaire (SDQ) were administered. Results 1) Parental educational parental anxiety significantly positively predicted preschool children's emotional and behavioral problems (β=0.305, P<0.001).2) Parental burnout partially mediated the relationship between educational anxiety and emotional and behavioral problems in preschool-age children (β=0.052, 95%CI: 0.027 - 0.085), accounting for 17.05% of the total effect.3) Reflective functioning moderated the relationship between parental educational anxiety and parental burnout (β=-0.093, t=-2.503, P<0.05), and the low reflective functioning group demonstrated a more significant predictive effect (β=0.366, t =6.403, P<0.001) compared to high reflective functioning group (β=0.179, t=3.158, P<0.01). Conclusions Parental educational anxiety significantly predicts emotional and behavioral problems in preschool children, with parental burnout serving as a partial mediator and reflective functioning moderating the first half of this mediation model.Interventions should focus on alleviating parental educational anxiety, reducing the risk of parental burnout, and enhancing reflective functioning to prevent and reduce emotional and behavioral problems in young children.

Objective To investigate the prevalence of unhealthy lifestyles among urban children aged 7 - 12 years in Qingdao, and to identify associated demographic factors, so as to provide evidence for early intervention. Methods From September to November 2023, a cluster random sampling survey was conducted in five primary schools in urban Qingdao. Demographic characteristics and lifestyle-related behaviors were collected using questionnaires. Four unhealthy lifestyle domains were defined based on published evidence and guidelines: excessive screen exposure, insufficient physical activity, insufficient sleep, and unhealthy diet. Differences across demographic subgroups were compared, and logistic regression analysis was performed to explore associated factors. Results A total of 2 232 valid questionnaires were included. Overall, 57.2% of children had two or more unhealthy lifestyle behaviors. Logistic regression analyses showed that older age was associated with excessive screen exposure (OR=1.194, 95%CI: 1.027 - 1.389). Low family income (OR=1.578,95%CI: 1.007 - 2.475) and fathers with a college education (OR=1.315, 95%CI: 1.012 - 1.710) were associated with insufficient physical activity, whereas being an only child was associated with lower odds of insufficient physical activity (OR=0.161, 95%CI: 0.132 - 0.196). Older age (OR=1.090, 95%CI:1.022 - 1.163) and mothers with a college education (OR=1.568, 95%CI: 1.174 - 2.094) were associated with insufficient sleep. Older age (OR=1.081, 95%CI: 1.014 - 1.153) and low family income (OR=1.906, 95%CI: 1.144 - 3.173) were associated with unhealthy diet, while girls had lower odds of an unhealthy diet (OR=0.716, 95%CI: 0.586 - 0.876). Older age (OR=1.171, 95%CI: 1.072 - 1.279) and low family income (OR=2.622, 95%CI:1.321 - 5.206) were also associated with the coexistence of multiple unhealthy lifestyle behaviors, whereas girls (OR=0.678, 95%CI: 0.513 - 0.898) and only children (OR=0.295, 95%CI: 0.213 - 0.409) had lower risks of such coexisting behaviors. Conclusions Unhealthy lifestyles are prevalent among urban children aged 7 - 12 years in Qingdao, and are associated with age, sex, only-child status, and family socioeconomic factors. Comprehensive interventions targeting high-risk populations should be implemented, with a core focus on reducing sedentary screen time, promoting regular physical activity and adequate sleep, and improving dietary patterns.

Objective To develop a combined criterion for screening clinical obesity based on body mass index (BMI), waist circumference (WC), and waist-to-height ratio (WHtR), and to evaluate its performance in identifying obesity-related metabolic risk among Chinese children and adolescents. Methods Data were obtained from physical examinations and blood biochemical measurements of 15 850 children and adolescents aged 6 - 17 years who participated in a multicenter intervention study. A positive combined criterion was defined as exceeding the corresponding cutoffs for at least two of the three anthropometric indicators: BMI, WC, and WHtR. The obesity detection rate based on the combined criterion was compared with that based on the national health industry standard for BMI-based screening. Receiver operating characteristic curve analysis was performed to evaluate the predictive performance of the BMI-based standard, the combined criterion, and different pairwise anthropometric combinations for metabolic abnormalities. The associations of discordant screening results based on the combined criterion and the BMI standard with metabolic abnormalities were further analyzed. Results The obesity detection rate using the combined criterion was 13.95%, significantly higher than the 12.09% rate using the BMI-based standard (P<0.05).The AUC values for the combined criterion in predicting low high-density lipoprotein cholesterol(HDL-C), elevated triglycerides(TG), dyslipidemia, and cardiometabolic risk factor clustering(CRFC) were higher than those of the BMIbased standard; the AUC values for the combined criterion in predicting low HDL-C, elevated TG, and dyslipidemia were higher than those of the combination of the three pairwise anthropometric combinations, and all differences were statistically significant (P<0.05).Multivariable logistic regression showed that children and adolescents who were positive according to the composite criterion but negative according to the BMI-based standard had significantly higher risks of low high-density lipoprotein cholesterol, elevated triglycerides, dyslipidemia, and cardiometabolic risk factor clustering than those who were negative according to the composite criterion but positive according to the BMI-based standard (P<0.05). Conclusion Compared with the BMI-based national health industry standard alone, the combined criterion based on BMI, WC, and WHtR may improve the identification of obesity-related metabolic risk in children and adolescents, particularly among individuals who do not meet BMI-defined obesity criteria but have central obesity and metabolic abnormalities.

Objective To examine the longitudinal trajectories of maternal weight perception bias toward preschool children, to identify distinct trajectory groups, and to explore their associated sociodemographic characteristics. Methods In this longitudinal study, 176 mothers and their preschool children from eight public kindergartens in Shanghai were followed at three time points over a 2-year period, beginning in December 2020. Group-based trajectory modeling was used to identify trajectories of maternal weight perception bias, and multinomial logistic regression was performed to examine associated sociodemographic factors. Results Maternal misperception of children's weight status was predominantly characterized by underestimation. Across the three follow-up assessments, the proportions of accurate maternal perception were 64.2%, 63.1%, and 55.1%, respectively. Four trajectory groups were identified: persistent underestimation (n=29, 16.5%), underestimation-to-accurate perception (n=17, 9.6%), persistent accurate perception (n=88, 50.0%), and accurate perception-to-underestimation (n=42, 23.9%). Multinomial logistic regression showed that, compared with the persistent accurate perception group, a higher baseline BMI-for-age Z score (BAZ) was associated with a lower likelihood of persistent underestimation (OR=0.130, 95%CI: 0.059 - 0.289). In addition, compared with mothers of girls, mothers of boys were more likely to shift from accurate perception to underestimation (OR=4.793, 95%CI: 1.959 - 11.725). Conclusions Maternal weight perception bias toward preschool children follows distinct trajectories over time.Children's gender and early BAZ are important factors associated with trajectory patterns of maternal weight perception bias.

Objective To compare the metabolic status of preschool singleton children conceived by assisted reproductive technology (ART) with naturally conceived (NC) singleton children, so as to provide evidence for the health management of ART-conceived children. Methods A total of 70 ART-conceived singleton children aged 36 - 72 months who underwent physical examination at the Dalian Women and Children's Medical Group from January 2023 to January 2025 were enrolled, and 70 age-matched NC singleton children were included at a 1∶1 ratio during the same period. Parental demographics, perinatal information, and the children's feeding and dietary habits were collected. Anthropometric measurements (height, weight, waist circumference) and blood pressure were assessed. Fasting blood glucose (FBG), fasting insulin (FINS), triglycerides (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), apolipoprotein A1 (ApoA1), and apolipoprotein B (ApoB) levels were measured. Multiple linear regression models were employed to adjust for potential confounding factors, including dietary habits and parental body mass index (BMI). Results Parents in the ART group had significantly older reproductive ages and lower gestational weight gain than those in the NC group (t=6.761, 6.032,-2.329, P<0.05). After adjustment for confounding factors, there were no statistically significant differences in body weight, height, body mass index, or blood pressure between the two groups (P>0.05). However, waist circumference was significantly greater in the ART group than in the NC group (β=2.022, P<0.05). After adjustment, TG and ApoB levels remained significantly higher in the ART group(β=0.104,0.038), while HDL-C and ApoA1 levels were significantly lower than those in the NC group (β=-0.298,-0.105,P<0.05). No significant differences were found in TC, LDL-C, FBG, FINS, or HOMA-IR between the two groups (P>0.05). There were no significant differences in the detection rates of abnormal blood pressure, dyslipidemia, or impaired blood glucose between the two groups (P>0.05). The detection rate of overweight/obesity was significantly higher in the ART group than in the NC group (Z=-2.233, P<0.05). Conclusions Preschool singleton children conceived by ART exhibit differences in several blood lipid parameters, including TG, HDL-C, ApoB, and ApoA1. However, these differences do not increase the risk of dyslipidemia. Increased waist circumference and a higher prevalence of overweight/obesity are observed in ART-conceived children, highlighting the importance of long-term monitoring of nutritional and metabolic status in this population to prevent obesity and related metabolic disorders.

Objective To investigate the influencing factors of nonalcoholic fatty liver disease (NAFLD) in overweight and obese children, and to construct a nomogram model for predicting the risk of NAFLD. Methods A total of 147 overweight or obese children who visited The First Affiliated Hospital of Shihezi University from July 2020 to July 2025 were enrolled in this study, and were divided into an NAFLD group (n=41) and a non-NAFLD group (n=106). Multivariate logistic regression analysis was conducted to identify the independent influencing factors for NAFLD. Receiver operating characteristic (ROC) curve analysis was performed, and a nomogram model was constructed using R software to evaluate the predictive value. Results Among the NAFLD cases, 92.7% were obese and 7.3% were overweight. Univariate analysis showed that age, overweight/obesity, body mass index (BMI), alanine aminotransferase (ALT), uric acid (UA), white blood cell count (WBC), and insulin levels were significantly associated with NAFLD (P<0.05). Multivariate logistic regression indicated that BMI, ALT, and WBC were independent related factors for NAFLD (P < 0.05). ROC curve analysis demonstrated that the combined assessment of BMI, WBC, and ALT yielded an area under the curve (AUC) of 0.896 (95%CI: 0.847 - 0.946) for predicting NAFLD, with a sensitivity of 97.6% and a specificity of 68.9%. Conclusions Obese children have a significantly higher risk of NAFLD compared to overweight children. Elevated levels of BMI, ALT, and WBC are associated with an increased risk of NAFLD. The combined assessment of these three indicators has significant predictive value for the development of NAFLD.

Objective To analyze research hotspots and evolving trends in the diagnosis of nonalcoholic fatty liver disease (NAFLD) and metabolic dysfunction-associated fatty liver disease (MAFLD) in children and adolescents from 2014 to 2024 using bibliometric methods, so as to provide evidence for future research directions. Methods Relevant Chinese and English language literatures published from January 2014 to December 2024 were retrieved from the Web of Science (WOS) and China National Knowledge Infrastructure (CNKI) databases. CiteSpace and VOSviewer were used to conduct visual analyses of annual publication trends, core research institutions, author collaboration networks, keyword co-occurrence and clustering, burst keywords, and co-cited references. Results A total of 1 341 English publications and 319 Chinese publications were included. The annual number of publications in both Chinese and English showed an upward trend, with a more pronounced increase observed in English publications. Network analysis based on English literature revealed a closely connected multi-institutional collaboration network led by several core researchers, whereas Chinese studies were mainly characterized by small-team collaborations. After excluding search terms, the top three keywords by centrality in English publications were obesity, metabolic syndrome, and insulin resistance, while those in Chinese publications were hepatic fibrosis, childhood obesity, and insulin resistance. Keyword clustering of both Chinese and English publications indicated that research hotspots were mainly concentrated on childhood obesity, metabolic syndrome, noninvasive diagnostic techniques, and genetic mechanisms. Noninvasive imaging techniques and composite biomarkers have emerged as recent research frontiers. Conclusions Research on the diagnosis of NAFLD/MAFLD in children and adolescents has developed a framework centered on obesity-metabolic dysregulation-liver injury. Current trends focus primarily on improving noninvasive diagnostic technologies and comprehensively assessing multisystem metabolic health. These findings provide evidence to support the development of multidimensional pediatric diagnostic criteria, the integration of multicenter data, and the establishment of a life-course health management system.

Objective To systematically evaluate the effects of different exercise modalities and doses on adipokines in children and adolescents, so as to provide precise evidence-based practice recommendations for alleviating obesity in this population. Methods Six databases were searched from inception to November 2024 for randomized controlled trials (RCTs) investigating the effects of various exercise modalities on adipokines in children and adolescents. Bayesian network meta-analysis was conducted using R software. Risk of bias and certainty of evidence were assessed using the Cochrane risk-of-bias tool and CINeMA framework. Results A total of 46 RCTs involving 2 105 children and adolescents (48.32% female) were included. Compared with the non-exercise group, combined aerobic and resistance exercise was the most effective modality for reducing leptin levels (MD=-7.34, 95%CrI: -11.17 to -3.73, SUCRA=94.37) and increasing adiponectin levels (MD=1.79, 95%CrI: 0.92 to 2.65, SUCRA=95.42). High-intensity interval training was the most effective exercise modality for reducing interleukin-6 levels (MD=-3.98, 95%CrI:-10.57 to -0.19, SUCRA=95.27) and tumor necrosis factor-α levels (MD=-6.61, 95%CrI:-9.96 to -3.15, SUCRA=99.98). Conclusion High-intensity interval training and combined aerobic and resistance exercise appear to be the most effective exercise modalities for improving adipokines in children and adolescents.

Objective To identify optimal 24-hour movement behavior recommendations for preschool children using the Best Time Zone approach, based on executive function (EF), fundamental movement skills (FMS), and physical fitness (PF). Methods Using convenience sampling, 409 children aged 3 - 6 years were recruited from four kindergartens in Zhejiang Province between April and June 2024, of whom 289 provided valid data. Waking-time physical activity was measured objectively using accelerometers and classified into sedentary behavior (SB), light physical activity (LPA), and moderate-to-vigorous physical activity (MVPA). Sleep duration was obtained from the parent-reported Children's Sleep Habits Questionnaire (CSHQ). FMS were assessed using the Test of Gross Motor Development-3 (TGMD-3), PF was evaluated according to the National Physical Fitness Test Manual (Children's Section), and EF was measured using the Early Years Toolbox (EYT). Compositional data regression models were used to examine associations between 24-hour movement compositions and outcomes. Activity compositions corresponding to the top 10% of predicted outcome values were selected, visualized using a three-dimensional quaternary plot, and the overlap across EF, FMS, and PF was defined as the optimal time zone for overall health. Results The mean age was 5.17 ± 0.77 years. The 24-hour movement composition was significantly associated with EF (F=5.47, P<0.01), FMS (F=6.96, P<0.001), and PF (F=4.96, P<0.01). The optimal 24-hour movement recommendations for overall health were: MVPA 111 min/d (90-130), LPA 46 min/d (30-60), SB 683 min/d (570-780), and sleep 601 min/d (470-700). An online interactive tool was developed to provide personalized time-use suggestions based on weighted health priorities. Conclusion These findings propose optimal 24-hour movement behavior recommendations for preschool children based on EF, FMS, and PF, and may inform daily time-use planning and future guideline updates.

Objective To investigate the prevalence and influencing factors of anemia among children aged 6 months to 18 years in Hainan Province, so as to provide evidence for region-specific prevention and control strategies. Methods A cross-sectional study was conducted from December 2020 to July 2021 using a multistage stratified cluster sampling method. A total of 58 649 children aged 6 months to 18 years were recruited from 18 municipalities/counties in Hainan Province (excluding Sansha City). Participants were stratified into two age groups: 6 months -<3 years old and 3 - 18 years old. Demographic characteristics and lifestyle behaviors were collected using standardized questionnaires. Hemoglobin concentration was measured by electrical impedance combined with photoelectric colorimetry, and anemia was diagnosed according to the WHO Guideline on Haemoglobin Cutoffs to Define Anaemia (2024). Rao-Scott χ² tests were used for group comparisons, and weighted binary logistic regression models were applied to identify influencing factors. Results The weighted prevalence of anemia among children aged 6 months to 18 years in Hainan Province was 6.92%, including 4.60% mild anemia, 2.26% moderate anemia, and 0.06% severe anemia. The prevalence was highest during infancy (10.81%), decreased during primary school age (4.88%), and increased again during adolescence. Adolescent girls had a significantly higher prevalence than boys (13.98% vs. 3.22%, P<0.001). Significant regional differences in anemia prevalence were observed across municipalities/counties (P<0.001), with Baoting Li and Miao Autonomous County showing the highest prevalence (17.62%). Multivariable logistic regression analysis indicated that ethnic minority status, non-only-child status, and insufficient meat intake were common risk factors in both age groups (P<0.05). In the 6 months -<3 years group, infancy, lower maternal educational level, and insufficient egg intake were additionally associated with increased anemia risk (P<0.05). In the 3 - 18 years group, adolescence (12 - 18 years old), female, rural residence, history of neonatal diseases, multiple births, non-nuclear family structure, non-parental caregiving, lower paternal educational level, annual household income <30 000 RMB, picky eating, and frequent iron supplementation were associated with higher anemia risk (P<0.05). Conclusions Although the overall prevalence of anemia among children aged 6 months to 18 years in Hainan Province is relatively low, infants, adolescent girls, ethnic minority children, and rural populations remain key target groups for intervention. Strengthening nutrition education, emphasizing early-life nutritional intervention and adolescent dietary guidance, and promoting parent-involved comprehensive intervention strategies may help reduce the burden of childhood anemia.

The escalating contamination of micro/nanoplastics (MNPs) has raised significant concerns regarding their potential threats to human health, particularly that of infants and toddlers. Evidence suggests that MNPs exposure is widespread during infant and toddler care, with major sources including the use and degradation of plastic-containing products. These particles can enter children's bodies via ingestion, dermal contact and inhalation, potentially exerting adverse effects on their physical growth, as well as their immune, nervous, and endocrine systems.This review analyzes the sources, exposure pathways, and toxicological effects of MNPs contamination. Furthermore, it explores corresponding prevention and control measures to provide a scientific basis for mitigating pediatric MNPs exposure and formulating effective protective strategies.

Extensive attention has been paid to the association between environmental factors and individual telomere length. Childhood is a critical window period for assessing the potential impact of environmental factors on individual telomere length. This review synthesizes domestic and international research from multiple perspectives, including natural environmental factors—such as air pollutants, green spaces, and metal pollutants—as well as family environmental factors, including adverse childhood experiences of parents, parental psychological factors, and family socioeconomic status, aiming to deeply understand the influence of multiple environmental factors on children's telomere length, and provide references for promoting children's physical and mental health development.

The potential impact of the indoor environment on children's cognitive development has attracted increasing attention. Existing studies suggest that indoor environmental exposures may affect the development of children's cognitive function through mechanisms such as blood-brain barrier disruption, neuroinflammation, and oxidative stress.This review summarizes recent research on the relationship between indoor environmental factors and children's cognitive development from the perspectives of physical, chemical, and biological environments, and further discusses the possible underlying biological mechanisms. Overall, although the number of related studies has increased, the existing evidence remains limited. Future research should strengthen prospective cohort studies and intervention studies to clarify the association between indoor environmental factors and children's cognitive function, thereby providing evidence to support children's healthy development.

Overweight and obesity in children and adolescents have become increasingly serious public health concerns. A growing body of evidence suggests that screen behaviors are associated with an increased risk of overweight and obesity in this population. However, findings across studies remain inconsistent, and the potential mechanisms underlying this association have not been fully explored. This review summarizes current evidence on the associations of different types of screen behaviors with overweight and obesity in children and adolescents, discusses potential mechanisms,aiming to provide directions for future research and a theoretical basis for developing interventions of overweight and obesity in children and adolescents.

In recent years, the increasing prevalence of obesity among school-aged children and adolescents in China has attracted considerable attention from both the government and society. However, obesity in infancy remains underrecognized by many parents and is sometimes even regarded as a sign of good health. Because previous studies in China have used inconsistent criteria for defining infant overweight and obesity, accurate nationwide prevalence data are not yet available. Nevertheless, multiple studies have suggested that the detection rates of infant overweight and obesity in China are relatively high. Infant overweight and obesity result from the combined effects of genetic and environmental factors, and studies have shown that these conditions may lead to adverse consequences for health throughout the life course. Greater attention to overweight and obesity beginning in infancy among parents and clinical healthcare professionals, together with timely adjustments to nurturing and feeding practices, may effectively reduce the risk of obesity and metabolic complications during school age and adulthood. This reflects the health management philosophy of early intervention and proactive prevention.