Prevalence of obesity amongst Chinese populations revisited

As in Western populations, the prevalence of obesity has been increasing rapidly in Chinese populations in recent years, but if the same criteria to define obesity are used, it is still much less common in Chinese than in Caucasians. For BMI greater or equal to 30 kg/m(2), recent estimates suggest the prevalence ranges from 3 to 6% in different adult Chinese populations compared with figures of approximately 33% in the USA. However, it is generally accepted that the Chinese and other Asian populations have a greater amount of body fat than Caucasians at the same level of BMI or waist circumference, and that the prevalence of metabolic risk factors for cardiovascular disease and cardiovascular events start to increase at lower values of the obesity indices in Asians compared with Western people. Therefore, lower cut-off criteria have been proposed to define obesity in Chinese populations and if the cut-off value for BMI greater than or equal to 25 kg/m(2) is adopted, the overall prevalence of obesity in Chinese adults is approximately 21.8% in mainland China, 21.0% in Hong Kong, 25.1% in Taiwan and 27.8% in Singapore. In China, obesity is more common in the North than the South and, as in most other countries, it is more common in urban rather than rural communities. This rapid increase in obesity along with diabetes and the associated risk factors is likely to fuel a major increase in cardiovascular disease in Chinese populations in the very near future with major public health and economic consequences.