A Chunkier China

Youfa Wang and colleagues knew going into their study of the overweight in China that more and more Chinese were putting on some serious pounds. China's rapid economic development pretty much guaranteed the onset of chubbiness: more automobiles and taxis, fewer strenuous farm jobs—and a lot more fatty food.

"There's probably a McDonald's on every major street in Beijing," says Wang, the study's lead author and an assistant professor in the Department of International Health and the Center for Human Nutrition. "But the real cause of China's growing overweight problems is not fast food. It's diet changes in the home, coupled with a reduction of exercise," he says. "Fifteen or 20 years ago, people in the big cities were all riding bicycles. Now, many urban residents take taxis to get around, and in Beijing approximately 1 in 10 residents owns a car. Shanghai is considering banning bicycles."

Thus, when their meta-analysis of past national population studies revealed that approximately one-quarter of China's adults (and more than half of Beijing's) were overweight or obese, the researchers weren't very surprised. What did shock Wang and his colleagues was the lightning pace of China's epidemic: a greater than 50 percent rise in the prevalence of overweight people in a mere 10 years, from 1992 to 2002. In general, men, urban residents and high-income groups saw the greatest increases in overweight and obesity prevalence, according to the study, which was published in the May 2006 International Journal of Obesity. The researchers also found increases in the prevalence of hypertension, cardiovascular disease and type-2 diabetes, which are obesity-related illnesses.

Wang, MD, PhD, believes it's crucial that the Chinese government start getting the word out about the health consequences of being overweight. "The benefits of a traditional non-Western diet must be stressed," he says, "and the belief of many elderly that a little overweight is good [because it signals prosperity] must be challenged."

Can a nation of over one billion push away from the table en masse? Wang is optimistic, noting that anti-smoking campaigns have lowered the prevalence of smokers in China by 1 percentage point for each of the past 10 years. He believes that effective and vigorous programs can help fight the growing obesity epidemic in China. And he says the lessons learned in China will be useful to other developing nations soon to be in the same gravy boat.