China's epidemic of child obesity:

Abstract

China used to be known for its people being slender [ 1 Cheng T.O. The evolution of cardiology in China. in: Wan S. Yim A.P.C. Cardiothoracic Surgery in China. Past, Present and Future. The Chinese University of Hong Kong, Hong Kong2007: 204-305 Google Scholar , 2 Cheng T.O. The current state of cardiology in China. Int J Cardiol. 2004; 96: 425-439 Abstract Full Text Full Text PDF PubMed Scopus (86) Google Scholar ]. Now the Chinese are becoming obese [ 2 Cheng T.O. The current state of cardiology in China. Int J Cardiol. 2004; 96: 425-439 Abstract Full Text Full Text PDF PubMed Scopus (86) Google Scholar , 3 Cheng T.O. An obesity epidemic in modern China. Am J Cardiol. 2001; 88: 721-722 Abstract Full Text Full Text PDF PubMed Scopus (23) Google Scholar , 4 Cheng T.O. Obesity is the newest health risk in modern China. Lancet. 2005; ([http://www.thelancet.com/journals/lancet/article/PIIS0140673605673448/comments. Accessed October 7, 2005]) Google Scholar , 5 Cheng T.O. Obesity is a global challenge. Am J Med. 2006; 19: e11 Abstract Full Text Full Text PDF Scopus (22) Google Scholar , 6 Cheng T.O. Obesity epidemic in modern China. Int J Cardiol. 2007; 118: 397 Abstract Full Text Full Text PDF PubMed Scopus (18) Google Scholar , 7 Cheng T.O. Diabetes and obesity epidemics in China: a national crisis. Int J Cardiol. 2007; 123: 1-2 Abstract Full Text Full Text PDF PubMed Scopus (21) Google Scholar , 8 Cheng T.O. Cardiology in contemporary China: an update. Int J Cardiol. 2008; 126: 147-159 Abstract Full Text Full Text PDF PubMed Scopus (23) Google Scholar , 9 Cheng T.O. China's obesity epidemic. Beijing Review. http://www.bjreview.com/letter/txt/2008-10/20/content157570.htm Google Scholar , 10 Cheng T.O. Prevention of cardiovascular disease in modern China: utile or futile?. CVD Prev Control. 2009; 4: 1-7 Abstract Full Text Full Text PDF Scopus (14) Google Scholar , 11 Cheng T.O. Cardiovascular health, risks and diseases in contemporary China. Int J Cardiol. 2011; 152 ([Corrigendum 2012;154:96][Corrigendum 2012;154:233–242]): 285-294 Abstract Full Text Full Text PDF PubMed Scopus (8) Google Scholar ]. According to People's Daily, China's official newspaper, the number of obese people in China will go beyond 200 million, one sixth of China's total population, by 2015 [ [12] Number of obese people in China to exceed 200 million by 2015. http://english.peopledaily.com.cn/200506/16/eng20050616_190648.html Google Scholar ]. Obesity in China is not only an adult problem [ [13] Cheng T.O. Obesity is not only an adult problem. Clin Cardiol. 2004; 27: 532 Crossref PubMed Scopus (9) Google Scholar ]. The children in China are also getting fatter [ 11 Cheng T.O. Cardiovascular health, risks and diseases in contemporary China. Int J Cardiol. 2011; 152 ([Corrigendum 2012;154:96][Corrigendum 2012;154:233–242]): 285-294 Abstract Full Text Full Text PDF PubMed Scopus (8) Google Scholar , 13 Cheng T.O. Obesity is not only an adult problem. Clin Cardiol. 2004; 27: 532 Crossref PubMed Scopus (9) Google Scholar , 14 Cheng T.O. Obesity in Chinese children. J Roy Soc Med. 2004; 97: 254 Crossref PubMed Google Scholar , 15 Cheng T.O. Childhood obesity among the Chinese. Circulation. 2004; 110 ([Correction 2004; 110:3156]): e314 Crossref PubMed Scopus (3) Google Scholar , 16 Cheng T.O. Childhood obesity in China. Health Place. 2004; 10: 395-396 Crossref PubMed Scopus (21) Google Scholar , 17 Ji C.Y. Cheng T.O. Prevalence and geographic distribution of childhood obesity in China in 2005. Int J Cardiol. 2008; 131: 1-8 Abstract Full Text Full Text PDF PubMed Scopus (104) Google Scholar , 18 Ji C.Y. Cheng T.O. Epidemic increase in overweight and obesity in Chinese children from 1985 to 2005. Int J Cardiol. 2009; 132: 1-10 Abstract Full Text Full Text PDF PubMed Scopus (149) Google Scholar , 19 Cheng T.O. Childhood obesity in modern China. Int J Cardiol. 2012; 157: 315-317 Abstract Full Text Full Text PDF PubMed Scopus (12) Google Scholar ]. Child obesity developed in China only a quarter of a century ago [ [20] Song Y. Wang H.J. Ma J. Wang Z. Secular trends of obesity prevalence in urban Chinese children from 1985 to 2010: gender disparity. PLoS One. 2013; 8: e53069 Crossref PubMed Scopus (101) Google Scholar ] and has now reached an epidemic proportion [ 17 Ji C.Y. Cheng T.O. Prevalence and geographic distribution of childhood obesity in China in 2005. Int J Cardiol. 2008; 131: 1-8 Abstract Full Text Full Text PDF PubMed Scopus (104) Google Scholar , 18 Ji C.Y. Cheng T.O. Epidemic increase in overweight and obesity in Chinese children from 1985 to 2005. Int J Cardiol. 2009; 132: 1-10 Abstract Full Text Full Text PDF PubMed Scopus (149) Google Scholar , 19 Cheng T.O. Childhood obesity in modern China. Int J Cardiol. 2012; 157: 315-317 Abstract Full Text Full Text PDF PubMed Scopus (12) Google Scholar , 20 Song Y. Wang H.J. Ma J. Wang Z. Secular trends of obesity prevalence in urban Chinese children from 1985 to 2010: gender disparity. PLoS One. 2013; 8: e53069 Crossref PubMed Scopus (101) Google Scholar , 21 Glickstein B. East meets west: childhood obesity in China and the US. http://centerforhealthmediapolicy.com/2012/12/18/east-meets-west-childhood-obesity-in-china Google Scholar ]. The fastest increase took place in just the last decade [ 22 Li Y. Schouten E.G. Hu X. Cui Z. Luan D. Ma G. Obesity prevalence and time trend among youngsters in China, 1982–2002. Asia Pac J Clin Nutr. 2008; 17: 131-137 PubMed Google Scholar , 23 Zhang Y.X. Wang S.R. Prevalence and regional distribution of childhood overweight and obesity in Shandong Province, China. World J Pediatr. 2013; 9: 135-139 Crossref PubMed Scopus (12) Google Scholar ] (Fig. 1). The increased rates of the epidemic of child obesity in China were greatest in large coastal cities, but similar increases were found in all other regions including the once poverty-stricken rural west [ [24] Ji C.Y. Chen T.J. Working Group on Obesity in China (WGOC): empirical changes in the prevalence of overweight and obesity among Chinese students from 1985 to 2010 and corresponding preventive strategies. Biomed Environ Sci. 2013; 26: 1-12 PubMed Google Scholar ]. Furthermore, the changing pace was much faster in boys than in girls [ [25] Yu Z. Han S. Chu J. Xu Z. Zhu C. Guo X. Trends in overweight and obesity among children and adolescents in China from 1981 to 2010: a meta-analysis. PLoS One. 2012; 7: e51949 Crossref PubMed Scopus (113) Google Scholar ] (Fig. 2); the gender disparity suggests that the prevalence of obesity in boys will continue to be a large and growing proportion of obese children in China [ [20] Song Y. Wang H.J. Ma J. Wang Z. Secular trends of obesity prevalence in urban Chinese children from 1985 to 2010: gender disparity. PLoS One. 2013; 8: e53069 Crossref PubMed Scopus (101) Google Scholar ]. The situation is particularly alarming, because fat children grow up to be fat adults [ 26 Lakshman R. Elks C.E. Ong K.K. Childhood obesity. Circulation. 2012; 126: 1770-1779 Crossref PubMed Scopus (235) Google Scholar , 27 Cheng T.O. Fat kids grow up to be fat adults. A lesson to be learned from China. Int J Cardiol. 2007; 117: 133-135 Abstract Full Text Full Text PDF PubMed Scopus (21) Google Scholar , 28 Biro F.M. Wien M. Childhood obesity and adult morbidities. Am J Clin Nutr. 2010; 91: 1499S-1505S Crossref PubMed Scopus (714) Google Scholar , 29 Whitaker R.C. Wright J.A. Pepe M.S. Seidel K.D. Dietz W.H. Predicting obesity in young adulthood from childhood and parental obesity. N Engl J Med. 1997; 337: 869-873 Crossref PubMed Scopus (3208) Google Scholar , 30 Serdula M.K. Ivery D. Coates R.J. Freedman D.S. Williamson D.F. Byers T. Do obese children become obese adults? A review of the literature. Prev Med. 1993; 22: 167-177 Crossref PubMed Scopus (1338) Google Scholar ].