• Burden Of Disease
• Public Health
• Time series

• China
• body mass index
• ethnicity
• geographical
• obesity

• Adult
• Aged
• Middle Aged
• Male
• Humans
• Female
• Obesity, Abdominal/epidemiology
• Ethnicity
• Prevalence
• Obesity/epidemiology
• Body Mass Index
• China/epidemiology

• Z135080000022 National Major Public Health Service Projects
• 2019M660921 China Postdoctoral Science Foundation
• 2020T130436 China Postdoctoral Science Foundation

• BMI
• China
• DID
• Marriage
• Obesity

• Humans
• Body Mass Index
• Male
• Female
• China
• Adult
• Middle Aged
• Young Adult
• Adolescent
• Marriage/statistics & numerical data
• Nutrition Surveys
• Overweight/epidemiology
• Obesity/epidemiology
• Sex Factors
• Energy Intake
• Prevalence
• Socioeconomic Factors
• Exercise

• activity intensity
• cold climate
• college students
• high altitude
• outdoor thermal comfort

• Humans
• Altitude
• Climate
• Seasons
• Temperature
• Surveys and Questionnaires

• risk factors
• obesity
• epidemiology

• Adult
• Female
• Humans
• Male
• Body Mass Index
• Ethnicity
• Waist Circumference
• Risk Factors
• Birth Cohort
• Life Change Events
• Malaysia/epidemiology
• Obesity/complications

• death
• dietary
• global burden
• ischemic heart disease
• temporal trends

• Shu-Mu acupoints
• abdominal obesity
• acupoint catgut embedding
• compatibility relation
• female
• neurological mechanism
• study protocol

• Yunnan Province Applied Fundamental Research Project-Joint General Project of Traditional Chinese Medicine
• Top-notch Young Talent Project of Yunnan Ten Thousand Talents
• “Famous Doctor” special talent program of the Yunnan Provincial Xing Dian Talent Support Program
• The funding agencies do not play any role in the design, collection, analysis, or writing manuscripts of the study

• Adult
• Child
• Female
• Humans
• Child, Preschool
• Adolescent
• Young Adult
• Middle Aged
• Aged
• Aged, 80 and over
• Overweight/epidemiology
• Body Mass Index
• Cohort Studies
• Obesity/epidemiology
• England/epidemiology
• Prevalence

• MR/S009868/1 Medical Research Council
• Medical Research Council

Taiwan has gone through rapid industrialization, urbanization and economic growth in the 20th and early 21st centuries. Therefore, the population has experienced significant changes in the physical and social environment during the life course, which may affect the overall adiposity. Our aim was to examine the age trajectories of height, weight and body mass index (BMI) in the Taiwanese population and to explore the influences of sex, birth cohort and education.

The sample comprised 572,358 residents between 20 and 94 years of age in Taiwan who attended at least one health examination during 1996 to 2017 in a cohort study. Repeated measures of body weight and height were collected using an auto-anthropometer. We conducted a series of linear mixed-effects growth curve models to examine the trajectory of height, weight, and BMI across the life course with stratification by sex.

Age-related trajectories of BMI differed between men and women and stronger cohort effects were observed among men, with younger cohorts having higher BMI. After holding cohort and age variables constant, men with junior high or lower education were shorter, thinner and had higher BMI than men with university or higher education (effect sizes: − 3.138 cm, p < 0.001; − 2.277 kg, p < 0.001; 0.121 kg/m², p < 0.001, respectively). Women with junior high or lower education were shorter, heavier and had higher BMI than women with university or higher education (effect sizes: − 2.368 cm, p < 0.001; 2.417 kg, p < 0.001; 1.691 kg/m², p < 0.001, respectively). The educational disparities in BMI were found to be larger among women.

Our findings suggest that younger generations, especially men, and lower educational level individuals, particularly women, have increasing levels of BMI. The influence of age and cohort effects together with sex and educational disparities on adiposity should be highlighted when designing future interventions and policies regarding overweight and obesity.

• Body mass index
• Cohort effect
• Education
• Health disparities
• Sex

Online health-specific goal challenge groups gather people with the same health concerns and provide an environment to keep on track, exchange experiences, and compete for achievements. We examine how group health status composition influences social contact, and how both group health status composition and social contact affect individual health achievement. Using longitudinal data from 2479 online health challenge group users and their corresponding group information, we found that (a) compared with individual health status, group conditions (average weight status and member affiliation) are more strongly connected with social contact; (b) different mechanisms affect whether people participate in social contact and increase their participation, and weight loss; and (c) average group condition influences individuals’ weight loss through social contact. We emphasize the effect of group composition and the social contact process in health enhancement.

• BMI
• diabetes mellitus
• gestational diabetes mellitus
• medical nutrition therapy
• postpartum glucose tolerance

Background: Unintentional falls seriously threaten the life and health of people in China. This study aimed to assess the long-term trends of mortality from unintentional falls in China and to examine the age-, period-, and cohort-specific effects behind them.

Methods: This population-based multiyear cross-sectional study of Chinese people aged 0–84 years was a secondary analysis of the mortality data of fall injuries from 1990 to 2019, derived from the Global Burden of Disease Study 2019. Age-standardized mortality rates of unintentional falls by year, sex, and age group were used as the main outcomes and were analyzed within the age-period-cohort framework.

Results: Although the crude mortality rates of unintentional falls for men and women showed a significant upward trend, the age-standardized mortality rates for both sexes only increased slightly. The net drift of unintentional fall mortality was 0.13% (95% CI, −0.04 to 0.3%) per year for men and −0.71% (95% CI, −0.96 to −0.46%) per year for women. The local drift values for both sexes increased with age group. Significant age, cohort, and period effects were found behind the mortality trends of the unintentional falls for both sexes in China.

Conclusions: Unintentional falls are still a major public health problem that disproportionately threatens the lives of men and women in China. Efforts should be put in place urgently to prevent the growing number of fall-related mortality for men over 40 years old and women over 70 years old. Gains observed in the recent period, relative risks (RRs), and cohort RRs may be related to improved healthcare and better education.

• Accidental Falls/mortality
• Adolescent
• Adult
• Aged
• Aged, 80 and over
• Child
• Child, Preschool
• China/epidemiology
• Cohort Studies
• Cross-Sectional Studies
• Female
• Humans
• Infant
• Infant, Newborn
• Male
• Middle Aged
• Young Adult

(1) Background: The study aims to estimate the prevalence of normal weight with central obesity (NWCO) and to examine the relationship between NWCO and cardiovascular disease risk factors in adults of the province of Shaanxi. (2) Methods: A population-based cross-sectional survey was conducted among residents who were aged 18–80 years and had been living in Zhenba County, Shaanxi Province, for over six months in 2018. Descriptive data analysis and prevalence/frequency were conducted. Logistic regression analyses were used to detect the corresponding factors associated with central obesity. (3) Results: A total of 2312 participants (936 men and 1376 women) were analyzed. The prevalence of NWCO was 58.3%. NWCO was significantly associated with hypertension and dyslipidemia. Compared with normal weight non-central obesity (NWNO), the adjusted odds ratios (ORs) for hypertension were 1.47 (95% CI 1.10–1.98) in men and 1.55 (1.14–2.10) in women, and the corresponding odds ratios for dyslipidemia were 2.71 (1.77–4.13) in men and 1.84 (1.29–2.61) in women. Female sex, age over 58 years, and lower education level were also significantly predictors of abdominal obesity. (4) Conclusions: Body mass index alone as a measure of obesity is not sufficient for assessing health risks. Central obesity index should be used together for clinical assessment.

• body mass index
• central obesity
• metabolic disease
• prevalence
• risk factor

The association between obesity parameters and lung function indicators in the general Chinese rural adult population remains unclear.

In total, 8,284 Chinese adults aged 20 years to 80 years old from Xinxiang were recruited. Obesity-related parameters, including body mass index (BMI), waist circumference (WC), hip circumference (HC), waist-to-hip ratio (WHR), waistto-height ratio (WHtR), body fat percentage (BFP), basal metabolism, and visceral fat index, and lung function parameters such as forced vital capacity and forced expiratory volume in first second were measured.

The total prevalence of obesity defined by BMI, WC, WHR, WHtR, and BFP was 23.2%, 58.2%, 66.7%, 69.2%, and 56.5%, respectively. Spearman correlation analyses showed significant correlations between all obesity-related parameters and lung function. Linear regression analyses further demonstrated that BMI, WHtR, BFP, and general obesity defined using those indicators were negatively associated with lung function, while WC, WHR, and central obesity defined accordingly were positively associated with lung function. The relationship between general obesity and lung function was more evident in women than in men, while the link between central obesity and lung function was more obvious in men than in women.

Obesity is closely related to lung function in the general Chinese adult population. Weight control and loss are important strategies to improve lung function and respiratory health.

• Chinese
• fat
• lung function
• obesity
• overweight
• rural area

• Adolescent
• Adult
• Aged
• Body Mass Index
• China/epidemiology
• Female
• Health Surveys
• Humans
• Male
• Middle Aged
• Obesity/epidemiology
• Risk Factors
• Rural Population/statistics & numerical data
• Urban Population/statistics & numerical data
• Young Adult

• 209376/Z/17/Z Wellcome Trust
• 212946/Z/18/Z Wellcome Trust
• 29186 Cancer Research UK
• MC_UU_12026/2 Medical Research Council
• MC_UU_00017/1 Medical Research Council
• MC_U137686851 Medical Research Council
• 16896 Cancer Research UK
• 209376 Wellcome Trust
• Wellcome Trust

Intrauterine malnutrition has a long-term effect on human health. This study aimed to evaluate the associations between exposure to famine in early life and obesity in adulthood in Chinese adults. A total of 5033 participants (22,132 observations) of the China Health and Nutrition Survey (CHNS) in 1991–2015 were classified into three famine exposure groups according to their birth year: unexposed (1963–1966), fetal-exposed (1959–1962) and childhood-exposed (1955–1958). Compared with the unexposed group, the fetal-exposed group had higher levels of body-mass-index (BMI) and waist-circumference (WC), and higher prevalence of overweight and central obesity, whereas the childhood-exposed group had lower levels of the measurements. However, the positive associations of fetal exposure with BMI, WC and prevalence of overweight and central obesity were attenuated by additionally adjusting for age at survey. Stratified analysis showed that the adverse effect of fetal exposure to famine was only observed in subjects at several specific age-groups, and in men living in rural areas and in women living in more severe famine exposed areas (p for interaction < 0.05). Our results provide evidence for the weak effect of fetal exposure to famine on body measurements in adulthood, and suggest the importance of severity of famine exposure and timing of exposure.

• adulthood
• body mass index
• central obesity
• famine exposure
• overweight
• waist circumference

• Gut microbiota
• geographic differences
• machine learning
• microbiota-host associations

• Adult
• China/epidemiology
• Diet
• Female
• Gastrointestinal Microbiome
• Geography
• Humans
• Male
• Middle Aged

• P30 ES010126 NIEHS NIH HHS
• R01 HD030880 NICHD NIH HHS
• R01 DK104371 NIDDK NIH HHS
• R01 AG065357 NIA NIH HHS
• T32 HL129982 NHLBI NIH HHS
• D43 TW009077 FIC NIH HHS
• P2C HD050924 NICHD NIH HHS
• Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)
• National Institute of Health (NIH)
• National Institute of Health (NIH), National Institute of Diabetes and Digestive and Kidney Diseases
• Genetic Epidemiology of Heart, Lung, and Blood (HLB) Traits Training Grant
• NIH Fogarty grant

• China
• body weight
• fat intake
• longitudinal analysis
• overweight and obesity

• Adult
• Body Mass Index
• Body Weight/physiology
• China/epidemiology
• Cohort Studies
• Diet/adverse effects
• Diet/statistics & numerical data
• Diet Records
• Dietary Fats/analysis
• Eating/physiology
• Exercise
• Female
• Humans
• Male
• Middle Aged
• Nutrition Surveys
• Nutritional Status
• Obesity/epidemiology
• Obesity/etiology
• Overweight/epidemiology
• Overweight/etiology
• Prevalence
• Risk Factors
• Young Adult

• R01 HD030880 NICHD NIH HHS
• R01 AG065357 NIA NIH HHS
• D43-TW009077 FIC NIH HHS
• R01-HD30880; R01-HD38700; R24-HD050924; DK056350 NIH HHS
• P2C HD050924 NICHD NIH HHS

To evaluate the economic and humanistic burden associated with cardiovascular diseases that were attributable to fine particulate matter (≤ 2.5 μg/m³ in aerodynamic diameter; PM_2.5) in Beijing.

This study used a health economic modelling approach to compare the actual annual average PM_2.5 concentration with the PM_2.5 concentration limit (35 µg/m³) as defined by the Chinese Ambient Air Quality Standard in terms of cardiovascular disease outcomes in Beijing adult population. The outcomes included medical costs, quality-adjusted life-years (QALYs) and net monetary loss (NML). Beijing annual average PM_2.5 concentration was around 105 µg/m³ during 2013–2015. Therefore, we estimated the differences in cardiovascular outcomes of Beijing adults between exposure to the PM_2.5 concentration of 105 µg/m³ and exposure to the concentration of 35 µg/m³. According to WHO estimates, the hazard ratios of coronary heart disease and stroke associated with the increase of PM_2.5 concentration from 35 to 105 µg/m³ were 1.15 and 1.29, respectively.

The total 1-year excess medical costs of cardiovascular diseases associated with PM_2.5 pollution in Beijing was US$147.9 million and the total 1-year QALY loss was 92 574 in 2015, amounting to an NML of US$2281.8 million. The expected lifetime incremental costs for a male Beijing adult and a female Beijing adult were US$237 and US$163, the corresponding QALY loss was 0.14 and 0.12, and the corresponding NML was US$3514 and US$2935.

PM_2.5-related cardiovascular diseases imposed high economic and QALY burden on Beijing society. Continuous and intensive investment on reducing PM_2.5 concentration is warranted even when only cardiovascular benefits are considered.

• cardiovascular disease
• health economics

• Age-period-cohort model
• Chinese adults
• Gender difference
• Overweight

• Metabolic phenotype
• Metabolic syndrome
• Metal
• Obesity
• Urine

• Adult
• Cholesterol, HDL
• Copper
• Cross-Sectional Studies
• Environmental Exposure
• Female
• Humans
• Iron
• Logistic Models
• Male
• Metabolic Syndrome
• Metals/urine
• Middle Aged
• Obesity
• Odds Ratio
• Overweight
• Phenotype
• Prospective Studies
• Zinc

• age-period-cohort model
• identification problem
• linear and nonlinear effects
• linear dependency
• random effects models

• P2C HD041025 NICHD NIH HHS

• drinking
• self-perceived stress
• smoking
• weight status

• Adult
• Alcohol Drinking
• China/epidemiology
• Cross-Sectional Studies
• Female
• Humans
• Male
• Middle Aged
• Nutrition Surveys
• Obesity/epidemiology
• Obesity/etiology
• Obesity/psychology
• Prevalence
• Smoking
• Socioeconomic Factors
• Stress, Psychological

• Age–period–cohort
• Body mass index
• Estonia
• Obesity

• adolescents
• age–period–cohort study
• body mass index
• epidemiology
• growth
• severe obesity

• Cognitive decline
• Cohort trend
• Socio-economic disparity
• Socio-economically disadvantaged

• Activities of Daily Living
• Aged
• China
• Cognition
• Cognitive Dysfunction
• Female
• Humans
• Male
• Multiple Birth Offspring
• Socioeconomic Factors

• Body mass index
• Obesity
• Overweight
• Pancreaticoduodenectomy

Use of generalized linear models with continuous, non-linear functions for age, period and cohort makes it possible to estimate these effects so they are interpretable, reliable and easily displayed graphically. To demonstrate the methods we use data on the prevalence of obesity among Australian women from two independent data sources obtained using different study designs.

We used data from two long-running nationally representative studies: seven cross-sectional Australian National Health Surveys conducted between 1995 and 2017–18, each involving 6000–8000 women; and the Australian Longitudinal Study on Women’s Health which started in 1996 and involves more than 57,000 women in four age cohorts who are re-surveyed at three-yearly intervals or annually. Age-period-cohort analysis was conducted using generalized linear models with splines to describe non-linear continuous effects.

When analysed in the same way both data sets showed similar patterns. Prevalence of obesity increased with age until late middle age and then declined; increased only slightly across surveys; but increased steadily with birth year until the 1960s and then accelerated.

The methods illustrated here make the estimation and visualisation of age, period and cohort effects accessible and interpretable. Regardless of how the data are collected (from repeated cross-sectional surveys or longitudinal cohort studies), it is clear that younger generations of Australian women are becoming heavier at younger ages. Analyses of trends in obesity should include cohort, in addition to age and period, effects in order to focus preventive strategies appropriately.

• Age-period-cohort effects
• Australian women
• Obesity
• Statistical modelling

• Japanese worker
• body mass index
• epidemiology
• obesity
• overweight

• Adult
• Body Mass Index
• Female
• Humans
• Incidence
• Japan/epidemiology
• Male
• Middle Aged
• Obesity/epidemiology
• Occupational Health
• Overweight/epidemiology
• Young Adult

• 140202-01 Industrial Disease Clinical Research Grants
• 150903-01 Industrial Disease Clinical Research Grants
• 170301-01 Industrial Disease Clinical Research Grants
• 16H05251 Japan Society for the Promotion of Science KAKENHI
• 28-Shi-1206 National Center for Global Health and Medicine
• Industrial Health Foundation
• National Center for Global Health and Medicine

• economic independence
• leisure activities
• life course trajectories
• longitudinal changes

•

Cohort effect shows that obesity for recent cohort has narrowed down.

• Central obesity
• General obesity
• Hypertension
• Urbanization

• Adolescent
• Adult
• Aged
• Body Mass Index
• China/epidemiology
• Cross-Sectional Studies
• Female
• Health Surveys
• Humans
• Hypertension/epidemiology
• Male
• Middle Aged
• Obesity/epidemiology
• Obesity, Abdominal/epidemiology
• Prevalence
• Risk Factors
• Rural Population/statistics & numerical data
• Urban Population/statistics & numerical data
• Waist Circumference
• Young Adult

• R01 HD030880 NICHD NIH HHS
• R01 DK104371 NIDDK NIH HHS
• D43 TW009077 FIC NIH HHS
• P2C HD050924 NICHD NIH HHS
• National Center for Medical Rehabilitation Research
• National Institute of Diabetes and Digestive and Kidney Diseases
• NIH Fogarty

The objective of this study was to investigate the longitudinal trajectory of BMI in the Chinese population, and to assess whether the gender or other personal characteristics were related to BMI, and whether there was a change in trajectory over time.

Data were obtained from 3,574 Chinese (5 to 89 years of age) who participated in the 2000–2011 of the China Health and Nutrition Survey. Latent growth curve models were used to investigate the longitudinal trajectory of BMI, and to examine the effect of some personal characteristics on BMI trajectory.

The linear model resulted in a mean initial BMI value of 22.90 and a significant mean slope (Ms = 0.19, t = 10.73, p<0.001), suggesting a steady increase in BMI over time for the whole sample. For covariates, the educational level, alcohol and physical activity had differences on initial scores for BMI (β = 0.05, p<0.001; β = -0.12, p<0.05; β = -0.08, p<0.05; respectively.), and the age had differences on both the initial scores and slope for BMI (β = 0.01, p = <0.05; β = -0.03, p<0.01; respectively.). Baseline measures revealed gender-associated differences on initial scores for BMI, and the slope for male was significantly steeper than that for female (β = -0.11, p<0.05). The initial BMI status of Chinese living in the rural areas was significantly higher than that of Chinese living in the urban areas, and the slope for rural status was significantly steeper than that for urban status (β = 0.21, p<0.001).

Results indicated a linear trajectory of BMI in the Chinese population over a 12-year period. The longitudinal trajectories differed by age, gender and urban-rural status, suggesting different interventions should be adopted for different groups.

• Adolescent
• Adult
• Aged
• Aged, 80 and over
• Body Mass Index
• Child
• Child, Preschool
• China/epidemiology
• Exercise
• Female
• Humans
• Longitudinal Studies
• Male
• Middle Aged
• Models, Statistical
• Obesity/epidemiology
• Young Adult

• Abdominal obesity
• China
• Life course
• Socioeconomic disparities

• Age-Period-Cohort analysis
• BMI
• obesity

The purpose of this study is to assess the prevalence of overweight/obesity, abdominal obesity and obesity-related risk factors in southern China.

A cross-sectional survey of 15,364 participants aged 15 years and older was conducted from November 2013 to August 2014 in Jiangxi Province, China, using questionnaire forms and physical measurements. The physical measurements included body height, weight, waist circumference (WC), body fat percentage (BFP) and visceral adipose index (VAI). Multivariate logistic regression analysis was performed to evaluate the risk factors for overweight/obesity and abdominal obesity.

The prevalence of overweight was 25.8% (25.9% in males and 25.7% in females), while that of obesity was 7.9% (8.4% in males and 7.6% in females). The prevalence of abdominal obesity was 10.2% (8.6% in males and 11.3% in females). The prevalence of overweight/obesity was 37.1% in urban residents and 30.2% in rural residents, and this difference was significant (P < 0.001). Urban residents had a significantly higher prevalence of abdominal obesity than rural residents (11.6% vs 8.7%, P < 0.001). Among the participants with an underweight/normal body mass index (BMI), 1.3% still had abdominal obesity, 16.1% had a high BFP and 1.0% had a high VAI. Moreover, among obese participants, 9.7% had a low /normal WC, 0.8% had a normal BFP and 15.9% had a normal VAI. Meanwhile, the partial correlation analysis indicated that the correlation coefficients between VAI and BMI, VAI and WC, and BMI and WC were 0.700, 0.666, and 0.721, respectively. A multivariate logistic regression analysis indicated that being female and having a high BFP and a high VAI were significantly associated with an increased risk of overweight/obesity and abdominal obesity. In addition, living in an urban area and older age correlated with overweight/obesity.

This study revealed that obesity and abdominal obesity, which differed by gender and age, are epidemic in southern China. Moreover, there was a very high, significant, positive correlation between WC, BMI and VAI. However, further studies are needed to explore which indicator of body fat could be used as the best marker to indirectly reflect cardiometabolic risk.

• Body mass index
• Overweight
• Pancreatic cancer
• Smoking history
• Survival analysis

• Adult
• Aged
• Aged, 80 and over
• Body Mass Index
• Carcinoma, Pancreatic Ductal/mortality
• Carcinoma, Pancreatic Ductal/pathology
• China/epidemiology
• Comorbidity
• Coronary Artery Disease/epidemiology
• Diabetes Mellitus/epidemiology
• Disease Progression
• Female
• Follow-Up Studies
• Humans
• Kaplan-Meier Estimate
• Male
• Middle Aged
• Neoplasm Staging
• Overweight/epidemiology
• Pancreatic Neoplasms/mortality
• Pancreatic Neoplasms/pathology
• Proportional Hazards Models
• Retrospective Studies
• Risk Factors
• Thinness/epidemiology
• Young Adult

• China
• Hypertension
• Life Course
• Socioeconomic disparities;

• Adult
• Aged
• Aged, 80 and over
• China/epidemiology
• Female
• Health Knowledge, Attitudes, Practice
• Health Status Disparities
• Health Surveys
• Humans
• Hypertension/epidemiology
• Hypertension/prevention & control
• Hypertension/psychology
• Hypertension/therapy
• Male
• Middle Aged
• Prevalence
• Socioeconomic Factors