Obesity in Chinese children

I do not wish to add fuel to the fire by entering into a discussion on food
advertising versus physical inactivity as the culprit for childhood obesity
that was prompted by Dr Ashton’s editorial (February 2004
JRSM¹). I
always tell my overweight or obese patients that body fat does not grow on the
tree; it has to come from an external source, either overeating or
underexertion. The best example comes from China.

China used to be known for her slender people; I never saw a fat person in
China until very
recently.² Now China
is fighting obesity, especially childhood obesity, just like the rest of the
world. According to the latest statistics from China, the proportion of
obesity among children under the age of 15 increased from 15% in 1982 to 27%
today.³ Among the
predisposing factors for increasing prevalence of childhood obesity in China,
fast food and physical inactivity are the two most important. Because of the
efficient advertisements of such fast food giants in the United States as
McDonald’s and Kentucky Fried Chicken, Chinese children are devouring the
American fast food faster than
ever.^2,4
All of the children in China recognize the image of Ronald McDonald, even
though they might not be able to read
English.⁴

That physical inactivity is the other important risk factor for obesity in
Chinese children is illustrated by three observations. First, the effect of
television on childhood obesity in China has been documented: each hourly
increment of television viewing is associated with a 1-2% increase in the
prevalence of obesity in urban
China.⁵ Second,
childhood obesity is more prevalent in urban areas than in rural areas, not
only because children in rural China are physically more
active⁶ but also
because urban boys consume more fat than rural boys—23-30% versus
16-20%.⁷ Third,
urban children in China are engaged in more homework because they are under
pressure to achieve scholastically, whereas rural Chinese children are engaged
more in field work because of economic
necessity.⁸