title: Overall obesity is leveling-off while abdominal obesity continues to rise in a Chinese population experiencing rapid economic development: analysis of serial cross-sectional health survey data 2002-2010.
abstract: BACKGROUND
  Obesity epidemic is related to industrialization and urbanization that have lead to changes in nutrition, lifestyle and socio-economic status. However, information on the trajectory of the obesity epidemic in populations experiencing rapid economic development is limited. We therefore investigate trends in obesity from 2002 to 2010 in a southern Chinese population experiencing world's fastest economic development.
  
  
  METHODS
  Between 2002 and 2010 four standardized surveys were conducted in a population of 85 million residents in Guangdong, China. Multistage cluster sampling was adopted to recruit representative samples. Weight, height and waist circumference of the participants were measured in a standardized way. The analysis included residents aged between 18 and 69 years. The number of participants included in the present analysis for Surveys conducted in 2002, 2004, 2007 and 2010 were 13058, 7646, 6441 and 8575, respectively.
  
  
  RESULTS
  From year 2002 to 2010, the age-standardized Body mass index (BMI) insignificantly changed from 21.7  kg m(-2) to 22.3  kg m(-2), and the prevalence of overweight and overall obesity from 15.8 to 16.6% (both P>0.05). The age-standardized waist circumference increased from 73.7 to 78.4 cm, and prevalence of abdominal obesity increased from 12.9 to 23.7% (both P<0.001). In urban areas, BMI and overall obesity changed little during the 8-year period (BMI increased from 22.6 to 22.7  kg m(-2) and overall obesity changed from 23.7 to 21.4%), whereas there were slight increases of the same in rural areas (BMI increased from 20.8 to 22.1 kg m(-2)and overall obesity increased from 8.2 to 13.3%). Waist circumference and abdominal obesity increased significantly in both areas, but the increase was more pronounced in rural areas (in urban area, waist circumference increased from 75.1 to 78.5 cm and abdominal obesity from 16.8 to 26.5%; in rural area, waist circumference from 72.2 to 78.3 and abdominal obesity from 8.8 to 22.0%).
  
  
  CONCLUSIONS
  BMI and overall obesity in this population, which has experienced the world's fastest economic development over the past three decades, has been leveling-off, while waist circumference and abdominal obesity, independent predictors of cardiovascular risk, have continued to rise. Our findings suggest that obesity epidemic transition in rapidly developing populations may be much faster than what has been observed in Western countries.
authors.affiliation: 1] School of Public Health and Primary Care, Chinese University of Hong Kong, Hongkong, China [2] Shenzhen Research Institute of the Chinese University of Hong Kong, Shenzhen, China.
authors.forename: X Q
authors.initials: XQ
authors.lastname: Lao
authors.affiliation: 1] Center for disease Control and Prevention of Guangdong Province, Guangzhou, China [2] Guangdong Provincial Institute of Public Health, Guangzhou, China.
authors.forename: W J
authors.initials: WJ
authors.lastname: Ma
authors.affiliation: Institute of Human Performance, The University of Hong Kong, Hongkong, China.
authors.forename: T
authors.initials: T
authors.lastname: Sobko
authors.affiliation: Center for disease Control and Prevention of Guangdong Province, Guangzhou, China.
authors.forename: Y H
authors.initials: YH
authors.lastname: Zhang
authors.affiliation: Center for disease Control and Prevention of Guangdong Province, Guangzhou, China.
authors.forename: Y J
authors.initials: YJ
authors.lastname: Xu
authors.affiliation: Center for disease Control and Prevention of Guangdong Province, Guangzhou, China.
authors.forename: X J
authors.initials: XJ
authors.lastname: Xu
authors.affiliation: National Institute for Nutrition and Food Safety, Chinese Center for Disease Control and Prevention, Beijing, China.
authors.forename: D M
authors.initials: DM
authors.lastname: Yu
authors.affiliation: Center for disease Control and Prevention of Guangdong Province, Guangzhou, China.
authors.forename: S P
authors.initials: SP
authors.lastname: Nie
authors.affiliation: Center for disease Control and Prevention of Guangdong Province, Guangzhou, China.
authors.forename: Q M
authors.initials: QM
authors.lastname: Cai
authors.affiliation: Center for disease Control and Prevention of Guangdong Province, Guangzhou, China.
authors.forename: L
authors.initials: L
authors.lastname: Xia
authors.affiliation: School of Health and Population Sciences, the University of Birmingham, Birmingham, UK.
authors.forename: G N
authors.initials: GN
authors.lastname: Thomas
authors.affiliation: School of Public Health and Primary Care, Chinese University of Hong Kong, Hongkong, China.
authors.forename: S M
authors.initials: SM
authors.lastname: Griffiths
mesh_terms: D000328:Adult; D044466:Asian People / Q000706:statistics & numerical data*; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control; D002681:China / Q000453:epidemiology; D003430:Cross-Sectional Studies; D057217:Economic Development / Q000639:trends*; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D056128:Obesity, Abdominal / Q000150:complications / Q000453:epidemiology* / Q000517:prevention & control; D011159:Population Surveillance; D015995:Prevalence; D011634:Public Health; D012307:Risk Factors; D014507:Urbanization / Q000639:trends*; D055105:Waist Circumference