Long-Term Dynamics of Overweight and Obesity in Chinese Adults and Association with Blood Pressure: Evidence from the China Health and Nutrition Survey
Abstract
Background: Overweight and obesity have turned into a substantial public health crisis worldwide. We aimed to estimate the prevalence and risk factors of overweight and obesity.
Method: Data collected from the China Health and Nutrition Survey (CHNS) from 1993 to 2015, including 75,559 adults. We used linear-by-linear trend tests, logistic models, and Cox regression models to test the relationship between the prevalence of overweight and obesity and blood pressure.
Results: From 1993 to 2015, the prevalence of overweight and obesity increased from 34.94% to 69.63%, and the prevalence of females was higher than that of males. Cox regression analysis showed that systolic pressure (SBP) <140 and diastolic pressure (DBP) <90 was associated with a lower prevalence in participants. Compared by both age and gender, SBP and DBP were risk factors for the prevalence of overweight and obesity.
Conclusion: Higher DBP and SBP were associated with a higher risk of overweight and obesity. When developing blood pressure control strategies, comprehensive consideration should be given to population demographics, with an emphasis on promoting individualized intervention approaches.
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2. Peeters A, Backholer K (2015). Reducing so-cioeconomic inequalities in obesity: the role of population prevention. Lancet Diabetes Endocrinol, 3(11):838-40.
3. World Health Organization (2024). Obesity and overweight.
4. Phelps NH, Singleton RK, Zhou B, et al (2024). Worldwide trends in underweight and obesity from 1990 to 2022: a pooled analysis of 3 663 population-representative studies with 222 million children, adolescents, and adults. Lancet, 403(10431):1027-1050.
5. Ng M, Gakidou E, Lo J, et al (2025). Global, regional, and national prevalence of adult overweight and obesity, 1990–2021, with forecasts to 2050: a forecasting study for the Global Burden of Disease Study 2021. Lancet, 405(10481):813-38.
6. Li M, Fan C, Wang C, et al (2025). Acceler-ometry-Based Physical Activity and Sed-entary Behavior Among Chinese Adults - 7 PLADs, China. China CDC Wkly, 7(1):15-20.
7. Pan XF, Wang L, Pan A (2021). Epidemiolo-gy and determinants of obesity in Chi-na. Lancet Diabetes Endocrinol, 9(6):373-92.
8. Wang Y, Zhao L, Gao L, et al (2021). Health policy and public health implications of obesity in China. Lancet Diabetes Endo-crinol, 9(7):446-61.
9. Wang H, Zhai F (2013). Programme and policy options for preventing obesity in China. Obes Rev, 14 Suppl 2(0 2):134-40.
10. National Health Commission of the Peo-ple’s Republic of China (2024). Imple-mentation plan for the “Year of Weight Management” action (2024-2026).
11. Nuttall FQ (2015). Body mass index: obesi-ty, BMI, and health: a critical review. Nutr Today, 50(3):117–28.
12. Pischon T (2010). Commentary: use of the body mass index to assess the risk of health outcomes: time to say goodbye? Int J Epidemiol, 39(2):528-29.
13. Ross R, Neeland IJ, Yamashita S, et al (2020). Waist circumference as a vital sign in clinical practice: a Consensus Statement from the IAS and ICCR Working Group on visceral obesity. Nat Rev Endocrinol, 16(3):177–89.
14. Hewage N, Wijesekara U, Perera R (2023). Determining the best method for evalu-ating obesity and the risk for non-communicable diseases in women of childbearing age by measuring BMI, waist circumference, waist-to-hip ratio, waist-to-height ratio, A Body Shape In-dex and hip index. Nutrition, 114:112135.
15. Zhao Y, Tang S, Mao W, Akinyemiju T (2022). Socio-economic and rural-urban differences in healthcare and cata-strophic health expenditure among can-cer patients in China: analysis of the China Health and Retirement Longitu-dinal Study. Front Public Health, 9:779285.
16. WHO Expert Consultation (2004). Appro-priate body-mass index for Asian popu-lations and its implications for policy and intervention strategies. Lancet, 363(9403):157-63.
17. Alberti KGMM, Zimmet P, Shaw J (2005). The metabolic syndrome-a new world-wide definition. Lancet, 366(9491):1059-62.
18. Wang R, Feng Z, Liu Y, Qiu Y (2020). Is life-style a bridge between urbanization and overweight in China? Cities, 99:102616.
19. He J, Xie Y (2022). The sociocultural mech-anism of obesity: the influence of gen-der role attitudes on obesity and the gender gap. Soc Sci Med, 293:114655.
20. Ramis JM, Salinas R, Garcia Sanz JM, et al (2006). Depot- and gender-related dif-ferences in the lipolytic pathway of adi-pose tissue from severely obese patients. Cell Physiol Biochem, 17(3-4):173-80.
21. Yang Y, Kelifa MO, Yu B, et al (2020). Gen-der-specific temporal trends in over-weight prevalence among Chinese adults: a hierarchical age-period-cohort analysis from 2008 to 2015. Glob Health Res Policy, 5:42.
22. Huang CC, Yabiku ST, Ayers SL, Kronen-feld JJ (2016). The obesity pay gap: gen-der, body size, and wage inequalities—a longitudinal study of Chinese adults, 1991-2011. Journal of Population Research, 33:221-42.
23. Deng X, Wang P, Yuan H (2020). Epidemi-ology, risk factors across the spectrum of age-related metabolic diseases. J Trace Elem Med Biol, 61:126497.
24. Shur NF, Creedon L, Skirrow S, et al (2021). Age related changes in muscle architec-ture and metabolism in humans: the likely contribution of physical inactivity to age related functional decline. Ageing Res Rev, 68:101344.
25. Jiang Y, Zhang X, Xu T, et al (2022). Secular difference in body mass index from 2014 to 2020 in Chinese older adults: a time series cross sectional study. Front Nutr, 9:923539.
| Files | ||
| Issue | Vol 54 No 11 (2025) | |
| Section | Original Article(s) | |
| Keywords | ||
| Overweight Obesity Systolic pressure Diastolic pressure Chinese adults | ||
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How to Cite
1.
Chen Y, Yang X. Long-Term Dynamics of Overweight and Obesity in Chinese Adults and Association with Blood Pressure: Evidence from the China Health and Nutrition Survey. Iran J Public Health. 2025;54(11):2454-2462.
