Trends and Distributional Characteristics of Forced Vital Capacity and Forced Vital Capacity Adjusted for Weight Among Chinese Children and Adolescents Over the Three Decades
Abstract
Background: To assess trends and distributional characteristics of forced vital capacity (FVC) and vital capacity index (VCI) (a measure of FVC adjusted for weight) among Chinese children and adolescents aged 7-18 years from 1985 to 2019.
Methods: FVC and VCI data for Chinese children and adolescents were obtained from the Chinese National Surveillance on Students’ Constitution and Health surveys in 1985, 1995, 2000, 2005, 2010, 2014 and 2019. VCI (ml/kg) = FVC (ml)/weight (kg). Trends were estimated by sample-weighted regressions with post-stratification population-weighted procedures. The trends in the distributional characteristics were visually described.
Results: For the total population, FVC improved by 78.7 ml (95% confidence interval: -203.3 to 360.7 ml) or 0.12 effect size (ES) (-0.42 to 0.66 ES), which was a negligible improvement. VCI decreased by 11.5 ml/kg (4.8 to 18.3 ml/kg) or 0.84 ES (0.34 to 1.34 ES), which was a large decrease from 1985 to 2019. The sex, residence, and age-stratified VCI both experienced significant moderate to large decreases. Stratified by period, the FVC and VCI decreased dramatically until the 21st century, and the decrease stabilized from 2000 to 2010 and thereafter improved. FVC decreased in the lower percentile and increased in the higher percentile. For the VCI, the larger the percentile was, the smaller the decrease was.
Conclusion: Absolute levels of lung function among Chinese children and adolescents have stabilized over the past three decades, but relative levels of lung function have declined significantly. The government should implement health promotion programs to improve respiratory health.
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24. Central People's Government of the Peo-ple's Republic of China (2013). Decision of the Central Committee of the Com-munist Party of China on Several Major Issues Concerning Comprehensively Deepening Reform. https://www.gov.cn/zhengce/2013-11/15/content_5407874.htm
25. Central People's Government of the Peo-ple's Republic of China (2016). Healthy China 2030 Plan Outline. https://www.gov.cn/gongbao/content/2016/content_5133024.htm
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27. Ma N, Shi D, Dang JJ, et al (2023). Secular trends and urban-rural disparities in the median age at menarche among Chi-nese han girls from 1985 to 2019. World J Pediat, 19(12):1162-1168.
28. Shi D, Ma N, Liu Y, et al (2023). Secular trend and urban-rural disparity for age at spermarche among Chinese Han boys from 1995 to 2019. Acta Paediatr, 112(3):529-536.
29. Chen L, Zhang Y, Chen MM, et al (2022). Prevalence of unhealthy lifestyle among children and adolescents of Han na-tionality in China. Zhonghua Xin Xue Guan Bing Za Zhi, 50(12):1177-1185. (in Chinese)
30. Zheng W, Shen H, Belhaidas MB, et al (2023). The Relationship between Physi-cal Fitness and Perceived Well-Being, Motivation, and Enjoyment in Chinese Adolescents during Physical Education: A Preliminary Cross-Sectional Study. Children, 10(1):111.
31. Cairney J, Hay JA, Faught BE, et al (2008). Generalized self-efficacy and perfor-mance on the 20-metre shuttle run in children. Am J Hum Biol, 20(2):132-138.
32. Liang Y, Chen X, Zhao C, et al (2022). Nu-trition improvement program for rural compulsory education students and in-dividual health. Front Public Health, 10:1051810.
2. Wu H, Zhang Y, Wei J, et al (2022). Associa-tion between short-term exposure to ambient PM1 and PM2.5 and forced vi-tal capacity in Chinese children and ad-olescents. Environ Sci Pollut Res Int, 29(47):71665-71675.
3. Li G, Lu Y, Qiao Y, et al (2022). Role of Pulmonary Function in Predicting New-Onset Cardiometabolic Diseases and Cardiometabolic Multimorbidity. Chest, 162(2):421-432.
4. Forno E, Han YY, Mullen J, Celedón JC (2018). Overweight, Obesity, and Lung Function in Children and Adults-A Me-ta-analysis. J Allergy Clin Immunol Pract, 6(2):570-581.e10.
5. Balbinot F, Gerbase MW (2024). Physical Activity Predicts Better Lung Function in Children and Adolescents. Pediatr Exerc Sci, 37(3):278-285.
6. Bush A, Byrnes CA, Chan KC, et al (2024). Social determinants of respiratory health from birth: still of concern in the 21st century?. Eur Respir Rev, 33(172):230222.
7. Dong Y, Lau PWC, Dong B, et al (2019). Trends in physical fitness, growth, and nutritional status of Chinese children and adolescents: a retrospective analysis of 1·5 million students from six succes-sive national surveys between 1985 and 2014. Lancet Child Adolesc Health, 3(12):871-880.
8. Gan X, Yu K, Wen X, et al (2021). Longitu-dinal Association of Economic Growth with Lung Function of Chinese Children and Adolescents over 30 Years: Evi-dence from Seven Successive National Surveys. Int J Environ Res Public Health, 18(12):6592.
9. Bi C, Zhang F, Gu Y, et al (2020). Secular Trend in the Physical Fitness of Xin-jiang Children and Adolescents between 1985 and 2014. Int J Environ Res Public Health, 17(7):2195.
10. Zhang S, Wu L, Zhong Y, et al (2023). Trend and heterogeneity in forced vital capacity among Chinese students during 1985-2019: results from Chinese Nation-al Survey on Students' Constitution and Health. Respir Res, 24(1):268.
11. Xiang Y, Wang Y, Deng Y, et al (2024). In-dependent and joint associations of multiple metals exposure with vital ca-pacity index: a cross-sectional study in Chinese children and adolescents. Int Arch Occup Environ Health, 97(7):791-801.
12. Luo D, Ma N, Liu Y, et al (2023). Long-term trends and urban-rural disparities in the physical growth of children and adoles-cents in China: an analysis of five na-tional school surveys over three dec-ades. Lancet Child Adolesc Health, 7(11):762-772.
13. National Student Physical Fitness and In-vestigation Group (2022). Report on the physical fitness and health surveillance of Chi-nese school students in 2019. 1st ed. Beijing: Higher Education Press.
14. Liu J, Wu S, Fu Y (2025). Population-based trends and distributional characteristics in sit-ups performance among school-aged girls in urban China over three decades. Sci Rep, 15(1):16750.
15. Office of the Leading Group for the Sev-enth National Population Census of the State Council (2021). Major figures on 2020 population census of China. Beijing: China Statistics Press.
16. Cohen J (1988). Statistical power analysis for the behavioral sciences. 2nd ed. Aufl. Mahwah, NJ: Lawrence Erlbaum.
17. Dang J, Liu Y, Cai S, et al (2025). Secular trend and projection of overweight and obesity among Chinese children and adolescents aged 7-18 years from 1985 to 2019: Rural areas are becoming the focus of investment. Chin Med J, 138(3):311-317.
18. Guo Y, Yin X, Wu H, et al (2019). Trends in Overweight and Obesity Among Chil-dren and Adolescents in China from 1991 to 2015: A Meta-Analysis. Int J Envi-ron Res Public Health, 16(23):4656.
19. Hong Y, Ullah R, Wang JB, et al (2023). Trends of obesity and overweight among children and adolescents in China. World J Pediatr, 19(12):1115-1126.
20. Song Y, Agardh A, Ma J, et al (2019). Na-tional trends in stunting, thinness and overweight among Chinese school-aged children, 1985-2014. Int J Obes, 43(2):402-411.
21. Yang X, Leung AW, Zhai Y, et al (2021). Recent Trends in Physical Activity among Chinese Children Based on Their Demographic and Social Charac-teristics. Biomed Environ Sci, 34(5):404-409.
22. Yang X, Leung WY, Chen YS, et al (2021). Recent Trends in Sedentary Behaviors among Chinese Children According to Demographic and Social Characteris-tics. Biomed Environ Sci, 34(8):593-605.
23. Guo MM, Koh KT, Wang XZ (2024). Trends of physical activity and recrea-tional screen time among Chinese chil-dren and adolescents: a national study from 2017 to 2019. BMC Public Health, 24(1):1305.
24. Central People's Government of the Peo-ple's Republic of China (2013). Decision of the Central Committee of the Com-munist Party of China on Several Major Issues Concerning Comprehensively Deepening Reform. https://www.gov.cn/zhengce/2013-11/15/content_5407874.htm
25. Central People's Government of the Peo-ple's Republic of China (2016). Healthy China 2030 Plan Outline. https://www.gov.cn/gongbao/content/2016/content_5133024.htm
26. Gill D, Sheehan NA, Wielscher M, et al (2017). Age at menarche and lung func-tion: a Mendelian randomization study. Eur J Epidemiol, 32(8):701-710.
27. Ma N, Shi D, Dang JJ, et al (2023). Secular trends and urban-rural disparities in the median age at menarche among Chi-nese han girls from 1985 to 2019. World J Pediat, 19(12):1162-1168.
28. Shi D, Ma N, Liu Y, et al (2023). Secular trend and urban-rural disparity for age at spermarche among Chinese Han boys from 1995 to 2019. Acta Paediatr, 112(3):529-536.
29. Chen L, Zhang Y, Chen MM, et al (2022). Prevalence of unhealthy lifestyle among children and adolescents of Han na-tionality in China. Zhonghua Xin Xue Guan Bing Za Zhi, 50(12):1177-1185. (in Chinese)
30. Zheng W, Shen H, Belhaidas MB, et al (2023). The Relationship between Physi-cal Fitness and Perceived Well-Being, Motivation, and Enjoyment in Chinese Adolescents during Physical Education: A Preliminary Cross-Sectional Study. Children, 10(1):111.
31. Cairney J, Hay JA, Faught BE, et al (2008). Generalized self-efficacy and perfor-mance on the 20-metre shuttle run in children. Am J Hum Biol, 20(2):132-138.
32. Liang Y, Chen X, Zhao C, et al (2022). Nu-trition improvement program for rural compulsory education students and in-dividual health. Front Public Health, 10:1051810.
| Files | ||
| Issue | Vol 55 No 1 (2026) | |
| Section | Original Article(s) | |
| DOI | https://doi.org/10.18502/ijph.v55i1.20979 | |
| Keywords | ||
| Forced vital capacity Vital capacity index Child Distribution Public health | ||
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How to Cite
1.
Li C, Gu J. Trends and Distributional Characteristics of Forced Vital Capacity and Forced Vital Capacity Adjusted for Weight Among Chinese Children and Adolescents Over the Three Decades. Iran J Public Health. 2026;55(1):133-142.
