Obesity has become a global public health crisis, 1–4 and China has the largest number of affected people worldwide, with about 46% of adults and 15% of children being obese or overweight.4 Increasingly Chinese society is making efforts to address the rising obesity and chronic disease epidemic.3 In this context, in 2015, two of us (YW and YY) initiated a project … Epidemiology of physical activity from adolescence to young adulthood. South Med J 2005; 98: 124. to save searches, favorite articles and access email content alerts. Pediatr Pulmonol 2006; 41: 1175–1181. In only 20 years car ownership85 has increased 500% in China and urbanization is occurring dramatically. 79. 69. Jia W, Wu H, Bao Y, Wang C, Lu J, Zhu J, et al. When positive energy balance is imposed through overfeeding, NEAT increases.81,82 Moreover, the change in NEAT is predictive of fat gain.83 Those who with overfeeding increase their NEAT the most, gain the least fat. Eur J Cardiovasc Prev Rehabil 2004; 11: 113–120. 74. 28. Nutr Metab Cardiovasc Dis 1999; 9: 45–50. This time course of a million years is consistent with the calculated, spontaneous mutation rate in DNA. 12. Report on childhood obesity in China (4) prevalence and trends of overweight and obesity in Chinese urban school-age children and adolescents, 1985-2000. The current prevalence status of body overweight and obesity in China: data from the China nutrition and health survey. 26. 32. Human energy expenditure in affluent societies: an analysis of 574 doubly-labeled water measurements. If the obese subjects were to adopt the same NEAT-o-type as the lean subjects, they might expend an additional 1464 kJ/d (350 kcal/d). How is obesity determined? What causes obesity and overweight? Once effective solutions have been defined, it takes skilled, forward-thinking leadership and national will to implement them. In so doing, a modern person sits during their drive to work, sits all day at work, sits to drive home and sits in the evening watching television, surfing the internet or playing video games. Prentice AM, Jebb SA. Lam JC, Lam B, Lam CL, Fong D, Wang JK, Tse HF, et al. These changes are often associated with an increase in obesity and chronic disease. The remaining component, activity thermogenesis can be sub-divided into exercise and non-exercise activity thermogenesis (NEAT). Registered users can save articles, searches, and manage email alerts. 43. “The rate of growth in obesity is largest in rural areas, where food tastes are changing and practically all field work is now done by machines,” says Zheng Zhihao a … 49. Because of its ease of implementation, body mass index (BMI) (weight in kg/height in msquared) is universally used as an index of overweight and obesity. Obesity Res 2002; 10: 277–283. Int J Environ Res Public Health. One in five of the people with obesity in the world are Chinese.8 There are distinct elements of obesity as it relates to Chinese people. Finkelstein E, Fiebelkorn C, Wang G. The costs of obesity among full-time employees. Nearly all of its variability (-80% of the variance) is accounted for by body size - or more precisely lean body mass - the bigger a person, the greater their basal metabolic rate.70 The thermic effect of food is the energy expended in response to a meal and is that associated with digestion, absorption, and fuel storage.70,71 The thermic effect of food accounts for about 10% of daily energy needs and does not vary greatly between people. J Stud Alcohol 2005; 66: 332–343. The data trends strongly suggest that obesity rates are likely to increase.10–13 This is supported by the data that 23% of the Chinese population is overweight; for example, in Beijing alone 60% of adults are overweight and one in three children are overweight. Aaron DJ, Jekal YS, LaPorte RE. Prevention of obesity: the role of the food industry. An email with instructions to reset your password will be sent to that address. 56. In contrast, a 2013 review found that grade 1 obesity (BMI … Cue reactivity in adolescents: measurement of separate approach and avoidance reactions. Pediatr Int 2004; 46: 425–428. This is happening across modern China. 18. NLM The fundamental cause of obesity and overweight is an energy imbalance between calories consumed and calories expended. Biomed Environ Sci 2004; 17 Suppl: s1–s36. Less than 150 years ago in England and America, slaves from Africa were legal, and today a presidential candidate is African American. Thus the language of obesity solutions must speak to its economic consequences. Springfield, MA: Merriam-Webster Inc.; 2003. Prevalence and risk factors of overweight and obesity in China. 2005. 82. Introduction. Seidell JC. Am J Clin Nutr 1998; 68: 962–969. Exploratory investigation of obesity risk and prevention in Chinese Americans. Thus, obesity is associated with a NEAT-defect that predisposes obese people to sit.84 Lean people have an innate tendency to stand and walk. This appears to apply in at least four continents. Implementing obesity solutions is possible with strong leadership that is focused on the health of the people. Try again. 36. 1–4 Childhood obesity is linked to various immediate and long-term adverse health outcomes such as sleep apnea, hypertension, heart disease, stroke, type 2 diabetes, osteoarthritis, and certain types of cancer, and it leads to social and psychological problems such as … Wu Y, Ma G, Hu Y, Li Y, Li X, Cui Z. Obesity is sweeping through China because people are expending fewer and fewer calories through modernization but are not decreasing energy intake at the same rate. Photograph: Aly Song/Reuters Li YP, Yang XG, Zhai FY, Piao JH, Zhao WH, Zhang J, Ma GS. Diaz EO, Prentice AM, Goldberg GR, Murgatroyd PR, Coward WA. Epub 2006 May 2. Enter and submit the email address you registered with. Over 1–2 million years, energy intakes matched daily energy expenditure and most people were lean. The boom in economic development and cultural factors are often cited as drivers. Natl Med J China (Chin) 2004; 84: 534–538. 22. Trends in the distribution of body mass index among Chinese adults, aged 20-45 years (1989-2000). Blame doting grandparents, rising incomes and cultural attitudes around food for Chinese youngsters' poor health and eating habits. Int J Epidemiol 2006; 35: 159–166. Saudi Dent J. Chin J Prev Med (Chin) 2005; 39: 316–320. Psychiatry Clin Neurosci 2004; 58: 403–409. Zhang Q, Du WJ, Hu XQ, Liu AL, Pan H, Ma GS. Am J Health Promot 2005; 20: 45–51. 7 The most well-known monogenic condition causing obesity is the Melanocortin 4 MC4 receptor deficiency due to polymorphism affecting chromosome 18. In Asia, obesity rates do not directly correspond with diabetes rates. Med Sci Sports Exerc 1999; 31 (11 Suppl): 646–662. Sex-specific association of the SPTY2D1 rs7934205 polymorphism and serum lipid levels. 45. Left Ventricular Hypertrophy and Asymptomatic Cardiac Function Impairment in Chinese Patients with Simple Obesity using Echocardiography. Hsiao CC, Ree SC, Chiang YL, Yeh SS, Chen CK. Metabolic response to experimental overfeeding in lean and overweight healthy volunteers. The components of human energy expenditure are basal metabolic rate, the thermic effect of food and activity thermogenesis. 19. 44. Biomed Environ Sci 2007; 20: 1–10. McGee DL. 46. Why is it so devastating that obesity rates have increased 30-fold in 15 years in China? Atherosclerosis 2006; 184: 438–445. There needs to be a system for resource sharing, universally recognized evaluation tools or defining the standard for “success”. Obes Rev 2006; 7: 271–293. Eur J Clin Nutr 2006; 60: 1189–1194. Plasma lipid, lipoprotein and apolipoprotein levels in a random population sample of 2875 Hong Kong Chinese adults and their implications (NCEP ATP-III, 2001 guidelines) on cardiovascular risk assessment. The work burden of women. • The key causes are increased consumption of energy-dense foods high in saturated fats and sugars,and reduced physical activity. 78. Genome-wide scan for metabolic syndrome and related quantitative traits in Hong Kong Chinese and confirmation of a susceptibility locus on chromosome 1q21-q25. If so, high NEAT might confer massive health benefit and longer life. Lean individuals exploit opportunities to walk, where the obese find opportunities to sit. NEAT is expended every day and can most easily be classified as NEAT associated with occupation and NEAT associated with leisure. 2016 Jan;28(1):44-8. doi: 10.1016/j.sdentj.2015.01.005. Prentice AM, Leavesley K, Murgatroyd PR, Coward WA, Schorah CJ, Bladon PT, et al. In obesity we need to organize a similar series of protocols that allow obesity interventions (personal or population) to be evaluated and compared in a common scientific-language. 80. The diet and lifestyle of each is different based upon cultural/ethnic traditions and the environment. Washington: National Center for Biomedical Communications, 2007. Popkin BM, Kim S, Rusev ER, Du S, Zizza C. Measuring the full economic costs of diet, physical activity and obesity-related chronic diseases. 2005 Dec;18(6):401-10. Since the changes in energy expenditure were not accounted for by changes in basal metabolic rate, indirectly changes in NEAT were implicated. Many obese children become obese adults, especially if one or both parents are obese. A number of reviews have found that mortality risk is lowest at a BMI of 20–25 kg/m 2 in non-smokers and at 24–27 kg/m 2 in current smokers, with risk increasing along with changes in either direction. Daily energy expenditure varies substantially.72 In fact highly active people expend three times more energy per day than inactive people72 and this marked variability in daily energy expenditure is even greater when data from non-industrialized countries are considered.73,74 Overall, for two adults of similar size, daily energy expenditure varies by as much as 8368 kJ/d (2000 kcal/d). If people, who fail to increase NEAT with overfeeding gain excess body fat, could there be a NEAT defect in obesity? It is crucial that successful obesity solutions need to be financially advantageous. Get the latest public health information from CDC: https://www.coronavirus.gov, Get the latest research information from NIH: https://www.nih.gov/coronavirus, Find NCBI SARS-CoV-2 literature, sequence, and clinical content: https://www.ncbi.nlm.nih.gov/sars-cov-2/. Classically, there are three components of human daily energy expenditure. Obesity in China is becoming a pandemic disease resulting from a shift in energy balance caused by altered genes, a sedentary lifestyle, and neurohormonal imbalances. 86-10-51322179 The movement to achieve population-wide weight loss starts with a single step just as the Great Wall of China started from a single brick. 25. The first question is what should be the definition of obesity for China.  |  History repeatedly demonstrates that societal change is achievable. 58. In this review, we will assess specific obesity gene and environment interactions, childhood obesity etiology, metabolic syndrome, and dietary and behavioral causes. In China the opportunity exists to half obesity before this occurs. Disease risks of childhood obesity in China. Blair SN, Brodney S. Effects of physical inactivity and obesity on morbidity and mortality: current evidence and research issues. Now imagine he/she becomes aware of the unpainted bedroom, the weeds growing in the garden, at the possibility of cycling to work (rather than driving in a car). Liou D, Bauer KD. In so doing a “successful” program can be distinguished from an “unsuccessful” one. Klein S, Goran M. Energy metabolism in response to overfeeding in young adult men. 70. Regional adiposity and morbidity. In one example, an aggressive healthy office program is associated with decreased diabetes medications and fewer days off work. Maskarinec G, Takata Y, Pagano I, Carlin L, Goodman MT, Le Marchand L, et al. (Accessed October 3, 2007 at. If activity thermogenesis varies by 8368 kJ/d (2000 kcal/d), is it because of exercise or is it because of NEAT? According to doctors, unhealthy diets and lack of awareness among parents are the main causes of child obesity in China. J Endocrinol Invest 2006; 29: 528–35. The relation between body mass index and percentage body fat among Chinese adolescent living in urban Beijing. Computed tomographic evaluation of the role of craniofacial and upper airway morphology in obstructive sleep apnea in Chinese. Gu D, He J, Duan X, Reynolds K, Wu X, Chen J, et al. Physiol Rev 1994; 74: 761–811. In rural China over the same period, obesity rates fell.4 Though childhood obesity is on the rise worldwide, the patterns Diabetes Res Clin Pract 2004; 64: 123–128. Obesity, which is characterized by excessive fat deposition, is a growing problem in China because of economic development and improved living standards. cent for boys by 1998.3 In urban areas in China, the prevalence of obesity increased among chil-dren aged two to six from 1.5 percent in 1989 to 12.6 percent in 1997. The trends in obesity and chronic disease in China. Modern informational technology exists to build real-time expert texts on obesity etiology, biology and treatment. Obesity is an abnormal or excessive accumulation of fat that may damage health. It is clear that even in the highly competitive technology industry the consumer benefits by competing companies being organized and sharing common operational systems and protocols. Rapid income growth adversely affects diet quality in China - particularly for the poor! Obesity and overweight. These programs are not organized. Natl Med J China (Chin) 2005; 85: 2830–2834. To address the causes for obesity in all of China is not feasible in a single article. This avoids duplication, which is common at present in the United States. 61. Defining obesity cut points in a multiethnic population. By the law of conservation of energy, body fat increases when energy intake is consistently greater than energy expenditure. Thus NEAT and specifically walking are of substantial energetic importance in obesity. History also dictates that movements that effect social change are always multidimensional. J Biol Rhythms 1989; 4: 267–283. Body mass index and colon cancer risk in Chinese people: menopause as an effect modifier. Lippincott Journals Subscribers please login with your username or email along with your password. It is a chronic disease that needs to be prevented and treated. Kant AK, Graubard BI. Just as individual solutions are examined for weight loss, similarly population wide-models need to be devised and evaluated. National obesity rates mirror economic status. There was four-fold variation in weight gain, which by definition must have reflected substantial variance in energy expenditure. This is because some occupations are far more energy expending than others and, because leisure activities range from almost complete rest to those that are highly energized. Waist-to-height ratio is an accurate and easier index for evaluating obesity in children and adolescents. He Y, Pan A, Wang Y, Yang Y, Xu J, Zhang Y, Liu D, Wang Q, Shen H, Zhang Y, Yan D, Peng Z, Hu FB, Ma X. Sci Rep. 2017 Jul 10;7(1):5012. doi: 10.1038/s41598-017-04135-4. The above-mentioned causes are the prime reasons for an alarming increase in the number of obese people in India. 2. The collective determination of scientists, politicians and the populous therefore needs to converge. Variability in energy expenditure and its components. Thomas GN, McGhee SM, Schooling CM, Ho SY, Lam KS, Janus ED, et al. The survey showed that in China between 1992 and 2002, more than 60 million people became obese. Coward WA. 8. Report on childhood obesity in China (5) body weight, body dissatisfaction, and depression symptoms of Chinese children aged 9-10 years. N Engl J Med 1990; 322: 1477–1482. In America, it is now normal to be overweight and by the end of this decade most children will be obese. 83. 5. Int J Cardiol 2005; 103: 343. Obes Rev. Successful obesity solutions must be economically viable. USA.gov. 2007 Jan;31(1):177-88. doi: 10.1038/sj.ijo.0803354. Obes Facts. Registered users can save articles, searches, and manage email alerts. Chen YM, Ho SC, Lam SS, Chan SS. J Nutr Educ Behav 2007; 39: 134–141. For immediate assistance, contact Customer Service: 59. Zhou BF. 55. NEAT then increases to 3138–4707 kJ for the evening ((2 or 3)*6276bmr*(6/24) hours). 27. The guidelines for prevention and control of overweight and obesity in Chinese adults. For example, already 100 million people in China have high blood pressure and 26 million people have diabetes and these numbers are likely to double by 2030 as obesity takes hold;14 every day in China, 3000 new diabetics are diagnosed.14 The economic impact of obesity on the growing Chinese economy has not yet been estimated but using the US cost-equivalents, obesity is already costing China many billions of US dollars each year.54,55 What is of greater concern still, is the vast number of Chinese children and youth56–60 that have obesity. An analogy is of a bank account. Children who are obese are above the normal weight for their age and height.Childhood obesity is particularly troubling because the extra pounds often start children on the path to health problems that were once considered adult problems — diabetes, high blood pressure and high cholesterol. Obesity in Britain: gluttony or sloth? Data is temporarily unavailable. Obesity is one of the leading preventable causes of death worldwide. Prevalence and risk factors of overweight and obesity in China. Eur J Clin Nutr 1996; 50: 72–92. If for many years a person spends exactly what they earn they will have no savings. Am J Physiol 1984; 247 (4 Pt 2): H495–H507.  |  The road to obesity or the path to prevention: motorized transportation and obesity in China. Much like our distant ancestors, they walked to work, had active work and walked home at the end of the day. By the end of 2020, more people in China will have obesity than in America. Occupation is a key determinant of NEAT. In a longer term view, if health enhancing schools decrease diabetes predisposition, this may render them cost-effective for the government, in the long-term. Obesity in Chinese children. Such partners for change include architects, the food industry, clothing manufacturers, the pharmaceutical industry, media companies, furniture companies and health insurers. Ann Epidemiol 2005; 15: 87–97. 6. 13. NIH Am J Physiol 1985; 248 (3 Pt 1): E370–E374. Obesity is a multifactorial disease that is associated with genetic, physiological, environmental, and cultural/traditional perspectives in order to provide a broadened view on this epidemic in China. Chin Med J 2007; 120: 1151–1154. 40. The lean sedentary volunteers stood & walked for more than 2 hours per day longer than obese subjects. Guo T, Yin RX, Chen X, Bin Y, Nie RJ, Li H. Int J Clin Exp Pathol. Du S, Mroz TA, Zhai F, Popkin BM. 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