1.Expert Consensus on Obesity Prevention and Treatment in China.
Chinese Journal of Epidemiology 2022;43(5):609-626
Obesity and related chronic diseases have become major public health problems in China and in the world. While a series of prevention and control policies and action plans have been implemented in China, obesity and related chronic diseases have not been effectively controlled yet. The Obesity Prevention and Control Section of the Chinese Nutrition Society facilitated the cooperation of 34 interdisciplinary leading experts in drafting this consensus based on the latest relevant guidelines and research results in China and from overseas. The consensus report aims to help guide the prevention and treatment of obesity in China, promote the participation of the whole society and contribute to 'Healthy China' national goals. This report includes seven chapters. It outlines the prevalence and main contributing factors of obesity, challenges, obesity screening and diagnosis, treatment, prevention and control during the whole life cycle, comprehensive prevention and control strategies involving the whole society, and recommendations for future work in China. This report will help promote obesity prevention and weight management efforts in China to be more scientific and effective.
China/epidemiology*
;
Consensus
;
Humans
;
Mass Screening
;
Obesity/prevention & control*
;
Prevalence
2.Effectiveness of different screening strategies for type 2 diabete on preventing cardiovascular diseases in a community-based Chinese population using a decision-analytic Markov model.
Jia Min WANG ; Qiu Ping LIU ; Ming Lu ZHANG ; Chao GONG ; Shu Dan LIU ; Wei Ye CHEN ; Peng SHEN ; Hong Bo LIN ; Pei GAO ; Xun TANG
Journal of Peking University(Health Sciences) 2022;54(3):450-457
OBJECTIVE:
To evaluate the effectiveness of different screening strategies for type 2 diabetes to prevent cardiovascular disease in a community-based Chinese population from economically developed areas based on the Chinese electronic health records research in Yinzhou (CHERRY) study.
METHODS:
A Markov model was used to simulate different systematic diabetes screening strategies, including: (1) screening among Chinese adults aged 40-70 years recommended by the 2020 Chinese Guideline for the prevention and Treatment of Type 2 Diabetes (Strategy 1); (2) screening among Chinese adults aged 35 to 70 years recommended by the 2022 American Diabetes Association Standard of Medical Care in Diabetes (Strategy 2); and (3) screening among Chinese adults aged 35-70 years with overweight or obesity recommended by the 2021 United States Preventive Services Task Force Recommendation Statement on Screening for Prediabetes and Type 2 Diabetes (Strategy 3). According to the guidelines, individuals who were screened positively (fasting plasma glucose ≥ 7.0 mmol/L) would be introduced to intensive glycemic targets management (glycated hemoglobin < 7.0%).The Markov model simulated different screening scenarios for ten years (cycles) with parameters mainly from the CHERRY study or published literature. Number of cardiovascular disease events or deaths could be prevented and number needed to screen (NNS) were calculated to compare the effectiveness of the different strategies. One-way sensitivity analysis on the sensitivity of screening methods and probabilistic sensitivity analysis on uncertainties of diabetes incidence, the sensitivity of screening methods, and intensive glycemic management effects were conducted.
RESULTS:
Totally 289 245 Chinese adults aged 35-70 years without cardiovascular diseases or diagnosed diabetes at baseline were enrolled. In terms of the number of cardiovascular disease events could be prevented, Strategy 1 for systematic diabetes screening among the adults aged 35-70 years was 222 (95%UI: 180-264), Strategy 2 for systematic diabetes screening among the adults aged 40-70 years was 227 (95%UI: 185-271), and Strategy 3 for systematic diabetes screening among the adults aged 35-70 years with obesity or overweight (body mass index ≥ 24 kg/m2) was 131 (95%UI: 98-164), compared with opportunistic screening. NNS per cardiovascular disease event for the strategies 1, 2 and 3 were 1 184 (95%UI: 994-1 456), 1 274 (95%UI: 1 067-1 564) and 814 (95%UI: 649-1 091), respectively. Compared with Strategy 1, NNS per cardiovascular disease event for Strategy 2 increased by 90 (95%UI: -197-381) with similar effectiveness of cardiovascular prevention; however, NNS per cardiovascular disease event for Strategy 3 was reduced by 460 (95%UI: 185-724) in contrast to the Strategy 2, suggesting that the Strategy 3 was more efficient. The results were consistent in multiple sensitivity analyses.
CONCLUSION
Systematic screening for diabetes based on the latest guidelines in economically developed areas of China can reduce cardiovascular events and deaths. However, merely lowering the starting age of screening from 40 to 35 years seems ineffective for preventing cardiovascular disease, while screening strategy for Chinese adults aged 35-70 years with overweight or obesity is recommended to improve efficiency.
Adult
;
Cardiovascular Diseases/prevention & control*
;
China/epidemiology*
;
Cost-Benefit Analysis
;
Diabetes Mellitus, Type 2/prevention & control*
;
Humans
;
Mass Screening/methods*
;
Obesity
;
Overweight
;
United States
3.Sharing Chinese experience in obesity prevention and treatment with African countries.
Chinese Journal of Preventive Medicine 2022;56(8):1136-1141
Obesity has become a global public health problem that seriously threatens population health. The Chinese government has attached great importance to prevent and control the negative impacts of obesity on individuals, families and society. China has established a policy system for obesity, and made certain achievements in behavioral intervention, drug treatment, traditional Chinese medicine treatment, and surgical treatment. This study summarizes the prevention and treatment experience of obesity in China in order to provide reference for African countries to better formulate prevention and treatment strategies for obesity in line with their local context.
Asian People
;
China/epidemiology*
;
Government
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Humans
;
Obesity/prevention & control*
;
Public Health
4.Epidemiology of gastric cancer in Korea
Journal of the Korean Medical Association 2019;62(8):398-406
Rapid aging, economic development, lifestyle westernization, hygiene improvement, and scientific development have contributed for the epidemiologic changes of gastric cancer. This study aimed to review the descriptive epidemiology, risk factors, and prevention of gastric cancer in Korea. Age-standardized incidence and mortality of gastric cancer have decreased and showed age effect and cohort effect. Annual percent change in the incidence of gastric cancer has been prominent in recent years. Major risk factor of gastric cancer is Helicobacter pylori infection. Although H. pylori infection was associated with only non-cardia gastric cancer in meta-analysis, H. pylori infection was associated with both non-cardia and cardia gastric cancer in Asian studies. The estimated population attributable fraction of H. pylori regarding gastric cancer incidence was about 76% in Korean. Cigarette smoking and alcohol drinking was associated with gastric cancer regardless of cardia and non-cardia gastric cancer. Cigarette smoking was estimated to be responsible for 28% of gastric cancer incidence in men and 2% in women. Obesity was risk factor for cardia gastric cancer but not non-cardia gastric cancer. This discrepancy between cardia and non-cardia gastric cancer was consistently shown in epidemiologic studies in Korea. Salt intake was also well-known risk factor of gastric cancer and prevalence of high sodium intake more than 2,000mg in Korean was 81.5%. For primary prevention of gastric cancer, eradication of H. pylori and life-style modification including no smoking, no alcohol drinking, weight control, and low sodium intake are important. Gastric endoscopy is recommended for secondary prevention of gastric cancer.
Aging
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Alcohol Drinking
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Asian Continental Ancestry Group
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Cardia
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Cohort Effect
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Economic Development
;
Endoscopy
;
Epidemiologic Studies
;
Epidemiology
;
Female
;
Helicobacter pylori
;
Humans
;
Hygiene
;
Incidence
;
Korea
;
Life Style
;
Male
;
Mortality
;
Obesity
;
Prevalence
;
Primary Prevention
;
Risk Factors
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Secondary Prevention
;
Smoke
;
Smoking
;
Sodium
;
Stomach Neoplasms
5.Early-onset diabetes: an epidemic in China.
Frontiers of Medicine 2018;12(6):624-633
Although type 2 diabetes is a disease often associated with aging, the global prevalence of early-onset diabetes has been increasing due to man's sedentary lifestyle, low-physical activity, obesity, and some nonmodifiable risk factors. Many studies have found that individuals with early-onset type 2 diabetes were at higher risk of developing vascular complications than those with late-onset diabetes. Individuals with early-onset diabetes are usually unwilling to visit hospital and have more confidence in their health, which results in poor glycemic control and the delayed detection of diabetes-related complications. Few studies have focused on the treatment and prevention of complications in specific population of individuals with early-onset type 2 diabetes. Therefore, focusing on this particular population is critical for the government and academic societies. Screening for T2DM is imminent for young adults with a family history of diabetes, obesity, markers of insulin resistance, or alcohol consumption. More data are definitely required to establish a reasonable risk model to screen for early-onset diabetes.
Age of Onset
;
Alcohol Drinking
;
Cardiovascular Diseases
;
epidemiology
;
etiology
;
China
;
epidemiology
;
Comorbidity
;
Diabetes Complications
;
prevention & control
;
Diabetes Mellitus, Type 2
;
complications
;
epidemiology
;
therapy
;
Humans
;
Insulin Resistance
;
Obesity
;
complications
;
epidemiology
;
Randomized Controlled Trials as Topic
;
Risk Factors
6.Epidemic obesity in children and adolescents: risk factors and prevention.
Frontiers of Medicine 2018;12(6):658-666
The prevalence of obesity among children and adolescents (aged 2-18 years) has increased rapidly, with more than 100 million affected in 2015. Moreover, the epidemic of obesity in this population has been an important public health problem in developed and developing countries for the following reasons. Childhood and adolescent obesity tracks adulthood obesity and has been implicated in many chronic diseases, including type 2 diabetes, hypertension, and cardiovascular disease. Furthermore, childhood and adolescent obesity is linked to adulthood mortality and premature death. Although an imbalance between caloric intake and physical activity is a principal cause of childhood and adolescent obesity, environmental factors are exclusively important for development of obesity among children and adolescents. In addition to genetic and biological factors, socioenvironmental factors, including family, school, community, and national policies, can play a crucial role. The complexity of risk factors for developing obesity among children and adolescents leads to difficulty in treatment for this population. Many interventional trials for childhood and adolescent obesity have been proven ineffective. Therefore, early identification and prevention is the key to control the global epidemic of obesity. Given that the proportion of overweight children and adolescents is far greater than that of obesity, an effective prevention strategy is to focus on overweight youth, who are at high risk for developing obesity. Multifaceted, comprehensive strategies involving behavioral, psychological, and environmental risk factors must also be developed to prevent obesity among children and adolescents.
Adolescent
;
Child
;
Child, Preschool
;
Global Health
;
Humans
;
Pediatric Obesity
;
epidemiology
;
etiology
;
prevention & control
;
therapy
;
Risk Assessment
;
Risk Factors
7.Prevention and control on childhood overweight and obesity is of urgent importance in China.
Chinese Journal of Epidemiology 2018;39(6):705-706
As many developed countries have walked through the course, the trends of obesity epidemic among children in China are also rapidly increasing. This article describes the strategies for prevention and control of obesity at home and abroad, as well as the prevalence of overweight and obesity among children and adolescents at different ages in China. Related factors and negative impacts on overweight and obesity regarding individual health and the society are clarified. Evidence shows that it is imminent to control childhood obesity.
Adolescent
;
Child
;
China/epidemiology*
;
Epidemics
;
Female
;
Humans
;
Male
;
Obesity
;
Overweight/prevention & control*
;
Pediatric Obesity/prevention & control*
;
Prevalence
8.Only Self-control, Concerted Efforts Can Settle Rising Obesity in Adolescents.
Zhong JIA ; Zhi-Tian LI ; Kai WU
Chinese Medical Journal 2016;129(24):3007-3007
Adolescent
;
Body Mass Index
;
Female
;
Humans
;
Male
;
Obesity
;
epidemiology
;
prevention & control
;
therapy
;
Risk Factors
;
Self-Control
;
Weight Loss
;
physiology
9.Health hazards in childhood obesity: Evidence based on Chinese population.
Peiyu YE ; Fangfang CHEN ; Jie MI
Chinese Journal of Preventive Medicine 2016;50(1):97-100
Childhood obesity has become a critical issue in public health area. We searched Wanfang Data and PubMed databases for published studies on health hazards of childhood obesity in China during 2000-2015. From the evidence of the Chinese population studies, we know childhood obesity brings not only cardiovascular, endocrine and respiratory system health hazards, but also other health hazards to liver, moving skeleton, psychological behavior and cognition intelligence, et al. Only to understand the health hazards of childhood obesity, and put the key preventable period of chronic diseases forward to childhood, can pandemic of chronic diseases be controlled from the sources.
China
;
Chronic Disease
;
prevention & control
;
Humans
;
Pediatric Obesity
;
epidemiology
;
physiopathology
10.Developmental origins of cardiovascular disease and early intervention windows.
Chinese Journal of Preventive Medicine 2016;50(1):1-3
Cardiovascular diseases are the major threat to human health and underlie almost half of all deaths in China. Even more serious, obesity and cardiometabolic risk factors have emerged to be prevalent in children and adolescents of some affluent regions. As scientific knowledge emerges on the role of nutritional factors and exposures to environmental risk factors in the developmental origins of health and disease, evidence suggests that it is imperative to create and implement early effective prevention strategies, including optimisation of nutrition at first 1 000 days in life course and reduction of risk factors of obesity exposures during whole childhood, to suppress the rising trend of cardiovascular disease, otherwise, the future costs of diagnosis and treatment are likely to be unaffordable.
Adolescent
;
Cardiovascular Diseases
;
prevention & control
;
Child
;
China
;
Early Medical Intervention
;
Humans
;
Pediatric Obesity
;
epidemiology
;
Risk Factors

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