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PLoS One. 2019 Dec 11;14(12):e0226279. doi: 10.1371/journal.pone.0226279. eCollection 2019.

Air quality and obesity at older ages in China: The role of duration, severity and pollutants.

Author information

Social Statistics, Cathie Marsh Institute for Social Research (CMI), School of Social Sciences, The University of Manchester, Manchester, United Kingdom.
Manchester Institute for Collaborative Research on Ageing (MICRA), School of Social Sciences, The University of Manchester, Manchester, United Kingdom.
Key Laboratory of Watershed Geographic Sciences, Nanjing Institute of Geography and Limnology, Chinese Academy of Sciences, Nanjing, China.
Manchester Urban Institute, Urban Planning, School of Environment, Education and Development, The University of Manchester, United Kingdom.
Faculty of Education, University of Cambridge, Cambridge, United Kingdom.
Sociology, School of Social Sciences, The University of Manchester, Manchester, United Kingdom.



Population ageing and air pollution have emerged as two of the most pressing challenges in China. However, little evidence has explored the impact of air pollution on obesity among older adults in China.


The China Health and Retirement Longitudinal Study-a nationally representative sample of middle-aged and older Chinese was linked to the air pollution data at the city level. Multilevel logistic models were fitted on obesity status among older people in relation to different air quality measures such as chronic exposures to severities of air pollution and pollutants.


Air pollution was positively associated with increased risks of general obesity and abdominal obesity among older adults (N = 4,364) especially for those with disability. The marginal effects of average air quality index (AQI) on obesity suggest that one standard deviation increase in AQI is associated with increased risks of central obesity by 2.8% (95%CI 1.7% 3.9%) and abdominal obesity by 6.2% (95%CI 4.4% 8.0%). The risk of chronic exposures to light (and moderate), heavy and severe pollution on obesity elevated in a graded fashion in line with the level of pollution. Durations of exposure to PM2.5 and PM10 were significantly associated with increased risk of obesity among older people in China.


Chronic exposures to severe air pollution and certain pollutants such as PM2.5 and PM10 raise the risk of obesity among older people in China and the relationships were stronger for those with disability. Future policies that target these factors might provide a promising way of enhancing the physical health of older people.

Conflict of interest statement

The authors have declared that no competing interests exist.

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