Epidemiology

Internal medicine

Disease

Population

Obesity

Political science

China

Prevalence

Disease surveillance

Risk factor

Medicine

Environmental health

Annals of Internal Medicine

Letters18 February 2020Geographic Variation in Prevalence of Adult Obesity in China: Results From the 2013–2014 National Chronic Disease and Risk Factor SurveillanceXiao Zhang, MD, PhD, Mei Zhang, MD, PhD, Zhenping Zhao, MD, Zhengjing Huang, MPH, Qian Deng, MD, PhD, Yichong Li, MD, PhD, An Pan, MD, PhD, Chun Li, MD, Zhihua Chen, MD, Maigeng Zhou, MD, PhD, Chao Yu, PhD, Alfred Stein, PhD, Peng Jia, PhD*, and Limin Wang, MPH*Xiao Zhang, MD, PhDNational Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China (X.Z., M.Z., Z.Z., Z.H., Q.D., Y.L., C.L., Z.C., M.Z., L.W.), Mei Zhang, MD, PhDNational Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China (X.Z., M.Z., Z.Z., Z.H., Q.D., Y.L., C.L., Z.C., M.Z., L.W.), Zhenping Zhao, MDNational Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China (X.Z., M.Z., Z.Z., Z.H., Q.D., Y.L., C.L., Z.C., M.Z., L.W.), Zhengjing Huang, MPHNational Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China (X.Z., M.Z., Z.Z., Z.H., Q.D., Y.L., C.L., Z.C., M.Z., L.W.), Qian Deng, MD, PhDNational Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China (X.Z., M.Z., Z.Z., Z.H., Q.D., Y.L., C.L., Z.C., M.Z., L.W.), Yichong Li, MD, PhDNational Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China (X.Z., M.Z., Z.Z., Z.H., Q.D., Y.L., C.L., Z.C., M.Z., L.W.), An Pan, MD, PhDSchool of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China (A.P.), Chun Li, MDNational Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China (X.Z., M.Z., Z.Z., Z.H., Q.D., Y.L., C.L., Z.C., M.Z., L.W.), Zhihua Chen, MDNational Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China (X.Z., M.Z., Z.Z., Z.H., Q.D., Y.L., C.L., Z.C., M.Z., L.W.), Maigeng Zhou, MD, PhDNational Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China (X.Z., M.Z., Z.Z., Z.H., Q.D., Y.L., C.L., Z.C., M.Z., L.W.), Chao Yu, PhDState Key Laboratory of Remote Sensing Science, Institute of Remote Sensing and Digital Earth, Chinese Academy of Sciences, Beijing, China (C.Y.), Alfred Stein, PhDFaculty of Geo-information Science and Earth Observation, University of Twente, Enschede, the Netherlands (A.S.), Peng Jia, PhD*GeoHealth Initiative, Faculty of Geo-information Science and Earth Observation, University of Twente, and International Initiative on Spatial Lifecourse Epidemiology (ISLE), Enschede, the Netherlands (P.J.), and Limin Wang, MPH*National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China (X.Z., M.Z., Z.Z., Z.H., Q.D., Y.L., C.L., Z.C., M.Z., L.W.)Author, Article, and Disclosure Informationhttps://doi.org/10.7326/M19-0477 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Background: Obesity prevalence has grown rapidly worldwide. According to the World Health Organization, the global prevalence of obesity nearly doubled between 1980 and 2008. This increase in obesity prevalence has been observed in China as well, but most national efforts have focused on childhood obesity (1). Data from the first China Chronic Disease and Risk Factor Surveillance (CCDRFS) in 2004 indicate that the prevalence of general obesity (defined as a body mass index [BMI] ≥30 kg/m2) among adults was 3.3% and that 25.9% of participants were considered to have abdominal obesity on the basis of criteria at that time (a ...References1. Jia P, Ma S, Qi X, et al. Spatial and temporal changes in prevalence of obesity among Chinese children and adolescents. Prev Chronic Dis. 2019. [Forthcoming]. CrossrefMedlineGoogle Scholar2. Xu Y, Wang L, He J, et al; 2010 China Noncommunicable Disease Surveillance Group. Prevalence and control of diabetes in Chinese adults. JAMA. 2013;310:948-59. [PMID: 24002281] doi:10.1001/jama.2013.168118 CrossrefMedlineGoogle Scholar3. Ladabaum U, Mannalithara A, Myer PA, et al. Obesity, abdominal obesity, physical activity, and caloric intake in US adults: 1988 to 2010. Am J Med. 2014;127:717-27. [PMID: 24631411] doi:10.1016/j.amjmed.2014.02.026 CrossrefMedlineGoogle Scholar4. Goh VH, Tain CF, Tong TY, et al. Are BMI and other anthropometric measures appropriate as indices for obesity? A study in an Asian population. J Lipid Res. 2004;45:1892-8. [PMID: 15258201] CrossrefMedlineGoogle Scholar5. Jia P, Xue H, Cheng X, et al. Effects of school neighborhood food environments on childhood obesity at multiple scales: a longitudinal kindergarten cohort study in the USA. BMC Med. 2019;17:99. [PMID: 31117993] doi:10.1186/s12916-019-1329-2 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China (X.Z., M.Z., Z.Z., Z.H., Q.D., Y.L., C.L., Z.C., M.Z., L.W.)School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China (A.P.)State Key Laboratory of Remote Sensing Science, Institute of Remote Sensing and Digital Earth, Chinese Academy of Sciences, Beijing, China (C.Y.)Faculty of Geo-information Science and Earth Observation, University of Twente, Enschede, the Netherlands (A.S.)GeoHealth Initiative, Faculty of Geo-information Science and Earth Observation, University of Twente, and International Initiative on Spatial Lifecourse Epidemiology (ISLE), Enschede, the Netherlands (P.J.)Financial Support: By the Chinese central government (Key Project of Public Health Program), the National Key Research and Development Program of China (2018YFC1311700), the National Natural Science Foundation of China (81473043, 81230066, and 91546120), and the State Key Laboratory of Urban and Regional Ecology of China (SKLURE 2018-2-5). Dr. Jia, Director of the International Initiative on Spatial Lifecourse Epidemiology (ISLE), thanks the Lorentz Center, the Netherlands Organization for Scientific Research, the Royal Netherlands Academy of Arts and Sciences, the Chinese Center for Disease Control and Prevention, and the West China School of Public Health in Sichuan University for funding the ISLE and supporting its research activities. The funders had no role in the design or conduct of the study; collection, management, analysis, or interpretation of the data; preparation, review, or approval of the manuscript; or decision to submit the manuscript for publication.Disclosures: Authors have disclosed no conflicts of interest. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M19-0477.Reproducible Research Statement: Study protocol and data set: Available on from Dr. Wang (e-mail, [email protected]chinacdc.cn). Statistical code: Available from Dr. Jia (e-mail, [email protected]com).* Drs. Wang and Jia cosupervised this work.This article was published at Annals.org on 29 October 2019. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byIndividual and combined associations of body mass index and waist circumference with components of metabolic syndrome among multiethnic middle-aged and older adults: A cross-sectional studyCholestyramine resin administration alleviated cerebral ischemic injury in obese mice by improving gut dysbiosis and modulating the bile acid profileInhibitory effect of Zanthoxylum bungeanum maxim. and Capsicum annuum L. on the activities of pancreatic lipase and α‐amylaseWhey protein and soy protein prevent obesity by upregulating uncoupling protein 1 to activate brown adipose tissue and promote white adipose tissue browning in high-fat diet-fed miceQuercetin improves high‐fat diet‐induced obesity by modulating gut microbiota and metabolites in C57BL/6J miceConicity-index predicts all-cause mortality in Chinese older people: a 10-year community follow-upCombined consideration of body mass index and waist circumference identifies obesity patterns associated with risk of stroke in a Chinese prospective cohort studyGeographical disparities in obesity prevalence: small-area analysis of the Chilean National Health SurveysYale Food Addiction Scale 2.0 (YFAS 2.0) and modified YFAS 2.0 (mYFAS 2.0): Rasch analysis and differential item functioningStaple Food Preference and Obesity Phenotypes: The Regional Ethnic Cohort Study in Northwest ChinaExposure to Polybrominated Diphenyl Ethers and Phthalates in China: A Disease Burden and Cost AnalysisThe prevalence of obesity-related hypertension among middle-aged and older adults in ChinaPrevalence and risk factors of MRI-defined brain infarcts among Chinese adultsTime-restricted eating with or without low-carbohydrate diet reduces visceral fat and improves metabolic syndrome: A randomized trialGeographic Variations in Dietary Patterns and Their Associations with Overweight/Obesity and Hypertension in China: Findings from China Nutrition and Health Surveillance (2015–2017)Association between environmental lead/cadmium co-exposure in drinking water and soil and type 2 diabetes mellitus/obesity in Southern ChinaHealth consequences of obesity and projected future obesity health burden in ChinaProvincial heterogeneity in the management of care cascade for hypertension, diabetes, and dyslipidaemia in China: Analysis of nationally representative population-based surveyEstablishing a new body mass index cutoff value for malnutrition diagnosis using the Global Leadership Initiative on Malnutrition (GLIM) tool in Chinese older adultsThree lactic acid bacteria with anti-obesity properties: In vitro screening and probiotic assessmentInfluences of achieved SBP on age and sex-related left ventricular structural alteration in community hypertensive populationsData Resource Profile: China Chronic Disease and Risk Factor Surveillance (CCDRFS)High incidence of hypertension-mediated organ damage in a series of Chinese patients with 17α-hydroxylase deficiencyAssociation of visceral adiposity index with new-onset type 2 diabetes and impaired fasting glucose in hypertensive Chinese adultsAssociation between residential greenness and overweight/obesity among rural adults in northwestern ChinaAdiposity, metabolomic biomarkers, and risk of nonalcoholic fatty liver disease: a case-cohort studyComparison of time trends in the incidence of primary liver cancer between China and the United States: an age–period–cohort analysis of the Global Burden of Disease 2019Prevalence and Risk Factors of Abnormal Carotid Artery in Young Adults without Overt Cardiovascular DiseaseGender-specific prevalence of metabolic-associated fatty liver disease among government employees in Tianjin, China: a cross-sectional studyAssociation of Daytime Napping with chronic diseases among Tibetan people in China: a cross-sectional studyTranslation of the Chinese version of the modified Yale Food Addiction Scale 2.0 and its validation among college studentsGut microbiota and its metabolites: Bridge of dietary nutrients and obesity-related diseasesIntegrated Metagenomics and Metabolomics to Reveal the Effects of Policosanol on Modulating the Gut Microbiota and Lipid Metabolism in Hyperlipidemic C57BL/6 MiceDietary patterns and cardiometabolic risks in diverse less-developed ethnic minority regions: results from the China Multi-Ethnic Cohort (CMEC) StudyThe association of nighttime sleep duration and quality with chronic kidney disease in middle-aged and older Chinese: a cohort studyAssociation between endogenous LH level prior to progesterone administration and live birth rate in artificial frozen-thawed blastocyst transfer cycles of ovulatory womenIBI362 (LY3305677), a weekly-dose GLP-1 and glucagon receptor dual agonist, in Chinese adults with overweight or obesity: A randomised, placebo-controlled, multiple ascending dose phase 1b studyThe patterns of left ventricular alteration by adipose tissue distribution: implication for heart failure preventionThree-Year Outcomes of Sleeve Gastrectomy Plus Jejunojejunal Bypass: a Retrospective Case-Matched Study with Sleeve Gastrectomy and Gastric Bypass in Chinese Patients with BMI ≥35 kg/m2Maternal Overweight and Obesity during Pregnancy Are Associated with Neonatal, but Not Maternal, Hepcidin ConcentrationsSex Differences in the Association Between Obesity and Cognitive Impairment in a Low-Income Elderly Population in Rural China: A Population-Based Cross-Sectional StudyBody-mass index and obesity in urban and rural China: findings from consecutive nationally representative surveys during 2004–18Learning from East to West and vice versa: Clinical epidemiology of colorectal cancer in ChinaSex differences in clinical characteristics and risk factors for disease severity of hospitalized patients with COVID‐19Epidemiology and determinants of obesity in ChinaClinical management and treatment of obesity in ChinaObesity Prevalence and Risks Among Chinese Adults: Findings From the China PEACE Million Persons Project, 2014–2018Obesity and COVID-19 in Adult Patients With DiabetesOpportunistic Screening Using Low‐Dose CT and the Prevalence of Osteoporosis in China: A Nationwide, Multicenter StudyAntibiotics biomonitored in urine and obesogenic risk in a community-dwelling elderly populationImpact of obesity on COVID-19 patientsTraffic‐related environmental factors and childhood obesity: A systematic review and meta‐analysisUrban sprawl and childhood obesityState‐of‐the‐art of measures of the obesogenic environment for childrenImpact of Obesity-Related Inflammation on Cardiac Metabolism and FunctionPrevalence of dyslipidemia and associated risk factors among adults aged ≥35 years in northern China: a cross-sectional studyAnalysis of lifetime death probability for major causes of death among residents in ChinaBariatric Surgery for Patients With Obesity: The Earlier the Better?Christina C. Wee, MD, MPH, Deputy EditorWage Penalties or Wage Premiums? A Socioeconomic Analysis of Gender Disparity in Obesity in Urban China Long Sleep Duration is Associated with Increased High-Sensitivity C-Reactive Protein: A Nationwide Study on Chinese Population L-Carnitine Is Involved in Hyperbaric Oxygen-Mediated Therapeutic Effects in High Fat Diet-Induced Lipid Metabolism Dysfunction 18 February 2020Volume 172, Issue 4Page: 291-293KeywordsBloodBody mass indexForecastingGlobal healthHeartLungsMedical risk factorsObesityPrevention, policy, and public healthResearch laboratories ePublished: 29 October 2019 Issue Published: 18 February 2020 Copyright & PermissionsCopyright © 2019 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...

Geographic Variation in Prevalence of Adult Obesity in China: Results From the 2013–2014 National Chronic Disease and Risk Factor Surveillance