In recent years, to pay attention to children's health and effectively strengthen the prevention of obesity among children and adolescents, the Ministry of Education and five other departments jointly formulated and released the "Implementation Plan for the Prevention and Control of Obesity among Children and Adolescents" (hereinafter referred to as the "Plan"). The Plan points out that with the rapid development of China's economy and the significant improvement of people's living standards, profound changes have occurred in children's dietary structure and lifestyle. The rates of overweight and obesity have shown a rapid upward trend, becoming an important public health issue threatening children's physical and mental health. It should be noted that obesity is no longer a "patent" of urban children; the detection rate of overweight and obesity among rural children is also increasing rapidly.

These children often have lower physical confidence, are prone to social adaptation disorders and behavioral disorders, and have a higher risk of developing cardiovascular diseases, diabetes, metabolic syndrome and tumors in adulthood. Given the complexity and particularity of the living environment of rural children, their physical fitness issues need to draw more social attention.

After processing the health data from the national census, researchers found that although the detection rate of obesity among rural children is lower than that in urban areas, the increase is higher and the development is faster. Scholars such as Ji Chengye have proposed that the detection rate of overweight among urban and rural children began to increase significantly around 1995. Around 2000, the number of overweight and obese children in most rural areas rose sharply. After 2005, the rates of overweight and obesity among rural children rose across the board. In the absence of a significant decline in the detection rates of malnutrition and low weight among rural children, The "bimodal phenomenon" has been formed. It is very necessary to study and analyze issues such as the current situation of overweight and obesity among rural children and the reasons for their declining physical fitness.
First of all, there are deviations in the parenting styles of rural children. With the rapid development of China's economy, an increasing number of rural laborers have been transferred to cities, leading to a sharp increase in the number of left-behind children in rural areas and migrant children in cities. A large number of studies on the current situation of overweight and obesity among left-behind children have shown that nutrition education in rural areas is relatively backward. The main reasons for the increase of "little fat kids" in rural areas are the lack of nutrition knowledge among caregivers, improper family diet structure, and incorrect parenting and feeding methods. For instance, excessive intake of sugar and fried foods, prolonged use of electronic products, and lack of sleep, among other unhealthy dietary and living habits, have all contributed to the overweight and obesity of left-behind children in rural areas to a certain extent. In addition, the main caregivers and parenting patterns are also among the influencing factors. The overweight and obesity rate of left-behind children whose caregivers are other people is as high as 29.8%, which is much higher than that of children raised by their parents. Due to the influence of their parents going out to work, some rural children cannot receive unified management and education from the government. Scattered living has also become an independent influencing factor for overweight and obesity among rural children.
Secondly, health education for rural children is weak, and there is a serious shortage of health care teachers. The health education links in rural schools and kindergartens are weak, resulting in a lack of knowledge about nutrition and health among rural children. Most rural children do not know what foods are rich in protein. Some children take eggs to the small store to exchange for snacks. Many parents, due to a lack of health knowledge and failure to restrict their children's intake of unhealthy food, have led to the occurrence of overweight and obesity. Research data shows that urban children have a significantly higher awareness rate of chronic diseases related to obesity than rural children, and the number of health education hours in urban kindergartens is also significantly higher than that in rural areas. All these reflect the omissions in health education for rural children.

In addition, there is a serious shortage of health care teachers in rural kindergartens and primary and secondary schools, and full-time school doctors are even rarer. Full-time school doctors shoulder the important responsibility of daily supervision and management of children's health conditions. Their absence leads to the fact that the health conditions of children in rural kindergartens and schools cannot be evaluated and intervened in a timely manner. According to the "Regulations on School Health Work", the health rooms of rural central primary schools and ordinary middle schools should be staffed with full-time health technicians at a ratio of 600:1 based on the number of students. However, actual research data shows that there is a significant difference in the allocation rate of full-time school doctors between urban and rural areas. The qualified allocation rate of school doctors in rural areas is 1.12%, and the average allocation ratio of full-time school doctors is 1155:1.
Finally, traditional concepts are deeply rooted, with an excessive focus on diet and nutrition. "Food is the Paramount necessity of the people." Since ancient times, the Chinese have had high demands for food. Moreover, with the significant improvement of people's living standards, many rural areas have shaken off poverty and their dietary conditions have also been enhanced. Previously impoverished families began to provide compensatory feeding to their children. Coupled with the deeply-rooted image of children as "chubby and fair-skinned" in traditional beliefs, incorrect and excessive feeding methods eventually led to overweight and obesity among rural children.

Rome wasn't built in a day. The solution to the "chubby boy" problem also requires clarifying the thinking and advancing in a coordinated manner. In response to the "dual-peak phenomenon" of malnutrition and overnutritism among rural children, it is necessary to adjust and refine the nutrition policies for young children. To address the issues of low birth weight and malnutrition among rural children, the government has introduced a series of nutrition subsidy policies, providing compensatory nutritious meals or economic assistance. For instance, a daily subsidy of 4 yuan is provided to each student in rural compulsory education in contiguous special hardship areas in the central and western regions, and drinking milk is offered to primary and secondary school students at school. At present, in the face of the "dual-peak phenomenon" that exists simultaneously among rural children, it is urgent to study and formulate suitable nutrition policies for different groups of people respectively to avoid aggravating the phenomenon of childhood obesity due to the inability of policies to precisely target.
To improve the physical fitness of rural children, the concept of "integrating health into all policies" should be established. "Integrating health into all policies" is a concept proposed and advocated by the World Health Organization. Its application in improving the physical fitness of rural children in China requires the health department to carry out cross-departmental activities and cooperate with other departments to jointly formulate policies and implement interventions. The sports and housing and urban-rural development departments should provide fitness venues and sufficient equipment. The environmental protection and industrial sectors should make great efforts to win the battle for blue skies. Agricultural and market supervision departments should ensure food safety and also integrate children's sports with new rural construction and villagers' health projects. Only when the entire society and all sectors establish a unified health value system and form a synergy through policy measures can the implementation of "integrating health into all policies" be promoted, and ultimately the physical condition of rural children be improved.

Establish a one-stop children's health care service model, integrating nutrition services, nutrition education and physical fitness improvement into planned immunization programs. With the transformation of the medical model, children's health care services have shifted from the prevention and treatment of the four diseases to preventive and control medical services such as planned immunization, nutritional guidance, and regular physical examinations, aiming to promote children's health and focus on children's health care. In the medical care of grassroots towns and townships in our country, there exists a situation where the utilization rate of children's nutrition and health care resources is relatively low and the planned immunization work is relatively mature. A one-stop children's health care service model can be adopted, taking advantage of the relatively mature environment related to planned immunization, to promote the development of nutrition services, nutrition education and physical fitness improvement projects for rural children, solve the problem of improving the physical fitness of rural children, increase the management rate of children's health care, enhance parents' trust and satisfaction in the management of rural children's health care, and help parents better understand the improvement of children's physical fitness
A qualitative approach.

Taking the township central kindergarten as the platform, carry out activities suitable for both home and kindergarten. The World Health Organization proposes that children should engage in 60 minutes of moderate to vigorous activity every day. Activities suitable for both kindergartens and families can be carried out by taking the central kindergartens in towns and townships as the radiation platform. In kindergartens, household chores are combined with labor education, gardening activities, etc. Advocate green travel for children and encourage them to do physical exercise. When creating the environment and arranging equipment, pay attention to the richness and think about the relationship among "adults - children - environment and equipment", so that the sports activities of rural children can be carried out more effectively. Kindergartens can promote the value of sports and games to families and provide simple and easy-to-learn sports games and physical activities that children in families can engage in with their grandparents.

(Author's Affiliation: Department of Preschool Education, Faculty of Education, East China Normal University)