Skip to main content

Thank you for visiting You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

Influence of dietary pattern on the development of overweight in a Chinese population



To examine dietary factors predisposing to overweight and obesity, taking into account age, gender, education level and physical activity.


Longitudinal population study.


Community living subjects in Hong Kong.


One thousand and ten Chinese subjects participating in a territory wide dietary and cardiovascular risk factor prevalence survey in 1995–1996 were followed up for 5–9 years.


Body mass index (BMI) was measured. Information was collected on factors predisposing to development of overweight and obesity (age, gender, education level, physical activity, macronutrient intake, Mediterranean diet score and food variety), and the predisposing dietary factors examined, adjusted for other confounding factors, using logistic regression.


The 5–9-year incidence of overweight is 22.6% (BMI 23 kg/m2, 95% confidence interval (CI)=15.0–30.1%) or 11.5% (BMI 25 kg/m2, 95% CI=7.3–15.7%), and for obesity (BMI 30 kg/m2) is 0.6% (95% CI=−0.2–1.4%). The corresponding figures for women were 14.1% (95% CI=8.8–19.5%), 9.7% (95% CI=6.0–13.4%) and 3% (95% CI=1.3–4.8%). After adjusting for confounding factors (age, sex, education and physical activity), increased variety of snack consumption was associated with increased risk of developing overweight (BMI 23 kg/m2) in the Hong Kong Chinese population over a 5–9-year period.


Increased variety of snack consumption may predispose to weight gain over a 5–9-year period.


Research Grants Council and Health Services Research Fund, Hong Kong Government

This is a preview of subscription content

Access options

Buy article

Get time limited or full article access on ReadCube.


All prices are NET prices.


  • Bazzano LA, Song Y, Bubes V, Good CK, Manson JE, Liu S (2005). Dietary intake of whole and refined grain breakfast cereals and weight gain in men. Obes Res 13, 1952–1960.

    Article  Google Scholar 

  • Bell AC, Ge K, Popkin BM (2001). Weight gain and its predictors in Chinese adults. Int J Obes 25, 1079–1086.

    CAS  Article  Google Scholar 

  • Deurenberg-Yap M, Yian TB, Kai CS, Deurenberg P, van Staveren WA (1999). Manifestation of cardiovascular risk factors at low levels of body mass index and waist-to-hip ratio in Singapore Chinese. Asia Pacific J Clin Nutr 8, 177–183.

    CAS  Article  Google Scholar 

  • Drummond S, Crombie N, Kirk T (1996). A critique of the effects of snacking on body weight status. Eur J Clin Nutr 50, 779–783.

    CAS  PubMed  Google Scholar 

  • Francis LA, Lee Y, Birch LL (2003). Parental weight status and girls' television viewing, snacking, and body mass indexes. Obes Res 11, 143–151.

    Article  Google Scholar 

  • Fu FH, Hao X (2002). Physical development and lifestyle of Hong Kong secondary school children. Prev Med 35, 499–505.

    Article  Google Scholar 

  • Ghosh A, Bose K, Das C, Asit B (2003). Association of food patterns, central obesity measures and metabolic risk factors for coronary heart disease (CHD) in middle aged Bengalee Hindu men, Calcutta, India. Asia Pacific J Nutr 166–171.

  • Halkjaer J, Tjønneland A, Thomsen BL, Overvad K, Sørensen TIA (2006). Intake of macronutrients as predictors of five-year changes in waist circumference. J Nutr Health Ageing 10, 73.

    Google Scholar 

  • Holland B, Welch AA, Unwin ID, Buss DH, Paul AA, Southgate DAI et al. (1992). The Composition of Foods. 4th edn. The Royal Society of Chemistry and Ministry of Agriculture, Fisheries and Food: UK.

    Google Scholar 

  • Howard BV, Manson JE, Stefanick M, Beresford SA, Frank G, Jones B et al. (2006). Low fat dietary pattern and weight change over 7 tears. The Women's Health Initiative Dietary Modification Trial. JAMA 295, 39–49.

    CAS  Article  Google Scholar 

  • (2006):, (accessed 21 February).

  • (2006):, (accessed 21 February).

  • Hubert HB, Snider J, Winkleby MA (2005). Health status, health behaviours and acculturation factors associated with overweight and obesity in Latinos from a community and agricultural labor camp survey. Prev Med 40, 642–651.

    Article  Google Scholar 

  • Institute of Health (1992). Food Composition Tables. People's Health Press: Chinese Medical Sciences Institute, China. (Chinese).

  • Janus ED, For the Cardiovascular Risk Factor Prevalence Study Group (1997). Hong Kong Cardiovascular Risk Factor Prevalence Study 1995–1996. Department of Clinical Biochemistry: Queen Mary Hospital, Hong Kong.

    Google Scholar 

  • Kelishadi R, Pour MH, Sarraf-Zadegan N, Sadry GH, Ansari R, Alikhassy H et al. (2003). Obesity and associated modifiable environmental factors in Iranian adolescents: Isfahan Heart Healthy Program—Heart Health Promotion from childhood. Paediatr Int 45, 435–442.

    Article  Google Scholar 

  • Kim S, Haines PS, Siega-Riz AM, Popkin BM (2003). The Diet Quality Index-International (DQI-I) provides an effective tool for cross-national comparison of diet quality as illustrated by China and the United States. J Nutr 133, 3476–3484.

    CAS  Article  Google Scholar 

  • Kirk TR (2000). Role of dietary carbohydrate and frequent eating in body-weight control. Proc Nutr Soc 59, 349–358.

    CAS  Article  Google Scholar 

  • Ko GTC, Chan JCN, Cockram CS, Woo J (1999). Prediction of hypertension, diabetes, dyslipidemia or albuminuria using simple anthropometric indexes in Hong Kong Chinese. Int J Obes 23, 1136–1142.

    CAS  Article  Google Scholar 

  • Leung R, Woo J, Chan D, Tang N (2000). Validation of prediction equations for basal metabolic rate in Chinese Subjects. Eur J Clin Nutr 54, 551–554.

    CAS  Article  Google Scholar 

  • McCrory MA, Fuss PJ, McCallum JE, Yao M, Vinken AG, Hays NP et al. (1999). Dietary variety within food groups: association with energy intake and body fatness in men and women. Am J Clin Nutr 69, 440–447.

    CAS  Article  Google Scholar 

  • Moreno LA, Sarria A, Popkin BM (2002). The nutrition transition in Spain: a European Mediterranean country. Eur J Clin Nutr 56, 992–1003.

    CAS  Article  Google Scholar 

  • Nicklas TA, Yang SJ, Baranowski T, Zakeri I, Berenson G (2003). Eating patterns and obesity in children. The Bogalusa Heart Study. Am J Prev Med 25, 9–16.

    Article  Google Scholar 

  • Notarbartolo A, Barbagallo CM (2001). Eating behaviour, body mass index and lipids of children in a free-living rural Sicilian population. Nutr Metab Cardiovasc Dis 11, 60–63.

    PubMed  Google Scholar 

  • Popkin BM (2001). The nutrition transition and obesity in the developing world. J Nutr 131, 871S–873S.

    CAS  Article  Google Scholar 

  • Schroder H, Marrugat J, Vila J, Covas MI, Elosua R (2004). Adherence to the traditional Mediterranean diet is inversely associated with body mass index and obesity in a Spanish population. J Nutr 134, 3355–3361.

    Article  Google Scholar 

  • Sea MMM, Woo J, Tong PCY, Chow CC, Chan JCN (2004). Associations between food variety and body fatness in Hong Kong Chinese adults. J Am Coll Nutr 23, 404–413.

    Article  Google Scholar 

  • Serra-Majem L, Ngo de la Cruz J, Ribas L, Tur JA (2003). Olive oil and the Mediterranean diet: beyond the rhetoric. Eur J Clin Nutr 57, S2–S7.

    CAS  Article  Google Scholar 

  • Sichieri R (2002). Dietary patterns and their associations with obesity in the Brazilian City of Rio de Janeiro. Obes Res 10, 42–48.

    Article  Google Scholar 

  • Simopoulos AP, Visioli F (2000). Mediterranean diets. World Review of Nutrition and Dietetics 87, Switzerland: Karger, Basel.

    Google Scholar 

  • Sothern MS (2004). Obesity prevention in children physical activity and nutrition. Nutrition 20, 704–708.

    Article  Google Scholar 

  • Speed C (2004). The transposability of the Mediterranean-type diet in non-Mediterranean regions: application to the physician/allied health team. Eur J Cancer Prev 13, 529–534.

    CAS  Article  Google Scholar 

  • Trichopoulou A, Naska A, Orfanos P, Trichopoulos D (2005). Mediterranean diet in relation to body mass index and waist-to-hip ratio the Greek European Prospective Investigation into Cancer and Nutrition Study. Am J Clin Nutr 82, 935–940.

    CAS  Article  Google Scholar 

  • Trichopoulou A, Costacou T, Bamia C, Trichopoulos D (2003). Adherence to a Mediterranean diet and survival in a Greek population. N Engl J Med 348, 2599–2608.

    Article  Google Scholar 

  • Tur JA, Romaguera D, Pons A (2005). The Diet Quality Index-International (DQI-I): is it a useful tool to evaluate the quality of the Mediterranean diet. Br J Nutr 93, 369–376.

    CAS  Article  Google Scholar 

  • Vasan RS, Pencina MJ, Cobain M, Freiberg MS, D'Agostino RB (2005). Estimated risks for developing obesity in the Framingham Heart Study. Ann Intern Med 143, 473–480.

    Article  Google Scholar 

  • Wahlqvist ML, Kouris-blazos A, Wattanapenpaiboon N (1999). The significance of eating patterns: an elderly Greek case study. Appetite 32, 23–32.

    CAS  Article  Google Scholar 

  • Waller CE, Du S, Popkin BM (2003). Patterns of overweight, inactivity, and snacking in Chinese children. Obes Res 11, 957–961.

    Article  Google Scholar 

  • Warwick P (2006). Trends in energy and macronutrient intakes in non-under-reporters vary with the method used to identify under-reporters. J Hum Nutr Dietet 19, 31–40.

    CAS  Article  Google Scholar 

  • Woo J, Leung SSF, Ho SC, Chan SM (1999). Is there a typical Chinese diet and what are the health implications. Ecol Food Nutr 38, 491–503.

    Article  Google Scholar 

  • Woo J, Leung SSF, Ho SC, Lam TH, Janus ED (1997). A food frequency questionnaire for use in the Chinese population in Hong Kong description and examination of validity. Nutr Res 17, 1633–1641.

    CAS  Article  Google Scholar 

  • Woo J, Woo KS, Leung SSF, Chook P, Liu B, Ip R et al. (2001). The Mediterranean score of dietary habits in Chinese populations in four different geographical areas. Eur J Clin Nutr 55, 215–220.

    CAS  Article  Google Scholar 

  • World Health Organization (1998). Prevention and Management of the Global Epidemic of Obesity: Report of the WHO Consultation in Obesity. World Health Organization: Geneva, Switzerland. Report WHO/NUT/NCD/98.1.

  • Zimmet P (2001). Global and societal implications of the diabetes epidemic. Nature 414, 782–787.

    CAS  Article  Google Scholar 

Download references


The study was funded by the Research Grants Council of Hong Kong, project No. CUHK 7229/01M, and Health Services Research Grant No. 421001 1994–1995, Hong Kong Government.

Author information

Authors and Affiliations


Corresponding author

Correspondence to J Woo.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Woo, J., Cheung, B., Ho, S. et al. Influence of dietary pattern on the development of overweight in a Chinese population. Eur J Clin Nutr 62, 480–487 (2008).

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI:


  • food variety
  • Mediterranean diet
  • overweight

Further reading


Quick links