Abstract
ObjectivesTo explore the impact of population aging on the projected prevalence of obesity among Chinese adults in 2030.MethodsIn total, 71450 observations were extracted from the China Health and Nutrition Survey between 1991 and 2015.Population was projected to 2030 using a Bayesian hierarchical modeling method. Two different approaches were adopted to estimate and project the national prevalence of overweight/obesity from 1991 to 2030. One method assumed a constant population at the base year, while the other allowed the age and gender distributions vary in each year.ResultsOur projection indicated that approximately two-thirds of Chinese adults would be affected by overweight/general obesity in 2030, and more than 60% of Chinese adults will suffer from abdominal obesity in 2030. Ignoring population aging led to an underestimation of overweight, general obesity and abdominal obesity for women by 3.81, 0.06, and 3.16 percentage points (pp), and overweight and abdominal obesity among men by 1.67 and 0.53 pp, respectively; but the prevalence of general obesity among men will be overestimated by 2.11 pp. Similar underestimations were detected in the estimation from 1991 to 2015.ConclusionsEstimating and projecting the national prevalence of obesity using a constant population structure at the base line would cause significant underestimation if countries are undergoing rapid population aging.
Highlights
In 2017, high body mass index (BMI) was associated with 4.7 million deaths and 147.7 million disability-adjusted life years (DALYs) globally, and has become an important contributor to the global disease burden [9], for cardiovascular disease [10], type 2 diabetes [11] and certain types of cancers [12]
By comparing the two estimations with or without taking population aging into account, we found that ignoring population aging will underestimate the prevalence of overweight, general obesity and abdominal obesity for women by
71450 observations were extracted from China Health and Nutrition Survey (CHNS) data between 1991 and 2015 to demonstrate the secular trend of national prevalence of overweight, general obesity and abdominal obesity in Chinese adults
Summary
The growing overweight and obesity epidemic has been well documented in both developed countries and developing countries [1–7]. The global prevalence of obesity in adults has almost tripled between 1975 and 2016 [8], and the global deaths and disability-adjusted life years (DALYs) attributable to high body mass index (BMI) have more than doubled from 1990 to 2017 [9]. In China, BMI, waist circumference (WC) and the prevalence of overweight/obesity have been increasing steadily since the early 1980s along with rapid economic development [4, 13–17]. The prevalence of abdominal obesity (waist circumference ≥ 90 in men and ≥85 cm in women respectively) among Chinese adults grew to 46.9% in 2015 [17]. The estimated attribution percentage of overweight and obesity-associated noncommunicable disease (NCD) deaths increased from 5.7% in 1990 to 11.1% in 2019 in China [19]
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