The recent rapid and continuing nutrition and lifestyle transitions in Macau, China, have been associated with increased prevalence of obesity and other lifestyle-related chronic diseases. The aim of this study was to investigate trends of BMI with increased age in Macau, and to make comparisons with data from Australia. Additionally, demographic and modifiable lifestyle associations with risk of being overweight/obese were explored in the Macau sample.
A representative random sample (n=1406, aged 18 – 93y, 55% female) from Macau, China were recruited for this cross-sectional study in 2012. The Australian sample was extracted from the recent Australian Health Survey 2011–12 (ABS) (n=7958 Australian subjects (aged 18 to ≥85y, 52% female)). Risk factors presented as Odds Ratios (OR) and 95% confidence Intervals (CI) were analysed by multivariate logistic regression.
Demographic analyses in the Macau sample showed risk of being overweight/obesity was higher with age >40 (OR=2.6 (95%CI=2.2 – 3.1)), marriage (OR=1.3 (95%CI=1.1 – 1.5)) and lower socio-economic level (OR=1.2 (95%CI=1.0 – 1.4)). Modifiable risk factors associated with overweight/obesity included being less physically active (OR=1.1 (95%CI=1.0 – 1.3)), having less sleep (OR=1.5 (95%CI=1.3 – 1.8)), sitting more (OR=1.3 (95%CI=1.1 – 1.5)) and having less intake of protein sources such as milk (OR=1.3 (1.2 – 1.5)) and eggs (OR=1.1 (95%CI=1.0 – 1.3). Interestingly, there were gender differences in the associations between overweight/obesity and marriage, socio-economic level, physical activity and sitting.
BMI in Australians was greater than Macanese, with mean BMI difference of 4.4 kg/m2 between the populations (P<0.001). While BMI increases steadily with ageing in each population, the plateau for Macau subjects appears 5 – 10 years earlier than that for Australians. Rapid and continuing BMI increases in younger Macanese men and women, which may reflect lifestyle and nutrition transitions in China, are of concern for future population health in Macau.