Over the past two decades, China has enjoyed impressive economic development, and her citizens have experienced many remarked changes in their lifestyle. These changes are often associated with an increase in obesity and chronic disease.
In this meta-analysis, based on nationally representative data, we studied the current prevalence of obesity and the trends in obesity, mortality and morbidity in China.
Between 1992 and 2002, the prevalence of overweight and obesity increased in all gender and age groups and in all geographic areas. Using the World Health Organization body mass index cut points, the combined prevalence of overweight and obesity increased from 14.6 to 21.8%. The Chinese obesity standard shows an increase from 20.0 to 29.9%. The annual increase rate was highest in men aged 18–44 years and women aged 45–59 years (approximately 1.6 and 1.0% points, respectively). In general, male subjects, urban residents, and high-income groups had a greater increase. With the increase in overweight and obesity, obesity-, and diet-related chronic diseases (e.g., hypertension, cardiovascular disease (CVD), and type 2 diabetes) also increased over the past decade and became a more important preventable cause of death. Hypertension increased from 14.4% in 1991 to 18.8% in 2002 in adults; in older adults aged 35–74 years, it increased from 19.7 to 28.6%. Between 1993 and 2003, the prevalence of CVD increased from 31.4 to 50.0%; diabetes increased from 1.9 to 5.6%. During 1990–2003, although total mortality rate (per 100 000) decreased, overall the mortality rate and contribution (as percentages) to total death of obesity-related chronic disease increased, in particular, in rural areas. Mortality rate (per 100 000) of CVD increased from 128 to 145 and its contribution to total death, 27 to 32%, in rural areas; the figures decreased slightly in urban areas. The mortality rate of ‘nutrition, endocrinology and metabolism-related disease’ (NEMD) increased in both rural and urban areas between 1990 and 2000, 8.0 to 10.6 and 4.9 to 5.3, respectively. The current prevalence of hypertension, dyslipidaemia, metabolic syndrome, and diabetes among Chinese adults is approximately 20, 20, 15, and 3%, respectively.
The prevalence of overweight and obesity and obesity-related chronic diseases have increased in China in the past decade. Our findings provide useful information for the projection of future trends and the formulation of national strategies and programmes that can address the challenges of the growing obesity and chronic disease epidemic.
This is a preview of subscription content
Subscribe to Journal
Get full journal access for 1 year
only $9.92 per issue
All prices are NET prices.
VAT will be added later in the checkout.
Tax calculation will be finalised during checkout.
Get time limited or full article access on ReadCube.
All prices are NET prices.
World Health Organization. Obesity: Preventing and managing the Global Epidemic – Report of a WHO Consultation. WHO Technical Report Series, No. 894, WHO: Geneva, 2000.
Popkin BM, Doak CM . The obesity epidemic is a worldwide phenomenon. Nutr Rev 1998; 56: 106–114.
Wang Y, Monteiro C, Popkin BM . Trends of obesity and underweight in older children and adolescents in the United States, Brazil, China, and Russia. Am J Clin Nutr 2002; 75: 971–977.
US Department of Health and Human Services (USDHHS). Public Health Service. The Surgeon General's Call To Action To Prevent and Decrease Overweight and Obesity. Office of the Surgeon General: Rockville, MD, 2001.
Chinese Ministry of Public Health (CMPH). Report of the 2002 China National Nutrition and Health Survey. 2004 (in Chinese).
Ge K . The Dietary and Nutritional Status of Chinese Population: 1992 National Nutrition Survey, vol. 1. People's Medical Publishing House: Beijing, 1996.
Ge K . The Dietary and Nutritional Status of Chinese Population: 1992 National Nutrition Survey, vol. 2 (children and adolescents). People's Medical Publishing House: Beijing, 1999.
Gu D, Reynolds K, Wu X, Chen J, Duan X, Reynolds RF, et al., InterASIA Collaborative Group. Prevalence of the metabolic syndrome and overweight among adults in China. Lancet 2005; 365: 1398–1405.
Li L, Rao K, Kong L, Yao C, Xiang H, Zhai F et al. A description of the Chinese national nutrition and health survey in 2005. Chin J Epidemiol 2005; 26: 478–484 (in Chinese).
Ma GS, Li YP, Wu YF, Zhai FY, Cui ZH, Hu XQ et al. The prevalence of overweight and obesity and its changes among Chinese people during 1992–2002. Chin J Prev Med 2005 (in press, in Chinese).
Wang W, Wang K, Li T . A study on the epidemiological characteristics of obesity in China adults. Chin J Epidemiol 2001; 22: 129–132 (in Chinese).
Wang JH, Zhai F, Du SF, Wang ZH, He YN . The trends of prevalence of obesity in adults in part areas of China. Acta Nutrimenta Sinica 2004; 26: 329–332.
Wu Y, The Collaborative Study Group on Trends of Cardiovascular Diseases in China and Preventive Study. Current status of major cardiovascular risk factors in Chinese population and the trends in the past two decades. Chin J Cardiol 2001; 29: 74–79 (in Chinese).
Zhou BF, Cooperative Meta-Analysis Group of the Working Group on Obesity in China. Predictive values of body mass index and waist circumference for risk factors of certain related diseases in Chinese adults – study on optimal cut-off points of body mass index and waist circumference in Chinese adults. Biomed Environ Sci 2002; 15: 83–96.
Deurenberg-Yap M, Deurenberg P . Is a re-evaluation of WHO body mass index cut-off values needed? The case of Asians in Singapore. Nutr Rev 2003; 61: S80–S87.
Misra A . Revisions of cutoffs of body mass index to define overweight and obesity are needed for the Asian-ethnic groups. Int J Obes Relat Metab Disord 2003; 27: 1294–1296.
WHO Expert Consultation. Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. Lancet 2004; 363: 157–163.
Inoue S, Zimmet P, Caterson I, Chen CM, Ikeda Y, Khalid AK et al. The Asia-Pacific perspective: redefining obesity and its treatment. 2000, http://iotf.org/ (The document has been coordinated by the International Diabetes Institute, a WHO Collaborating Centre; co-sponsored jointly by the Regional Office for the Western Pacific, World Health Organization, the International Association for the Study of Obesity and the International Obesity Task Force).
Wu Y, Ma G, Hu Y, Li YP, Li X, Cui ZH et al. The current status in prevalence of overweight and obesity in China: data from the China National Nutrition and Health Survey (NNAHS). Chin J Prev Med 2005; 39: 316–320 (in Chinese).
Du S, Lu B, Zhai F, Popkin BM . A new stage of the nutrition transition in China. Public Health Nutr 2002; 5: 169–174.
Pang X, Jian S, Huang L, Duan J, Ren G, Liu Z . Nutrition and health sttaus of the Beijing residents. Chin J Prev Med 2005; 39: 269–272 (in Chinese).
Wang W, Wu ZS, Zhao D, Wu GX, Wang WH, Liu J et al. The trends of body mass index and overweight in population aged 25–64 in Beijing during 1984–1999. Chin J Epidemiol 2003; 24: 272–275 (in Chinese).
Wu Y, Zhou B, Tao S, Wu X, Yang J, Li Y et al. Prevalence of overweight and obesity in Chinese middle-aged population: current status and the trend of development. Chin J Epidemiol 2002; 23: 11–16 (in Chinese).
Chinese Ministry of Public Health (CMPH). Annual Statistical Reports of Death, Injury and Cause of Death in China, 1993-2005 (in Chinese).
Wang K, Li T, Xiang H . Study on the epidemiological characteristics of diabetes mellitus and IGT in China. Chin J Epidemiol 1998; 19: 282–285 (in Chinese).
Wu X, Duan X, Gu D, Hao J, Tao S, Fan D . Prevalence of hypertension and its trends in Chinese populations. Int J Cardiol 1995; 52: 39–44.
Gu D, Reynolds K, Wu X, Chen J, Duan X, Muntner P, et al., InterASIA Collaborative Group. The International Collaborative Study of Cardiovascular Disease in ASIA. Prevalence, awareness, treatment, and control of hypertension in China. Hypertension 2002; 40: 920–927.
Wang Z, Wu Y, Zhao L, Li Y, Yang J, Zhou B, Cooperative Research Group of the Study on Trends of Cardiovascular Diseases in China and Preventive Strategy for the 21st Century. Trends in prevalence, awareness, treatment and control of hypertension in the middle-aged population of China, 1992–1998. Hypertens Res 2004; 27: 703–709.
NIH. Executive summary of the third report of the National Cholesterol Education Program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III). JAMA 2001; 285: 2486–2497.
Li ZY, Xu GB, Xia TA . Prevalence rate of metabolic syndrome and dyslipidaemia in a large professional population in Beijing. Atherosclerosis 2006; 184: 188–192.
Mi J, Cheng H, Zhao XY et al. Ponderal index at birth predicts metabolic syndrome in mid-aged Chinese. Chin J Prev Med 2004; 38: 221–225 (in Chinese).
China State Statistics Bureau. China Statistical Yearbook 2002. China Statistics Press: Beijing, 2002 (in Chinese).
Caballero B, Popkin BM . The Nutrition Transition: Diet and Disease in the Developing World. Academic Press: London, 2002.
Popkin BM, Horton S, Kim S, Mahal A, Shuigao J . Trends in diet, nutritional status, and diet-related noncommunicable diseases in China and India: the economic costs of the nutrition transition. Nutr Rev 2001; 59: 379–390.
Yang GH, Ma JM, Liu N, Chen AP . Study on diet, physical activities and body mass index in Chinese population in 2002. Chin J Epidemiol 2005; 26: 246–251 (in Chinese).
Beijing Statistics Bureau. Beijing Statistics Bureau 2004 Domestic Economic and Social Development Report. 2005 (in Chinese).
World Bank. World Development Indicators 2001. Washington, DC, 2001. World Bank.
Centers for Disease Control and Prevention (CDC). Guidelines for school health programs to promote lifelong healthy eating. MMWR Recomm Rep 1996; 45: 1–41.
Centers for Disease Control and Prevention (CDC). Guidelines for school and community programs to promote lifelong physical activity among young people. MMWR 1997; 46: 1–36.
The study was supported by the Johns Hopkins University and Dr Youfa Wang was also funded by research grants from the US National Institutes of Health (NIH)/National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)(#1 R01 DK63383) and US Department of Agriculture (USDA, 2044-05322). Dr Jie Mi was supported by a research grant (H030930030031) from Beijing Municipal Science & Technology Commission.
Conflict of interest statements:
The authors declare that there is no conflict of interest.
About this article
Cite this article
Wang, Y., Mi, J., Shan, Xy. et al. Is China facing an obesity epidemic and the consequences? The trends in obesity and chronic disease in China. Int J Obes 31, 177–188 (2007). https://doi.org/10.1038/sj.ijo.0803354
- chronic disease
Cardiovascular Diabetology (2022)
Clinical and biological risk factors associated with inflammation in patients with type 2 diabetes mellitus
BMC Endocrine Disorders (2022)
Associations of Gestational Diabetes Mellitus and Excessive Gestational Weight Gain with Offspring Obesity Risk
Current Medical Science (2022)
Gender-health disparities: exploring the counterbalancing mechanisms of labor disadvantage and health behaviors in rural China
China Population and Development Studies (2022)
Analysis of the health effects of the transition of traditional Chinese food on the emergence of nontraditional eating behaviors
Journal of Ethnic Foods (2021)