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Analyses of changes in the nutritional status of the Chinese people are usually based on the studies on growth rate of children (Ge, He & Chang, 1991; Child Nutrition Surveillance Working Team, 1991). There are a few publications observing adults' height and body weight (Li, 1986) but, to our knowledge, nothing has been published on the BMI of Chinese adults.
The distribution of BMI of Chinese adults surveyed in 1982 and 1989 showed that 78-84% of the sampled subjects were within the normal BMI range, i.e. between 18.5-25 kg/m2. There were only 7-13% underweight and 6-12% overweight adults, of whom the majority were mild cases. The percentage of chronic energy deficiency cases was therefore low in comparison with figures observed in other developing countries, e.g. 51-70% in India, and 50-58% in Ethiopia (Ferro-Luzzi et al., 1992). The better results in China may well be related to the relatively even distribution of food in the country over several decades. Although the per capita food availability was not high, the government has put into practice a set of policies to secure the basic food needs of the people. The best-known policies are the food quota policy and food price subsidy policy (Editorial Committee of Today's China, 1989) for the urban inhabitants, and the poverty relief policy for the rural population (Office of Steering Group for Economic Development in Poor Areas in China, 1989).
Table 8. Dietary intake of energy, protein and fat in China between 1978-1989 (per capita per day)
|
Energy (Kcal) |
Protein (g) |
Fat (g) | ||||
|
Year |
Urban |
Rural |
Urban |
Rural |
Urban |
Rural |
|
1981 |
2088 |
2418 |
60 |
62 |
61 |
35 |
|
1982 |
2117 |
2461 |
61 |
63 |
64 |
37 |
|
1983 |
2192 |
2496 |
63 |
64 |
70 |
39 |
|
1984 |
2186 |
2587 |
62 |
66 |
70 |
41 |
|
1985 |
2072 |
2526 |
61 |
64 |
65 |
42 |
|
1986 |
2176 |
2567 |
64 |
65 |
71 |
43 |
|
1987 |
2146 |
2589 |
62 |
65 |
72 |
45 |
|
1988 |
2166 |
2581 |
63 |
65 |
71 |
43 |
|
1989 |
- |
2603 |
- |
67 |
- |
44 |
Source: Pinstrup-Anderson et al. (1991).
The proportions of men and women with BMI <18.5 were lower in 1989 than in 1982. This change is well in line with the increase of average food consumption during this period (Pinstrup-Anderson et al., 1991). The per capita energy consumption of rural people was 2461 kcal/day in 1982 and 2603 kcal/day in 1989, and that of protein was 63g and 67g respectively, and of fat 36 g and 44 g (Table 8). There was an increase in the prevalence of overweight between 1982 and 1 989 in both urban and rural areas, hut the change was particularly clear in urban adults (i.e. 7.2-12.0%). The energy intake of the urban population has increased slightly, hut there has also been a marked shift in the structure of the diet with a marked increase in the proportion of the population consuming more than 30% of energy from fat (Popkin et al., 1993). Not only has the diet changed but it is presumed that the rapid industrialization in urban areas has led to a reduced need for energy expenditure at work. This combination probably explains the increased obesity of urban adults.
Acknowledgements - The CNS-82 data analysis was part funded by the Food Policy and Nutrition Division, FAO, and the results presented in this paper were prepared with financial and technical support from FAO. Funding for parts Of the CHNS-89 research was provided by the Chinese Academy Of Preventive Medicine (CAPM), the Carolina Population Center (CPC) Of the University of North Carolina at Chapel Hill (UNC-CH), and the National Institute of Health (NIH) (P01HD28076-01). Collaborative training and development work has been funded by the National Science Foundation (grant no. 37486) and the Ford Foundation.
Child Nutrition Surveillance Working Team (1991): The nutrition status of the preschool children in some poor areas in China Proc. Int. Symp. Food Nutr Social Economic Development. Beijing: Chinese Sci. Tech. Publishing House.
Editorial Committee of Serial Books of Today's China (1989): Price of Today's China. Beijing: China Social Sci. Publishing House.
Ferro-Luzzi A, Sette S. Franklin M & James WPT (1992): As simplified approach of adult chronic energy deficiency. Eur J. Clin. Nutr 46, 173-186.
Ge K, Chen C & Shen T (1991): Food consumption and nutritional status in China. Food Nutr Agric. 1 (2/3), 54-61.
Ge K, He W. Chang Y et al. (199]): Further analysis Of the anthropometry data of preschool children surveyed in nine provinces in 1987. Proc. Int. Symp. Food Nutr. Social Economic Development Beijing: Chinese Sci. Tech. Publishing House.
James WPT, Ferro-Luzzi A & Waterlow JC (1988): Definition of chronic energy deficiency in adults. Report of a Working Party of the International Dietary Energy Consultative Group. Eur J. Clin. Nutr 42, 969-981.
Li S (1986): An investigation on the normal value of the body weight for adults with different heights in North China. Acta Nutr. Sinica 8, 98-109.
Office of the Steering Group for Economic Development in Poor Areas, the State Council (1989): Outlines of economic development for poor areas in China. Beijing: Agricultural Publishing House.
Pinstrup-Anderson P. Yang D, Xian Z & Yang Y (1991): Changes in incomes, expenditures, and food consumption among rural and urban households in China during the period 1978-1988. Proc. Int. Symp. Food Nutr. Social Economic Development. Beijing: Chinese Sci. Tech. Publishing House.
Popkin BM, Keyou G. Fengying Z. Guo X, Haijiang M & Zohoori N (1993): The nutrition transition in China: a cross-sectional analysis. Eur. J. Clin. Nutr. 47, 333-346. state Statistics Bureau (1991): 1991 Statistical Yearbook of China. Beijing: Chinese Statistics Publishing House.
Strickland: On a province basis, there was no relationship between BMI and income, but have you looked at the level of individual income?
Ge: Individual income is almost impossible to measure in rural areas. It is really based on the household unit.
Baskaram: In your group that had a low BMI and were eating animal food, do you know if they were eating animal food regularly or like vegetarians in India who may eat meat about once in 14 days?
Ge: Those people who eat more meat with a low BMI are mostly young people in urban areas who eat meat and vegetables and cut down on cereal intake to keep fashionably slim.