While the risks are highest among overweight adults, 33 percent of those who aren’t overweight also have at least one cardiometabolic risk factor. Cardiometabolic risk is a cluster of factors that are good indicators of a patient’s overall likelihood of developing type 2 diabetes and cardiovascular disease. Adults at a healthy weight are less likely to be screened for these factors.
“The fact that high levels of risk were present even in non-overweight adults is highly concerning, given the societal and economic costs of these diseases,” said Penny Gordon-Larsen, Ph.D., associate professor of nutrition at Gillings School of Global Public Health and the study’s principal investigator. “Rates of risk increase dramatically with age, even in the non-overweight adults. Of even greater concern is the fact that we see these high levels of risk in individuals living across the entire country – in rural and urban areas.”
The new data come from the longest ongoing study in China, the China Health and Nutrition Survey, a joint project of UNC and the Chinese Center for Disease Control National Institute of Nutrition and Food Safety. This longitudinal study has followed more than 29,000 people in 300 communities throughout China from 1989 to 2011. Surveys were conducted in 1989, 1991, 1993, 1997, 2000, 2004, 2006, 2009 and 2011. The study is funded by the National Institutes of Health with additional funding from the Chinese Center for Disease Control.
China, home to more than 1.3 billion people, has seen unprecedented economic growth in the past two decades, accompanied by equally dramatic changes in diet, activity, inactivity and obesity. The 2009 study, which followed a randomly selected sample representing 56 percent of the Chinese population, found large increases in overweight and cardiometabolic risk factors, even in young adults.
“China has had a history of undernutrition followed by the most rapid increase in obesity and related diseases worldwide,” said Barry M. Popkin, Ph.D., W.R. Kenan Jr. Distinguished Professor of Nutrition and a co-author of the study. “Given the current picture, we can expect tremendous health burden in China in the coming years.”
Given the speed of modernization in China, these findings shed light on patterns of risk in the United States, where change has been more gradual. These findings also call attention to the cardiovascular risk in thin individuals.
Other UNC study co-authors include Shufa Du, Ph.D., research assistant professor of nutrition; Linda Adair, Ph.D., and Beth Mayer-Davis, professors of nutrition; and Amy Herring, Ph.D., professor of biostatistics.
Another study co-author is James M. Meigs, M.D., Massachusetts General Hospital and Harvard Medical School, Boston. The Chinese co-authors, both of Beijing, are Sheng-kai Yan, Beijing Homa Biological Engineering Co. Ltd. and department of laboratory medicine, China-Japan Friendship Hospital; and Bing Zhang, department of public health nutrition, National Institute of Nutrition and Food Safety.
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