Different worlds, different tasks for health promotion: comparisons of health risk profiles in Chinese and Finnish rural people

Multilevel evaluation of 'China Healthy Lifestyles for All', a nationwide initiative to promote lower intakes of salt and edible oil

OBJECTIVE

To evaluate the impact of 'China Healthy Lifestyle for All' on levels of knowledge, taste and intentions to modify future consumption of salt and edible oil.

METHODS

Between May and August 2012, a face-to-face survey carried out in all 31 provinces, autonomous regions, and municipalities in mainland China, achieved a 98.1% response. Intention-To-Treat analysis via multilevel logistic regression was used to examine differences in outcomes between 31,396 non-institutionalised individuals aged > 18 years from 31 'intervention' (i.e. participating) and 26 'control' (i.e. non-participating) counties respectively.

RESULTS

Adjusting for socioeconomic confounders, participants in 'intervention' counties were more likely to know the limit of salt (Odds Ratio 3.14, 95% Confidence Interval (95% CI) 1.98, 4.96) and oil consumption (3.67, 95% CI 2.31, 5.82), and were more intent to modify their consumption (salt 1.98, 95% CI 1.41, 2.76; oil OR 1.99, 95% CI 1.41, 2.81) and to report a change in taste (salt 1.90, 95% CI 1.31, 2.75; oil 2.07, 95% CI 1.38, 3.10). 'Intervention' effects were consistent regardless of income or education, but women and older participants benefited disproportionately. Outcomes were 2.8 and 4.7 times more likely among those with better recall.

CONCLUSION

Place-based health promotion interventions have an important role to play in addressing non-communicable disease in China.

Impact of body mass index on incident hypertension and diabetes in Chinese Asians, American Whites, and American Blacks: the People's Republic of China Study and the Atherosclerosis Risk in Communities Study

Researchers have hypothesized that the impact of body mass index on chronic disease may be greater in Asians than in Whites; however, most studies are cross-sectional and have no White comparison group. The authors compared the associations with body mass index in Chinese Asians (n = 5,980), American Whites (n = 10,776), and American Blacks (n = 3,582) using prospective data from the People's Republic of China Study (1983-1994) and the Atherosclerosis Risk in Communities Study (1987-1998). Slopes of risk differences over body mass index levels were compared among the three ethnic groups in adjusted analyses. The authors found larger associations with body mass index in Chinese Asians compared with American Whites and Blacks for hypertension (p < 0.05). The increase in the incidence of hypertension associated with a one-unit increase in body mass index over approximately 8 years of follow-up was 2.5, 1.7, and 1.8 percentage points for Chinese Asians, American Whites, and American Blacks, respectively. For diabetes, the estimates were 1.7, 1.1, and 1.6 percentage points for the same groups- higher in Chinese Asians than in American Whites (p < 0.05) but similar between Chinese Asians and American Blacks. Given the ethnic differences in associations, the results support advocacy of public health and medical actions toward obesity prevention and treatment in China.

Prevalence and associated factors of overweight and obesity in a Chinese rural population

BACKGROUND

Overweight and obesity are now considered as a serious health problem, and a very important risk factor for many diseases.

OBJECTIVE

This study was designed to investigate the epidemiologic features of overweight and obesity among rural adults in China.

METHOD AND PROCEDURES

A cross-sectional survey was conducted during 2004-2005, using a multistage cluster sampling method to select a representative sample in Fuxin county, Liaoning province, China. A total of 29,970 adults, aged > or =35 years, were examined. At baseline, lifestyle and other factors were obtained. Overweight and obesity were defined according to the classification by the World Health Organization.

RESULTS

Overall, the prevalence of overweight was 18.6%; 15.1% in men and 22.1% in women. The prevalence of obesity was 1.7%; 1.2% in men and 2.2% in women. Multivariable logistic regression revealed certain risk factors of obesity that included being a women, Mongolian nationality and education status of over junior high school level. Moderate physical activity alone was shown as protective factor.

DISCUSSION

Although the prevalence of obesity was low, overweight was relatively high in the Chinese rural population, especially in adult women. Gender, diet, physical activity, education levels, and ethnicity were associated with the prevalence of these health conditions.