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

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.

[1]  M. He,et al.  Leading determinants for multimorbidity in middle-aged Australian men and women: A nine-year follow-up cohort study. , 2020, Preventive medicine.

[2]  C. Szoeke,et al.  Incidence, Progression, and Patterns of Multimorbidity in Community-Dwelling Middle-Aged Men and Women , 2020, Frontiers in Public Health.

[3]  M. He,et al.  Are Leading Risk Factors for Cancer and Mental Disorders Multimorbidity Shared by These Two Individual Conditions in Community-Dwelling Middle-Aged Adults? , 2020, Cancers.

[4]  M. He,et al.  Predicting the Development of Type 2 Diabetes in a Large Australian Cohort Using Machine-Learning Techniques: Longitudinal Survey Study , 2019, JMIR medical informatics.

[5]  Yongjie Chen,et al.  The prevalence and increasing trends of overweight, general obesity, and abdominal obesity among Chinese adults: a repeated cross-sectional study , 2019, BMC Public Health.

[6]  Amit J. Shah,et al.  Independent and joint association of obesity and metabolic syndrome with depression and inflammation. , 2019, Health psychology : official journal of the Division of Health Psychology, American Psychological Association.

[7]  M. Zhang,et al.  A J-shaped relation of BMI and stroke: Systematic review and dose-response meta-analysis of 4.43 million participants. , 2018, Nutrition, metabolism, and cardiovascular diseases : NMCD.

[8]  Xian-ping Wu,et al.  Association of Educational Level and Marital Status With Obesity: A Study of Chinese Twins , 2018, Twin Research and Human Genetics.

[9]  Joanna Syrda.  The impact of marriage and parenthood on male body mass index: Static and dynamic effects. , 2017, Social science & medicine.

[10]  S. M. Matos,et al.  Obesity and kidney disease. , 2017, Jornal brasileiro de nefrologia : 'orgao oficial de Sociedades Brasileira e Latino-Americana de Nefrologia.

[11]  K. Straif,et al.  Body Fatness and Cancer--Viewpoint of the IARC Working Group. , 2016, The New England journal of medicine.

[12]  Guang Ning,et al.  Curbing the obesity epidemic in China. , 2016, The lancet. Diabetes & endocrinology.

[13]  A. Bauman,et al.  Factors relating to participation in follow-up to the 45 and up study in Aboriginal and non-Aboriginal individuals , 2016, BMC Medical Research Methodology.

[14]  Hongwei Xu,et al.  Developmental idealism, body weight and shape, and marriage entry in transitional China , 2016, Chinese journal of sociology.

[15]  J. Teachman.  Body Weight, Marital Status, and Changes in Marital Status , 2016, Journal of family issues.

[16]  Yu Xie,et al.  Marriage and Family in East Asia: Continuity and Change. , 2015, Annual review of sociology.

[17]  Jacob C. Seidell,et al.  The Global Burden of Obesity and the Challenges of Prevention , 2015, Annals of Nutrition and Metabolism.

[18]  Alan D. Lopez,et al.  Global, regional, and national prevalence of overweight and obesity in children and adults during 1980–2013: a systematic analysis for the Global Burden of Disease Study 2013 , 2014, The Lancet.

[19]  J. Sobal,et al.  Marital status and body weight, weight perception, and weight management among U.S. adults. , 2013, Eating behaviors.

[20]  Sven E. Wilson.  Marriage, gender and obesity in later life. , 2012, Economics and human biology.

[21]  Liying Jiang,et al.  Body mass index and susceptibility to knee osteoarthritis: a systematic review and meta-analysis. , 2012, Joint, bone, spine : revue du rhumatisme.

[22]  J. Danesh,et al.  Separate and combined associations of body-mass index and abdominal adiposity with cardiovascular disease: collaborative analysis of 58 prospective studies , 2011, The Lancet.

[23]  Gretchen A. Stevens,et al.  National, regional, and global trends in body-mass index since 1980: systematic analysis of health examination surveys and epidemiological studies with 960 country-years and 9·1 million participants , 2011, The Lancet.

[24]  E. Kapantais,et al.  Marital status and educational level associated to obesity in Greek adults: data from the National Epidemiological Survey , 2010, BMC public health.

[25]  D. K. Singh,et al.  Obesity and its mechanisms--who to blame after marriage? , 2010, Medical hypotheses.

[26]  E. Frongillo,et al.  Gender, Ethnicity, Marital Status, and Body Weight in the United States , 2009, Obesity.

[27]  D. Umberson,et al.  Marital Status, Marital Transitions, and Body Weight∗ , 2009, Journal of health and social behavior.

[28]  P. Gordon-Larsen,et al.  Entry Into Romantic Partnership Is Associated With Obesity , 2009, Obesity.

[29]  Laura M. Argys,et al.  For better or worse: relationship status and body mass index. , 2008, Economics and human biology.

[30]  M. Janghorbani,et al.  Association of body mass index and abdominal obesity with marital status in adults. , 2008, Archives of Iranian medicine.

[31]  P. Lundborg,et al.  GETTING READY FOR THE MARRIAGE MARKET? THE ASSOCIATION BETWEEN DIVORCE RISKS AND INVESTMENTS IN ATTRACTIVE BODY MASS AMONG MARRIED EUROPEANS , 2007, Journal of Biosocial Science.

[32]  T. Young,et al.  Short Sleep Duration Is Associated with Reduced Leptin, Elevated Ghrelin, and Increased Body Mass Index , 2004, PLoS medicine.

[33]  E. Frongillo,et al.  Marital status changes and body weight changes: a US longitudinal analysis. , 2003, Social science & medicine.

[34]  R. Jeffery,et al.  Cross-sectional and longitudinal associations between body mass index and marriage-related factors. , 2002, Obesity research.

[35]  Bei-fan Zhou.  Predictive values of body mass index and waist circumference for risk factors of certain related diseases in Chinese adults--study on optimal cut-off points of body mass index and waist circumference in Chinese adults. , 2002, Biomedical and environmental sciences : BES.

[36]  J. Kiecolt-Glaser,et al.  Marriage and health: his and hers. , 2001, Psychological bulletin.

[37]  E. M. Hetherington,et al.  The adjustment of children with divorced parents: a risk and resiliency perspective. , 1999, Journal of child psychology and psychiatry, and allied disciplines.

[38]  中華人民共和国国家統計局.  Statistical yearbook of China , 1986 .

[39]  W. Gove,et al.  Does marriage have positive effects on the psychological well-being of the individual? , 1983, Journal of health and social behavior.