Non-communicable chronic diseases(NCD)have become the main burden of disease in China, which cause great challenges to public health and social development. Unhealthy diet is one of the main risk factors of the occurrence and development of NCD. Based on the latest international understanding of various forms of malnutrition and National Nutrition Survey and Monitoring in China, this paper describes the change trend of low weight, overweight and obesity in different age groups and highlights two classic cases: the diabetes research of Daqing in China and NCD prevention and control project of the North Carolina Project in Finland. The article concludes that dietary nutrition intervention is a cost-effective and sustainable key measure to prevent and control NCD.
Diet ; Humans ; Noncommunicable Diseases/prevention & control* ; Nutritional Status ; Obesity/prevention & control* ; Overweight ; Risk Factors

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

INTRODUCTION: Obesity has been linked to the development of type 2 diabetes mellitus (T2DM) and cardiovascular diseases. This study primarily aims to determine the prevalence of obesity among the Filipino patients in our institution since there have been no previous studies on this subset of patients. METHODS: A cross-sectional analytical study of 2,078 patients at the Primary Preventive Cardiology Out-Patient Clinic of the Philippine Heart Center (PHC) was done from January 1, 2002 to December 31, 2017. The prevalence of obesity was determined using the World Health Organization (WHO) and Asian classification. Factors associated with obesity were determined using binary logistic regression analysis. RESULTS: A majority of the patients were females (1499, 71.14%) with a higher mean age compared to the male patients (57.67±10.5 vs 55.66±11.8, p<0.001). Hypertension (68.5%), coronary artery disease (37.1%) and T2DM (20.3%) were the most common co-morbid illnesses in both genders. The mean body mass index (BMI) was 25.8±4.3 kg/m2 for the female patients while it was 25.2±4.1 kg/m2 for the male patients (p<0.001). The prevalence of obesity using the WHO and Asian classifications was 15% (n=312). Compared to the Asian criteria, there were significantly more patients classified as having normal weight (44.09% vs 24.95%, p<0.001) and overweight (37.98% vs 19.13%, p<0.001) using the WHO classification. Pre-obesity, an additional criterion of the Asian classification which was not adopted by WHO was seen in 37.98% of the patients. On multivariate analysis, female gender (OR 1.31, 95% CI [1.08-1.59)] p=0.006) and T2DM (OR 1.25, 95% CI [1.01-1.56], p=0.42) were significant factors associated with obesity while age (OR 0.98, 95% CI [0.98-0.99], p<0.001) was protective of obesity. CONCLUSION: The prevalence of obesity in our cohort was consistent with the worldwide prevalence reported by the WHO which underscores the need for effective weight management programs and primary preventive strategies 7to lower the prevalence and obviate the development of complications related to obesity. Female gender and T2DM were significant factors associated with obesity, while age was a significant protective factor of obesity.
Overweight ; Obesity ; Primary Prevention

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

BACKGROUND AND PURPOSE: One explanation for the ‘obesity paradox’, where obese patients seem to have better cardiovascular outcomes than lean patients, is that obese patients display an identifiable high cardiovascular risk phenotype that may lead to receiving or seeking earlier/more aggressive treatment. METHODS: We analyzed a clinical trial dataset comprising 3643 recent (<120 days) ischemic stroke patients followed up for 2 years. Subjects were categorized as lean (body mass index [BMI], <25 kg/m², n=1,006), overweight (25-29.9 kg/m², n=1,493), or obese (≥30 kg/m², n=1,144). Subjects were classified as level 0 to III depending on the number of secondary prevention prescriptions divided by the number of potentially indicated drugs (0=none of the indicated medications and III=all indicated medications as optimal combination drug treatment [OCT]). Independent associations between each BMI category and stroke/myocardial infarction/vascular death (major vascular events [MVEs]) and all-cause death were assessed. RESULTS: MVEs occurred in 17.4% of lean, 16.1% of overweight, and 17.1% of obese patients; death occurred in 7.3%, 5.5%, and 5.1%, respectively. Individuals with a higher BMI status received more OCT (45.8%, 51.7%, and 55.3%, respectively; P<0.001). In the lean patient group, multivariable adjusted Cox analyses, showed that compared with levels 0-I, level II and level III were linked to lower risk of MVEs (hazard ratio [HR] 0.55; 95% confidence interval [CI]: 0.32–0.95 and HR 0.48; 95% CI: 0.28−0.83, respectively) and death (0.44; 0.21–0.96 and 0.23; 0.10−0.54, respectively). CONCLUSIONS: OCT for secondary prevention after an ischemic stroke is less frequent in lean (vs. obese) subjects, but when implemented is related to significantly better clinical outcomes.
Body Mass Index ; Dataset ; Humans ; Obesity* ; Overweight ; Phenotype ; Prescriptions ; Secondary Prevention ; Stroke* ; Vitamins*

PURPOSE: The purpose of this study was to analyze differences in health behaviors among adolescents in order to provide fundamental data to develop an effective body weight control program. METHODS: Secondary analysis was done using data from the 9th (2013) Online Survey on Ado-lescents' Health Behaviors by the Korea Centers for Disease Control and Prevention. The adolescents were divided into low weight, normal weight, overweight, and obesity groups according to body mass index (BMI). Differences in health behaviors were analyzed. RESULTS: Gender, grade, socioeconomic status, perceived-health status, exercise, breakfast, fast food, ramen noodles, snacks, carbonated soft drinks, fruits and vegetables, satisfaction with sleep, stress, smoking, and alcohol consumption were significantly different among the groups. Ingestion of carbonated soft drinks and snacks was significantly higher in the low weight group compared to the normal weight group. Eating fast foods, ramen noodles, and snacks was significantly lower in the overweight and obesity groups compared to the normal weight group. CONCLUSION: Findings indicate that health behaviors among the groups differ from traditional knowledge about obesity. To develop optimal programs and improve efficacy, prior knowledge should be used to think differently and individualized programs should be based on an understanding health behaviors of adolescents.
Adolescent Health* ; Adolescent* ; Alcohol Drinking ; Body Mass Index* ; Body Weight ; Breakfast ; Carbon ; Carbonated Beverages ; Centers for Disease Control and Prevention (U.S.) ; Eating ; Fast Foods ; Fruit ; Health Behavior ; Humans ; Korea ; Obesity ; Overweight ; Smoke ; Smoking ; Snacks ; Social Class ; Thinness ; Vegetables

OBJECTIVETo explore the effect of weight-loss for overweight or obese population under the health management programs, and to provide evidence for the development of safe and effective weight-loss programs.

METHODS738 participants who resided in Beijing longer than one year, under 22 to 55 years of age, with BMI≥24 kg/m(2) and without organic diseases were voluntarily recruited, from September 1(st) to October 15(th) 2013. All the participants were randomly divided into general management group or under health management group, in which all the subjects received intervention measures for 6 months. Anthropometry and body composition were measured at baseline and 6 months for all the subjects. Weight-loss effect from the health management programs was evaluated through analyzing the changes on weight and body fat.

RESULTS618 participants completed the follow-up process, including 321 in the general management group and 297 in the health management group. 6 months after the intervention process, values of weight and body fat rate in the two groups appeared both significantly lower than that at the baseline levels. Difference before and after the intervention program was statistically significant (P<0.001). However, the differences of those with reduction value as 2.19 kg or 2.19% among health management group were higher than that in the general management group, which were 0.97 kg and 1.28% respectively, with difference statistically significant (P<0.001). The effective rate of 24.2% loss-weight and the 52.5% losing rate on body fat among the health management group were both higher than 11.8% and 34.3%, seen in the general management group, respectively, with difference statistically significant (P<0.001).

CONCLUSIONThe healthy management programs could effectively control the weight and body fate rate among the overweight or obese adults.

Adipose Tissue ; Adult ; Behavior Therapy ; Body Composition ; Body Mass Index ; China ; Exercise ; Feeding Behavior ; Female ; Humans ; Middle Aged ; Obesity ; prevention & control ; Overweight ; Risk Reduction Behavior ; Treatment Outcome ; Weight Loss ; physiology ; Weight Reduction Programs ; methods

OBJECTIVETo investigate foot biomechanics characteristic of patients with type 2 diabetes mellitus.

METHODSThis study was conducted among 303 patients with type 2 diabetes. The whole foot was divided into 10 regions, namely the first toe (T1); the second to fifth toes (T2-5); the first, second, third, fourth, and fifth metatarsals (M1, M2, M3, M4, and M5, respectively); midfoot (MF), and the heel medial (HM). Foot arch index, foot angle and maximum peak pressure (MPP) of the 10 regions were measured using a Footscan gait system.

RESULTSThe maximum peak pressure of 10 regions decreased in the order of M3>M2>HM>M4>HL>M1>M5>T1>ML>T2-5 for the left foot, and in the order of M3>M2>HM>M4>HL>M1>M5>T1>ML>T2-5 for the right foot. The MPP in M1 region was higher in the right than in the left foot (P<0.05). The MPP in M3, M4, M5, and MF was higher in the left than in the right foot (P<0.05). The percentage of high-risk foot (defined by a total plantar pressure ≥70 N/cm) was 34% on the left and 17.7% on the right. An increased BMI was associated with a significant increase in high-risk foot, but not for the right foot in underweight patients. Foot flat phase was extended and forefoot push-off phase shortened in stance phase in the patients. Compared with the right foot, the left foot showed a significantly increased foot arch index and increased low and high arch rates with a decreased normal arch rate. Total plantar pressure was higher in of the left high arch foot than in normal arch foot. The foot angle was significantly larger on the right than on the left. The bilateral total plantar pressures were significantly greater in male patients (P<0.05) and increased with age but were not associated with the duration of DM, foot angle, or glycosylated hemoglobin level.

CONCLUSIONDiabetic patients have obvious alterations in foot biomechanics with abnormalities of the plantar pressure, and the percentage of high-risk foot increases in overweight and obese patients, suggesting the need of body weight control in these patients when administering offloading treatment for prevention of diabetic foot ulcer.

Biomechanical Phenomena ; Diabetes Mellitus, Type 2 ; physiopathology ; Diabetic Foot ; prevention & control ; Female ; Foot ; physiopathology ; Gait ; Heel ; physiopathology ; Humans ; Male ; Obesity ; physiopathology ; Overweight ; physiopathology ; Pressure

OBJECTIVETo explore prenatal related factors of high BMI status in children at 1 and 2 years of age.

METHODA total of 2 220 newborns from Shenyang, Wuhan and Guangzhou were recruited in this birth cohort, thereafter they were followed up to two years of age.Self-administered questionnaires were used to collect such variables as social-demographic characteristics and feeding practice, etc. The anthropometric measures of children were collected by trained health staff. The data were subjected to multiple logistic regression analysis to determine the related factors for high BMI among infants and toddlers.

RESULTThe number of children with high BMI status were 550 (32.80%) at one year of age and 309 (26.23%) at two, respectively. The number of boys with high BMI status were 178 and girls 309 at age two years. The prevalence of high BMI status among boys (29.1%) at age two was significantly higher than that of girls (23.1%) (χ² = 5.52, P = 0.02). Logistic regression analysis showed that after the adjustment for sex, parental educational level, family economic status and other confounding factors, maternal passive smoking during pregnancy [OR:aged one:1.38 (1.05-1.82);aged two:1.48 (1.05-2.09)], maternal pre-pregnancy overweight and obesity [aged one:1.29 (1.05-1.58); aged two:1.35 (1.04-1.76)], paternal overweight and obesity [aged one:1.50 (1.21-1.87); aged two:1.47 (1.11-1.95)] and birth weight [aged one:1.53 (1.05-1.82); aged two:1.87 (1.33-2.63)]were identified to be associated with high BMI status in children.

CONCLUSIONMaternal passive smoking during pregnancy, paternal and maternal (pre-pregnancy) overweight or obesity and high birth weight are found to be important related factors for high BMI status in young children. Childhood overweight/obesity prevention should be considered starting as early as before pregnancy.

Birth Weight ; Body Mass Index ; Child, Preschool ; China ; epidemiology ; Cohort Studies ; Female ; Humans ; Infant ; Infant, Newborn ; Male ; Multivariate Analysis ; Odds Ratio ; Overweight ; epidemiology ; etiology ; prevention & control ; Parents ; Pediatric Obesity ; epidemiology ; etiology ; prevention & control ; Pregnancy ; Prenatal Exposure Delayed Effects ; epidemiology ; Risk Factors ; Smoking ; adverse effects ; Surveys and Questionnaires

OBJECTIVETo analyze the relationship between birth weight and elevated blood pressure among schoolchildren aged 6-11 years in 8 provinces of China.

METHODA stratified random cluster sampling was used from sampling frame of eight provinces in the mainland of China. A total of 18 920 students aged 6-11 years eventually participated in this study. Height, weight, waist circumference (WC) and blood pressure of all the subjects were measured. Korotkoff I and V were recorded as systolic blood pressure (SBP) and diastolic blood pressure (DBP). Elevated blood pressure was considered for SBP and/or DBP equal to or above the reference sex-, age- and height-specific 95th percentile. Birth weight and family history of hypertension were collected by self-administered questionnaire. Analysis of variance was used to compare body measure indicators among 3 birth weight groups. Multivariate Logistic regression analysis was performed to identify the relationship between birth weight, current BMI and elevated blood pressure among children.

RESULTThe level of height, weight, WC, BMI, SBP and DBP were on the rise with the increase of the birth weight groups among boys (P < 0.05), except for WC among boys aged 6-8 years. The level of height, weight, WC, BMI and DBP showed a trend of escalation among girls (P < 0.05). But, SBP among 3 birth weight groups in girls was not significantly different (P = 0.099). After adjusting for age and family history of hypertension, compared with the normal birth weight group, the odds ratio and 95%CI of having elevated blood pressure among boys and girls in high birth weight group were 1.23 (1.06-1.43) and 0.89 (0.71-1.10), respectively; and the ORs(95%CI) were 1.06 (0.90-1.24) for boys and 0.73 (0.58-0.91) for girls after adjusting for age, family history of hypertension and current BMI of students. The relative risk of elevated blood pressure for boys and girls in low birth weight group were not significantly different as compared with normal birth weight group.

CONCLUSIONCurrent BMI but not birth weight was found to be a strong determinant of elevated blood pressure among children aged 6-11 years in China.

Birth Weight ; Blood Pressure ; physiology ; Blood Pressure Determination ; Body Mass Index ; Body Weight ; Child ; China ; epidemiology ; Female ; Humans ; Hypertension ; epidemiology ; physiopathology ; prevention & control ; Male ; Overweight ; epidemiology ; physiopathology ; Risk Factors ; Sampling Studies ; Surveys and Questionnaires ; Waist Circumference