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J Rural Health. 2014 Winter;30(1):101-12. doi: 10.1111/jrh.12041. Epub 2013 Jul 29.

Overweight and obesity difference of Chinese population between different urbanization levels.

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School of Public Health, Fudan University, Shanghai, China; Chinese Center for Health Education, Beijing, China.



To determine the difference of Body Mass Index (BMI), the prevalence of overweight and obesity, and their predictors among residents of different urbanization levels in China.


A stratified, multistage, random cluster sampling method was used to select a representative sample aged 18-60 years in metropolitan, prefecture, and rural areas in 4 provinces and Beijing City in China. A total of 6,159 residents were interviewed. Multiple logistic regression was used to evaluate the association between urbanization levels and the prevalence of overweight/obesity adjusted for sociodemographic characteristics and lifestyle factors.


The prevalence of overweight and obesity was 21.0% and 2.5%, respectively. Compared to metropolitan residents (BMI = 22.76 ± 3.20 kg/m(2)), rural and prefecture residents had a higher BMI, 23.17 ± 3.49 kg/m(2) (P < .001) and 23.06 ± 3.31 kg/m(2) (P = .004), respectively. Multiple logistic regression showed that, compared to the rural residents, those in prefecture and metropolitan areas were less likely to be overweight and obese (OR = 0.80 [95% CI: 0.68-0.94] and OR = 0.68 [95% CI: 0.57-0.80], respectively). The prevalence of overweight/obesity was higher in males (OR = 1.68 [95% CI: 1.43-1.97]) and patients with noncommunicable chronic diseases (NCD; OR = 2.50 [95% CI: 2.16-2.89]). Less frequency of physical activity was associated with a higher prevalence of overweight/obesity (OR: 0.85, [95% CI: 0.74, 0.97]).


The rural population had an increased prevalence of overweight/obesity compared to both the prefecture and metropolitan populations. Male gender, older age, and NCD were positively associated with the prevalence of overweight/obesity. Policies are urgently needed to combat the overweight and obesity challenge in rural China.


epidemiology; health disparities; health promotion; obesity; overweight

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