Prevalence and ethnic pattern of overweight and obesity among middle-aged and elderly adults in China

Abstract

Overweight and obesity are associated with increased morbidity and mortality, and a pooled analysis from 16 prospective cohort studies showed that overweight is associated with double the risk of developing cardiometabolic multimorbidity and the risk increases to be more than four times in obese individuals. Another meta-analysis showed that obesity was associated significantly with higher all-cause mortality. In addition, a cohort study based on the large national registry in London also showed that obesity could increase the risk of sudden cardiac death such as sudden arrhythmic death syndrome, and the prevalence of critical and noncritical coronary artery disease was significantly higher in obese individuals (23% vs. 10% in non-obese individuals, P< 0.001). In China, rapid economic growth has led to changes in dietary and physical activity patterns, especially in the past two decades, which in turn have led to an increase in obesity and overweight prevalence. Fortunately, it is well established that appropriate control of obesity through lifestyle changes could result in a significant reduction in cardiovascular morbidity and mortality. Therefore, ongoing reliable estimations are necessary to plan effective national prevention for obesity management. Although a few studies were available to estimate the prevalence of obesity and overweight, the data from different studies were conducted in different areas or population. Only one study based on the China Health and Nutrition Surveys (CHNS) described the secular trends in general and abdominal obesity among Chinese adults from 1993 to 2009, and another two studies estimated the prevalence and trends of abdominal obesity. 12 A recent publication reported the prevalence of obesity and overweight in different ethnic groups aged 15–49 years in rural areas in China. However, few studies were conducted among middle-aged and elderly adults, who have a higher risk of chronic diseases such as hypertension and diabetes. Therefore, obtaining more accurate and comprehensive estimates of obesity and overweight is crucial for evidence-based and ethnic-specific planning and an evaluation of the currently implemented treatment strategies. The purpose of this study is to provide the most recent national estimates of obesity and overweight among Chinese adults aged 40 years and above according to the China National Stroke Screening and Prevention Project Study (CNSSPP) survey, which was carried out in 30 provinces (excluded Tibet) in China from October 2014 to November 2015 and the details have been described in previous study. Excluding 61 individuals due to missing information on height and weight, a total of 726,390 participants were included in the present study. The mean age and body mass index (BMI) was 57.2 (standard deviation