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Human Behaviors Determine Health: Strategic Thoughts on the Prevention of Chronic Non-communicable Diseases in China

International Journal of Behavioral Medicine volume 18, pages 295–301 (2011)Cite this article

Abstract

Background

In the last three decades, people’s living standards have significantly increased along with the rapid growth of the national economy of China. However, the prevalence of unhealthy behaviors and unfavorable lifestyles (e.g., smoking, excessive use of alcohol, physical inactivity, and unhealthy diets) also steadily increased, which may contribute to the growing epidemic of chronic non-communicable diseases (CNCDs) such as diabetes, coronary heart disease, stroke, and cancers.

Purpose

To briefly summarize the major studies from China concerning epidemic and burden of CNCDs and unhealthy lifestyles, and propose intervention strategies toward unhealthy lifestyles and behaviors aiming for effective control of the growing epidemic of CNCDs in China.

Methods

We first review the major national studies addressing the epidemic and burden of CNCDs and unhealthy behaviors in China. Then, we aim to develop the preventive strategies against the increasing epidemic of CNCDs by focusing on the intervention campaign toward health unfavorable behaviors and lifestyles.

Results

CNCDs have posed major challenges to public health and the ongoing reform of health care system in China. Unhealthy lifestyles and behaviors (e.g., smoking, excessive alcohol consumpsion, physical inactivity, and imbalanced diets) are responsible for the growing epidemic of CNCDs. Adherence to healthy behaviors and lifestyles is critical for maintaining physical and mental health.

Conclusion

Active implementation of the population-wide intervention program of health education and promotion by targeting unhealthy behaviors and lifestyles may help to constrain the growing epidemic of CNCDs in China.

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References

  1. World Health Organization (WHO). The global burden of disease: 2004 update. Geneva: WHO Press; 2008.

    Google Scholar 

  2. Beaglehole R, Bonita R, Horton R, Adams C, Alleyne G, Asaria P, et al. Priority actions for the non-communicable disease crisis. Lancet. 2011;377:1438–47.

    PubMed  Article  Google Scholar 

  3. Beaglehole R, Epping-Jordan J, Patel V, Chopra M, Ebrahim S, Kidd M, et al. Improving the prevention and management of chronic disease in low-income and middle-income countries: a priority for primary health care. Lancet. 2008;372:940–9.

    PubMed  Article  Google Scholar 

  4. Samb B, Desai N, Nishtar S, Mendis S, Bekedam H, Wright A, et al. Prevention and management of chronic disease: a litmus test for health-systems strengthening in low-income and middle-income countries. Lancet. 2010;376:1785–97.

    PubMed  Article  Google Scholar 

  5. Wang L, Kong L, Wu F, Bai Y, Burton R. Preventing chronic diseases in China. Lancet. 2005;366:1821–4.

    PubMed  Article  Google Scholar 

  6. Yang G, Kong L, Zhao W, Wan X, Zhai Y, Chen LC, et al. Emergence of chronic non-communicable diseases in China. Lancet. 2008;372:1697–705.

    PubMed  Article  Google Scholar 

  7. He J, Gu D, Wu X, Reynolds K, Duan X, Yao C, et al. Major causes of death among men and women in China. N Engl J Med. 2005;353:1124–34.

    PubMed  Article  CAS  Google Scholar 

  8. Gu D, He J, Duan X, Reynolds K, Wu X, Chen J, et al. Body weight and mortality among men and women in China. JAMA. 2006;295:776–83.

    PubMed  Article  CAS  Google Scholar 

  9. Bazzano LA, Gu D, Reynolds K, Wu X, Chen CS, Duan X, et al. Alcohol consumption and risk for stroke among Chinese men. Ann Neurol. 2007;62:569–78.

    PubMed  Article  Google Scholar 

  10. Gu D, Kelly TN, Wu X, Chen J, Samet JM, Huang JF, et al. Mortality attributable to smoking in China. N Engl J Med. 2009;360:150–9.

    PubMed  Article  CAS  Google Scholar 

  11. Bazzano LA, Gu D, Reynolds K, Chen J, Wu X, Chen CS, et al. Alcohol consumption and risk of coronary heart disease among Chinese men. Int J Cardiol. 2009;135:78–85.

    PubMed  Article  Google Scholar 

  12. Bazzano LA, Gu D, Whelton MR, Wu X, Chen CS, Duan X, et al. Body mass index and risk of stroke among Chinese men and women. Ann Neurol. 2010;67:11–20.

    PubMed  Article  Google Scholar 

  13. Wang H, Cao J, Li J, Chen J, Wu X, Duan X, et al. Blood pressure, body mass index and risk of cardiovascular disease in Chinese men and women. BMC Public Health. 2010;10:189.

    PubMed  Article  Google Scholar 

  14. Yang W, Lu J, Weng J, Jia W, Ji L, Xiao J, et al. Prevalence of diabetes among men and women in China. N Engl J Med. 2010;362:1090–101.

    PubMed  Article  CAS  Google Scholar 

  15. Tian H, Song G, Xie H, Zhang H, Tuomilehto J, Hu G. Prevalence of diabetes and impaired fasting glucose among 769,792 rural Chinese adults. Diabetes Res Clin Pract. 2009;84:273–8.

    PubMed  Article  CAS  Google Scholar 

  16. Moran A, Zhao D, Gu D, Coxson P, Chen CS, Cheng J, et al. The future impact of population growth and aging on coronary heart disease in China: projections from the Coronary Heart Disease Policy Model-China. BMC Public Health. 2008;8:394.

    PubMed  Article  Google Scholar 

  17. Hu D, Sun L, Fu P, Xie J, Lu J, Zhou J, et al. Prevalence and risk factors for type 2 diabetes mellitus in the Chinese adult population: the InterASIA Study. Diabetes Res Clin Pract. 2009;84:288–95.

    PubMed  Article  CAS  Google Scholar 

  18. Liu M, Wu B, Wang WZ, Lee LM, Zhang SH, Kong LZ. Stroke in China: epidemiology, prevention, and management strategies. Lancet Neurol. 2007;6:456–64.

    PubMed  Article  Google Scholar 

  19. Ferri CP, Schoenborn C, Kalra L, Acosta D, Guerra M, Huang Y, et al. Prevalence of stroke and related burden among older people living in Latin America, India and China. J Neurol Neurosurg Psychiatry. doi:10.1136/jnnp.2010.234153

  20. Moran A, Gu D, Zhao D, Coxson P, Wang YC, Chen CS, et al. Future cardiovascular disease in China: Markov model and risk factor scenario projections from the coronary heart disease policy model-china. Circ Cardiovasc Qual Outcomes. 2010;3:243–52.

    PubMed  Article  Google Scholar 

  21. He J, Gu D, Chen J, Wu X, Kelly TN, Huang JF, et al. Premature deaths attributable to blood pressure in China: a prospective cohort study. Lancet. 2009;374:1765–72.

    PubMed  Article  Google Scholar 

  22. Yang L, Parkin DM, Whelan S, Zhang S, Chen Y, Lu F, et al. Statistics on cancer in China: cancer registration in 2002. Eur J Cancer Prev. 2005;14:329–35.

    PubMed  Article  CAS  Google Scholar 

  23. Yang L, Parkin DM, Ferlay J, Li L, Chen Y. Estimates of cancer incidence in China for 2000 and projections for 2005. Cancer Epidemiol Biomark Prev. 2005;14:243–50.

    Article  Google Scholar 

  24. Zhao P, Dai M, Chen W, Li N. Cancer trends in China. Jpn J Clin Oncol. 2010;40:281–5.

    PubMed  Article  Google Scholar 

  25. Kelly TN, Gu D, Chen J, Huang JF, Chen JC, Duan X, et al. Cigarette smoking and risk of stroke in the Chinese adult population. Stroke. 2008;39:1688–93.

    PubMed  Article  Google Scholar 

  26. Hao W, Su Z, Liu B, Zhang K, Yang H, Chen S, et al. Drinking and drinking patterns and health status in the general population of five areas of China. Alcohol Alcohol. 2004;39:43–52.

    PubMed  Google Scholar 

  27. Li Y, Yang H, Cao J. Association between alcohol consumption and cancers in the Chinese population: a systematic review and meta-analysis. Plos One. 2011;6:e18776.

    PubMed  Article  CAS  Google Scholar 

  28. Phillips MR, Zhang J, Shi Q, Song Z, Ding Z, Pang S, et al. Prevalence, treatment, and associated disability of mental disorders in four provinces in China during 2001–05: an epidemiological survey. Lancet. 2009;373:2041–53.

    PubMed  Article  Google Scholar 

  29. World Health Organization (WHO). Preventing chronic diseases—a vital investment: WHO global report. Geneva: WHO Press; 2005.

    Google Scholar 

  30. Liu Z. Dietary sodium and the incidence of hypertension in the Chinese population: a review of nationwide surveys. Am J Hypertens. 2009;22:929–33.

    PubMed  Article  CAS  Google Scholar 

  31. Cai H, Shu XO, Gao YT, Li H, Yang G, Zheng W. A prospective study of dietary patterns and mortality in Chinese women. Epidemiology. 2007;18:393–401.

    PubMed  Article  Google Scholar 

  32. Wu Y. Overweight and obesity in China: the once lean giant has a weight problem that is increasing rapidly. BMJ. 2006;333:362–3. Editorials.

    PubMed  Article  Google Scholar 

  33. Reynolds K, Gu D, Whelton PK, Wu X, Duan X, Mo J, et al. Prevalence and risk factors of overweight and obesity in China. Obesity (Silver Spring). 2007;15:10–8.

    Article  Google Scholar 

  34. Wildman RP, Gu D, Muntner P, Wu X, Reynolds K, Duan X, et al. Trends in overweight and obesity in Chinese adults: between 1991 and 1999–2000. Obesity (Silver Spring). 2008;16:1448–53.

    Article  Google Scholar 

  35. Rosengren A, Hawken S, Ounpuu S, Sliwa K, Zubaid M, Almahmeed WA, et al. Association of psychosocial risk factors with risk of acute myocardial infarction in 11119 cases and 13648 controls from 52 countries (the INTERHEART study): case-control study. Lancet. 2004;364:953–62.

    PubMed  Article  Google Scholar 

  36. Knowler WC, Barrett-Connor E, Fowler SE, Hamman RF, Lachin JM, Walker EA, et al. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med. 2002;346:393–403.

    PubMed  Article  CAS  Google Scholar 

  37. Daar AS, Singer PA, Persad DL, Pramming SK, Matthews DR, Beaglehole R, et al. Grand challenges in chronic non-communicable diseases. Nature. 2007;450:494–6.

    PubMed  Article  CAS  Google Scholar 

  38. Epping-Jordan JE, Galea G, Tukuitonga C, Beaglehole R. Preventing chronic diseases: taking stepwise action. Lancet. 2005;366:1667–71.

    PubMed  Article  Google Scholar 

  39. Strong K, Mathers C, Leeder S, Beaglehole R. Preventing chronic diseases: how many lives can we save? Lancet. 2005;366:1578–82.

    PubMed  Article  Google Scholar 

  40. Beaglehole R, Ebrahim S, Reddy S, Voûte J, Leeder S. Prevention of chronic diseases: a call to action. Lancet. 2007;370:2152–7.

    PubMed  Article  Google Scholar 

  41. Lim SS, Gaziano TA, Gakidou E, Reddy KS, Farzadfar F, Lozano R, et al. Prevention of cardiovascular disease in high-risk individuals in low-income and middle-income countries: health effects and costs. Lancet. 2007;370:2054–62.

    PubMed  Article  Google Scholar 

  42. Wang WZ, Jiang B, Wu SP, Hong Z, Yang QD, Sander JW, et al. Change in stroke incidence from a population-based intervention trial in three urban communities in China. Neuroepidemiology. 2007;28:155–61.

    PubMed  Article  Google Scholar 

  43. Vadheim LM, Brewer KA, Kassner DR, Vanderwood KK, Hall TO, Butcher MK, et al. Effectiveness of a lifestyle intervention program among persons at high risk for cardiovascular disease and diabetes in a rural community. J Rural Health. 2010;26:266–72.

    PubMed  Article  Google Scholar 

  44. Pennant M, Davenport C, Bayliss S, Greenheld W, Marshall T, Hyde C. Community programs for the prevention of cardiovascular disease: a systematic review. Am J Epidemiol. 2010;172:501–16.

    PubMed  Article  Google Scholar 

  45. Chen CM, Zhao W, Yang Z, Zhai Y, Wu Y, Kong L. The role of dietary factors in chronic disease control in China. Obes Rev. 2008;9 Suppl 1:100–3.

    PubMed  Article  Google Scholar 

  46. Yang Z-Y. Behaviors determine health. Chin J Behav Med Brain Sci. 2009;18:961–2. In Chinese.

    Google Scholar 

  47. Yang Z-Y, editor. Behavioral medicine. Beijing: Higher Education Press; 2008. p. 1–14. In Chinese.

    Google Scholar 

  48. Prince M, Patel V, Saxena S, Maj M, Maselko J, Phillips MR, et al. No health without mental health. Lancet. 2007;370:859–77.

    PubMed  Article  Google Scholar 

  49. Abegunde DO, Mathers CD, Adam T, Ortegon M, Strong K. The burden and costs of chronic diseases in low-income and middle-income countries. Lancet. 2007;370:1929–38.

    PubMed  Article  Google Scholar 

  50. Wakefield MA, Loken B, Hornik RC. Use of mass media campaigns to change health behaviour. Lancet. 2010;376:1261–71.

    PubMed  Article  Google Scholar 

  51. Hu D, Fu P, Xie J, Chen CS, Yu D, Whelton PK, et al. Increasing prevalence and low awareness, treatment and control of diabetes mellitus among Chinese adults: the InterASIA study. Diabetes Res Clin Pract. 2008;81:250–7.

    PubMed  Article  Google Scholar 

  52. Yang Z-Y, Kong L-B, Yang Z, Zhang Z-J, Qi H-X. Establishment of the model for standardizing the diagnostic and therapeutic behaviors and related influencing factors. Chin J Behav Med Sci. 2006;15:234–6. In Chinese.

    Google Scholar 

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Acknowledgments

This work was supported in part by a grant from the China National Science and Technology Supporting Program (PI: Z.-Y.Y.). C.Q. was supported by the European Research area in Ageing-Future Leaders of Ageing Research in Europe (ERA-FLARE) Program from the Swedish Council for Working Life and Social Research (FAS), Sweden.

Conflict of Interest Statement

Z.-Y.Y. is the President of the Branch of Behavioral Medicine of Chinese Medical Association, and the Editor-in-Chief of the Chinese Journal of Behavioral Medicine and Brain Science. All the other authors have no conflict of interest in connection with this study.

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Affiliations

  1. Institute of Behavioral Medicine, Jining Medical College, Shandong, People’s Republic of China

    Zhi-Yin Yang, Lifang Zhu & Chengxuan Qiu

  2. Zhongshan Hospital, Fudan University, Shanghai, People’s Republic of China

    Zhen Yang

  3. Aging Research Center, Karolinska Institutet-Stockholm University, Gävlegatan 16, 113 30, Stockholm, Sweden

    Chengxuan Qiu

Authors
  1. Zhi-Yin Yang
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  2. Zhen Yang
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  3. Lifang Zhu
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  4. Chengxuan Qiu
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Corresponding author

Correspondence to Chengxuan Qiu.

Additional information

Z.-Y. Y. and Z. Y. contributed equally to this work.

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Yang, ZY., Yang, Z., Zhu, L. et al. Human Behaviors Determine Health: Strategic Thoughts on the Prevention of Chronic Non-communicable Diseases in China. Int.J. Behav. Med. 18, 295–301 (2011). https://doi.org/10.1007/s12529-011-9187-0

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Keywords

  • Lifestyles
  • Chronic non-communicable diseases (CNCDs)
  • Intervention study
  • Preventive strategies
  • China