MacDonald in China
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These days, a McDonald's Big Mac Hamburger is known internationally. While the fast food market has become more global, health issues like obesity and diabetes have had far reaching impacts in other countries around the world. In particular, researchers at the University of North Carolina, Chapel Hill (UNC) recently discovered that Chinese teenagers have a diabetes rate that is four times higher than teenagers in the United States. The increase in the number of diabetes cases reported corresponds to the rise in the amount of cardiovascular risk. The investigators believe that the findings are related to a Chinese population that is become increasingly overweight.

The study was led by Barry Popkin, the W.R. Kenan Jr. Distinguished professor of nutrition at UNC's Gillings School of Global Public Health, and conducted with Chinese researchers. The team utilized data from the China Health and Nutrition Survey (CNH) that was completed between 1989 and 2011. In the survey, the scientists tracked the data of over 29,000 people who lived in 300 different communities throughout China. The scientists were made up of members from UNC and the Chinese Center for Disease Control (CDC) National Institute of Nutrition and Food Safety.

"What is unprecedented is the changes in diet, weight and cardiovascular risk for children age 7 and older," commented Popkin in a prepared statement. "These estimates highlight the huge burden that China's health care system is expected to face if nothing changes."

While China has experienced economic growth in the last twenty years, it also has had significant changes in terms of people's weight, diets, and physical activity. The team of researchers tracked a randomly selected sample that represented 56 percent of the Chinese population in 2009. During the study, they saw that there were huge increases in cardiometabolic risk factors and the number of people who were obese.

"What is unprecedented is the changes in diet, weight and cardiovascular risk for children age 7 and older," noted Popkin in the statement. "These estimates highlight the huge burden that China's health care system is expected to face if nothing changes."

In the study, the scientists also saw that Chinese children between the ages of seven and 17 had a diabetes rate of 1.9 percent and a pre-diabetes rate of 14.9 percent. Researchers also believe that high levels of glycosylated hemoglobin (HbA1c) were identified in the blood, which can count the average plasma-glucose over time.

"The findings suggest a very high burden of chronic disease risk starting at a young age, with 1.7 million Chinese children ages 7-18 having diabetes and another 27.7 million considered prediabetic," explained Popkin in the statement. "In addition, more than one-third of children under age 18 had high levels of at least one cardiometabolic risk factor."

Following data collection, the investigators compared the Chinese data with the U.S. data pooled from the National Health and Nutrition survey (NHANES). The authors discovered that diabetes and inflammation rates were higher in Chinese children than in U.S. children or other Asian countries. While 0.5 percent of U.S. children had diabetes, 1.9 percent of Chinese children between the ages of 12 and 18 had diabetes. Likewise, 8.5 percent of children in the U.S. had high inflammation risk and 12.1 percent of Chinese children had high inflammation risk. This disparity in inflammation showed that there could be cardiovascular risks for Chinese adolescents.

"The number of individuals with high levels of at least one cardiovascular risk factor increased to 85 percent in individuals age 40 and older," noted Penny Gordon-Larsen, professor of nutrition in UNC's Gillings School of Global Public Health, in the statement. "Of even greater concern is the fact that we see these high levels of risk in individuals living across the entire country - in rural and urban, as well as high and low-income areas. So the impending health care costs and implications are immense."

The researchers concluded that the project's findings correlate to earlier research studies that showed that there were higher levels of obesity among China's poor and rural population as compared to years before. The research was recently published online in Obesity Reviews and will be published in the September issue of the publication. Obesity Reviews is associated with the International Association for the Study of Obesity.