Research ArticlePrevalence and Secular Trends in Obesity Among Chinese Adults, 1991−2011
Introduction
Obesity is a major risk factor for hypertension, diabetes, coronary heart disease, and certain types of cancer.1, 2, 3, 4, 5, 6 Ongoing monitoring of trends in obesity is important for assessing interventions aimed at preventing or reducing the burden of obesity. With the increasing global pandemic of obesity, there has also been a dramatic rise in the number of obese adults in China.7, 8 For example, during 1989−2000, the prevalence of obesity combined with overweight increased by 50% in adults aged 20−45 years.9 Additionally, Gu et al.10 found that the risk of cardiovascular disease increased with increasing BMI. However, most previous estimates of obesity and overweight were either based on limited survey data that only reflected a relatively short period of changes in obesity9, 11, 12 or on clinical data. Recent prevalence and trends in the distribution of BMI among Chinese adults remain unknown. In this study, we provide new estimates of the prevalence of obesity and overweight in adults aged 20 years or older based on measurements of weight and height in 2011; we also provide the long-term trend to determine if it is continuing. We further compare the prevalence of obesity in adults between the Chinese and U.S. populations. In addition, we provide the BMI distribution from 1991 to 2011 of the China Health and Nutrition Survey (CHNS) both for the overall adult population and by sex and age group.
Section snippets
Study Design
The CHNS is an international collaborative project between the National Institute for Nutrition and Food Safety, Chinese Center for Disease Control and Prevention, and University of North Carolina at Chapel Hill, and is also the only large-scale, longitudinal, household-based survey in China to date.13 The first round of the CHNS was conducted in 1989, and subsequently in 1991, 1993, 1997, 2000, 2004, 2006, 2009, and 2011.14 The CHNS began with eight provinces and added a ninth, Heilongjiang in
Results
Pregnant (n=452) or lactating (n=440) women were excluded from data analysis. Additionally, participants with missing data (n=4,027), extreme height (n=75), or extreme BMI values of <15.0 kg/m2 or >40.0 kg/m2 (n=234) were also excluded. The remaining participants aged ≥20 years were 8,142 for 1991; 7,776 for 1993; 8,282 for 1997; 9,184 for 2000; 8,966 for 2004; 8,982 for 2006; 9,297 for 2009; and 12,249 for 2011. Sample sizes for analyses of the eight waves of the CHNS for 1991−2011 are
Discussion
The present data show striking increases in the prevalence of BMI-defined obesity and overweight in adults in China over the 20-year period from 1991 through 2011 for both men and women. Remarkably, both the prevalence of obesity and the combined prevalence of overweight and obesity increased more rapidly among men than women. Meanwhile, there was a significant rising tendency in log-transformed mean BMI from 1991 through 2011 both for men and women. Notably, the changes of BMI in men were
Acknowledgments
This research uses data from China Health and Nutrition Survey (CHNS). We thank the National Institute of Nutrition and Food Safety, China Center for Disease Control and Prevention, Carolina Population Center (5 R24 HD050924), University of North Carolina at Chapel Hill, NIH (R01-HD30880, DK056350, R24 HD050924, and R01-HD38700), and Fogarty International Center, NIH for financial support for the CHNS data collection and analysis files from 1989 to 2011 and future surveys, and the China-Japan
References (41)
Health implications of obesity in American Indians and Alaska Natives
Am J Clin Nutr
(1991)- et al.
BMI and lifestyle changes as correlates to changes in self-reported diagnosis of hypertension among older Chinese adults
J Am Soc Hypertens
(2011) - et al.
Television use and snacking behaviors among children and adolescents in China
J Adolesc Health
(2010) - et al.
Assessing body shape index as a risk predictor for cardiovascular diseases and metabolic syndrome among Iranian adults
Nutrition
(2014) - et al.
Optimal cutoffs of percentage body fat for predicting obesity-related cardiovascular disease risk factors in Korean adults
Am J Clin Nutr
(2011) - et al.
The disease burden associated with overweight and obesity
J Am Med Assoc
(1999) - et al.
Obesity is the key determinant of cardiovascular risk factors in the Hong Kong Chinese population: cross-sectional clinic-based study
Hong Kong Med J
(2000) - et al.
Body mass index and cardiovascular risk factors in a rural Chinese population
Am J Epidemiol
(2000) Adiposity as a risk determinant for postmenopausal breast cancer
Int J Obes Relat Metab Disord
(2000)- et al.
Weight gain and its predictors in Chinese adults
Int J Obes Relat Metab Disord
(2001)