The Nutrition Transition and Obesity in China


Fuzhi Cheng


Fuzhi Cheng (2007). Case Study #3-9, "The Nutrition Transition and Obesity in China". In: Per Pinstrup-Andersen and Fuzhi Cheng (editors), "Food Policy for Developing Countries: Case Studies." 11 pp.


Before China’s economic reforms of the late 1970s, the typical Chinese diet consisted primarily of grain products and starchy roots, with few animal source foods, caloric sweeteners, or fruits and vegetables. Since the 1980s, Chinese people have experienced drastic changes in their food consumption behavior and nutritional status as a result of rapid economic development, expansion of agricultural production, globalization, urbanization, and technological improvement. These social and economic changes have helped shift the Chinese dietary structure toward increased consumption of energy-dense foods that are high in fat, particularly saturated fat, and low in carbohydrates. Dietary changes have been accompanied by a decline in energy expenditure associated with sedentary lifestyles, motorized transportation, labor-saving devices at home and at work, and physically undemanding leisure activities.

Along with the nutritional transition in China has come a rising epidemic of overweight and obesity among adults and adolescents, as well as widespread diet-related, noncommunicable diseases (DR-NCDs) including cardiovascular diseases, diabetes, and certain forms of cancer. The DR-NCDs are currently the leading causes of death, and mortality rates are projected to increase in the future. Obesity and related chronic diseases create large adverse impacts on individuals, families, communities, and the country as a whole and are China’s primary public health concerns.

Recognizing that obesity and associated diseases are both individual and social problems, China has pursued a set of integrated, multisectoral, and population-based policies. The National Plan of Action for Nutrition in China serves as an overarching framework for setting food-based policies related to the country’s nutrition and health issues. Specific polices range from promoting healthy diets and lifestyles to providing incentives to healthy food growers. In addition to food-based policies, China is implementing intensive disease prevention and control programs to address clinical aspects of obesity-related diseases.

Despite these efforts, the country still faces complex food and nutrition issues that are at the core of its economic and social development. Broadbased nutrition programs are still missing owing to the lack of funding for nutritional activities and a lack of institutions to coordinate and manage nutrition interventions. Food policies, including those designed to affect the relative prices of unhealthy foods, remain questionable because it is often difficult to identify certain foods as “unhealthy”. The coexistence of underweight, micronutrientdeficient, and overweight populations further complicates the situation. Given that large pockets of poverty exist, special care must be taken to avoid increasing the likelihood of underweight and micronutrient deficiency among the population as a result of policy changes to cope with overweight and obesity. It is increasingly important that policies focusing on healthy diets and physical activities will lead to optimal health outcomes.

Your assignment is to design what you would consider the most appropriate policy measures to address the problems identified in this case. Justify the policy measures you select, and assess the likely consequences of these policy measures for public health, nutrition, and economic development in China.

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