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.

Body composition, energy expenditure and physical activity

Longitudinal association of leisure time physical activity and sedentary behaviors with body weight among Chinese adults from China Health and Nutrition Survey 2004–2011




Present study aims to longitudinally explore independent association of physical activity and sedentary behaviors with body weight.


This study included 15050 adults who have complete demographic and dietary data, leisure time physical activity (LTPA) and sedentary behavior evaluations, anthropometric measurements from longitudinal data of China Health and Nutrition Survey 2004–2011. Three-level mixed-effects linear and logistic regression models were performed for association analysis.


Overweight and obesity prevalence in men and women progressively increased from 2004 to 2011. MET-h/week from LTPA declined, whereas time (h/day) spent in sedentary behaviors increased in men and women over 7 years. After adjustment for confounders, LTPA (MET-h/week) was linked with weight gain for moderate (β=0.43, 95% confidence interval (CI): 0.16–0.60, P<0.01) and low (β=0.52, 95% CI: 0.23–0.81, P<0.01) versus high LTPA in men; weight was increased by 0.7 kg (95% CI: 0.44–0.93, P<0.001) and 0.4 kg (95% CI: 0.12–0.68, P<0.01) among men and women without LTPA, respectively, compared with those with high LTPA. Sedentary behavior was associated with weight gain in men (β=0.45, 95% CI: 0.14–0.76, P<0.01) and in women (β=0.29, 95% CI: 0.11–0.49, P<0.05) for high versus low level. Moreover, overweight and obesity risk in men with low LTPA or without LTPA was 1.88 (95% CI: 1.15–2.51, P<0.05) and 2.01 (95% CI: 1.41–3.03, P<0.001) times higher than those with high LTPA, respectively. Odds of overweight and obesity were increased to 1.63 (95% CI: 1.29–2.21, P<0.01) times in women with low LTPA and 1.69 (95% CI: 1.37–2.27, P<0.001) times in women without LTPA compared with those with high LTPA. High level sedentary behavior was associated with 19% (OR=1.19, 95% CI: 1.04–1.35, P<0.05) greater odds of overweight and obesity against low level in men.


LTPA and sedentary behaviors are independently and longitudinally associated with overweight and obesity, especially in men.

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.

Figure 1
Figure 2


  1. Xiao J, Shen C, Chu MJ, Gao YX, Xu GF, Huang JP et al. Physical activity and sedentary behavior associated with components of Metabolic Syndrome among people in rural China. PLoS One 2016; 11: e0147062.

    Article  Google Scholar 

  2. World Health Organization. Prevalence of insufficient physical activity. Available at

  3. Chen XR, Jiang Y, Wang LM, Li YC, Zhang M, Hu N et al. Leisure-time physical activity and sedentary behaviors among Chinese adults in 2010. Chin J Prev Med 2012; 5: 399–403.

    Google Scholar 

  4. World Health Organization. Obesity: preventing and managing the global epidemic. Report of a WHO consultation. WHO Tech Rep Ser 2000; 894: 1–253.

  5. Ng M, Fleming T, Robinson M, Thomson B, Graetz N, Margono C et al. Global, regional, and national prevalence of overweight and obesity in children and adults during 1980-2013: a systematic analysis for the global burden of disease study 2013. Lancet 2014; 384: 766–781.

    Article  Google Scholar 

  6. Li XY, Jiang Y, Hu N, Li YC, Zhang M, Huang ZJ et al. Prevalence and characteristic of overweight and obesity among adults in China, 2010. Zhonghua Yu Fang Yi Xue Za Zhi 2012; 46: 683–686.

    PubMed  Google Scholar 

  7. Anderssen SA, Engeland A, Sogaard AJ, Nystad W, Graff-Iversen S, Holme I . Changes in physical activity behavior and the development of body mass index during the last 30 years in Norway. Scand J Med Sci Sports 2008; 18: 309–317.

    CAS  Article  Google Scholar 

  8. Thorp AA, Owen N, Neuhaus M, Dunstan D . Sedentary behaviors and subsequent health outcomes in adults a systematic review of longitudinal studies, 1996-2011. Am J Prev Med 2011; 41: 207–215.

    Article  Google Scholar 

  9. Wenche DB, Holmen J, Krüger Ø, Midthjell K . Leisure time physical activity and change in body mass index: an 11-year follow-up study of 9357 normal weight health women 20-49 years old. J Womens Health (Larchmt) 2004; 13: 55–62.

    Article  Google Scholar 

  10. Durant RH, Baranowski T, Johnson M, Thompson WO . The relationship among television watching, physical-activity, and body-composition of Young-children. Pediatrics 1994; 94: 449–455.

    CAS  PubMed  Google Scholar 

  11. FitzGerald SJ, Kriska AM, Pereira MA, DeCourten MP . Associations among physical activity, television watching, and obesity in adult Pima Indians. Med Sci Sports Exerc 1997; 29: 910–915.

    CAS  Article  Google Scholar 

  12. Zhang B, Zhai FY, Du SF, Popkin BM . The China Health and Nutrition Survey, 1989-2011. Obes Rev 2014; 15 (Suppl 1), 2–7.

    Article  Google Scholar 

  13. Su C, Jia X, Wang Z, Wang H, Zhang B . Trends in dietary cholesterol intake among Chinese adults: a longitudinal study from the China Health and Nutrition Survey, 1991-2011. BMJ Open 2015; 5: e007532.

    Article  Google Scholar 

  14. Su C, Zhang B, Wang YF, JiaXF, Xue H, Wang HJ . Epidemics of overweight and obesity among growing childhood in China between 1997 and 2009: impact of family income, dietary intake, and physical activity dynamics. Chin Med J (Engl) 2015; 128: 1879–1886.

    Article  Google Scholar 

  15. Chen C, Lu FC, Department of Disease Control Ministry of Health, PR China. The guidelines for prevention and control of overweight and obesity in Chinese adults. Biomed Environ Sci 2004; 17, (Suppl) 1–36.

    PubMed  Google Scholar 

  16. Sallis JF, Haskell WL, Wood PD, Fortmann SP, Rogers T, Blair SN et al. Physical activity assessment methodology in the five-city project. Am J Epidemiol 1985; 121: 91–106.

    CAS  Article  Google Scholar 

  17. Ng SW, Popkin BM . Time use and physical activity: a shift away from movement across globe. Obes Rev 2012; 13: 659–680.

    CAS  Article  Google Scholar 

  18. Ng SW, Norton EC, Popkin BM . Why have physical activity levels declined among Chinese adults? Findings from the 1991-2006 China Health and Nutrition Surveys. Soc Sci Med 2009; 68: 1305–1314.

    Article  Google Scholar 

  19. Bureau for Disease Control and Prevention, Ministry of Health, People’s Republic of China Physical Activity Guideline for Chinese Adults. People’s Medical Publishing House: Beijing, China, 2011.

  20. World Health Organization Global Recommendations on Physical Activity for Health. WHO Press: Geneva, Switzerland, 2010, p 26.

  21. Jones-Smith JC, Popkin BM . Understanding community context and adult health changes in China: development of an urbanicity scale. Soc Sci Med 2010; 71: 1436–1446.

    Article  Google Scholar 

  22. Wang H, Zhai F . Program and policy options for preventing obesity in China. Obes Rev 2013; 14: 134–140.

    CAS  Article  Google Scholar 

  23. Scidell JC . Epidemiology of obesity. Semin Vasc Med 2005; 5: 3–14.

    Article  Google Scholar 

  24. Wang H, Wang J, Liu MM, Wang D, Liu YQ, Zhao Y et al. Epidemiology of general obesity, abdominal obesity and related risk factors in urban adults from 33 communities of northeast China: the CHPSNE study. BMC Public Health 2012; 12: 967.

    Article  Google Scholar 

  25. Sternfeld B, Wang H, Quesenberry CP Jr, Abrams B, Everson-Rose SA, Greendale GA et al. Physical activity and changes in weight and waist circumference in midlife women: findings from the Study of Women’s Health Across the Nation. Am J Epidemiol 2004; 160: 912–922.

    Article  Google Scholar 

  26. Pirgon Ö, Aslan N . The role of urbanization in childhood obesity. J Clin Res Pediatr Endocrinol 2015; 7: 163–167.

    Article  Google Scholar 

  27. Nicklas BJ, Tomoyasu N, Muir J, Goldberg AP . Effect of cigarette smoking and its cessation on body weight and plasma leptin levels. Metabolism 1999; 48: 804–808.

    CAS  Article  Google Scholar 

  28. Wang Y, Mi J, Shan XY, Wang QJ, Ge KY . Is China facing an obesity epidemic and the consequences? The trends in obesity and chronic disease in China. Int J Obes (Lond) 2007; 31: 177–188.

    CAS  Article  Google Scholar 

  29. Brownson RC, Boehmer TK, Luke DA . Declining rates of physical activity in the United States: what are the contributors? Annu Rev Public Health 2005; 26: 421–443.

    Article  Google Scholar 

  30. Ng SW, Howard AG, Wang HJ, Su C, Zhang B . The physical activity transition among adults in China: 1991-2011. Obes Rev 2014; 15 (Suppl 1), 27–36.

    Article  Google Scholar 

  31. Monda KL, Gordon-Larsen P, Stevens J, Popkin BM . China’s transition: the effect of rapid urbanization on adult occupational physical activity. Soc Sci Med 2007; 64: 858–870.

    Article  Google Scholar 

  32. Healy GN, Matthews CE, Dunstan DW, Winkler EA, Owen N . Sedentary time and cardio-metabolic biomarkers in US adults: NHANES 2003-06. Eur Heart J 2011; 32: 590–597.

    Article  Google Scholar 

  33. Hankinson AL, Daviglus ML, Bouchard C, Carnethon M, Lewis CE, Schreiner PJ et al. Maintaining a high physical activity level over 20 years and weight gain. JAMA 2010; 304: 2603–2610.

    CAS  Article  Google Scholar 

  34. Chau JY, van der Ploeg HP, Merom D, Chey T, Bauman AE . Cross-sectional associations between occupational and leisure-time sitting, physical activity and obesity in working adults. Prev Med 2012; 54: 195–200.

    Article  Google Scholar 

  35. Kronenberg F, Pereira MA, Schmitz MK, Arnett DK, Evenson KR, Crapo RO et al. Influence of leisure time physical activity and television watching on atherosclerosis risk factors in the NHLBI Family Heart Study. Atherosclerosis 2000; 153: 433–443.

    CAS  Article  Google Scholar 

  36. Monda KL, Adair LS, Zhai F, Popkin BM . Longitudinal relationships between occupational and domestic physical activity patterns and body weight in China. Eur J Clin Nutr 2008; 62: 1318–1325.

    CAS  Article  Google Scholar 

  37. Sugiyama T, Healy GN, Dunstan DW, Salmon J . Joint associations of multiple leisure-time sedentary behaviours and physical activity with obesity in Australian adults. Int J Behav Nutr Phys Act 2008; 5: 35.

    Article  Google Scholar 

  38. Blanck HM, McCullough ML, Patel AV, Gillespie C, Calle EE, Cokkinidest VE et al. Sedentary behavior, recreational physical activity, and 7-year weight gain among postmenopausal US women. Obesity (Silver Spring) 2007; 15: 1578–1588.

    Article  Google Scholar 

  39. Sallis JF, Saelens BE . Assessment of physical activity by self-report: status, limitations, and future directions. Res Q Exerc Sport 2000; 71: S1–S14.

    CAS  Article  Google Scholar 

  40. Haskell WL . Physical activity by self-report: a brief history and future issues. J Phys Act Health 2012; 9: S5–S10.

    Article  Google Scholar 

Download references


We thank the National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Carolina Population Center (5 R24 HD050924); The University of North Carolina at Chapel Hill, The NIH (R01-HD30880, DK056350, P2C HD050924, and R01-HD38700); and the Fogarty International Center, NIH, for providing financial support for the collection and analysis of the CHNS data from 1989 to 2011 and the future surveys. The present study is also funded by grants from the National Natural Science Foundation of China (No.81573155).

Author information

Authors and Affiliations


Corresponding author

Correspondence to B Zhang.

Ethics declarations

Competing interests

The authors declare no conflict of interest.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Su, C., Jia, X., Wang, Z. et al. Longitudinal association of leisure time physical activity and sedentary behaviors with body weight among Chinese adults from China Health and Nutrition Survey 2004–2011. Eur J Clin Nutr 71, 383–388 (2017).

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI:

Further reading


Quick links