Marriage contributes to higher obesity risk in China: findings from the China Health and Nutrition Survey

Jinli Liu; Malgorzata A Garstka; Zhonglin Chai; Yifan Chen; Veronika Lipkova; Mark E Cooper; Kingsley Katleho Mokoena; Youfa Wang; Lei Zhang

doi:10.21037/atm-20-4550

Marriage contributes to higher obesity risk in China: findings from the China Health and Nutrition Survey

Ann Transl Med. 2021 Apr;9(7):564. doi: 10.21037/atm-20-4550.

Authors

Jinli Liu¹, Malgorzata A Garstka², Zhonglin Chai³, Yifan Chen⁴, Veronika Lipkova⁴, Mark E Cooper³, Kingsley Katleho Mokoena⁵, Youfa Wang⁶, Lei Zhang^{1

7

8

9}

Affiliations

¹ China-Australia Joint Research Centre for Infectious Diseases, School of Public Health, Xi'an Jiaotong University Health Science Centre, Xi'an, China.
² Core Research Laboratory, Department of Endocrinology, National & Local Joint Engineering Research Center of Biodiagnosis and Biotherapy, The Second Affiliated Hospital, School of Medicine, Xi'an Jiaotong University, Xi'an, China.
³ Department of Diabetes, Central Clinical School, Monash University, Melbourne, Australia.
⁴ Medical Sciences Division, University of Oxford, Oxford, UK.
⁵ School of Public Health, Xi'an Jiaotong University Health Science Centre, Xi'an, China.
⁶ Global Health Institute, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, China.
⁷ Melbourne Sexual Health Centre, Alfred Health, Melbourne, Australia.
⁸ Central Clinical School, Faculty of Medicine, Monash University, Melbourne, Australia.
⁹ Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, China.

Abstract

Background: To investigate the association between marriage and the prevalence of overweight and obesity in China.

Methods: We conducted cross-sectional and retrospective cohort analyses using a nationwide sample of 36,310 individuals from the China Health and Nutrition Survey [2004-2015].

Results: The prevalence of overweight and obesity increased from 28.7% to 36.7% and from 8.0% to 14.5% between 2004 and 2015, respectively. The cross-sectional analysis showed that married individuals were at a higher risk of being overweight (OR =2.18; 95% CI, 1.90-2.51) or obese (OR =1.95; 1.57-2.43) than never-married individuals. Divorced/widowed individuals were also at a greater risk of being overweight (OR =1.80; 1.51-2.13) or obese (OR =1.67; 1.28-2.17) than never-married individuals. Retrospective cohort analysis showed that individuals who married during the study were 1.55 (1.13-2.11) times more likely to be overweight than those who remained never-married. Compared to those who remained never-married, individuals who remained married were 1.71 (1.42-2.07) and 1.45 (1.11-1.89) times more likely to be overweight and obese. Individuals who became divorced or widowed were more likely to be overweight (RR =1.59; 1.18-2.15) or obese (RR =1.63; 1.08-2.46) than those who remained never-married. However, the risk of being overweight or obese among those who became divorced or widowed did not differ significantly from the risk among those who remained married.

Conclusions: Marriage contributes to an increased risk of overweight and obesity in China; however, this risk is not significantly reduced by exiting a marriage.

Keywords: BMI; Overweight; marital status; obesity.

Abstract

Grants and funding