Urban China Struggles With Battle of the Bulge

For Chinese raised in an era of food rationing, with memories of grumbling, empty bellies, long food lines and dusty piles of winter cabbage, buying groceries these days is truly like being a kid in a candy shop.

Shelves burst with choices -- crackers, cookies, chocolates, chips. Tubs of dried fruit, jelly and pudding line crowded aisles. Traditional pastries packed with lard, egg yolks and bean paste are no longer once-a-year treats but handy snacks.

Small wonder that tens of millions of Chinese -- members of a culture so food-focused that “Have you eaten yet?” is one way of saying hello -- have joined the global epidemic of obesity that has left one in four humans overweight.

“It was a matter of fulfilling my every wish,” says Jia Yihe, a hefty 23-year-old from northern China, citing an old saying to explain the reason for the weight gain that prompted his family to send him to a Shanghai weight-loss clinic. “It also had a lot to do with KFC and McDonald’s,” he admits.

Although fast foods are one culprit, a universal fattening of the global food trade is seen by many experts as a key cause for the mass abandonment of traditional, low-cost diets rich in fiber and grain for those higher in sugar, oil and animal fat.

Obesity rates have soared as China shifts from staple foods to culinary abundance and from grueling physical labor to more sedentary work.

“In China, we’ve seen that as people have a little bit of money to spend, it’s easy for them to add much more oil and meat to their diet. Instead of steamed rice, they’ll have fried rice,” says Brian Halweil, a researcher at Washington-based Worldwatch Institute who has studied the effect of the global food industry on public health.

The small farms that supply open-air markets are yielding to vast agribusiness conglomerates that feed ever-larger supermarket chains. It’s a trend in developing countries, including China.

China still imports less than 5% of the groceries that show up on its dinner tables, but you’d never guess that by looking at the dizzying array of Western- and Asian-style snack foods crammed into every supermarket and convenience store.

A traditional supporter of China’s inefficient and land-starved farmers, the government began subsidizing food-processing and packaging companies a decade ago, hoping to improve quality and boost competitiveness. Since then, the variety of made-in-China processed foods has expanded vastly, as have Chinese waistlines.

Many are products licensed by foreign food conglomerates to local manufacturers, using ingredients grown in China -- frequently with an extra measure of sugar, even in supposedly salty snacks.

The Nonggongshang No. 101 grocery store, which translates as “Farm, Industry, Business,” is -- like hundreds of other Shanghai supermarkets -- a feast for the eyes. There are shelves of plainly packaged staples such as dried tree fungus, vermicelli and seaweed. But most aisles explode with the bright reds, yellows and blues of packages of crispy, salty and sweet snack foods: Wang Wang rice crackers, Lay’s potato chips -- and 101 flavors of instant noodles, including curry and roast chicken.

“Leisure-time foods like cookies and potato chips are the most popular food in our stores,” says Liang Jianfang, business manager at Hualian Group, a rival Shanghai supermarket chain. She says the most-coveted foods are least healthy.

The stores can’t afford to reject unhealthy products if customers want them, she said, “But I do remind my daughter not to overeat fried chicken, for the sake of her health.”

For several decades after the 1949 Communist revolution, shopping usually involved lining up at state-run stores. Families relied on ration coupons provided by state-run work units for grain, oil, sugar and other necessities. There were no Western-style convenience stores or supermarkets.

Many older Chinese recall the hunger and desperation of China’s last major famine, when as many 40 million people starved to death after Mao Tse-tung’s Great Leap Forward of the late 1950s.

Today, pockets of hunger exist among China’s poorest, who still number in the tens of millions. But most young urban Chinese have never gone hungry. Convenience stores compete side-by-side. KFC and McDonald’s both have hundreds of restaurants in hundreds of cities.

Hothouse farming supplies strawberries, melons and tomatoes year-round. In winter, peddlers outside Beijing subway stations hawk mangosteens, a tropical fruit. Piles of winter cabbage, the traditional seasonal staple, virtually disappeared.

When Jia was born in the early 1980s, China was embarking on an unprecedented era of affluence. Since then, Chinese have more than tripled their per-capita consumption of edible oil and meat, and doubled the amount of sugar they eat. Consumption of eggs and liquor has soared more than six times. Even tiny diners dish up lavish meals of deep-fried meat in sticky-sweet or spicy gravy.

“Twenty or 30 years ago, average meals were much less greasy partly because oil was rationed. Now people are unknowingly taking in more calories per meal,” says Dr. Ray Yip, a nutritional expert at the U.S. Centers for Disease Control and Prevention and a longtime Beijing resident who now runs the CDC’s AIDS program there.

Mainland Chinese may not have a word for “love handles,” but they’ve become all-too-familiar with “pijiu du” (beer bellies) and “spider guys” -- men with big, round bodies and skinny arms and legs.

Just a decade ago, only one in 10 Chinese was overweight, with very few classified as obese. Estimates of the number of overweight Chinese vary. One study by Tulane University showed that by 2000, just under a third of all Chinese adults were overweight. In the United States, about two-thirds of the population is too heavy.

A study by the Shanghai Children’s Health Care Institute found that 8% of children aged 3 to 6 were obese. Parallel studies by the Tulane research team found a sharp rise in levels of blood cholesterol and diagnoses of high blood pressure and diabetes over the last decade, even in children.

Despite many Chinese studies documenting the same trends, the government has yet to take concerted action. In one recent report, though, it noted that the problems were worst in China’s big cities thanks to diets heavy in high-calorie foods.

For most of the 800 million Chinese in the countryside, though, getting fat is a minor worry. There, less than 5% are overweight. Daily chores -- hoeing fields, scrubbing clothes on a washboard, fetching water or bicycling vegetables to market -- are a natural workout. Malnutrition is not uncommon. According to the Food and Agricultural Organization of the United Nations, more than 40% of children in China’s poorest western provinces have stunted growth caused by malnutrition.

Yet as growing numbers of farmers migrate to the cities, they add pounds as their need for calories declines and their access to fattening foods rises. Urban lifestyles are being transformed from active to sedentary as people who once bicycled long distances switch to commuting by subway, car or motor scooter -- or give up strolls.

Dr. Jiao Donghai treats patients with a combination of traditional Chinese medicine, massage and what he calls the “fundamentals.” “Eat less and move more -- that’s the basic rule,” he says.