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Epidemiology and Population Health

Trends in the prevalence of overweight, obesity, and abdominal obesity among Chinese adults between 1993 and 2015

International Journal of Obesity volume 45, pages 427–437 (2021)Cite this article

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Abstract

Background

Most previous studies on trends in the prevalence of obesity or abdominal obesity in Chinese adults were based on regional data and/or short time intervals, and recent trends are not available. We aimed to examine the secular trends in the prevalence of overweight, obesity, and abdominal obesity among Chinese adults at the national level from 1993 to 2015.

Methods

A total of 70,242 Chinese adults aged 18–80 years were from the cross-sectional surveys conducted from 1993 to 2015. According to the World Health Organization criteria, overweight was defined as body mass index (BMI) ≥23.0 kg/m2 and <27.5 kg/m2, and obesity was defined as BMI ≥27.5 kg/m2. According to the International Diabetes Federation criteria, abdominal obesity was defined as waist circumference (WC) ≥90 cm for men and ≥80 cm for women. Mean values and prevalence of adiposity markers were standardized to the age distribution of the China population in 2010.

Results

Between 1993 and 2015, and based on age-standardized values, mean BMI increased from 21.9 kg/m2 in 1993 to 23.9 kg/m2 (+2.0 kg/m2) in 2015 (P for trend < 0.001), and mean WC increased from 76.0 cm to 83.4 cm (+7.4 cm) (P for trend <0.001). From 1993 to 2015, the prevalence increased from 26.6% to 41.3% (+14.7%) for overweight, from 4.2% to 15.7% (+11.5%) for obesity, and from 20.2% to 46.9% (+26.7%) for abdominal obesity (all P for trends < 0.001). In multivariate linear regression analysis, time (calendar years), older age and urban regions were strongly and independently associated with BMI.

Conclusions

The prevalence of overweight, obesity, and abdominal obesity increased markedly among Chinese adults during the past two decades. Weight control programs and public health measures to address the societal causes of obesity should be strengthened.

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Fig. 1: Distribution of body mass index and waist circumference in Chinese adults from 1993 to 2015.
Fig. 2: Trends in the crude and age-standardized prevalence of overweight, obesity and abdominal obesity, in Chinese adults from 1993 to 2015 according to various definitions.

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Acknowledgements

This study was supported by National Institutes of Health (NIH) (P01-HD28076, HD30880, and HD39183).The authors thank the Chinese Centers for Disease Control and Prevention and the University of North Carolina for sharing their data.

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Authors and Affiliations

  1. Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China

    Shujing Ma, Bo Xi, Liu Yang & Jiahong Sun

  2. Department of Nutrition and Food Hygiene, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China

    Min Zhao

  3. Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland

    Pascal Bovet

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Contributions

BX and PB conceptualised and designed the study, supervised the data collation, statistical analyses, and reviewed and revised the manuscript. SM did the statistical analyses, drafted the initial manuscript, and reviewed and revised the manuscript. LY, JS, and MZ reviewed and revised the manuscript. We approved the final manuscript as submitted and agree to be accountable for all aspects of the work.

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Correspondence to Bo Xi.

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Ma, S., Xi, B., Yang, L. et al. Trends in the prevalence of overweight, obesity, and abdominal obesity among Chinese adults between 1993 and 2015. Int J Obes 45, 427–437 (2021). https://doi.org/10.1038/s41366-020-00698-x

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