Overweight and obesity in China
BMJ 2006; 333 doi: https://doi.org/10.1136/bmj.333.7564.362 (Published 17 August 2006) Cite this as: BMJ 2006;333:362All rapid responses
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China's obesity problem is increasing at an "alarming" rate, with
nearly 15% of the population overweight and a 28-fold increase in the
problem in children in 15 years and explanations of China's recent
epidemic of overweight and obesity include changes to traditional diet,
reduced levels of physical activity, and increased sedentary lifestyles
(1).
During the past decades it became increasingly evident that the
spatial and social environments are particularly relevant factors within
the "web of causation" of obesity and chronic diseases (2). A recent cross
sectional and cohort study shows that the ownership of motorized transport
by households in China is associated with increasing obesity related
problems in children and adults (3).
Walking and cycling are two forms of physical activity that meet the
metabolic criteria for achieving health benefits from exercise (4, 5).
Rapid motorization has resulted reduction of cycling and walking in China.
We need to protect cyclists and pedestrians and other vulnerable road
users from both invasion of space by motor vehicles and risks of injuries
at crossings, and when walking in the streets due to blocked or inadequate
sidewalks. Efforts to create safe and accessible routes for people to walk
and bike to work can facilitate safe walking and biking related health
benefit for people of all ages.
Otherwise private ownership of motor vehicle continues to propagate
avoidance of walking and cycling among general population then the disease
burden (with inactivity as a risk factor for other diseases) will
increase, and the total burden of disease will be much larger than the WHO
predicts in 2020. We need improve mobility opportunities for the general
population so that people need not to rely on private owned vehicles.
In addition policy makers in China need to increase investment in
public transit infrastructure to ease traffic congestion and shift the
orientation in transport and land-use planning toward facilitate
pedestrian flow and bicycle traffic, and build high-density urban villages
to encourage walking and the use of public transportation.
Singapore has made auto ownership prohibitively expensive through the
imposition of various taxes and fees. Singapore was able to develop an
extensive public transportation system that provides access to almost
everywhere on the island.
REFERENCES:
(1). Wu Y., Overweight and obesity in China. BMJ. 2006:19;
333(7564):362-3.
(2). Bell A.C., Ge K., Popkin B.M., The road to obesity or the path
to prevention: motorized transportation and obesity in China. Obesity
Research 2002: 10: 277-83.
(3). Desapriya E., Obesity epidemic. Lancet. 2004:23-29;
364(9444):1488.
(4). Morris J.N., Hardman A.E., Walking to health. Sports Medicine
1997:23:306-32.
(5). Vuori I.M., Oja P., Paronen O., Physically active commuting to
work: testing its potential for exercise promotion. Medicine and Science
in Sports and Exercise 1994: 26:844-50.
Competing interests:
None declared
Competing interests: No competing interests
OBESITY – THE EVER INCREASING PROBLEM
Dr Charu Chanana
The article very rightly mentions the ever increasing problem of
overweight and obesity that was already rampant in the western world and
is now quickly catching up in developing nations of Asia. No age group is
immune to this disease that may take up an epidemic proportion. The most
likely explanation for the sudden increase in the number of overweight and
obese individuals is today’s sedentary lifestyle with every little time
for outdoor activities. Obesity and its consequences namely hypertension,
diabetes, heart attacks, strokes and arthritis amongst others is probably
the price we have to pay for modernization.
No age group is immune from this disease. Obesity is prevalent even in
school children. The only form of recreation for them is the television by
being couch potatoes- outdoor sports is unheard off these days. Household
work can be accomplished by the press of a button and no longer requires
physical activity, which leaves homemakers with little physical work to
do. The long and stressful office hours require an individual to be seated
for long hours at a stretch and leaves less time for physical work.
But inspite of this I feel at everyone should have at least 30 minutes a
day of exercise in some form is it walking, jogging, swimming, cycling,
and working in the gym, yoga or anything else. In addition cutting down on
colas and fried stuff may also help improve the situation and help us live
a healthier and disease free life.
Competing interests:
None declared
Competing interests: No competing interests
The article is a timely one and a true eye opener. Obesity is on the
rise in the third world nations just as the western world and is highly
prevalent even among school children.It might be attributed to the
increasing use of refined food and changes in lifestyle.
I used to go for walk with my brother in the early mornings for three
months at the musuem grounds of Trivandrum where we could see that the
place was crowded by health conscious people of all ages coming for their
morning walk. I do not know whether this is a good sign or a bad one
because we did not find any loss of weight for us or any noticable change
for others during the three months though we had a general feeling of well
being. On top of that were the small shops selling all sorts of goodies
just near the area which might have been a real source of inspiration for
the morning walkers.
Obesity posses various effects on the health of the individual including
lifestyle diseases like hypertension, diabetes and coronary vascular
diseases in addition to the increased risks of morbidity after surgery. I
feel that the factors which might help to arrest progression of overweight
to obesity includes vegetarianism, practice of martial arts, yoga or tai-
chi and exercises like cycling or skipping. These and health awareness
should be included in the educational curriculum of primary school
children for a timely initiation of appropriate health care.
Competing interests:
None declared
Competing interests: No competing interests
During my recent visit to China, my first impression was how lean and
fit most people looked there. True, there were more cars than cycles on
roads, but it was heartening to see the cycle lanes filled with cycles in
the early morning rush. Professor Wu's article is a surprising but welcome
one especially the conclusion that we all must learn from what the West
failed to recognize and act, the chronic disease burden due to high
prevalence of obesity.Economic development should go hand in hand with
strategies to control consumption behavior deleterious to health, perhaps
based on the WHO strategy of "Diet, Physical Activity and Health".
Although it is the 'know-do'gap which affects the West, there is need for
considerable evidence base for what is effective for the emmerging
economies in Asia such as India,China and others taking into account
social, cultural,genetic and infra structural differences. International
collaboration and support are needed to provide an evidence base for
efficacious public health interventions and a move towards evidence based
global health initiatives to prevent obesity and chronic disease.
Competing interests:
None declared
Competing interests: No competing interests
OKINAWA phenomenon
People of Okinawa " which is a small japanese island in south
pacific" used to enjoy a remarkable longevity that has been attributed to
"OKINAWA diet".
It consisted mainly of seafood,vegetables and fruits.
After the famous battle of OKINAWA close to the end of the second
World war and establishing US bases there, there has been a shift towards
a western type diet with more saturated and partially hydrogenated fats
and processed food.
The result was a dramatic increase in obesity with metabolic syndrome
sequalae.
To be noted is the fact that the definition of overweight and obesity
for asian population is marked at lower body mass indeces "BMI" than white
population.
I am afraid that we are witnessing the same negative nutritional
change in china leading to this epidemic of obesity.
Competing interests:
None declared
Competing interests: No competing interests