The aim of this work was to study the relationship between excess body weight and the risks of hypertension and diabetes in the population of northeastern China. Subsections of a cross-sectional survey in Da Qing City were used to assess the relationship of excess weight to risk factors for coronary heart disease (CHD). A 6-year prospective study also assessed the probability of developing Type 2 diabetes. A total of 2856 adults (25-70 years of age) were assessed cross-sectionally and 629 non-diabetic subjects of similar age were followed-up for 6 years. Blood pressure, plasma fasting glucose, triglycerides, high-density lipoporotein (HDL) cholesterol and fibrinogen levels were measured as well as weight, height and waist and hip circumferences. About 45% of adults had a body mass index (BMI) of > or =25.0. Risk factors increased with increasing BMI from a baseline value of 21.0: at a BMI of 23.0-24.9, the risk of hypertension and hypertriglyceridaemia doubled; the risk increased threefold at a BMI of 25.0-26.9. The prevalence of Type 2 diabetes increased progressively in women within the normal BMI range and in men from a BMI of 25.0. Type 2 diabetes was four times as common if the BMI was >27.0. Increasing waist measurements predicted 10-fold increases in hypertension and a three-to-five times increased risk of diabetes. Suitable waist cut-off points were 85cm for men and 80cm for women, with statistical analysis showing waist as the more dominant predictor of risk than age, waist-to-hip ratios or BMIs. Hence, small increases in BMI, and particularly in waist circumference, predict a substantial increase in the risk of diabetes and risk for CHD, especially hypertension, in Chinese adults.