Health policy and public health implications of obesity in China

Wang, Youfa; Zhao, Li; Gao, Liwang; Pan, An; Xue, Hong

doi:10.1016/s2213-8587(21)00118-2

Cited by 182 publications

(99 citation statements)

References 91 publications

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“…Reasons for the increase are unclear, and a few studies suggested some potential risk factors, including increasing prevalence of obesity and diabetes mellitus, westernized diet, and inadequate physical activity ( 51 – 55 ). Taking China for example, the prevalence of overweight and obesity has been increasing from 29.9 to 50.7% in the past two decades, and it was expected to reach 65.3% by 2030 ( 56 ).…”

Section: Discussionmentioning

confidence: 99%

Prostate Cancer Incidence and Mortality: Global Status and Temporal Trends in 89 Countries From 2000 to 2019

Wang

Lü

et al. 2022

Front. Public Health

195

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AimsTo evaluate current status of prostate cancer incidence and mortality worldwide, and compare the global trends of incidence and mortality in the past two decades and in the most recent period.MethodsData on the incidence and mortality of prostate cancer for 174 countries in 2020 were obtained from the GLOBOCAN 2020 database, and associations with the human development index (HDI) were evaluated. Data for trend analyses in 89 countries from 2000 to 2019 were retrieved from the Global Burden of Disease 2019 platform. Age standardized incidence rate (ASIR) and mortality rate (ASMR) were calculated by using the Segi's population. The average annual percent changes (AAPC) of ASIRs and ASMRs were evaluated by joinpoint regression analysis.ResultsA total of 1 414 259 new cases of prostate cancer and 375 304 related deaths were reported in 2020 globally. HDI was positively correlated with ASIRs (P < 0.001) and negatively correlated with ASMRs (P < 0.001). In the past two decades, ASIRs have been increasing in 65 countries, stable in 15 countries and decreasing in 9 countries, and ASMRs have been increasing in 19 countries, stable in 25 countries and decreasing in 45 countries, respectively. In the most recent period, 44 countries have increasing ASIRs, and 32 countries have decreasing ASMRs, respectively. For instance, in the United States of America, the AAPC of ASIRs significantly decreased by 0.62% and ASMRs significantly decreased by 1.22% from 2000 to 2019, while the AAPC from 2015 to 2019 significantly increased by 0.49% for ASIRs and significantly increased by 0.48% for ASMRs.ConclusionThe magnitude of increasing incidence and decreasing mortality of prostate cancer is attenuated in the recent period. Further study is needed to analyze the absolute effect of risk factors, PSA screening and treatment.

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Section: Discussionmentioning

confidence: 99%

Prostate Cancer Incidence and Mortality: Global Status and Temporal Trends in 89 Countries From 2000 to 2019

Wang

Lü

et al. 2022

Front. Public Health

195

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“…Although this systematic review did not include studies conducted in children, it should be noted that the obesity rate of children and adolescents in China is rising alarmingly [74]. Several policies have been proposed to address this significant public health concern such as accelerating the development of standards to limit production and sale of high-sugar foods, revising the general rules for nutrition labeling to include mandatory labeling of sugar in prepackaged foods, and enhancing the nutrition education about added sugar intake restriction [75].…”

Section: Discussionmentioning

confidence: 99%

A Systematic Review of Diet Quality Index and Obesity among Chinese Adults

et al. 2021

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Diet quality scores are designed mainly based on Western-style dietary patterns. They were demonstrated to be good indicators of obesity in developed but not developing countries. Several diet quality scores were developed based on the Chinese dietary guidelines, yet no systematic review exists regarding how they were related to obesity. We searched research articles published between 2000 and 2021 in PubMed, CINAHL, and Scopus databases. Both cross-sectional and prospective studies that examined the relationship between a diet quality score and weight, body mass index, obesity, or waist circumference conducted in a Chinese population were selected. From the 602 articles searched, 20 articles were selected (12 are cross-sectional studies and 8 are prospective cohort studies). The relationship between internationally used scores and obesity was inconsistent among studies. Scores tailored to the Chinese diet demonstrated a strong relationship with both being underweight and obesity. The heterogeneity of the populations and the major nutrition transition in China may partially explain the discrepancies among studies. In conclusion, diet quality scores tailored to the Chinese diet may be associated with both undernutrition and overnutrition, as well as being underweight and obesity outcomes.

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“…However, such ecological observations are subject to multiple interpretations, among them that people in these rural societies had high levels of occupational physical activity and restricted food availability, both of which might offset dietary influences on weight gain. Among Chinese with recent access to high-GL/high-sugar diets, obesity and metabolic disease have reached epidemic proportions ( 159 ). Beyond macronutrient changes, the “nutrition transition” in developing nations beginning in the 1970s (coincident with the low-fat diet era in the United States and Europe) is typified by replacement of traditional carbohydrates with processed starches and sugars that have a higher GL ( 160 ).…”

Section: Criticismsmentioning

confidence: 99%

The carbohydrate-insulin model: a physiological perspective on the obesity pandemic

Ludwig

Aronne

Astrup

et al. 2021

The American Journal of Clinical Nutrition

155

109

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According to a commonly held view, the obesity pandemic is caused by overconsumption of modern, highly palatable, energy-dense processed foods, exacerbated by a sedentary lifestyle. However, obesity rates remain at historic highs, despite a persistent focus on eating less and moving more, as guided by the energy balance model (EBM). This public health failure may arise from a fundamental limitation of the EBM itself. Conceptualizing obesity as a disorder of energy balance restates a principle of physics without considering the biological mechanisms that promote weight gain. An alternative paradigm, the carbohydrate-insulin model (CIM), proposes a reversal of causal direction. According to the CIM, increasing fat deposition in the body—resulting from the hormonal responses to a high-glycemic-load diet—drives positive energy balance. The CIM provides a conceptual framework with testable hypotheses for how various modifiable factors influence energy balance and fat storage. Rigorous research is needed to compare the validity of these 2 models, which have substantially different implications for obesity management, and to generate new models that best encompass the evidence.

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Health policy and public health implications of obesity in China

Cited by 182 publications

References 91 publications

Prostate Cancer Incidence and Mortality: Global Status and Temporal Trends in 89 Countries From 2000 to 2019

Prostate Cancer Incidence and Mortality: Global Status and Temporal Trends in 89 Countries From 2000 to 2019

A Systematic Review of Diet Quality Index and Obesity among Chinese Adults

The carbohydrate-insulin model: a physiological perspective on the obesity pandemic

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