Department of Epidemiology and Biostatistics and Ministry of Education Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Division of Epidemiology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA.
National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China.
Lancet Diabetes Endocrinol. 2021 Jun;9(6):373-392. doi: 10.1016/S2213-8587(21)00045-0.
Obesity has become a major public health issue in China. Overweight and obesity have increased rapidly in the past four decades, and the latest national prevalence estimates for 2015-19, based on Chinese criteria, were 6·8% for overweight and 3·6% for obesity in children younger than 6 years, 11·1% for overweight and 7·9% for obesity in children and adolescents aged 6-17 years, and 34·3% for overweight and 16·4% for obesity in adults (≥18 years). Prevalence differed by sex, age group, and geographical location, but was substantial in all subpopulations. Strong evidence from prospective cohort studies has linked overweight and obesity to increased risks of major non-communicable diseases and premature mortality in Chinese populations. The growing burden of overweight and obesity could be driven by economic developments, sociocultural norms, and policies that have shaped individual-level risk factors for obesity through urbanisation, urban planning and built environments, and food systems and environments. Substantial changes in dietary patterns have occurred in China, with increased consumption of animal-source foods, refined grains, and highly processed, high-sugar, and high-fat foods, while physical activity levels in all major domains have decreased with increasing sedentary behaviours. The effects of dietary factors and physical inactivity intersect with other individual-level risk factors such as genetic susceptibility, psychosocial factors, obesogens, and in-utero and early-life exposures. In view of the scarcity of research around the individual and collective roles of these upstream and downstream factors, multidisciplinary and transdisciplinary studies are urgently needed to identify systemic approaches that target both the population-level determinants and individual-level risk factors for obesity in China.
肥胖已成为中国的一个主要公共卫生问题。在过去的四十年中，超重和肥胖问题迅速增加，根据中国标准，2015-2019 年最新的全国流行率估计值为：6 岁以下儿童超重率为 6.8%，肥胖率为 3.6%；6-17 岁儿童和青少年超重率为 11.1%，肥胖率为 7.9%；成年人（≥18 岁）超重率为 34.3%，肥胖率为 16.4%。流行率因性别、年龄组和地理位置而异，但在所有亚人群中都相当高。来自前瞻性队列研究的有力证据表明，超重和肥胖与中国人群主要非传染性疾病和过早死亡风险增加有关。超重和肥胖负担的增加可能是由经济发展、社会文化规范以及通过城市化、城市规划和建筑环境以及食品系统和环境塑造个体肥胖风险因素的政策推动的。中国的饮食模式发生了重大变化，动物源性食品、精制谷物以及高度加工、高糖和高脂肪食品的消费增加，而所有主要领域的身体活动水平都随着久坐行为的增加而下降。饮食因素和身体活动不足的影响与遗传易感性、心理社会因素、肥胖物和宫内及生命早期暴露等其他个体风险因素相互作用。鉴于围绕这些上游和下游因素的个体和集体作用的研究稀缺，迫切需要进行多学科和跨学科研究，以确定针对中国肥胖人群水平决定因素和个体风险因素的系统方法。
