Live Right, Stay Light

“I began to skip dinner... Sometimes I got so hungry at night that I cried in bed. Believe me, a man can be starved into tears…Whenever I felt I could no longer hold on, I would stand naked in front of a mirror, and gaze at my body...If invited to dinner, I just watched my friends gobble and guzzle without taking a bite myself. Of course it was difficult. To resist the temptation, I would take out my wallet and look at a photo of me at my optimum weight.” This is part of a young man’s account of his struggle to slim down, given on a Tianjin TV program that brought tears to the eyes and smiles to the lips of the audience, as his experience resonated with many of them. Today weight control is a trending and concerning topic on TV and the Internet, as it has become a concern for a growing number of Chinese.

According to a 2020 report on nutrition and chronic diseases among Chinese people, more than half at or above 18 were overweight (34.3 percent) or obese (16.4 percent). The share is 19 percent for the group aged six to 17 and 10.4 percent for children below six. This report was based on studies organized by the National Health Commission between 2015 and 2019 that covered 600 million mainland residents. It noticed that the weight problem was found in all age groups in both urban and rural areas, and associated with rising incidence of many chronic diseases, such as hypertension, diabetes and hypercholesterolemia.

The report also reveals a trend of steady weight gain among Chinese people. A similar report released in 2014 showed that 32.7 percent of adults and 41.6 percent of elderly people in China were overweight, up 0.6 percent and 1.8 percent respectively over 2010; and 10.5 percent and 13.9 percent of the two demographic groups were obese, edging up 0.6 percent and 0.9 percent respectively from 2010.

The need to lose weight was unthinkable for most Chinese just a few decades ago. When the People’s Republic of China was founded in 1949, grain output was 113.2 billion kilograms for the year, which means a paltry 209 kilograms for each person. With this amount, people were not sufficiently, let alone properly, fed. Fast-forward to 2022, when China’s grain output reached 686.85 billion kilograms, the eighth year in a row exceeding the 650 billion kilograms mark.

In addition to grains, China has also secured sufficient supply of cooking oil, vegetables, fruits, and meat. This has led to significant changes to its people’s dietary habits. A 2022 McKinsey report said that China consumed nearly 100 million metric tons of meat in 2021, twice the amount of the U.S. (but half of the U.S. level per capita). Just 50 years before, Chinese people ate only 3.3 kilograms of meat each in a year, or 0.5 kilogram every month. This amount was a mere one-seventh of the world average.

As people are eating more and better, they are moving less. Back in 1949, nearly 90 percent of Chinese population were rural residents, who tilled fields or raised animals to earn a living. By 2018 this share had shrunk to 40.42 percent. Meanwhile, agricultural production has become far less labor intensive. For instance, the comprehensive mechanization rates for growing wheat, corn, and rice now stand at 97, 90, and 85 percent respectively. In urban areas, technological advances have led to higher automation in factories, and higher incomes means more people can afford a car (or a motorcycle), and fewer are cycling for daily commutes. The prevalence of electronic devices for communication and entertainment, such as mobile phones, are also making people more sedentary.

These factors, among others, contribute to growing waistlines and the consequent surge in weight-related health problems. According to the 10th edition of IDF Diabetes Atlas, released in 2021, the number of Chinese people with diabetes rose from 90 million to 140 million over the past decade, to become the largest in the world; and China’s spending on this disease is the second highest worldwide.

“In a span of 40 years, the incidence of diabetes surged 10-fold in China. It is still going up, along with that of cardiovascular diseases, as obesity is creeping up in young people. This poses a health risk that deserves priority attention from the entire society,” said Shen Yueliang, a professor of the School of Medicine, Zhejiang University.

This health risk has aroused growing concern for individual citizens and the government as well. At the press conference for the release of the latest report on nutrition and chronic diseases among Chinese people issued in 2020, Zhao Wenhua, chief nutrition scientist of the Chinese Center for Disease Control and Prevention, acknowledged that widely found overweight and obesity are a side effect of social evolution, and also closely associated with lifestyle and individual behavior. Zhao hence underscored that preventing them requires the joint efforts of the government, society, families and individuals.

On the part of the government, solid action has been taken on multiple fronts. Efforts have been intensified during recent years to build more pedestrian and biking lanes, sports facilities, and parks. As of the end of 2021, there were 3.97 million sport venues across China, with the total area exceeding 3.4 billion square meters and the size for each citizen reaching 2.41 square meters. This represents an increase of 134.3, 71.2 and 65.1 percent respectively from 2013. Public educational campaigns have also been rolled out to promote healthier lifestyles, such as lowering intakes of salt, sugar, and cooking oil.

In 2021 the National Health Commission and the General Administration of Sport of China jointly released a guideline on physical activity for Chinese people, offering specific advice for six age groups and people with chronic diseases. Many more national plans have been introduced to encourage better nutrition and healthy ways of living.

The National Nutrition Plan (2017-2030) for instance mentions conducting nationwide nutrition monitoring, transforming the traditional cooking method, and establishing healthy dining restaurants and canteens as demonstration sites. The Healthy China 2030 Outline says that a public sports facility network will be built covering counties, townships and villages; in cities residents will have access to exercise space in a 15-minute radius to their homes; and public sports facilities will open to the public free of charge or at affordable rates.

In addition, special attention is paid to obese children. In 2020, six central authorities jointly released a plan for preventing and controlling childhood obesity. It calls for parents, schools, medical health institutions, and the government to shoulder their respective responsibilities in tackling this problem. It also sets the goal of bringing down the annual increase in overweight and obesity rates among 0-18 years old youth by 70 percent from the 2002-2017 level during the 2020-2030 period.

In 2021 the Ministry of Education issued a circular on enhancing management of the physical health of primary and secondary school students. It urges schools with proper facilities to open one PE class every day, and allow their students to have at least one-hour outdoor activities on and off campus respectively. Restrictions are imposed on sales of snacks and drinks high in sugar, as well as their supply in student canteens at primary and middle schools.

Recent policies and measures on ensuring sufficient sleep for children and teenagers also have the benefit of reducing obesity among this group. A 2021 circular of the Ministry of Education advises 10-hour sleep per day for primary school students, nine hours for junior middle school students and eight hours for those at senior middle schools. To meet this goal, it proposes control on the amount of homework and tighter regulation of online courses and computer games, among other measures.

Last summer the education commission and other authorities of Daxing District in southern Beijing launched a targeted weight control program. It recruited 300-plus primary school students who were overweight or obese. During a course of three months, dietitians and other experts provided real-time monitoring, one-on-one analysis, customized intervention, and relevant advice. The result was immediate and obvious: more than 60 percent of participants shed some pounds at the end of the program. Long-term benefits are also anticipated for them and their families.

To make a change, people like the mother of Zheng Hao, an overweight nine-year-old participant of the Daxing program, said that she is cooking more meals herself instead of ordering takeout. She is also using an oil dispenser and non-stick frying pan to reduce oil consumption. Other parents observed that their kids are cutting back on sweetened snacks and having more sports activities. It is the shared understanding among average citizens and policy-makers that the overweight problem can only be approached bite by bite, and step by step.