Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Paper
  • Published:

Weight gain and its predictors in Chinese adults

Abstract

OBJECTIVE: To describe 8 y weight change in Chinese adults and to determine the baseline characteristics of those who gained weight.

DESIGN: A population-based cohort study of weight change and its predictors from 1989 to 1997.

PARTICIPANTS: A cohort of 2488 adults aged 20–45 in 1989 drawn from seven provinces in China using multistage, random cluster sampling.

MEASUREMENTS: Weight change over 8 y was the outcome variable. The key exposures were baseline energy intake, physical activity at work, alcohol consumption and smoking status. Baseline weight, weight status, height, age, residence, income and educational attainment were control variables.

RESULTS: Overweight (body mass index, BMI≥25 kg/m2) doubled in females (10.4–20.8%) and almost tripled in males (5.0–14.1%). Low physical activity was a strong predictor of weight gain. Compared to those whose weight remained stable (±2 kg/8 y), males and females who experienced large weight gain (>5 kg/8 y) were 3 and 1.8 times more likely to engage in light rather than heavy work-related physical activity.

CONCLUSION: The prevalence of overweight increased dramatically in this cohort. Light work-related physical activity was the strongest predictor of this weight gain.

This is a preview of subscription content, access via your institution

Access options

Rent or buy this article

Prices vary by article type

from$1.95

to$39.95

Prices may be subject to local taxes which are calculated during checkout

Figure 1
Figure 2

Similar content being viewed by others

References

  1. Seidell JC, Flegal KM . Assessing obesity: classification and epidemiology Br Med Bull 1997 53: 238–252.

    Article  CAS  PubMed  Google Scholar 

  2. Popkin BM . The nutrition transition and its health implications in lower income countries Public Health Nutr 1998 1: 5–21.

    Article  CAS  PubMed  Google Scholar 

  3. Barker DJ . Fetal origins of cardiovascular disease Ann Med 1999 31 (Suppl 1): 3–6.

    Article  PubMed  Google Scholar 

  4. Bray GA, Popkin BM . Dietary fat intake does affect obesity! Am J Clin Nutr 1998 68: 1157–1173.

    Article  CAS  PubMed  Google Scholar 

  5. Willett WC . Is dietary fat a major determinant of body fat? Am J Clin Nutr 1998 67 (Suppl 1): 556S–562S.

    Article  CAS  PubMed  Google Scholar 

  6. Colditz GA, Willett WC, Stampfer MJ, London SJ, Segal MR, Speiser FE . Patterns of weight change and their relation to diet in a cohort of healthy women Am J Clin Nutr 1990 51: 1100–1105.

    Article  CAS  PubMed  Google Scholar 

  7. Klesges RC, Klesges LM, Haddock CK, Eck LH . A longitudinal analysis of the impact of dietary intake and physical activity on weight change in adults Am J Clin Nutr 1992 55: 818–822.

    Article  CAS  PubMed  Google Scholar 

  8. Murgatroyd PR, Goldberg GR, Leahy FE, Gilsenan MB, Prentice AM . Effects of inactivity and diet composition on human energy balance Int J Obes Relat Metab Disord 1999 23: 1269–1275.

    Article  CAS  PubMed  Google Scholar 

  9. Sundquist J, Johansson SE . The influence of socioeconomic status, ethnicity and lifestyle on body mass index in a longitudinal study Int J Epidemiol 1998 27: 57–63.

    Article  CAS  PubMed  Google Scholar 

  10. Rissanen AM, Heliovaara M, Knekt P, Reunanen A, Aromaa A . Determinants of weight gain and overweight in adult Finns Eur J Clin Nutr 1991 45: 419–430.

    CAS  PubMed  Google Scholar 

  11. Jorgensen LM, Sorensen TIA, Schroll M, Larsen S . Influence of dietary factors on weight change assessed by multivariate graphical models Int J Obes Relat Metab Disord 1995 19: 909–915.

    CAS  PubMed  Google Scholar 

  12. Williamson DF . Descriptive epidemiology of body weight and weight change in U.S. adults Ann Intern Med 1993 7: 646–649.

    Article  Google Scholar 

  13. Martikainen PT, Marmot MG . Socioeconomic differences in weight gain and determinants and consequences of coronary risk factors Am J Clin Nutr 1999 69: 719–726.

    Article  CAS  PubMed  Google Scholar 

  14. Burke GL, Bild DE, Hilner JE, Folsom AR, Wagenknecht LE, Sidney S . Differences in weight gain in relation to race, gender, age and education in young adults: the CARDIA study Ethnic Health 1996 1: 327–335.

    Article  CAS  Google Scholar 

  15. Heitmann BL, Lissner L, Sorensen TIA, Bengtsson C . Dietary fat intake and weight gain in women genetically predisposed for obesity Am J Clin Nutr 1995 61: 1213–1217.

    Article  CAS  PubMed  Google Scholar 

  16. Popkin BM, Doak CM . The obesity epidemic is a worldwide phenomenon Nutr Rev 1998 56: 106–114.

    Article  CAS  PubMed  Google Scholar 

  17. Galanis D, Sobal J, McGarvey ST, Pelletier DL, Bausserman L . Ten-year changes in the obesity, abdominal adiposity, and serum lipoprotein cholesterol measures of Western Samoan men J Clin Epidemiol 1995 48: 1485–1493.

    Article  CAS  PubMed  Google Scholar 

  18. Hodge AM, Dowse GK, Gareeboo H, Tuomilehto J, Alberti KG, Zimmet PZ . Incidence, increasing prevalence, and predictors of change in obesity and fat distribution over 5 years in the rapidly developing population of Mauritius Int J Obes Relat Metab Disord 1996 20: 137–146.

    CAS  PubMed  Google Scholar 

  19. Popkin BM, Paeratakul S, Keyou G, Fengying Z . Body weight patterns among the Chinese: results from the 1989 and 1991 China Health and Nutrition Surveys Am J Public Health 1995 85: 690–694.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  20. Heckman J . Sample selection bias as a specification error Econometrica 1979 47: 153–161.

    Article  Google Scholar 

  21. WHO Expert Committee . Physical status: the use and interpretation of anthropometry Report of a WHO expert committee, WHO Technical Report Series 854. WHO: Geneva 1995.

    Google Scholar 

  22. Report of a WHO Consultation on Obesity Obesity. Preventing and managing the global epidemic WHO: Geneva 1997.

  23. Paeratakul S, Popkin BM, Keyou G, Adair LS, Stevens J . Changes in diet and physical activity affect the body mass index of Chinese adults Int J Obes Relat Metab Disord 1998 22: 424–431.

    Article  CAS  PubMed  Google Scholar 

  24. Ko GTC, Chan JCN, Cockram CS, Woo J . Prediction of hypertension, diabetes, dyslipidaemia or albuminuria using simple anthropometric indexes in Hong Kong Chinese Int J Obes Relat Metab Disord 1999 23: 1136–1142.

    Article  CAS  PubMed  Google Scholar 

  25. Bell AC, Adair LS, Popkin BM . Ethnic differences in the association between body mass index and hypertension Unpublished manuscript 2000.

  26. Ge K, Weisell R, Guo S et al. The body mass index of Chinese adults in the 1980s Eur J Clin Nutr 1994 48 (Suppl 3): S148–S154.

    PubMed  Google Scholar 

  27. Wang Y, Monteiro C, Popkin B . Trends of child and adolescent obesity in four countries: America, Brazil, China and Russia Unpublished manuscript 2000.

  28. Ferro-Luzzi A, Martino L . Obesity and physical activity Ciba Found Symp 1996 201: 207–221.

    CAS  PubMed  Google Scholar 

  29. Hill JO, Peters JC . Environmental contributions to the obesity epidemic Science 1998 280: 1371–1374.

    Article  CAS  PubMed  Google Scholar 

  30. Kromhout D, Saris WH, Horst CH . Energy intake, energy expenditure, and smoking in relation to body fatness: the Zutphen Study Am J Clin Nutr 1988 45: 668–674.

    Article  Google Scholar 

  31. Salonen JT, Slater JS, Tuomilehto J, Rauramaa R . Leisure time and occupational physical activity: risk of ischemic heart disease Am J Epidemiol 1988 127: 87–94.

    Article  CAS  PubMed  Google Scholar 

  32. Willett W . Nutritional Epidemiology New York: Oxford University Press 1998.

    Book  Google Scholar 

  33. Hellerstedt WL, Jeffery RW, Murray DM . The association between alcohol intake and adiposity in the general population Am J Epidemiol 1990 132: 594–611.

    Article  CAS  PubMed  Google Scholar 

  34. Manson JE, Stampfer MJ, Hennekens CH, Willett WC . Body weight and longevity JAMA 1987 257: 353–358.

    Article  CAS  PubMed  Google Scholar 

  35. Boyle K, Dobson A, Bennett S, Egger G . Can the increasing weight of Australians be explained by the decreasing prevalence of smoking? Int J Obes Relat Metab Disord 1994 18: 55–60.

    CAS  PubMed  Google Scholar 

  36. Yang G, Fan L, Tan J, Qi G, Zhang Y, Samet JM, Taylor CE, Becker K, Xu J . Smoking in China. Findings of the 1996 National prevalence Survey JAMA 1999 282: 1247–1253.

    Article  CAS  PubMed  Google Scholar 

  37. Sobal J, Stunkard AJ . Socioeconomic status and obesity: a review of the literature Psychol Bull 1989 105: 260–275.

    Article  CAS  PubMed  Google Scholar 

  38. Monteiro CA, Conde WL, Popkin BM . Independent effects of income and education on the risk of obesity in the Brazilian adult population J Nutr (in press)

  39. Flegal KM, Harlan WT, Landis JR . Secular trends in body mass index and skinfold thickness with socioeconomic factors in young adult women Am J Clin Nutr 1988 48: 535–543.

    Article  CAS  PubMed  Google Scholar 

  40. Chan JM, Rimm EB, Colditz GA, Stampfer MJ, Willett WC . Obesity, fat distribution and weight gain as risk factors for clinical diabetes in men Diabetes Care 1994 17: 961–969.

    Article  CAS  PubMed  Google Scholar 

  41. Cassano PA, Rosner B, Vokonas PS, Weiss ST . Obesity and body fat distribution in relation to the incidence of non-insulin-dependent diabetes mellitus Am J Epidemiol 1992 136: 1474–1486.

    Article  CAS  PubMed  Google Scholar 

  42. Willett WC, Manson JE, Stampfer MJ, Colditz GA, Rosner B, Speizer FE, Hennekens CH . Weight, weight change and coronary heart disease in women: risk within the ‘normal’ weight range JAMA 1995 273: 461–465.

    Article  CAS  PubMed  Google Scholar 

  43. Calle EE, Thun MJ, Petrelli JM, Rodriguez C, Heath CW . Body-mass index and mortality in a prospective cohort of U.S. adults New Engl J Med 1999 341: 1097–1105.

    Article  CAS  PubMed  Google Scholar 

  44. Yuan JM, Ross RK, Gao YT, Yu MC . Body weight and mortality: a prospective evaluation in a cohort of middle-aged men in Shanghai, China Int J Epidemiol 1998 27: 824–832.

    Article  CAS  PubMed  Google Scholar 

  45. Royal College of Physicians . Obesity: a report of the Royal College of Physicians J R Coll Physicians Lond 1983 17: 5–65.

    Google Scholar 

  46. Hoffmans MD, Kromhout D, de Lezenne Coulander C . The impact of body mass index of 78 612 18-year-old Dutch men on 32-y mortality from all causes J Clin Epidemiol 1988 41: 749–756.

    Article  CAS  PubMed  Google Scholar 

  47. Deurenberg P, Deurenberg-Yap M, Wang J, Lin FP, Schmidt G . The impact of body build on the relationship between body mass index and percent body fat Int J Obes Relat Metab Disord 1999 23: 537–542.

    Article  CAS  PubMed  Google Scholar 

  48. Deurenberg P, Yap M, Staveren WA . Body mass index and percent body fat: a meta analysis among different ethnic groups Int J Obes Relat Metab Disord 1998 22: 1164–1171.

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgements

This study was conducted while Colin Bell was a postdoctoral research fellow at the Carolina Population Center, University of North Carolina at Chapel Hill, under funding from the Health Research Council of New Zealand and the National Institutes of Health. The China Health and Nutrition survey is a collaborative project between the Chinese Academy for Preventive Medicine and a group from the Carolina Population Center at the University of North Carolina at Chapel Hill. The study was supported in part by grants from the National Institutes of Health (NIH, R01-HD30880 and R01-HD38700). We thank Frances Dancy for her assistance with the manuscript and Tom Swasey for graphics support.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to BM Popkin.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Bell, A., Ge, K. & Popkin, B. Weight gain and its predictors in Chinese adults. Int J Obes 25, 1079–1086 (2001). https://doi.org/10.1038/sj.ijo.0801651

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/sj.ijo.0801651

Keywords

This article is cited by

Search

Quick links