Adults in southern China at high risk of metabolic syndrome

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A study indicates that close to eight percent of adults in Guangdong, China, have the metabolic syndrome. The metabolic syndrome is the constellation of cardiovascular risk factors including abdominal obesity, raised blood-sugar and high cholesterol. The metabolic syndrome is known to increase the risk of diabetes, heart disease and subsequent death.

The results of the study translate to a total of about four million adults age 20 years and older with the metabolic syndrome in this Chinese province of 85 million residents. More than 60 percent were found to have at least one individual component of the metabolic syndrome. Urban residence were more likely to have the syndrome than the rural population (close to 11 percent compared to four percent).

As China continues to be the fastest economic development in the world, it is expected to further increase its rate of modernization and urbanization–translating to more people consuming energy-dense diets and living increasingly sedentary lifestyles. The prevalence of the metabolic syndrome and related cardiovascular disease is therefore expected to increase enormously, according to the study.

“Urgent public health actions are needed to control this observed worsening situation in China,” the study concludes.

1. Lao XQ, Zhang YH, Wong MCS, et al. The prevalence of metabolic syndrome and cardiovascular risk factors in adults in southern China. BMC Public Health 2012; 12: 64. (open access)

Reversing China’s HIV/AIDS epidemic by 2015

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In the past decade, tremendous efforts have been made and impressive achievements have been obtained in accelerating universal access for HIV prevention, treatment and care and support worldwide and in China. China is one of only a few low- and middle-income countries in which domestic funds account for the major proportion of their HIV/AIDS program funding.

The International Journal of Epidemiology December 2010 supplement issue entitled “China’s AIDS Policy Implementation,” has assembled and editorial and 11 papers describing the various aspects of China’s response to the HIV/AIDS epidemic. All articles in the issue are open access.

Editorial: China AIDS policy implementation: reversing the HIV/AIDS epidemic by 2015

1. Evolution of information-driven HIV/AIDS policies in China
China’s current national policies are increasingly information driven and responsive to changes in the epidemic. However, gaps remain in policy implementation, and new policies are needed to meet emerging challenges.

2. Contributions of international cooperation projects to the HIV/AIDS response in China
International cooperation projects have been an invaluable component of China’s response to HIV/AIDS, and China has now been able to take this information and share its experiences with other countries with the help of these same international programs.

3. Estimating the number of people living with HIV/AIDS in China: 2003–09
Repeated estimates have improved understanding of the HIV/AIDS epidemic in China. HIV estimates are a valuable tool for guiding national AIDS policies evaluating HIV prevention and control programs.

4. Scaling up the national methadone maintenance treatment program in China: achievements and challenges
This article documents the steps China made in overcoming the many barriers to success of its methadone program. These lessons might be useful for other countries in the region that are scaling-up their methadone programs.

5. Scaling up prevention programmes to reduce the sexual transmission of HIV in China
Prevention programs for reducing sexual transmission of HIV have reasonable coverage, but can still improve. The quality of intervention needs to be improved in order to have a meaningful impact on changing behaviour to reducing HIV sexual transmission. Systematic evaluation of the policies, guidelines and intervention programmes needs to be conducted to understand their impact and to maintain adherence.

6. Design and implementation of a China comprehensive AIDS response programme (China CARES), 2003–08
China CARES has facilitated AIDS prevention, treatment and care in resource-poor, rural and ethnic minority areas of China.

7. Changing baseline characteristics among patients in the China National Free Antiretroviral Treatment Program, 2002–09
Limited treatment resources can be focused on areas with more patients. Greater emphasis needs to be placed on earlier HIV diagnosis and treatment. New strategies must be identified to bring HIV-infected injection drug users into treatment. Routine HIV testing would identify those at risk earlier.

8. From spectators to implementers: civil society organizations involved in AIDS programmes in China
Civil society organizations (CSOs) have significantly increased their participation and contribution to HIV/AIDS programs in China. Policies for registration and financial support to CSOs need to be developed to enable them to play an even greater role in HIV/AIDS programs.

9. Quality assurance in the HIV/AIDS laboratory network of China
China has made significant progress in establishing a well-coordinated HIV laboratory network and quality assurance systems. However, the coverage and intensity of HIV testing and quality assurance programs need to be strengthened so as to ensure that more infected persons are diagnosed and that they receive timely prevention and treatment services.

10. Development of a unified web-based national HIV/AIDS information system in China
China’s new unified, web-based HIV/AIDS information system has improved the efficiency of data collection, reporting, analysis and use, as well as data quality and security. It is a powerful tool to support policy making, program evaluation and implementation of the national HIV/AIDS program and, thus, may serve a model for other countries.

11. Quantitatively monitoring AIDS policy implementation in China
Setting targets for core indicators and monitoring performance has facilitated implementation of the national AIDS program in China.

Obesity and metabolic syndrome among Chinese children

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More than 11% of children are overweight in Guanzhou, China

China has experienced an increase in the prevalence of childhood overweight and obesity over the last decades. The overall prevalence of overweight and obesity among children in China were approximately five percent and two percent, respectively, in the 1980s. In 2002, 155 million children worldwide were overweight or obese, of which 12 million lived in China.

A new study conducted among school children (age 7-14 years) in Guanzhou City found that more than 11 percent were overweight and seven percent were obese. The prevalence of metabolic syndrome among the children was 6.6 percent overall, 33.1 percent in obese, 20.5 percent in overweight and 2.3 percent in normal weight children. Metabolic syndrome refers to a clustering of specific cardiovascular disease risk factors, such as insulin resistance, abdominal obesity, impaired glucose, elevated blood pressure, elevated triglycerides and reduced high-density lipoprotein (HDL) cholesterol.

“To address the problem of increasing prevalence of obesity and potentially deadly consequences of metabolic syndrome in Chinese children, more research will be needed focusing on the reasons for the increase of overweight/obesity in children and interventions so as to reduce the epidemics of overweight/obesity and metabolic syndrome in the population,” the study concluded.

1. Liu WJ, Lin R, Liu AL, et al. Prevalence and association between obesity and metabolic syndrome among Chinese elementary school children: a school-based survey. BMC Public Health 2010; 10: 780. (open access)

Alcohol-related cancer cases and deaths in China

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Despite more than 60 percent of Chinese men and 90 percent of Chinese women reporting no alcohol drinking, a study shows that alcohol consumption accounted for 4.40 percent of cancer deaths and 3.63 percent of cancer cases in China in 2005.

Liver cancer was the main alcohol-related cancer, contributing more than 60 percent of alcohol-related cancers.

“Particular attention needs to be paid to the harm of alcohol as well as its potential benefits when making public health recommendations on alcohol drinking,” according to the study.

1. Liang H, Wang J, Xiao H, et al. Estimation of cancer incidence and mortality attributable to alcohol drinking in china. BMC Public Health 2010; 10: 730. (open access)

Quitting smoking in China—the need for improved tobacco control

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China is facing a public health crisis with over 350 million smokers, representing nearly one-third of all smokers in the world. The World Health Organization estimates that one million smokers in China die from tobacco-related illnesses each year, and this number is expected to rise to 2.2 million deaths by 2020.

Despite these grim facts, more than three-fourths of Chinese smokers have no plans to quit smoking. Furthermore, less than one-third of smokers are aware of the harmful effects smoking has on their health, according to new research based on the International Tobacco Control (ICT) China Survey.

There is a need for smoking cessation support, anti-tobacco laws, higher cigarette taxes and awareness of the health risks of smoking.

Read more at Suite101.

1.Feng G, Jiang Y, Li Q, et al. Individual-level factors associated with intentions to quit smoking among adult smokers in six cities of China: findings from the ITC China Survey. Tobacco Control 2010; 19: i6-i11. (0pen access)
2.Jiang Y, Elton-Marshall T, Fong GT, Li Q. Quitting smoking in China: findings from the ITC China Survey. Tobacco Control 2010; 19: i12-i17. (open access)
3.Yang J, Hammond D, Driezen P, et al. Health knowledge and perception of risks among Chinese smokers and non-smokers: findings from the Wave 1 ITC China Survey. Tobacco Control 2010; 19: i18-i23. (open access)

Weak anti-smoking laws expose Chinese workers to secondhand smoke

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A high number of Chinese workers are exposed to secondhand smoke at work every day, and current smoking bans do not provide adequate protection, according to a study conducted in Shanghai published on 21 October 2010 in the journal Tobacco Control.

The highest level of exposure to secondhand smoke was among restaurant employees—an expected finding considering that restaurants tend to have the weakest smoking bans, if any at all. People who worked at kindergartens were exposed to the least amount of secondhand smoke, mainly because kindergartens employ mostly women, who are less likely to smoke.

There is an urgent need for implementation of comprehensive smoke-free legislation covering all workplaces, including restaurants and hotels, in order to improve occupational health, the study concluded.

Read more at Suite101.

1. Zheng P, Li W, Chapman S, et al. Workplace exposure to secondhand smoke and its association with respiratory symptoms—a cross-sectional study among workers in Shanghai. Tobacco Control, published online 21 Oct 2010. (open access)

Diabetes is a major public health problem in China

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Diabetes has become a major public health problem in China. Rapid economic growth, an increase in life expectancy and adoption of unhealthy lifestyles has contributed to the increase in diabetes among Chinese adults.

More than 92 million Chinese men and women have diabetes and 148 million have pre-diabetes, according to a study in the  New England Journal of Medicine.

The China National Diabetes and Metabolic Disorders Study is based on a nationally representative survey in which nearly 50,000 adults aged 20 years and older from 14 provinces and municipalities throughout China participated over a one-year period beginning in 2007.

Read more at Suite101.

1. Yang W, Lu J, Weng J, et al. Prevalence of diabetes among men and women in China. N Engl J Med 2010; 362: 1090-1101. (open access)

Support for smoking bans widespread in China

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Comprehensive anti-smoking policies in public places—particularly schools, public transportation and hospitals—are widely supported by both non-smokers and smokers in China, according to a six-city Chinese study.

Knowledge about the adverse health effects of secondhand smoke and the presence of existing anti-smoking laws likely increase support for a total smoking ban in workplaces, restaurants and bars, Additionally, the results of this study suggested that, like smokers in other countries, Chinese smokers are likely to adapt to and even eventually support 100 percent smoking bans.


1. Li Q, Hyland A, O’Conner R, et al. Support for smoke-free policies among smokers and non-smokers in six cities in China: ITC China Survey. Tobacco Control 2010;19:i40-i46. (0pen access)

Cigarette packs should carry health warnings with pictures

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Including graphic pictures on health warnings on cigarette packages is more effective than text-only warnings at getting people to consider the health risks of smoking and motivating them to quit smoking, a study from China has found.

More than 80 percent of smokers, non-smokers and youth from four Chinese cities that participated in the study said that warning labels on cigarette packs should include pictures. It is also notable that participants in Kunming, located in the heart of the tobacco industry in China, were the highest among the four cities in their desire for the government to implement stronger health warnings.


1. Fong GT, Hammond D, Jiang Y, et al. Perceptions of tobacco health warnings in China compared with picture and text-only health warnings from other countries: an experimental study. Tobacco Control 2010; 19: i69-i77. (open access)

Swine flu patients benefited from taking Tamiflu


Healthy people who caught the H1N1 flu during the 2009 pandemic may have been protected against developing (x-ray) confirmed pneumonia by taking the antiviral drug oseltamivir (Tamiflu), according to a study from China. The researchers call for continued investigation into the effectiveness of antiviral treatment to allow for improvement both in clinical treatment and public health guidance. The study was conducted among 1300 Chinese patients with confirmed 2009 H1N1 infection.

1. Yu H, Liao Q, Yuan Y, et al. Effectiveness of oseltamivir on disease progression and viral RNA shedding in patients with mild pandemic 2009 influenza A H1N1: opportunistic retrospective study of medical charts in China. BMJ 2010; 341: c4779. (open access)